BMC Health Services Research最新文献

{"title":"A web-based platform for optimizing healthcare resource allocation and workload management using agile methodology and WISN theory.","authors":"Akash Gajanan Prabhune, P S Karpaga Priya, Rohit Chandra, Ankur Thakur, Viany R Srihari, Sachin S Bhat","doi":"10.1186/s12913-025-12473-7","DOIUrl":"10.1186/s12913-025-12473-7","url":null,"abstract":"<p><strong>Background: </strong>Effective healthcare workforce management is critical for ensuring quality care delivery, particularly in resource-constrained settings. The World Health Organization's (WHO) Workload Indicators of Staffing Need (WISN) methodology provides an evidence-based framework for optimizing staffing levels. However, manual implementation of the WISN methodology is labour-intensive, error-prone, and time-consuming. To address these challenges, the Platform for Resource Allocation and Optimization for Healthcare Facilities (PRAYOJN) platform was developed as a web-based tool to automate WISN calculations, streamline data analysis, and improve workforce planning.</p><p><strong>Objective: </strong>To develop and validate a web-based system that automates the WISN methodology for healthcare workforce planning.</p><p><strong>Methods: </strong>The PRAYOJN platform was developed using an agile methodology, structured over five iterative sprints. These sprints incorporated stakeholder feedback to refine system functionalities, ensuring adaptability to real-world healthcare needs. The platform integrates data for principal, supporting, and ancillary tasks to calculate staffing requirements. Key functionalities include automated computation of Available Work Time (AWT), Standard Workload (SW), Category Allowance Factor (CAF), and Individual Allowance Factor (IAF). Alpha testing validated usability and accuracy, while beta testing in a clinical phlebotomy department assessed real-world performance.</p><p><strong>Results: </strong>The platform calculated an ideal staffing requirement of 15.53 Full-Time Equivalent (FTE) for the phlebotomy department, aligning closely with the current staff strength of 15 FTE. Agile development ensured iterative improvements, enhancing user interface (UI) and user experience (UX). Feedback highlighted the platform's user-friendly design, with dynamic visualizations such as pie charts and bar graphs aiding workload interpretation. Users praised its efficiency, adaptability, and role in reducing calculation complexity.</p><p><strong>Conclusion: </strong>PRAYOJN modernizes and enhances WISN-based workforce planning by automating workload calculations, improving data visualization, and supporting real-time decision-making. Its scalability and intuitive interface position it as a valuable tool for optimizing staffing efficiency across diverse healthcare environments.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"400"},"PeriodicalIF":2.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655582","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":"Interpretable machine learning models for prolonged Emergency Department wait time prediction.","authors":"Hao Wang, Nethra Sambamoorthi, Devin Sandlin, Usha Sambamoorthi","doi":"10.1186/s12913-025-12535-w","DOIUrl":"10.1186/s12913-025-12535-w","url":null,"abstract":"<p><strong>Objective: </strong>Prolonged Emergency Department (ED) wait times lead to diminished healthcare quality. Utilizing machine learning (ML) to predict patient wait times could aid in ED operational management. Our aim is to perform a comprehensive analysis of ML models for ED wait time prediction, identify key feature importance and associations with prolonged wait times, and interpret prediction model clinical relevance among ED patients.</p><p><strong>Methods: </strong>This is a single-centered retrospective study. We included ED patients assigned an Emergency Severity Index (ESI) level of 3 at triage. Patient wait times were categorized as <30 minutes and ≥30 minutes (prolonged wait time). We employed five ML algorithms - cross-validation logistic regression (CVLR), random forest (RF), extreme gradient boosting (XGBoost), artificial neural network (ANN), and support vector machine (SVM) - for predicting patient prolonged wait times. Performance assessment utilized accuracy, recall, precision, F1 score, false positive rate (FPR), and false negative rate (FNR). Furthermore, using XGBoost as an example, model key features and partial dependency plots (PDP) of these key features were illustrated. Shapley additive explanations (SHAP) were employed to interpret model outputs. Additionally, a top key feature interaction analysis was conducted.</p><p><strong>Results: </strong>Among total 177,665 patients, nearly half of them (48.20%, 85,632) experienced prolonged ED wait times. Though all five ML models exhibited similar performance, minimizing FNR is associated with the most clinical relevance for wait time predictions. The top features influencing patient wait times and gaining the top ranked interactions were ED crowding condition and patient mode of arrival.</p><p><strong>Conclusions: </strong>Nearly half of the patients experienced prolonged wait times in the ED. ML models demonstrated acceptable performance, particularly in minimizing FNR when predicting ED wait times. The prediction of prolonged wait times was influenced by multiple interacting factors. Proper application of ML models to clinical practice requires interpreting their predictions of prolonged wait times in the context of clinical significance.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"403"},"PeriodicalIF":2.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655751","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":"How are fast tracks organized in adult and pediatric emergency departments in Switzerland? A cross-sectional survey.","authors":"Franziska G Berger-von Orelli, Rebecca A-B Hertzog, Thomas C Sauter, Michelle Seiler, Fabian Spigariol, Maren Tomaske, Gianluca Gualco, Alex Donas, Rodo O von Vigier, Dagmar I Keller, Kristina Keitel","doi":"10.1186/s12913-025-12570-7","DOIUrl":"10.1186/s12913-025-12570-7","url":null,"abstract":"<p><strong>Background: </strong>In response to the challenges faced by emergency departments (ED), including overcrowding and high patient volumes, Fast Track (FT) systems are designed to optimize patient flow, yet their implementation and impact in Switzerland remain understudied. Our study provides a comprehensive description of Fast Track (FT) processes across both pediatric and adult settings in Switzerland and compares challenges.</p><p><strong>Methods: </strong>We conducted a cross-sectional online survey of ED leadership in Switzerland from May to September 2023, using the WHO SARA framework to explore FT processes. The survey included 28 pediatric EDs and their corresponding adult EDs, with questions addressing FT availability, staffing, infrastructure, and operational challenges. Results were analyzed descriptively, providing insights into FT organization and highlighting barriers to implementation and expansion.</p><p><strong>Results: </strong>The survey achieved a response rate of 93% (52/56 EDs). Overall, 68% of surveyed hospitals have implemented a FT system, with a higher prevalence in adult EDs (88%) than in pediatric EDs (59%). The absence of FTs in certain pediatric departments was primarily due to structural and personnel constraints. Most FTs are managed internally by hospitals, employing emergency team members, and occasionally general practitioners, reflecting a tailored approach to staffing based on departmental needs. Despite the strategic organization of FTs, operational challenges persist; 45% of respondents identified staff shortages as a major challenge, particularly in pediatric FTs (63%) compared to adult FTs (32%). Financial barriers, including disparities in external physician compensation, remain significant obstacles to FT expansion. Satisfaction levels among EDs with their FT systems were generally high, with improvements in personnel resource allocation and patient flow frequently reported.</p><p><strong>Conclusion: </strong>While FT systems in Swiss EDs have enhanced patient care and operational efficiency, their expansion and effectiveness are hampered by staffing and financial limitations. Addressing these barriers requires a collaborative effort to reform health system policies and financial frameworks, ensuring the sustainable implementation of FTs to meet the growing demands of emergency care.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"395"},"PeriodicalIF":2.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655806","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":"Hub-and-Spoke regional system supported by telehealth for managing coeliac disease in Liguria: a mixed-methods survey followed by an observational pilot study.","authors":"Marco Crocco, Federica Malerba, Paolo Gandullia, Noemi Zampatti, Maria Franca Corona, Monica Barrani, Massimiliano Leoni, Sara Ceresoli, Andrea Gazzolo, Alberto Gaiero, Riccardo Borea, Alessandro Giorgio Lo Curto, Maria Paola Ierardi, Silvia Scelsi, Giuseppe Spiga, Raffaele Spiazzi, Renato Botti, Marisa Alberti","doi":"10.1186/s12913-025-12459-5","DOIUrl":"10.1186/s12913-025-12459-5","url":null,"abstract":"<p><strong>Background: </strong>Due to the need to reorganize the care network for the national screening mandated by law, a new healthcare model was required for the management of coeliac disease. The hub-and-spoke model is a new healthcare organizational system, here we describe its application (supported by telehealth), in the management of pediatric coeliac disease (CD) in Liguria. The results of the pilot phase are presented and the system's strengths and weaknesses discussed.</p><p><strong>Methods: </strong>A mixed-methods survey followed by an observational pilot study was performed. A multiphase approach was used including preparation setting, operative planning and application. The pilot phase involves a single primary center. The reduction of families' expenditure and environmental impact was assessed using the Viamichelin calculator.</p><p><strong>Results: </strong>A regional meeting followed by a survey (specifically developed for this study) and a needs analysis highlighted the priority to have an efficient, up to date and homogeneous model of care assistance throughout the network. A diagnostic and therapeutic care pathway (PDTC) was developed by the regional working group. The project involved 986 Ligurian families and allowed a 90% reduction in the distance traveled by families residing within the pilot center's catchment area, saving €177 and 113 kg of CO2 on average per family per year.</p><p><strong>Conclusions: </strong>The Gaslini Diffuso hub-and-spoke system for managing CD in Liguria exemplifies a commitment to enhancing healthcare efficiency and patient care, reducing environmental impact and cost for both family and healthcare system.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"398"},"PeriodicalIF":2.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655824","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":"Influencing factors of self-advocacy in stroke patients from multiple perspectives: a qualitative study.","authors":"Zhixin Zhao, Beilei Lin, Zhenxiang Zhang, Chunhui Zhang, Yongxia Mei, Zhiwei Liu, Hu Jiang, Xiaoxuan Wang","doi":"10.1186/s12913-025-12563-6","DOIUrl":"10.1186/s12913-025-12563-6","url":null,"abstract":"<p><strong>Background: </strong>Self-advocacy can help stroke patients actively participate in disease management and maximize health benefits, which is a central issue in chronic disease management. The aim of the study was to explore the influencing factors of self-advocacy in stroke patients from multiple perspectives.</p><p><strong>Methods: </strong>A descriptive qualitative interview study was performed. Semi-structured in-depth interviews were conducted with 19 stroke patients, 6 caregivers, and 8 medical staff from two hospitals in Henan province between October 2023 to February 2024. This study analyzed interview data using a Social Ecological Model (SEM) and content analysis strategies.</p><p><strong>Results: </strong>Factors associated with stroke patients' self-advocacy were categorized using the social ecological model: (1) individual factors: influence of individual cognitive and psychological factors (weak sense of autonomy, insufficient disease cognition, severity of the disease, self-perceived burden, concerns about deteriorating doctor-patient relationship). (2) interpersonal factors: influence of family, peers and medical staff (insufficient family support, lack of peer support, authority of medical staff dominates). (3) community factors: influence of socio-environmental factors (shortage of medical staff, incomplete rehabilitation equipment, limited channels for information). (4) policy-economic factors: influence of existing policy (insufficient support from medical insurance, long-term financial burden).</p><p><strong>Conclusion: </strong>This study's application of a social ecological model helped to illuminate the complex and multilevel factors that may influence self-advocacy in stroke patients. Stroke patients' self-advocacy was influenced by the patients themselves, interpersonal relationships, community factors, and policy-economic factors. These findings can be used to guide the development of a multi-pronged intervention strategy to increase the level of self-advocacy for stroke patients in the self-management process.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"396"},"PeriodicalIF":2.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655828","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":"A mixed method impact assessment of the use of aerial logistics to improve maternal health and emergencies outcomes in the Ashanti Region of Ghana.","authors":"Pedro Kremer, Florence Haruna, Christina Briegleb, Maame Esi Amoah, Kenneth Fosu Oteng, Stephanie Boadi, Samuel Dwomoh, Adwoa Bentil, Emmanuel Tinkorang","doi":"10.1186/s12913-025-12479-1","DOIUrl":"10.1186/s12913-025-12479-1","url":null,"abstract":"<p><p>Maternal mortality, a critical global public health issue, is notably higher in low-to-middle-income countries (LMICs). In Ghana, access to healthcare, especially maternal and emergency services, is hindered by infrastructural deficiencies such as poor road networks and unreliable electricity, making the delivery of medical supplies and services difficult. The study used a mixed-method approach to assess the impact of aerial logistics on various maternal health outcomes in the Ashanti Region, focusing on the intervention by Zipline Mpanya distribution center. The study was conducted in the Ashanti Region of Ghana, where clinical outcome data were sourced from the health directorate. Pre-exposure years were 2017-2020, and post-exposure years were 2021-2022. Statistical analysis involved univariate explorations, T-tests, ANOVAs, and Zero-Inflated Poisson regressions, adjusting for factors like poverty. The qualitative study was to describe and analyze changes in providers' and patients' satisfaction, perceived quality across maternal health and health emergencies, and experiences using or being treated with the aerial logistics. The Zero-Inflated Poisson regression analysis indicated significant pre-post increases in antenatal visits and deliveries by 20% and 26% respectively, and a notable 3.41-fold increase in referrals, while emergency visits decreased by 4%. Maternal deaths decreased by 56%, with no substantial changes observed in rates of hysterectomies and neonatal deaths. Nonetheless, marginal means estimations in absolute terms showed overall declines in performance, consistent with the effects of the COVID-19 pandemic. Patients and healthcare providers perceived improvement in access to maternal and emergency medications. In conclusion, this study underscores the groundbreaking role of medical drones in enhancing public health strategies, especially in LMICs, by mitigating the impact of health emergencies on maternal health.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"390"},"PeriodicalIF":2.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646944","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":"What stops private hospitals from engaging with publicly funded health insurance schemes? A mixed-methods study on PMJAY/MJPJAY in Maharashtra, India.","authors":"Shweta Marathe, Prashant Ingle, Deepali Yakkundi, Kerry Scott","doi":"10.1186/s12913-025-12450-0","DOIUrl":"10.1186/s12913-025-12450-0","url":null,"abstract":"<p><strong>Background: </strong>Reducing patient expenditure and expanding healthcare access through private sector hospitals is widely touted strategy for governments to achieve Universal Health Care, including in India. However, private sector engagement in India's publicly funded health insurance schemes (PFHIS) remains low and is uneven across geographies and by hospitals size. This paper examines challenges to achieving effective private sector engagement in PFHIS by analysing private sector participation and exploring diverse stakeholder perspectives.</p><p><strong>Methods: </strong>This case study used sequential mixed methods design and was conducted in 2023-24 in Maharashtra, India. We combined quantitative analysis of the geographic distribution of empanelled private hospitals (993 across Maharashtra's 36 districts) and qualitative interviews (n = 16) with diverse stakeholders to understand why some facilities do not engage. The analysis was guided by our framework on private sector engagement that examined policy factors, hospital level factors and operational factors.</p><p><strong>Results: </strong>Only 13% of private hospitals were empanelled in Maharashtra's PFHIS, with higher empanelment in urban areas and among small and medium sized hospitals; rural areas had few empanelled hospitals and few large private hospitals participated. Districts with few empanelled private hospitals had lower overall hospitalization rates, suggesting persistent unmet population need for affordable hospitals. Low private sector engagement was driven by multiple factors: at the policy level, insufficient state budgets, low reimbursement rates, fixed scheme packages, strict empanelment criteria, complex claims processes, and delayed reimbursements; at the hospital level, economic non-viability, concerns about patient load and profile, and limited administrative capacities; and at the operational level, inadequate monitoring mechanisms for PFHIS and empanelled hospitals, gaps in the empanelment process, and delays in patient pre-authorization and claims processing.</p><p><strong>Conclusion: </strong>This study enhances understanding of private sector engagement challenges and provides insights for improving PFHIS and UHC in India. The framework developed can also be applied beyond India to assess the complexities of intent, capacity, and interactions between private and public actors in PFHIS. To create an enabling environment for private sector engagement and achieve the scheme's objectives, the state could increase reimbursement rates, implement responsive grievance redressal, regulate private hospitals, and improve governance processes. A two-fold strategy of strengthening the public health system and engaging with regulated private hospitals could enhance the scheme's effectiveness.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"389"},"PeriodicalIF":2.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646968","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":"Factors shaping the mental health of healthcare workers during the COVID-19 pandemic: a qualitative study in Ghana.","authors":"Akua O Gyamerah, Osamuedeme J Odiase, Helen H Habib, Fabian Achana, Andy Canizares, Monica Getahun, Raymond Aborigo, Jerry John Ouner, Hawa Malechi, John Koku Awoonor-Williams, Patience A Afulani","doi":"10.1186/s12913-025-12476-4","DOIUrl":"10.1186/s12913-025-12476-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The COVID-19 pandemic negatively impacted the working conditions and mental health of healthcare workers (HCWs) across the globe. Little is understood of the factors influencing the mental health of HCWs in low-and middle-income countries like Ghana, which faced significant challenges from the COVID-19 pandemic due to their overburdened healthcare systems. Our study qualitatively examined the multilevel factors influencing HCWs' mental health in response to the pandemic in Ghana, as well as coping strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Utilizing an exploratory, descriptive qualitative research design, we purposively sampled and interviewed HCWs (n = 26) and administrators (n = 3) across 13 regions in Ghana from our parent study (N = 646) between November 2020 and February 2021. Semi-structured interviews explored pandemic preparedness, experiences responding to the pandemic, the impact of the pandemic on life, work, quality of care, and mental health; challenges and facilitators of the COVID-19 response; and coping strategies. Transcripts were coded through a group-based collaborative approach in the Dedoose software and analyzed thematically guided by the socio-ecological framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;HCWs reported experiencing fear, anxiety, stress, and depression due to the COVID-19 pandemic and cited several individual, interpersonal, institutional, and societal factors that adversely impacted their mental health. Individual-level factors included low knowledge of COVID-19 risk and sequelae and contraction of COVID-19. Interpersonal factors included being a parent/caregiver, risk posed to family/household as frontline workers, and social isolation. Institutional factors included inadequate health system capacity (i.e., low staffing capacity) and pandemic preparedness (i.e., inadequate COVID-19 training), and frontline working conditions (i.e., long work hours; higher COVID-19 infection risk). Societal factors were COVID-19-related stigma against HCWs, COVID-19 social conspiracies, and sociocultural beliefs about mental health in Ghana. Despite the negative impact of the pandemic on HCWs' lives, most reported not receiving adequate support from their workplace or the government to mitigate mental health distress. However, HCWs identified several protective factors and coping strategies, including prayer/spirituality, spiritual and emotional support from family and colleagues, and, although limited, work-based or government incentives and appreciation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The COVID-19 pandemic has adversely impacted the mental health of HCWs in Ghana, who have inadequate resources to address these distresses. Investing in healthcare infrastructure, including expanding workforce and facility capacity and providing workplace mental health wellness services, can help mitigate the mental health impact of health crises like the COVID-19 pandemic on the healthcare workforce and subseq","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"388"},"PeriodicalIF":2.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647029","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":"How gender affects the mental health of healthcare workers across regions in Thailand.","authors":"Nattanicha Chairassamee, Kanokwan Chancharoenchai","doi":"10.1186/s12913-025-12518-x","DOIUrl":"10.1186/s12913-025-12518-x","url":null,"abstract":"<p><strong>Background: </strong>A shortage of healthcare professionals in Thailand can cause mental health impairment, low quality of life, high resignation rates, and low-quality services to patients due to heavy responsibilities. With the increasing rate of females entering medical careers, gender has become a significant factor in assessing healthcare workers' mental health. This study explores the relationship between the mental health and gender of healthcare workers across geographic regions in Thailand.</p><p><strong>Methods: </strong>The present study uses individual data of Thai healthcare workers from 2009 to 2015 and 2018-prior to the COVID-19 pandemic. We include overall mental health and work/job-related mental health. A linear regression with fixed effects is used to estimate the differentials of healthcare workers' gender on mental health issues.</p><p><strong>Results: </strong>Female healthcare workers feel more depressed and less satisfied with their health management than males do, particularly in rural areas. Young female healthcare professionals have lower levels of happiness and life satisfaction than male workers do. Predictions of mental health levels from our regressions show that nurses in rural areas experience higher levels of mental health impairment than doctors do.</p><p><strong>Conclusions: </strong>Female workers are more likely to feel depressed than males are, particularly in rural areas. We also find that nurses are less likely to be happy and satisfied with life than doctors are.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"387"},"PeriodicalIF":2.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647032","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":"A scoping review of digital health technologies in multimorbidity management: mechanisms, outcomes, challenges, and strategies.","authors":"Aklilu Endalamaw, Anteneh Zewdie, Eskinder Wolka, Yibeltal Assefa","doi":"10.1186/s12913-025-12548-5","DOIUrl":"10.1186/s12913-025-12548-5","url":null,"abstract":"<p><strong>Introduction: </strong>Multimorbidity amplifies healthcare burdens due to the intricate requirements of patients and the pathophysiological complexities of multiple diseases. To address this, digital health technologies play a crucial role in effective healthcare delivery, requiring comprehensive evidence on their applications in managing multimorbidity. Therefore, this scoping review aims to identify various types of digital health technologies, explore their mechanisms, and identify barriers and facilitators within the context of multimorbidity.</p><p><strong>Methods: </strong>This scoping review follows the Preferred Reporting Items for Scoping Reviews guidelines. PubMed, Scopus, Web of Science, EMBASE, and Google Scholar were used to search articles. Data extraction focused on study characteristics, types of health technologies, mechanisms, outcomes, challenges, and facilitators. Results were presented using figures, tables, and texts. Thematic analysis was employed to describe mechanisms, impacts, challenges, and strategies related to digital health technologies in managing multimorbidity.</p><p><strong>Results: </strong>Digital health technology encompasses smartphone apps, wearable devices, and platforms for remote healthcare (telehealth). These technologies work through care coordination, collaboration, communication, self-management, remote monitoring, health data management, and tele-referrals. Digital health technologies improved quality of care and life, cost efficiency, acceptability of care, collaboration, streamlined healthcare delivery, reduced workload, and bridging knowledge gaps. Patients' and healthcare providers' resistance and skills, lack of support (technical, financial, and infrastructure), and ethical concerns (e.g., privacy) barred digital health technologies implementation. Arranging organization, providing technical support, employing care coordination strategies, enhancing acceptability, deploying appropriate technology, considering patient needs, and adhering with ethical principles facilitate digital health technologies implementation.</p><p><strong>Conclusions: </strong>Digital health technology holds significant promise in improving care for individuals with multimorbidity by enhancing coordination, self-management, and monitoring. Successful implementation requires addressing challenges such as patient resistance and infrastructure limitations through targeted strategies and investments. It is also essential to consider usability, privacy, and trustworthiness when adopting these tools.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"382"},"PeriodicalIF":2.7,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633362","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}