BMC Health Services Research最新文献

{"title":"Information sources as determinants of use of formal long-term care: a cross-sectional study in Taiwan.","authors":"Yu-Hung Chang, Chia-Hui Hsu, Yu-Chun Tseng, Wan-Chun Yang, Hung-Yi Chiou","doi":"10.1186/s12913-025-12814-6","DOIUrl":"https://doi.org/10.1186/s12913-025-12814-6","url":null,"abstract":"<p><strong>Background: </strong>An ageing population has heightened the need for long-term care (LTC) access. It is not well understood how information sources, both formal and informal, impact the utilisation of LTC. This study aims to investigate the influence of formal and informal sources on the utilisation of LTC services by Taiwanese families employing migrant live-in caregivers.</p><p><strong>Methods: </strong>This study employed a cross-sectional design and used a structured telephone survey to collect data from 441 registered employers from households employing migrant caregivers. This included 216 families using LTC and 225 not using LTC. We collected data on the characteristics of employers and care recipients, as well as LTC-related information sources. Our formal sources (FS) included government promotional events, LTC community site volunteers, healthcare providers, and local LTC management centres, while informal sources (IS) comprised community leaders, friends and relatives, TV, print media, internet, and patient support groups. We assessed perceived information gaps by asking questions about reasons for not using LTC. We used logistic regressions to analyse the associations of FS and IS with LTC use, employer and care recipient characteristics, and perceived information gaps.</p><p><strong>Results: </strong>A higher number of FS was positively associated with LTC usage, while an increase in IS was negatively associated. FS and IS were associated with employer socio-demographics such as gender, education level, and care recipient factors, including living arrangements and care needs. FS reduced perceived information gaps, but IS did not.</p><p><strong>Conclusions: </strong>Information sources significantly influence the use of LTC among families employing migrant caregivers. Our findings suggest that LTC authorities should implement strategies to enhance the accessibility of formal information sources, while also leveraging informal sources more effectively to support accurate and timely LTC decisions for these families and the wider public.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"910"},"PeriodicalIF":2.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558963","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":"Looking ahead! the feasibility of implementing remote patient monitoring for high-risk oncology patients.","authors":"AnnMarie Mazzella-Ebstein, Hayley Dunnack-Yackel, Robert Michael Daly, Andrew L Salner, Mary Kate Eanniello, Sara Fontaine, Jennie Huang, Camila Bernal, Clare Wilhelm, Jill Ackerman, Katherine S Panageas, Gilad Kuperman, Jun Mao, Margaret Barton-Burke","doi":"10.1186/s12913-025-12947-8","DOIUrl":"https://doi.org/10.1186/s12913-025-12947-8","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"918"},"PeriodicalIF":2.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558964","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":"Health indicators and human development: developing a new health governance index with the case of Türkiye.","authors":"Bircan Kara","doi":"10.1186/s12913-025-13007-x","DOIUrl":"https://doi.org/10.1186/s12913-025-13007-x","url":null,"abstract":"<p><strong>Introduction: </strong>Economic development is influenced by GDP, educational attainment, production capacity, and health service indicators. The sustainability of human capital and production capacity depends on high-quality healthcare services supported by efficient governance. This study aims to construct a health governance index by analyzing the relationship between health indicators and the Human Development Index (HDI) in Türkiye.</p><p><strong>Method: </strong>This study utilizes a logarithmic differencing model to analyze quarterly data from Q1 2002 to Q4 2020. Annual health expenditure data is transformed into quarterly data. The methodology includes assessing data properties, testing for nonlinearity using the BDS (Brock, Dechert, and Scheinkman) test, and exploring quantile-based relationships using Quantile-on-Quantile Regression (QQR). To further confirm the results, Quantile Regression (QR) is applied to analyze the differential effects across various quantiles.</p><p><strong>Variables: </strong>Key variables include the Medical Service Quality Index (MDSQI), the Medical Service Capacity Index (MDSCI), and the Human Development Index (HDI). The study also considers the Health Economic Performance Capacity (HEPC) as an additional indicator to assess the broader health governance impact.</p><p><strong>Results: </strong>The analysis reveals that the majority of data exhibits non-normal distribution characteristics. Significant improvements in the MDSQI and MDSCI positively influence both the HDI and HEPC in Türkiye. The findings suggest that better management of healthcare services correlates with higher human development outcomes. Robustness checks confirm the consistency and reliability of the results.</p><p><strong>Conclusion: </strong>Efficient management of healthcare services and capacity significantly impacts HDI and HEPC in Türkiye. Increased healthcare expenditures enhance service quality and capacity, contributing to overall human development. Policy recommendations include investment in preventive healthcare, ensuring equal access, integrating health technology, enhancing human resource training, implementing inclusive health insurance, and securing sustainable funding to improve healthcare quality and ensure comprehensive coverage.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"920"},"PeriodicalIF":2.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558909","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":"Self-directed learning of informal caregivers using mobile health: a systematic review.","authors":"Dauster Souza Pereira, Priscilla Perez da Silva Pereira","doi":"10.1186/s12913-025-13019-7","DOIUrl":"https://doi.org/10.1186/s12913-025-13019-7","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"911"},"PeriodicalIF":2.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558969","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":"Setting up a comprehensive traffic injuries registry system in hospitals: a qualitative study on barriers and challenges.","authors":"Homayoun Sadeghi-Bazargani, Mina Golestani, Saber Azami-Aghdash, Ali Jafari-Khounigh, Leila Jahangiry, Elham Davtalab Esmaeili, Sepideh Harzand-Jadidi","doi":"10.1186/s12913-025-12961-w","DOIUrl":"https://doi.org/10.1186/s12913-025-12961-w","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"902"},"PeriodicalIF":2.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558970","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":"Spanish Hospital Cost Network Database: building a national benchmark from cost accounting practices.","authors":"Marc Carreras, Elisabet Buj-Gómez, Rocio Guerrero-Salinas, Mónica Núñez-García, Pere Oliveras-Alsina, Judit Pons-Cuni, Francesc Cots","doi":"10.1186/s12913-025-13059-z","DOIUrl":"https://doi.org/10.1186/s12913-025-13059-z","url":null,"abstract":"<p><strong>Background: </strong>Crucial input for a wide range of healthcare management decisions is cost information: pricing services, benchmarking etc., as well as the economic evaluation of health technologies and policies all require accurate cost data and exactly where to find such cost information remains a critical issue. The aim of this article is to describe the Spanish Hospital Cost Network Database characteristics and the underlying cost accounting criteria.</p><p><strong>Construction and content: </strong>The database includes episode-level cost information from of 34 Spanish hospitals, representing 11% of the Spanish National Health System in 2021 (n = 4,788,080 episodes collected since the creation of the network in 2008). Each episode is described according to a vector containing clinical variables, administrative variables and cost components. Key assumptions include full costs, combination of top-down and bottom-up micro-costing and Time-Driven Activity-Based Cost allocation.</p><p><strong>Utility and discussion: </strong>The main output of the RECH dataset is the distribution of costs for a previously user-defined episode of care. Cost statistics, length of stay statistics and the detail of cost components are presented for six example episodes: Breast cancer surgery, Child delivery, Coronary artery bypass, Covid-19, Hip replacement and Inguinal hernia surgery. The fundamental methodological assumptions of the Spanish Hospital Cost Network Database are consistent with those from the HealthBASKET and EuroDRG projects. The results of the dataset are freely available.</p><p><strong>Conclusions: </strong>The need to improve cost information is well defended from different perspectives in the literature. Throughout this work we have presented the methodologies underpinning the RECH project.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"901"},"PeriodicalIF":2.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558971","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":"Evaluation of the responsiveness of the Iranian health system to the needs of the elderly during the COVID-19 pandemic: a community-based study.","authors":"Sepideh Niazie, Heshmatolah Heydari, Hadi Hayati, Ali Dehghanie","doi":"10.1186/s12913-025-13018-8","DOIUrl":"10.1186/s12913-025-13018-8","url":null,"abstract":"<p><strong>Background: </strong>The elderly population is growing globally. As a vulnerable part of society, the elderly are exposed to more harm when facing pandemics of infectious diseases, so the quality of the health system's response is critical for these individuals. Considering a paucity of studies in this area, this research assessed the responsiveness of the Iranian health system to the needs of the elderly during the COVID-19 pandemic.</p><p><strong>Methods: </strong>This cross-sectional descriptive-analytical study was conducted on 259 elderly at the Lorestan University of Medical Sciences from April to September 2022. A combination of stratified multi-stage cluster systematic sampling, was used to recruit participants. The WHO Multi-country Survey Study on Health and Responsiveness was used for data collection. Data were analyzed by using SPSS v.24 software and descriptive/inferential statistics such as the Kolmogorov-Smirnov test, Pearson correlation, independent t-test, ANOVA, and multivariate regression at the statistical significance level of P <.05.</p><p><strong>Results: </strong>The data analysis revealed that the overall responsiveness of Iran's health system was average (79.99 ± 11.4). The best dimension of responsiveness was access to family support (10.17 ± 1.3), and autonomy was the weakest (7.46 ± 2.5). According to multiple linear regression analysis, the variables of age, gender, education level, medical history, number of children, marital status, and monthly income had a significant relationship with the total health responsiveness score (P <.005). According to the adjusted R² of 0.94, this regression model was able to explain 94% of variations in the mean total responsiveness score.</p><p><strong>Conclusion: </strong>The results showed that the Iranian health system's performance in responding to the needs of the elderly during the COVID-19 pandemic was acceptable. These findings can help the health system promote its responsiveness during future epidemics and pandemics and better fulfill the needs of the elderly. Since infrequent studies are available in this field, various dimensions of responsiveness are suggested to be investigated more deeply.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"887"},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551804","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":"Impact of the DEDICATED approach to optimizing palliative care for people with dementia: a multi-method study.","authors":"Jesper M A Biesmans, Sascha R Bolt, Niels Hameleers, Jos M G A Schols, Jenny T van der Steen, Sandra M G Zwakhalen, Daisy J A Janssen, Judith M M Meijers","doi":"10.1186/s12913-025-13063-3","DOIUrl":"https://doi.org/10.1186/s12913-025-13063-3","url":null,"abstract":"<p><strong>Background: </strong>Palliative care can improve the quality of life of people with dementia. However, nurses and other healthcare professionals often lack the confidence and skills to provide palliative care and struggle to initiate timely conversations about wishes and needs for palliative care. The DEDICATED approach aims to enhance the quality of palliative dementia care by improving knowledge, competencies, and interprofessional collaboration of healthcare professionals. This study explores its impact on palliative care provision from the perspectives of: (1) healthcare professionals implementing the approach; (2) their care team members; and (3) bereaved family caregivers.</p><p><strong>Methodology: </strong>This multi-method evaluation study used: (1) qualitative interviews with those who had acted as ambassadors in implementing the DEDICATED approach; (2) questionnaires measuring perceived self-efficacy, work engagement, and psychological empowerment among healthcare professionals working in these ambassadors' teams; and (3) questionnaires with bereaved family caregivers exploring the frequency of advance care planning discussion and their experiences with the end-of-life care provided to their relative with dementia.</p><p><strong>Results: </strong>The DEDICATED approach was implemented across 28 wards in three healthcare organizations. Interviews with ambassadors (n = 17) revealed that the approach raised awareness about person-centered palliative care and the importance of timely advance care planning (ACP) for people with dementia. DEDICATED showed no significant impact on healthcare professionals' self-efficacy, work engagement, and psychological empowerment. The frequency of ACP discussion and quality of end-of-life care showed no significant differences over time.</p><p><strong>Conclusion: </strong>DEDICATED ambassadors found the DEDICATED approach to be of value in enhancing person-centered palliative care. Although quantitative assessments of healthcare professionals' competence did not fully capture this, the positive feedback received suggests that more time may be needed for the approach to be fully integrated into practice. This could explain the modest results observed among team members and bereaved family caregivers. Future research should explore the long-term impact of the DEDICATED approach using longitudinal study designs.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"882"},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551807","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":"Development of a healthcare utilisation index to compare patients worldwide: a cross-sectional study.","authors":"Gregor John, Dominik Rebell, Jacques Donzé","doi":"10.1186/s12913-025-13029-5","DOIUrl":"10.1186/s12913-025-13029-5","url":null,"abstract":"<p><strong>Background: </strong>There is no simple tool for synthesising the total volume of different healthcare services a patient utilizes into a single meaningful measure. We aimed to develop such an instrument and explore its associations with two broad health indicators: mortality and life expectancy.</p><p><strong>Method: </strong>We constructed the Healthcare Utilisation (HUTIL) index to sum the weighted volume of healthcare services used over a given period. Each healthcare service's weighting was calculated using worldwide median ratios between that service's costs and those of a consultation with a primary care physician (PCP). Data were obtained from the literature and internet searches. Next, we calculated the annual average HUTIL index per capita for European countries by collecting data available from their statistical offices and the European Union. Life expectancy at birth and mortality rates per 100,000 inhabitants were used to compare countries with HUTIL index scores above and below the continental median.</p><p><strong>Results: </strong>In 63 countries worldwide, ratios of healthcare costs to PCP costs were 2 (IQR: 2-3) for a consultation with a specialist, 4 (IQR: 2-6) for an emergency department consultation, 0.5 (IQR: 0.4-0.8) for a home visit by a nurse and 8 (IQR: 4-17) for a day spent in hospital. Using these weigthing factors, an annual average HUTIL index per capita was calculated for 26 European countries. Countries with HUTIL index scores above the continental median had higher mortality rates (1047 deaths per 100,000 inhabitants [IQR: 979-1321] vs. 889 [IQR: 778-930]; p < 0.01) and lower life expectancy (78.2 years [IQR: 76.1-81.3] vs. 82.0 [IQR: 81.5-82.6]; p = 0.01) than countries with lower HUTIL index scores.</p><p><strong>Conclusions: </strong>Healthcare cost ratios were remarkably constant around the world. Based on these ratios, the HUTIL index could become a new, globally applicable tool to facilitate future research into healthcare services utilisation.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"895"},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551801","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":"Facilitators and barriers of healthcare financing modalities for universal maternal healthcare services in East Africa: a qualitative systematic review.","authors":"Ayal Debie, Annabelle Wilson, Alehegn Bishaw Geremew, Claire T Roberts, Molla M Wassie, Jacqueline H Stephens","doi":"10.1186/s12913-025-13010-2","DOIUrl":"10.1186/s12913-025-13010-2","url":null,"abstract":"<p><strong>Background: </strong>Universal health coverage is an approach that ensures all people have access to quality essential health services without facing financial hardship. Despite all United Nations Member States' aim to achieve universal health coverage by 2030, many low-income countries need help in funding and providing adequate maternal healthcare services. Thus, this review summarizes vital facilitators and barriers to healthcare financing modalities for universal maternal healthcare services in East Africa.</p><p><strong>Methods: </strong>Seven databases, including Medline, Scopus, Web of Science, Cochrane, CINAHL, Psych Info, and ProQuest, were used for article searching. We used four broad domains of search terms: maternal health, East Africa, mixed-method, and qualitative. Joanna Briggs Institute for qualitative studies and Mixed Methods Appraisal Tool for mixed method studies quality appraisal were used to evaluate the quality of studies. Thematic synthesis was conducted using data-driven headings.</p><p><strong>Results: </strong>Sixty-nine articles were included in this review. Fee removal for maternal healthcare services, free ambulance services, sharing of financial costs, and subsidization of insurance premium load for low-income groups improved women's access to maternal healthcare services. In addition, direct disbursement of funds to primary healthcare reduced procurement delays, enhanced outreach services, and strengthened engagement with community leaders which can help to improve maternity care delivery. On the contrary, the cost of direct medical services, direct non-medical costs, indirect costs, informal payments, and ineffective revenue and insurance management were the healthcare financing-related barriers to maternal healthcare services.</p><p><strong>Conclusion: </strong>High out-of-pocket expenditures and lack of funding were still critical challenges for universal maternal healthcare services. Therefore, reconsideration of non-medical costs to be covered under the free maternal healthcare policy and health insurance scheme will be a valuable intervention. Reimbursement of the expenses of medical services prescribed to private health facilities will be supportive of mothers' healthcare uptake. Integrating informal solutions into the formal healthcare system and taking measures to minimize corruption and ensure transparency can also help to improve overall maternal healthcare services.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"897"},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551805","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}