BMC Health Services Research最新文献

{"title":"Exploring cross-city hospital visiting trips for medical service evaluation in urban agglomeration areas based on automobile navigation data.","authors":"Xi Yu, Zhengdong Huang, Renzhong Guo, Jizhe Xia, Sa Ma","doi":"10.1186/s12913-026-14649-1","DOIUrl":"https://doi.org/10.1186/s12913-026-14649-1","url":null,"abstract":"<p><strong>Background: </strong>Understanding the supply-demand relationship of medical services is essential for regional planning. Existing city-scale studies typically exclude cross-city flows, whereas national-scale studies often overlook intra-city heterogeneity. In urban agglomerations, healthcare resources and transport infrastructure are usually planned by cities, although patients may cross city boundaries to seek care. The implications of cross-city trips for regional medical services remain insufficiently understood. Taking the Pearl River Delta as a case, this study investigates cross-city hospital visiting trips and their implications for medical service evaluation.</p><p><strong>Methods: </strong>Using 91.2 million automobile navigation records collected in 2019, 1.37 million hospital visiting trips to Grade 3 hospitals were identified through a modified spatial join method. A population-hospital bipartite network and a multi-scale analytical framework were constructed. Cross-city demand and supply indices were developed at the city, subdistrict, and hospital scales to characterize cross-city medical service patterns and influencing factors. Accessibility and Gini coefficients were computed under intra-city and regional evaluation scenarios to assess how incorporating cross-city hospital visiting trips affects medical service evaluation.</p><p><strong>Results: </strong>Based on automobile navigation data, 9.1% of identified hospital visiting trips crossed city boundaries. Guangzhou and Shenzhen served as dominant regional suppliers, with cross-city supply indices of 55.9% and 21.8%, respectively. Cross-city demand was negatively associated with distance to boundary, GDP per capita, and hospital beds. Cross-city service share was negatively associated with distance to boundary, whereas contributions to regional cross-city service provision were positively associated with hospital size and hospital grade. Incorporating cross-city flows increased accessibility in most peripheral areas and reduced the regional population-weighted Gini coefficient from 0.596 to 0.522.</p><p><strong>Conclusions: </strong>Based on automobile navigation data, cross-city hospital visiting trips constitute an important component of medical service utilization in urban agglomerations. At the subdistrict scale, cross-city demand was jointly associated with boundary proximity and local economic and medical conditions. At the hospital scale, the cross-city service share was higher among hospitals closer to city boundaries, whereas contributions to regional cross-city medical service provision were greater among larger and higher-grade hospitals. Evaluation frameworks relying solely on intra-city data tend to underestimate accessibility in boundary areas and, in most cases, overestimate the Gini coefficient.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ten-year healthcare utilization patterns among patients with type 2 diabetes and degenerative spinal disorders: a nationwide comparative analysis using nationwide sample.","authors":"Dong Jin Kim, Jungtae Leem, Yoon Jae Lee, In-Hyuk Ha, Ye-Seul Lee","doi":"10.1186/s12913-026-14657-1","DOIUrl":"https://doi.org/10.1186/s12913-026-14657-1","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) and degenerative or mechanical spinal disorders frequently co-occur and amplify one another's clinical and socioeconomic burden. T2DM has been associated with greater pain severity, prolonged disability, and higher reported risks of surgery and opioid use, although the underlying mechanisms remain hypothesized rather than established. In South Korea's dual healthcare system, patients may access both Western medicine (WM) and Korean medicine (KM), yet national-level evidence on spine-T2DM multimorbidity care patterns is limited. This study examined 10-year healthcare utilization, expenditures, and medication use among patients with coexisting T2DM and degenerative or mechanical spinal disorders.</p><p><strong>Methods: </strong>We conducted a retrospective study using the Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS) from 2010 to 2019. Patients with both T2DM (E11) and at least one degenerative spinal diagnosis (M47, M48, M51, M54, S33) were included. KM users were defined as those with ≥ 1 KM claim per year. Outcomes included annual claim counts, expenditures, service categories, medication use, and facility type. Annual percent change (APC) was estimated using log-linear regression, and baseline characteristics were compared using standardized mean differences (SMDs).</p><p><strong>Results: </strong>A total of 188,716 patients generated 9,590,400 claims over 10 years; 62.9% were KM users. KM users were more often female and slightly older; back pain (M54) showed the largest imbalance (SMD = 0.26). Total claims increased from 715,279 (2010) to 1,157,475 (2019). KM users had substantially more annual claims; yet per-patient expenditures were similar, reflecting reliance on lower-cost outpatient KM services, notably acupuncture. Medication use peaked in 2012 and declined thereafter following national drug pricing reforms. Non-users received fewer but higher-cost prescriptions, particularly for pain and inflammatory medications.</p><p><strong>Conclusions: </strong>Adults with coexisting T2DM and degenerative spinal disorders demonstrate increasing and complex healthcare needs driven primarily by chronic pain rather than glycemic management alone. KM users engage in high-frequency, multimodal outpatient care at lower unit cost, whereas non-users rely more heavily on tertiary WM services and higher-cost pharmaceuticals. Korea's dual healthcare system appears to support differentiated care pathways in this multimorbidity population. Findings underscore the need for integrated, longitudinal chronic care models that combine conservative pain management with diabetes care to reduce disability and long-term healthcare burden.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modification of Hospitalization Risk by Gender and Dementia Status Between the Ages of 85 and 95 in a German Cohort Based on Health Claims Data.","authors":"Gabriele Doblhammer, Elena Rakuša, Anne Fink","doi":"10.1186/s12913-026-14575-2","DOIUrl":"10.1186/s12913-026-14575-2","url":null,"abstract":"<p><strong>Background: </strong>Hospitalizations among older adults differ by dementia status, gender, and living arrangements. Understanding these differences, particularly in advanced age (age 85 and above), can inform appropriate healthcare strategies.</p><p><strong>Methods: </strong>Using health claims data for Germany, we followed the 1918 to 1923 birth cohort (n = 4,065 men and 13,302 women), who reached age 85 between 2004 and 2009 until death or age 95. Two-level mixed-effects linear probability models with repeated observations were conducted, adjusting for age, gender, dementia status, nursing home residency, dependency on long-term care, comorbidities, and quarter of death.</p><p><strong>Results: </strong>Men consistently exhibited higher probabilities of hospitalization compared to women, and individuals with dementia (PwD) had a greater probability of hospitalization than those without dementia (non-PwD). Specifically, when compared to male non-PwD, the probability of hospitalization increased by 0.10 (p ≤ 0.001) for male PwD; female non-PwD demonstrated a 0.02 (p ≤ 0.001) lower probability of hospitalization, while female PwD had an increased probability of 0.06 (p ≤ 0.001). Hospitalization probabilities increased with age among non-PwD (men: +0.052 from p₈₅=0.14 [95%CI = 0.13-0.14] to p₉₅=0.19 [95%CI = 0.18-0.20]), women: +0.021 from p₈₅=0.12 [95%CI = 0.12-0.13] to p₉₅=0.14 [95%CI = 0.14-0.15]), remained almost stable among male PwD (+ 0.018 from p₈₅=0. 24 [95%CI = 0.23-0.26] to p₉₅=0.26 [95%CI = 0.24-0.28]), but declined among female PwD (-0.023 from p₈₅=0.22 [95%CI = 0.21-0.22] to p₉₅=0.20 [95%CI = 0.19-0.20). The quarter of death strongly elevated hospitalization probabilities for all groups, though less so among women with dementia who had a lower probability than women without dementia (-0.04; p_non-PwD=0.58 [0.58-0.59], p_PwD=0.54 [0.53-0.55]). Dependence on long-term care significantly reduced hospitalization risk among women, especially those with dementia (-0.5; p_{no long-term care}=0.21 [0.21-0.21], p_{long-term care} =0.16 [0.16-0.17]), but showed no substantial effect for men. Nursing home residency increased hospitalization probabilities mainly for women without dementia (+ 0.02), but slightly decreased probabilities for women with dementia (-0.01). Higher comorbidity was consistently associated with greater hospitalization risk.</p><p><strong>Conclusion: </strong>Gender and dementia status significantly modulate hospitalization risks in advanced age. A gender-sensitive healthcare approach that accounts for dementia status and care needs is crucial for ensuring adequate hospital care in advanced age.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moral injury in a VUCA healthcare environment: ethical complexities and professional challenges for medical teams.","authors":"Lior Naamati-Schneider, Hagar Binoun-Chaki, Paula Feder-Bubis, Shir Daphna-Tekoah","doi":"10.1186/s12913-026-14664-2","DOIUrl":"https://doi.org/10.1186/s12913-026-14664-2","url":null,"abstract":"<p><strong>Background: </strong>Healthcare systems operate within a VUCA (Volatile, Uncertain, Complex, and Ambiguous) environment, shaped by economic, demographic, and systemic transformations. These rapid and unpredictable changes create ethical challenges, resource constraints, and heightened emotional and moral distress for healthcare professionals. The increasing complexity of care delivery, shifting institutional priorities, and external pressures contribute to moral injury, impacting professionals' ability to provide patient-centered care while maintaining their ethical and professional integrity.</p><p><strong>Methods: </strong>This qualitative study aimed to explore how healthcare professionals experience and cope with moral injury in a VUCA healthcare ecosystem. Through 35 semi-structured interviews, the study explores how healthcare professionals experience and cope with moral injury in such a dynamic healthcare ecosystem. The research uses an abductive analysis guided by the VUCA framework to examine the systemic roots of moral conflict.</p><p><strong>Results: </strong>The analysis identified six themes highlighting how instability, unpredictability, ambiguity, and systemic overload shape clinical decision-making, emotional burden, and ethical distress. Participants described moral injury as emerging from the misalignment between professional values and institutional demands, intensified by resource shortages, role ambiguity, and crisis normalization. These pressures affect professionals' well-being, compromise ethical integrity, and contribute to long-term psychological consequences.</p><p><strong>Conclusion: </strong>The findings emphasize the need to move beyond individual-level resilience strategies and focus on systemic reforms. Strengthening institutional support structures-including ethical leadership, reflective spaces, and alignment between organizational policy and professional ethics-is essential for protecting both clinicians' integrity and care quality in today's complex healthcare landscape.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators of parental healthcare-seeking for sick young infants with possible serious bacterial infection in Ethiopia: a qualitative study using a socio ecological model.","authors":"Wassie Negash Mekonnen, Gizachew Tadele Tiruneh, Adugnaw Berhane, Wubegzier Mekonnen","doi":"10.1186/s12913-026-14686-w","DOIUrl":"https://doi.org/10.1186/s12913-026-14686-w","url":null,"abstract":"<p><strong>Background: </strong>Ethiopia is among the countries with the highest number of newborn deaths globally. Despite the high mortality from treatable infectious conditions, many families do not seek care from health facilities. Therefore, this study explored the barriers and facilitators of care-seeking for sick infants in two districts in Ethiopia.</p><p><strong>Method: </strong>A qualitative descriptive study conducted among mothers to explore care-seeking practices for sick children in two districts, Ethiopia, from June 20 to August 30, 2025. We did total 21 interviews; ten in-depth interviews with mothers of infants and eleven key informant interviews with elders, health extension workers, program managers, and health workers. The data were analyzed using Open-Code software version 4.03. The data were thematically analyzed, where the Socio-Ecological Model (SEM) was applied as a theoretical framework to explore multilevel factors ranging from individual to policy contexts.</p><p><strong>Result: </strong>The study showed that the individual-level factors, like perceptions and knowledge of the disease as not life-threatening, and danger signs, doubts about the effectiveness of medical care, and perceived poor service quality were identified as barriers. The interpersonal-level factors, including family support, spousal agreement, and influence from elders, relatives, neighbors, and community health workers, were identified as facilitators for care seeking. The community-level factors, including cultural norms and traditional or faith-based practices, hinder early care seeking, particularly in the early postnatal period. Distance to health facilities, limited availability of drugs, low facility readiness, and inadequate quality of care, were institutional-level factors that deterred timely facility-based care-seeking. In contrast, the availability of trained providers, adequate medical supplies, and well-equipped facilities facilitated timely care-seeking. At the policy or societal level, factors such as conflict and political instability, the cost of healthcare, and financial hardship hindered access to care.</p><p><strong>Conclusion: </strong>Care-seeking for sick young infants is influenced by a complex interplay of individual, interpersonal, community, institutional, and societal factors. Addressing these multilevel barriers requires coordinated strategies to improve awareness, leverage social support, enhance service quality, and mitigate broader contextual challenges.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health needs of patients with osteoarthritis based on a preference perspective: a mixed-methods study.","authors":"Guiling Liao, JingJing Shang, Yaping Yi, Dongmei Xu, Jiapei Yao","doi":"10.1186/s12913-026-14553-8","DOIUrl":"https://doi.org/10.1186/s12913-026-14553-8","url":null,"abstract":"<p><strong>Objective: </strong>To explore the characteristics and influencing factors of mental health needs in patients with osteoarthritis (OA) from a preference-based perspective, and to inform the development of tailored service strategies based on their needs and preferences.</p><p><strong>Method: </strong>From March to June 2024, 385 patients with OA were recruited from three tertiary hospitals in Changzhou using convenience sampling. Quantitative data were collected using the Hospital Anxiety and Depression Scale (HADS) and a self-developed Mental Health Needs and Preferences Questionnaire, and analyzed using multiple linear regression. Between July and August 2024, a subset of 28 participants was purposively selected from the same sample for semi-structured interviews, and the qualitative data were analyzed thematically.</p><p><strong>Results: </strong>Quantitative results showed that 56.1% of patients screened positive for anxiety or depressive symptoms. The highest reported need was for disease knowledge (4.21 ± 0.63), followed by symptom control (4.05 ± 0.71), emotion/behavior management (3.85 ± 0.89), and social/occupational functioning (3.42 ± 0.95). Regarding service preferences, patients preferred an orthopedic surgeon-led mode (68.3%), personalized face-to-face consultation (76.4%), pain management content (85.7%), and outpatient support (71.9%). Multiple regression analysis identified six significant influencing factors, including age and education level (P < 0.05). Qualitative findings elaborated on these patterns, revealing four themes: Psychological burden in illness experience, The Foundation of Self-Management: Needs for Health Literacy and Symptom Control, Psychological and Social Functioning Needs, Facilitators Shaping Service Engagement and Preferences. The consistency between quantitative scores and qualitative descriptions reinforced the validity of the identified need domains.</p><p><strong>Conclusion: </strong>This mixed-methods study found a high prevalence of anxiety/depressive symptoms in OA patients and identified mental health needs across four dimensions: disease knowledge, symptom control, emotion/behavior management, and social/occupational functioning. Service preferences favored surgeon-involved, personalized, and pain-focused interventions. A multidisciplinary model integrating orthopedic and mental health professionals should be developed to provide personalized services aligned with patient preferences.</p><p><strong>Trial registration: </strong>This study was approved by the Ethics Committee of Changzhou Second People's Hospital (approval No. [2024]KY003-01). The trial was prospectively registered with the Chinese Clinical Trial Registry (registration number MR-32-25-004771, registered on 28 March 2023).</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospitalization expenses for radical prostatectomy in a tertiary hospital in China: a quantile regression and CHAID decision tree analysis.","authors":"Feiyue Su, Hualian Pei, Yichao Hu, Yiping Li, Weihong Wang, Qinhong Xu","doi":"10.1186/s12913-026-14667-z","DOIUrl":"https://doi.org/10.1186/s12913-026-14667-z","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the hospitalization expenses and identify their influencing factors in patients undergoing radical prostatectomy (RP), in order to inform strategies for controlling hospitalization costs and reducing the direct economic burden on patients.</p><p><strong>Methods: </strong>A retrospective study was conducted on 4,264 inpatients who underwent radical prostatectomy (RP) in the urology department of a tertiary hospital in Zhejiang Province between January 2022 and October 2025. Basic patient demographics and detailed hospitalization cost data were extracted from hospital records. The Mann‑Whitney U and Kruskal‑Wallis H tests were performed for univariate analysis using SPSS 27.0 and StataSE 15. Subsequently, quantile regression and the CHAID decision tree model were applied to analyze hospitalization costs.</p><p><strong>Results: </strong>The total hospitalization expenses for the 4,264 RP patients were US$ 30,617,940.09, with an out-of-pocket proportion of 48.83%. Surgical costs constituted the major component. Univariate analysis identified several factors associated with expenses, including lymph node dissection (LND), blood transfusion, operative time, age, length of stay (LOS), pathological stage, choice of robotic surgery, Gleason score, Charlson Comorbidity Index (CCI), and different surgical team. Quantile regression analysis revealed that LND, blood transfusion, Barthel Index score (≤ 40), LOS (8-14 days and >14 days), robotic surgery, and surgical team (Team 2 and Team 4) had a significant impact on the three quantiles of total hospitalization cost (Q₁₀, Q₅₀, Q₉₀) (P < 0.05). Both quantile regression and the Chi-squared Automatic Interaction Detection (CHAID) decision tree model identified LOS, choice of robotic surgery, and Gleason score as primary influencing factors.</p><p><strong>Conclusions: </strong>The economic burden of hospitalization for RP patients in this study was substantial, with surgical costs accounting for a large proportion and out‑of‑pocket payments representing nearly half of total expenses. LOS, robotic surgery, and Gleason score were identified as the primary drivers. These findings underscore the importance of implementing cost-containment strategies that address the key contributors to expenses, while ensuring that the quality of care is not compromised.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thirty-five years of dermatology workforce inequality and centralization in Austria.","authors":"Aleksandar Josipovic","doi":"10.1186/s12913-026-14673-1","DOIUrl":"https://doi.org/10.1186/s12913-026-14673-1","url":null,"abstract":"<p><p>The equitable distribution of medical specialists is critical for ensuring timely access to dermatologic care. However, the long-term patterns of dermatologist allocation have not been systematically examined in Austria. This paper addresses the research question: How has the dermatology workforce in Austria been distributed across its nine federal states from 1990 to 2025, and what factors contribute to geographic inequalities in access to dermatologic care? The study presents the first 35-year longitudinal analysis of the distribution of the dermatology workforce in Austria. Using annual dermatologist counts and population data, we calculate dermatologist density per 100,000 inhabitants, evaluate geographic inequality using the Gini coefficient, the Coefficient of Variation (CV), and the Theil index, and assess metropolitan dominance using Location Quotients (LQ). Additionally, we forecast the national workforce supply to 2030 using ARIMA modeling. The results reveal a substantial increase in the national dermatology workforce, reflected in a consistent rise in dermatologist density across all states, and a significant reduction in geographic inequality. The Gini coefficient decreased from 0.319 to 0.159, the CV from 0.684 to 0.315, and the Theil Index from 0.187 to 0.045. Despite these improvements, Vienna remains the primary dermatologic hub, with its dermatologist density rising from 9.23 to 17.01 per 100,000 inhabitants and LQ values consistently exceeding 3.0. The ARIMA(1,1,1) forecast predicts continued workforce growth to over 2,130 dermatologists by 2030, yet no natural redistribution toward underserved states is projected. These findings are interpreted through the lenses of the Inverse Care Law, the WHO Human Resources for Health framework, urban centralization theory, and path dependency. While Austria's dermatology workforce is expanding, it remains structurally imbalanced and unlikely to self-correct. To address this issue, policy strategies should focus on decentralized training programs, regional incentives, and the enhancement of dermatology capacity outside Vienna.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring barriers to women's participation in breast and cervical cancer screening programs: insights from national health surveys in Türkiye.","authors":"Sait Soyler, Banu Beyaz Sipahi, Dogancan Cavmak","doi":"10.1186/s12913-026-14656-2","DOIUrl":"https://doi.org/10.1186/s12913-026-14656-2","url":null,"abstract":"<p><strong>Background: </strong>The utilization of breast and cervical cancer screening services among women remains low in Turkiye, despite their importance for early diagnosis. Therefore, this study examines the influences of financial and physical barriers in accessing healthcare and socio-economic and demographic factors on Turkish women's participation in mammography and Pap smear screenings.</p><p><strong>Methods: </strong>The microdata from the Turkey Health Survey (TSA) conducted by the Turkish Statistical Institute (TURKSTAT) in 2014, 2016, 2019, and 2022 were pooled. A total of 26,931 women aged 35 and over were included. To analyze the factors affecting the likelihood of undergoing mammography and Pap smear tests, separate binary logistic regression (logit) models were estimated for each dependent variable. In the first stage, the effects of the variables were reported as odds ratios, and in the second stage, average marginal effects (AME) were calculated and presented through graphs.</p><p><strong>Results: </strong>Participation rates were 43.73% for breast cancer screening and 43.06% for cervical cancer screening. 20% of women faced financial barriers in accessing healthcare services, while 34% faced physical barriers. Encountering financial barriers, education and income levels, having access to a physician, and performing self-breast examinations were related to the level of mammography and Pap smear screening.</p><p><strong>Conclusions: </strong>To increase the effectiveness of screening programs, health policies must prioritize reducing financial barriers, promoting healthy behaviors, and improving physician services. Furthermore, strengthening the role of primary care services in this regard would also be a significant contribution.</p><p><strong>Clinical trial: </strong>Not applicable.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators for using research-based knowledge - A qualitative study on first-line managers' perspectives in municipal health and care services.","authors":"Maria Bjerk, Cille Hagland Sevild, Oddvar Førland, Lars Jørun Langøien","doi":"10.1186/s12913-026-14666-0","DOIUrl":"https://doi.org/10.1186/s12913-026-14666-0","url":null,"abstract":"<p><strong>Background: </strong>Research-based knowledge (RBK), together with the users' values and preferences and employees' experiences and skills, forms the essential foundation for evidence-based practice in health services. In Norway, as well as in many other countries, local municipalities are comprehensive deliverers of health and care services. Nevertheless, they face major challenges related to accessing and integrating new research into their services. First-line managers in municipal health care are crucial in creating an organisational culture to facilitate the application of RBK. This study aims to explore barriers and facilitators for using RBK in municipal health and care based on first-line managers' experiences.</p><p><strong>Methods: </strong>We conducted individual semi-structured qualitative interviews with twelve first-line managers in municipal health care services. We did a framework analysis to explore their experiences and perspectives.</p><p><strong>Findings: </strong>Four core themes were identified from the analysis: 1) organising for RBK, with the subthemes; current barriers for employing RBK and visioning the ideal promotion of RBK, 2) culture for RBK, with the subthemes; the inner culture and culture shaped by external conditions and expectations, 3) motivation for RBK, with the subthemes; first-line managers perspectives on their own motivation for RBK and on their employees´ motivation for RBK , and 4) barriers and facilitators related to competence on RBK, which we created as an overarching theme, with competence on the individual level and the system level as subthemes.</p><p><strong>Discussion: </strong>The managers experienced a gap between what is expected and what they can do. On a national or regional level, gathering research-based information and having supporting networks could facilitate the application of RBK. Locally, ensuring RBK in strategic documents, planning competence for RBK, emphasising RBK activities and having professional development roles supporting the managers were found to be important.</p><p><strong>Conclusion: </strong>First-line managers experience several barriers and facilitators in applying RBK in clinical practice related to organisational, cultural, motivational and competence elements in municipal health care. Both on the local and national level efforts are needed to support the integration of RBK into clinical expertise and the users' experiences, thereby strengthen municipal health and care services.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}