BMC Health Services Research最新文献

{"title":"Exploring health system challenges and gaps for crisis response in Ethiopia: a scoping review of publications and reports from 2020-2024.","authors":"Asmamaw Atnafu, Getachew Teshale, Endalkachew Dellie, Young Su Park","doi":"10.1186/s12913-025-13084-y","DOIUrl":"10.1186/s12913-025-13084-y","url":null,"abstract":"<p><strong>Background: </strong>Ethiopia's health system has faced significant challenges due to COVID-19, natural disasters, and conflicts, disrupting healthcare delivery. This scoping review examined health system gaps and responses during crises, aiming to recommend strategies for resilience.</p><p><strong>Method: </strong>We followed a systematic scoping review approach using the five-step methodology: defining the research question, identifying relevant literature, selecting studies, charting the data, and summarizing/analyzing results. The review was guided by PRISMA-ScR and used the Population, Concept, and Context (PCC) framework. We included all English-language studies published between January 2000 and December 2024 addressing challenges or responses of the Ethiopian health system during crises, regardless of study design. PubMed, SCOPUS, Google Scholar, and Google were searched using MeSH terms/keywords. After title, abstract, and full-text screening, 44 articles were included for final analysis. Data were synthesized using descriptive analytical methods and narrative synthesis to summarize and interpret findings.</p><p><strong>Results: </strong>Findings revealed crises severely impacted health services due to shortages of medical supplies, workforce, and infrastructure. Demand surges, transport restrictions, border closures, and financial constraints exacerbated these gaps. Additional challenges included poor data availability, high staff turnover, lack of emergency communication plans, and insufficient funding.</p><p><strong>Conclusion and recommendations: </strong>The COVID-19 pandemic and the northern Ethiopian conflict notably disrupted routine services, infrastructure, and health information systems. To build resilience, the study recommends: (1) developing scalable emergency plans for essential services, (2) strengthening primary healthcare and community-based systems, (3) maintaining medical stockpiles, and (4) providing crisis-specific training for health workers. These measures aim to enhance preparedness and sustainability in Ethiopia's health system amid future shocks.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"928"},"PeriodicalIF":2.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enablers, obstacles, value chain and business models for private digital health business on global goods: a collective case study on private entrepreneurs in Uganda digital health space.","authors":"Agnes Bwanika Naggirinya, Joshua Beinomugisha, Annet Kabuye Nanungi, Jackie Lydia Namukooli Ssemata, Moreen Nanyonjo, Martin Balaba, Francis Musinguzi, Rosalind Parkes-Ratanshi","doi":"10.1186/s12913-025-13087-9","DOIUrl":"10.1186/s12913-025-13087-9","url":null,"abstract":"<p><strong>Background: </strong>The Global Strategy on Digital Health 2020-2025 aims to use digital technologies as digital public goods to address health system challenges. Digital health technology and related products can help solve issues related to healthcare services provision and equal resource distribution. However, there is limited information on the best business models for local entrepreneurs in the digital health space.</p><p><strong>Methods: </strong>A multi-site collective case study was conducted with private entrepreneurs in two African countries operating in digital health based on public global goods. Data was collected through semi-structured questionnaires and interviews to generate rich data, and framework analysis was used to guide themes using NVivo version 14.0 software.</p><p><strong>Results: </strong>The study identified four major themes: sustainable business models, value chains businesses participate in, enablers and obstacles to business sustainability.</p><p><strong>Conclusion: </strong>The findings suggest that business-to-business, business-to-consumer, business-to-business-to-customer, and on-demand are sustainable business models.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"930"},"PeriodicalIF":2.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare utilization trends among patients with opioid use disorder in U.S. Hospitals: an analysis of length of stay, total charges, and costs, 2005-2020.","authors":"Fares Qeadan, Alexander Nicolson, Benjamin Tingey, Maurice L Moffett, Sunday Azagba","doi":"10.1186/s12913-025-13095-9","DOIUrl":"10.1186/s12913-025-13095-9","url":null,"abstract":"<p><strong>Objective: </strong>This study examines the relationship between opioid use disorder (OUD) and healthcare use, especially regarding length of stay, total charges, and costs in U.S. hospitals from 2005 to 2020.</p><p><strong>Methods: </strong>We used the Healthcare Cost & Utilization Projects (HCUP) National Inpatient Sample (NIS) data to compare these outcomes between patients with and without OUD. We applied generalized linear modeling (GLM) with gamma distribution and log link to assess the effect of OUD on the three outcomes.</p><p><strong>Results: </strong>Our results show that hospital stays for patients with OUD were significantly longer, while total charges and costs were lower than those without OUD. Over time, there was a tendency towards convergence between total charges and costs for OUD and non-OUD patients. The study also revealed that the severity of illness was strongly related to length of stay, total charge, and total cost, and OUD patients with greater illness severity and comorbid conditions demonstrated increased outcomes compared to those without OUD, with increased total costs and charges in 2020.</p><p><strong>Conclusions: </strong>Our results offer important insights into the healthcare impact of OUD. Future studies should use patient-level data to better understand the overall healthcare use per person rather than per hospital stay, as well as more recent years of data to study greater Covid-19 specific impacts.</p><p><strong>Implications: </strong>The study emphasizes the need for more efforts to decrease the prevalence of OUD in the U.S. to help ease the pressure on the healthcare system. It also demonstrates the potential influence of the severity of illness and comorbidity on healthcare use, suggesting a need for specific interventions for patients with severe conditions.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"927"},"PeriodicalIF":2.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness and benefit-risk of rotavirus vaccination in Afghanistan: a modelling analysis informed by post-licensure surveillance.","authors":"Palwasha Anwari, Frédéric Debellut, Sardar Parwiz, Clint Pecenka, Andrew Clark","doi":"10.1186/s12913-025-12885-5","DOIUrl":"10.1186/s12913-025-12885-5","url":null,"abstract":"<p><strong>Introduction: </strong>Afghanistan added ROTARIX to the routine national immunization programme in 2018. We aimed to estimate the cost-effectiveness and benefit-risk of ROTARIX and compare its continued use with other rotavirus vaccines that could be used in the future.</p><p><strong>Methods: </strong>We used a static cohort model with a finely disaggregated age structure (weeks of age < 5 years) to assess the use of ROTARIX (1-dose vial) over a seven-year period (2018-2024) in Afghanistan. The primary outcome measure was the discounted cost (2022 US$) per Disability Adjusted Life Year (DALY) averted (from government and societal perspectives) compared to no vaccination. We also calculated the benefit-risk ratio i.e., the number of RVGE deaths prevented per one excess intussusception death. Model inputs were informed by pre- and post-licensure surveillance data, new analyses of household survey data, and updated estimates from the international literature. We ran a separate analysis to compare the potential cost-effectiveness and benefit-risk of ROTARIX (1-dose vial), ROTASIIL (1-dose vial), ROTASIIL (2-dose vial), and ROTAVAC (5-dose vial) over a ten-year period (2025-2034). Each product was compared to no rotavirus vaccination and each other. We ran deterministic and probabilistic uncertainty analyses and interpreted our results over a range of cost-effectiveness thresholds.</p><p><strong>Findings: </strong>We estimated that routine use of ROTARIX between 2018 and 2024 has prevented 4,600 RVGE deaths (a 41% reduction), 86,400 hospital admissions, and 1.72 million RVGE cases. For every 1,493 RVGE deaths prevented by the vaccine, we estimated one potential excess intussusception death. With a heavily reduced vaccine dose cost (due to support from Gavi) the net cost to the Afghanistan government vaccine programme was estimated to be US$ 4.4 million per year. The cost per DALY averted was US$ 125 (0.25 times the national GDP per capita) when using a Gavi-subsidised vaccine cost and including household costs averted by vaccination. This increased to US$ 471 (0.94 times the national GDP per capita) when incorporating the full vaccine price without Gavi's subsidy and excluding household costs averted by vaccination. When assuming continued Gavi support over the period 2025-2034, the dominant product would be ROTARIX. Without Gavi support, ROTASIIL (2-dose vial) dominates.</p><p><strong>Conclusion: </strong>Our study supports the sustained use of rotavirus vaccination in Afghanistan. The health benefits of the vaccine greatly exceed the potential risks.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"926"},"PeriodicalIF":2.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why do female sex workers disengage from targeted reproductive and sexual health services? Experiences from the Sisters with a Voice programme in Zimbabwe.","authors":"Fortunate Machingura, Thomas Hartney, Galven Maringwa, Jasper Maguma, Sikhululiwe Mkwananzi, Rumbidzai Chipwere, Tariro Chinozvina, Primrose Matambanadzo, Gracious Madimutsa, Memory Makamba, Jeffrey Dirawo, M Sanni Ali, Sarah Bourdin, Triantafyllos Pliakas, Amon Mpofu, Owen Mugurungi, Brian Rice, Andrew Phillips, James R Hargreaves, Frances M Cowan","doi":"10.1186/s12913-025-12870-y","DOIUrl":"10.1186/s12913-025-12870-y","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"915"},"PeriodicalIF":2.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health technology assessment (HTA) and performance management (PM): a scoping review on the intersecting realms.","authors":"Esther Oluwatosin Akinbobola, Francesca De Domenico, Stefania Manetti, Guido Noto","doi":"10.1186/s12913-025-12879-3","DOIUrl":"10.1186/s12913-025-12879-3","url":null,"abstract":"<p><strong>Background: </strong>Both Health Technology Assessment (HTA) and Performance Management (PM) are clinical governance disciplines that aim to improve the quality, equity, and financial sustainability of health organizations and systems. Although HTA and PM share many features, to the authors' knowledge, few studies have investigated their interplay. This study attempts to fill this gap by analysing how the literature has explored and developed the integration between HTA and PM concepts and tolls within healthcare sector.</p><p><strong>Methods: </strong>To address this gap, this study examines 33 papers selected through a scoping review that explores the intersection of HTA and PM within the healthcare sector. In particular, the paper adopted the preferred reporting items for systematic reviews and meta-analysis (PRISMA) methodology to select and analyse articles.</p><p><strong>Results: </strong>The review highlights the dynamic convergence of HTA and PM, emphasizing how combining these frameworks and functions can enhance decision-making in healthcare. This integration ensures that technologies are adopted on the basis of proven effectiveness in pursuing healthcare systems goals and that performance metrics align with evidence-based practices, leading to better resource allocation and improved patient outcomes. The literature review underscores the need for further research to understand the integration between HTA and PM and their combined impact on organizational performance, sustainability, and resilience in the healthcare sector.</p><p><strong>Conclusion: </strong>This study contributes to the literature by providing a comprehensive overview of the current state of research on HTA and PM, offering insights for future studies, and practical recommendations for integrating these disciplines to improve healthcare management and policymaking.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"917"},"PeriodicalIF":2.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of quality of maternal and newborn care and its determinants: a national study of primary health care facilities in Nigeria.","authors":"Toluwani Oluwatola, Saheed Dipo Isiaka, Oluomachukwu Omeje, Folake Oni, Olugbemisola W Samuel, Sidney Sampson, Hilda Ebinim, Oluwadamilare Olatunji, Oluwafisayo Ayodeji, Dolapo Ajibola, Stallone Ngobua, Oluwafunmilayo Dehinbo, Helen Ukoh, Leyira Ken-Aminikpo, Segun Adenipekun, Hilary I Okagbue","doi":"10.1186/s12913-025-12957-6","DOIUrl":"10.1186/s12913-025-12957-6","url":null,"abstract":"<p><strong>Background: </strong>Reducing the global burden of maternal morbidity and mortality necessitates focusing on the quality of maternal and newborn care (MNC). This study aimed to assess the quality of MNCs among 25,840 public primary healthcare centers (PHCs) across Nigeria, analyze subnational variations, and determine the influence of contextual variables on the quality of care (QoC) by PHCs.</p><p><strong>Methods: </strong>Data from a nationwide PHC assessment conducted in 2022 were utilized to create the composite index of care for PHC facilities in Nigeria. Summary statistics were then generated for the composite of care scores across PHC facilities. Subnational differences in QoC among the 36 states and the Federal Capital Territory and the influence of four contextual variables (Basic Health Care Provision Fund-status of PHC, activity of ward development committees, implementation of quality improvement plan, and activity of facility management committees) on QOC were determined using a one-way analysis of variance and multiple linear regression respectively.</p><p><strong>Results: </strong>PHCs in Nigeria had QoC scores ranging from 0.06-4.0 and a mean QoC score of 2.07. There were significant variations in the mean PHC facility QoC across states, with Katsina and Ondo states having the lowest (1.35) and highest (2.98) QoC, respectively. The regression model showed that the contextual variables analyzed accounted for 31.5% of the variation in QoC, with varying statistically significant relationships with the QoC.</p><p><strong>Conclusion: </strong>The quality of maternal and newborn healthcare in Nigeria's PHC facilities is unsatisfactory, with noticeable subnational variation in the QoC. To achieve significant improvements in the quality of care provided by PHC facilities in the country, targeted interventions, such as empanelment of more PHCs as BHCPF facilities, strengthening implementation of quality improvement plans and strengthening activities of ward development committees, and facility management committees, are required to improve the quality of maternal and newborn care, and reduce maternal and infant mortality rates.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"921"},"PeriodicalIF":2.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Day care and inpatient cataract patient satisfaction with in-patient services at a Jiangsu public tertiary A hospital.","authors":"Jun Zhang, Dong Zhou, Jie Zhu, Jinye Zhu, Xi Zou, Zhinan Liu, Guohua Deng","doi":"10.1186/s12913-025-13027-7","DOIUrl":"10.1186/s12913-025-13027-7","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"906"},"PeriodicalIF":2.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender differences in health-seeking behaviour: insights from the National Health and Morbidity Survey 2019.","authors":"Devi Shantini Rata Mohan, Suhana Jawahir, Adilius Manual, Nur Elina Abdul Mutalib, Sarah Nurain Mohd Noh, Iqbal Ab Rahim, Jabrullah Ab Hamid, Awatef Amer Nordin","doi":"10.1186/s12913-025-13020-0","DOIUrl":"10.1186/s12913-025-13020-0","url":null,"abstract":"<p><strong>Background: </strong>Health-seeking behaviour involves actions taken by individuals who feel unwell to seek remedies and varies based on cognitive and non-cognitive factors like sex, age, socioeconomic status, and access to healthcare. Gender roles significantly impact health outcomes with the COVID-19 pandemic further accentuating the gender disparity in public health compliance. Using secondary data from a national health survey, this article aims to assess the gender-based characteristics and factors influencing health-seeking behaviour among the population in Malaysia.</p><p><strong>Methods: </strong>This study was a secondary data analysis of the NHMS 2019, a cross-sectional national health survey using Andersen's Behavioural Model. It evaluated factors influencing self-medication and treatment-seeking based on socio-demographics, enabling conditions, and perceived health needs. Descriptive statistics and logistic regression models were conducted to identify factors influencing health-seeking behaviour among men and women.</p><p><strong>Results: </strong>This study analysed the health-seeking behaviours of 10,933 Malaysian adults, representing 19.7 million people. The overall prevalence of sickness was 16.1% (95% CI = 14.8-17.4), with higher rates in women (18.1%; 95% CI = 95% CI = 16.3-19.9). Among those who were sick, 56.4% (95% CI = 52.9-60.0) sought professional treatment while 23.0% (95% CI = 19.8-26.2) self-medicated. Regression analysis showed that urban women and those rating their health poorly were more likely to seek professional care, while Chinese, those with no formal education, and retiree women were more likely to self-medicate. Among males, those with long-term condition are more likely to seek treatment while students were less likely to self-medicate compared to private employees.</p><p><strong>Conclusion: </strong>The study reveals significant gender and sociodemographic disparities in health-seeking behaviour amongst Malaysian men and women. The factors that influence these health-seeking behaviour is unique for each gender. This emphasises the importance of targeted interventions which are gender-sensitive to address structural inequities and achieve equitable healthcare utilisation across all demographic groups in Malaysia.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"900"},"PeriodicalIF":2.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of implementation of child-parent psychotherapy to treat early childhood trauma: a reflexive analysis.","authors":"Silje Marie Haga, Heidi Jacobsen, Thomas Engell","doi":"10.1186/s12913-025-12937-w","DOIUrl":"10.1186/s12913-025-12937-w","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"907"},"PeriodicalIF":2.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}