BMC Health Services Research最新文献

{"title":"Exploring communication between pharmacists and infection control staff: a qualitative study in ministry of health hospitals, Riyadh, Saudi Arabia.","authors":"Abdullah U Althemery, Abdullah Alfaifi, Ahmed Alshehri, Nehad Ahmed, Saad Alaeena, Abdullah Aljahan","doi":"10.1186/s12913-025-13556-1","DOIUrl":"10.1186/s12913-025-13556-1","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1372"},"PeriodicalIF":3.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312085","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 status and care utilization among Afghan refugees recently resettled in Calgary, Canada between 2011-2020.","authors":"Hannah Smati, Nour Hassan, Mohammad Yasir Essar, Fawzia Abdaly, Shayesta Noori, Rabina Grewal, Eric Norrie, Rachel Talavlikar, Julia Bietz, Sarah L Kimball, Annalee Coakley, Avik Chatterjee, Gabriel E Fabreau","doi":"10.1186/s12913-025-13544-5","DOIUrl":"10.1186/s12913-025-13544-5","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1373"},"PeriodicalIF":3.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312025","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":"Digital evolution and emerging inequalities in healthcare: a scoping review through the lens of knowledge management.","authors":"Walter Vesperi, Marzia Ventura, Concetta Lucia Cristofaro, Anna Maria Melina","doi":"10.1186/s12913-025-13302-7","DOIUrl":"10.1186/s12913-025-13302-7","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1371"},"PeriodicalIF":3.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12532871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145306700","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":"Treatment variability for shoulder pain between physician and non-physician clinicians based on initial setting and specific shoulder diagnosis: a health system analysis.","authors":"Daniel I Rhon, Maggie E Horn, Hui-Jie Lee, Sarah Morton-Oswald, Steven Z George","doi":"10.1186/s12913-025-13175-w","DOIUrl":"10.1186/s12913-025-13175-w","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1370"},"PeriodicalIF":3.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298265","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":"Evaluating the impact of easy-to-understand patient letters after discharge on patients' health literacy: a randomized controlled study.","authors":"Henna Riemenschneider, Annika Rettich, Henriette Hoffmann, Rebekka Post, Ronny Zenker, Karen Voigt, Antje Bergmann, Ansgar Jonietz","doi":"10.1186/s12913-025-13464-4","DOIUrl":"10.1186/s12913-025-13464-4","url":null,"abstract":"<p><strong>Background: </strong>More than half of the German population has considerable difficulties in understanding health information, reflecting limited health literacy, which is associated with poorer health outcomes. Personalized, automatically generated, easy-to-understand discharge letters (patient letters) are designed to improve patients' comprehension of medical information after hospital discharge. This study investigated whether these letters improve health literacy in cardiologic patients and explored their perceptions.</p><p><strong>Methods: </strong>This randomized controlled study included 738 patients discharged from a heart center in Dresden, Germany. The control group (CG; n = 375) received a conventional discharge letter only, whereas the intervention group (IG; n = 363) additionally received a software-generated patient letter by post. Five to nine days later, participants received a sociodemographic survey and the HLS-EU-Q16 health literacy questionnaire. IG participants additionally evaluated the patient letter, and n = 15 were interviewed qualitatively to gain deeper insights.</p><p><strong>Results: </strong>Post-intervention, IG participants had significantly higher health literacy than CG participants (p = .002, Mann-Whitney U test). Over 90% of IG participants rated the patient letter as helpful, comprehensible and informative. Qualitative interviews revealed a largely positive attitude toward patient letters, along with some suggestions for content improvement.</p><p><strong>Conclusions: </strong>Patient letters were associated with higher post-intervention health literacy in cardiologic patients and were well received. These results suggest that broad implementation of patient letters may benefit both patients and healthcare providers by enhancing patients' understanding of medical information regarding diagnoses and treatment, potentially contributing to improved health-related outcomes.</p><p><strong>Trial registration: </strong>The study was retrospectively registered in the German Clinical Trials Register on December 13, 2024 under the number DRKS00035706.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1366"},"PeriodicalIF":3.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298101","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":"Digitally dedicated nurses: a nationwide cross-sectional study of associated career and digital factors in the workplace.","authors":"Lotta Virtanen, Emma Kainiemi, Anu-Marja Kaihlanen, Tuulikki Vehko, Tarja Heponiemi","doi":"10.1186/s12913-025-13333-0","DOIUrl":"10.1186/s12913-025-13333-0","url":null,"abstract":"<p><strong>Background: </strong>Nurses need job dedication to manage demanding working conditions, deliver high-quality care, and sustain professional interest. This dedication expands into digital dedication with electronic health records (EHRs) and other health information systems (HISs) prevailing in the nursing working day, combined with technologies for remote client interactions. This study examined (1) nurses' digital dedication, (2) its variation based on career stage, position, EHR training opportunities, supportive HISs, and technology in use at work, and (3) whether EHR training opportunities moderate the association between career stage and digital dedication.</p><p><strong>Methods: </strong>A nationwide cross-sectional survey for registered nurses (N = 2926) was conducted in spring 2023 in Finland. Digital dedication was measured by perceived enthusiasm, inspiration, and pride in using nursing technologies. Associations of independent variables with dedication were analysed using linear regression, adjusted for background factors.</p><p><strong>Results: </strong>The mean digital dedication score was 2.91 (SD = 1.10, scale 1-5), indicating occasional dedication. In the multivariable model, late career stage was associated with lower dedication compared to early career stage (b = - 0.46, 95% CI [- 0.63, - 0.29]). EHR training opportunities moderated this association, weakening the negative effect of late career stage for those with training (b = 0.31, 95% CI [0.01, 0.62]). Additionally, nurse managers (b = 0.39, 95% CI [0.25, 0.52]), those using multiple HISs (b = 0.21, 95% CI [0.13, 0.30]), and working digitally with clients (b = 0.31, 95% CI [0.21, 0.40]) had higher scores compared to their counterparts. A stronger agreement with supportive HISs was associated with higher scores (b = 0.23, 95% CI [0.18, 0.28]).</p><p><strong>Conclusions: </strong>Digital dedication among nurses in Finland appears to be modest. Ensuring ongoing EHR training that addresses late career nurses' needs is crucial; it can elevate their dedication to early career levels. Regular team discussions on technology use could enable managers to foster greater staff dedication. When invested in systems that genuinely support tasks, greater technology use can also improve dedication. Promoting digital dedication in nursing is important, as it could enable new roles in digital and remote work, particularly benefitting those for whom traditional roles have become too physically demanding.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1365"},"PeriodicalIF":3.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298103","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":"\"I think it is quite naive to think everybody's goal is that\": how Zambian sexual violence stakeholder perspectives complicate global health roadmaps to 'decolonization'.","authors":"Nancy Nyutsem Breton, Nancy Lwimba Mukupa, Mazuba Mushota-Mafwenko","doi":"10.1186/s12913-025-13188-5","DOIUrl":"10.1186/s12913-025-13188-5","url":null,"abstract":"<p><strong>Background: </strong>The global health and development field is embracing calls to decolonize, producing 'roadmaps' to decolonial practices. These calls are echoed in the field of sexual and gender-based violence (SGBV), where entrenched global structural power relations undermine the potential for the community-centered, liberatory change to which decolonial roadmaps aspire. Despite the ubiquity of such calls, empirical research on the prospects for their implementation remains limited. This paper investigates the readiness among SGBV-related institutions in Zambia to address coloniality. We ask: can a decolonial praxis be realized amidst entrenched barriers, and is the global health and development industry ready to implement roadmaps for decolonization?</p><p><strong>Methods: </strong>We conducted 19 interviews with Zambia-based donor, implementing agency, and grassroots stakeholders involved in SGBV policy and programs. We performed a critical thematic analysis to explore the complexities within the country's SGBV interventions.</p><p><strong>Results: </strong>While the Zambian Anti-Gender-Based Violence Act and subsequent policies aimed to transform the SGBV landscape by establishing a systemized approach, we find considerable discrepancies between intervention expectations and the local implementation realities. Norms contributing to SGBV, a perception of a \"bad\" Zambian culture, and conflicting social values impede the impact of legal instruments. These challenges not only hinder sustainable implementation of transformative policies, but also reflect deeper structural and epistemic inequities that undermine efforts to pursue a decolonial praxis. As such, they illuminate how colonial legacies continue to shape policy and intervention outcomes and constrain the feasibility of decolonization in practice.</p><p><strong>Conclusion: </strong>This paper argues that addressing power dynamics and profit-driven motives is crucial for genuine transformation and will require a recalibration of current systems. The disparity between these factors raises critical questions about decolonization and the potential for alternative, community-focused interventions which give people agency over their liberation. The current study speaks to broader global health and development discussions by spotlighting the challenges to transformative interventions in Global Majority contexts. Confronting these challenges is essential for reshaping narratives around the implementation of decolonial roadmaps and the aspiration to community empowerment.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1364"},"PeriodicalIF":3.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298557","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":"Effects of the type and quality of usual source of care on medical expenditures in adults with diabetes before and during the COVID‑19 pandemic: a panel data analysis using the Korea Health Panel (2019-2022).","authors":"Hyun-Young Shin, Kyoungwoo Kim, Hwa-Young Lee, Jae-Ho Lee","doi":"10.1186/s12913-025-13518-7","DOIUrl":"10.1186/s12913-025-13518-7","url":null,"abstract":"<p><strong>Background: </strong>South Korea experiences the highest diabetes-related hospitalization rates among OECD countries. Although integrated primary care could potentially lower preventable hospitalizations and healthcare costs, the limited uptake of a usual source of care (USC) and underdeveloped primary care services in Korea have impeded progress, and the role and functions of primary care remain insufficiently defined.</p><p><strong>Methods: </strong>This study investigated how having a USC affects medical expenditures in adults with diabetes by using Korea Health Panel data from 2019 to 2022, spanning the pre-pandemic (2019) and pandemic (2020-2022) periods. The analysis included 6,144 individuals. The main independent variable was the type and quality of USC, categorized into three groups: no USC, place-only USC, and physician-based USC. Quality was assessed by patient-reported comprehensiveness and coordination, combined into an integrated quality index. We applied panel regression analysis using the Hausman-Taylor estimation technique to address both time-varying and time-invariant covariates while mitigating endogeneity concerns.</p><p><strong>Results: </strong>Between 2019 and 2022, the proportion of individuals with a physician at a regular location serving as their USC increased from 58.5% to 66.1%, while the proportion without a physician as their USC decreased from 15.1% to 10.9%, with larger variation among vulnerable populations. The physician-based USC group consistently incurred higher absolute expenditures but showed the smallest relative increase during the pandemic, compared with sharp rises in the no-USC and place-only USC groups. Adults with diabetes whose USC was a high-quality primary care physician-defined by favorable patient ratings of comprehensiveness and coordination-were associated with approximately 13.1% lower healthcare expenditures compared to those lacking a physician as their USC (β = - 0.140, P = 0.006). Moreover, community clinic-based physicians as USC were associated with lower expenditures, while hospital-based USC was associated with higher costs, though not statistically significant.</p><p><strong>Conclusion: </strong>These findings underscore the importance of increasing access to high-quality primary care physicians as USC to optimize chronic disease management and maintain sustainable healthcare systems.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1369"},"PeriodicalIF":3.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298107","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":"The impact of digital literacy on older adults' utilization of community-based home care services: a cross-sectional study.","authors":"Xueqing Xia, Mingbao Zhu","doi":"10.1186/s12913-025-13427-9","DOIUrl":"10.1186/s12913-025-13427-9","url":null,"abstract":"<p><strong>Background: </strong>China has entered a stage of moderate aging, characterized by a \"90-7-3\" eldercare pattern: 90% of the older adults opt for home-based care, 7% utilize community-based care, and 3% reside in institutional care facilities. With the rapid development of the digital economy, innovative solutions such as smart eldercare devices and telemedicine have emerged, offering new possibilities to enhance the efficiency and quality of eldercare services. However, while benefiting from digital technologies, the older adults generally face challenges posed by the \"digital divide,\" making digital literacy a critical factor constraining the digital transformation of eldercare services.</p><p><strong>Methods: </strong>This study utilizes data from the 2020 China Longitudinal Aging Social Survey (CLASS 2020) to examine the impact of digital literacy on older adults' utilization of community-based home care services (CHCS). Factor analysis was employed to measure digital literacy levels, while probit regression and Heckman's two-stage model were applied for empirical analysis.</p><p><strong>Conclusion: </strong>Our empirical analysis yields three key findings: (1) A significant negative relationship is found between digital literacy and the utilization of CHCS. This indicates that, on average, higher digital literacy is associated with a lower propensity to use CHCS. (2) Dimension-specific analysis reveals divergent impacts: Digital application literacy was positively associated with service utilization. However, device operation literacy, information acquisition literacy, and digital social literacy all exhibited significant negative correlations with service use. (3) Mechanism analysis indicates that digital literacy reduces older adults' reliance on CHCS through multiple pathways, including increased alternative consumption expenditures, strengthened social and family support, and improved self-efficacy.</p><p><strong>Discussion: </strong>The findings suggest that improved digital literacy may reduce older adults' utilization of CHCS, providing important implications for optimizing the elderly care system in the digital era. While promoting digital literacy among older populations, policymakers should establish integrated online-offline service delivery models to achieve precise matching between seniors' needs and care provision.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1367"},"PeriodicalIF":3.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298150","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":"Choosing regional, rural, and remote practice: what attracts or deters early-career doctors?","authors":"Sonia Minooee, Susan Wright, Torres Woolley","doi":"10.1186/s12913-025-13465-3","DOIUrl":"10.1186/s12913-025-13465-3","url":null,"abstract":"<p><strong>Background: </strong>Enhancing the retention of medical professionals in regional, rural and remote (RRR) areas requires a multi-faceted strategy that acknowledges and addresses the contextual barriers doctors face when deciding whether to continue practising in RRR hospitals. Gaining a deeper understanding of these factors can inform evidence-based workforce planning and policy development to mitigate the rural physician shortage across Australia. This study aimed to explore motivators and perceived barriers among junior medical doctors when choosing their training location- whether in RRR hospitals or metropolitan settings- during the early years of postgraduate training.</p><p><strong>Methods: </strong>A qualitative study was conducted using virtual one-on-one interviews. The setting included four Hospital and Health Services (HHSs) in Northern Queensland, Australia (Townsville, Cairns, Mackay and North West). Participants were doctors in training from intern level to postgraduate year 5 (including prevocational and early vocational doctors). Twenty-five interviews were transcribed verbatim. Data were thematically analysed, through an inductive approach.</p><p><strong>Results: </strong>Most participants were female (n = 19) and aged under 29 years (n = 21). The motivations for choosing RRR hospitals among most Australian-trained doctors included proximity to family, a desire for adventure, rural upbringing, peer recommendations, and the availability of benefits through incentivisation schemes. For many recently graduated doctors, regional hospitals were considered the \"right size\", offering a broad range of specialties without feeling lost in the crowd often associated with larger metropolitan hospitals. Barriers included limited job opportunities in rural settings, challenges in securing preferred rotations, social isolation, lack of camaraderie in the workplace, and the cost of living.</p><p><strong>Conclusion: </strong>This study provides valuable insights into the key pull and push factors influencing doctors' decisions to train/ work in RRR areas. At both the HHS and national levels, these findings can help guide decision-makers and employers on where to invest to positively influence doctors' choices regarding training and practice locations. A multifaceted approach is needed, with interventions tailored to doctors' specific needs, particularly those that support family life, increase rural exposure, and offer competitive remuneration.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1368"},"PeriodicalIF":3.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298146","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}