BMC Health Services Research最新文献

{"title":"Barriers and facilitators to accessing healthcare services among elderly people living in a rural Amazonian community, Brazil.","authors":"Gleica Soyan Barbosa Alves, Fernando José Herkrath, Rosana Cristina Pereira Parente, Rita Dariene da Silva Pinheiro, Mario Vianna Vettore","doi":"10.1186/s12913-025-12945-w","DOIUrl":"10.1186/s12913-025-12945-w","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"886"},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551799","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":"Solicitude toward artificial intelligence among health care providers and its relation to their patient's safety culture in Saudi Arabia.","authors":"Hamda Ahmed Mohamed Eldesoky, DaifAllah AlThubaity, Abeer Yahia Mahdy Shalby, Fatma Abdelaziz Mohammed","doi":"10.1186/s12913-025-13001-3","DOIUrl":"10.1186/s12913-025-13001-3","url":null,"abstract":"<p><strong>Background: </strong>The healthcare sector is undergoing a digital transformation, where the integration of Artificial Intelligence (AI) plays a vital role in reshaping healthcare practices. AI technologies promise to improve work procedures, mitigate future risks, and expedite proactive patient care. This guide seeks to address the significant knowledge gap among healthcare professionals, focusing on AI's integration within healthcare systems and its impact on patient safety culture.</p><p><strong>Methods: </strong>A descriptive correlational design was implemented to explore the correlations between healthcare providers' knowledge and attitudes toward artificial intelligence (AI) and their perception of patient safety culture. A non-probability, convenient sample of 238 healthcare providers comprising physicians, nurses, and technicians working at Najran University Hospital was included in the study. Data collection was conducted using two self-reported questionnaires: the Structured Knowledge and Attitude Questionnaire on Artificial Intelligence and the Hospital Survey on Patient Safety Culture (HSOPSC).</p><p><strong>Results: </strong>The research findings indicated that the healthcare providers' knowledge and attitude toward AI are significant predictors of patient safety culture, with a combined explanatory power of 60% (R² = 0.60). Both knowledge (B = 0.296, p = .000) and attitude (B = 0.502, p = .000) show significant positive relationships with patient safety culture, indicating that higher knowledge and a more positive attitude toward AI contribute to a stronger patient safety culture.</p><p><strong>Conclusions: </strong>This study's findings emphasize the need to enhance healthcare providers' knowledge and attitudes toward AI to reinforce a culture of patient safety. Healthcare institutions are encouraged to incorporate AI-centered education and training programs to enhance providers' comprehension and confidence in leveraging AI for safer clinical practice.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"889"},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551887","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":"Providing medicines-related support for people with COPD before and after hospital discharge-a qualitative study of hospital staff perspectives.","authors":"Torbjørn Nygård, David Wright, Reidun L S Kjome, Hamde Nazar, Aase Raddum","doi":"10.1186/s12913-025-12992-3","DOIUrl":"10.1186/s12913-025-12992-3","url":null,"abstract":"<p><strong>Background: </strong>People with chronic obstructive pulmonary disease (COPD) are frequently admitted to hospital and experience challenges with their medicines. Changing service delivery to address medicines-related challenges has been shown to reduce readmissions and improve patient outcomes. Before attempting to improve medicines-related support through new interventions, it is necessary to firstly understand contextual factors surrounding the delivery of current usual care. The aim was to identify improvement areas of medicines support during and after hospital discharge, and why this support is not always provided.</p><p><strong>Methods: </strong>Hospital pulmonary ward staff were included in a focus group and semi-structured interviews. Data were analysed through systematic text condensation.</p><p><strong>Results: </strong>Six major themes were developed and classified as organisational or practitioner level. Organisational level themes were: (1) transfer between care levels is challenging, (2) follow-up lacks coordination, and (3) low financial resources. Practitioner level themes were: (4) competence about COPD is needed, (5) clarification of professional role and task distribution, and (6) practitioners need to educate and support patients.</p><p><strong>Conclusions: </strong>Medicines support for people with COPD during and after discharge would benefit from undertaking medicines reconciliation and increasing coordination across care levels. Furthermore, choice of inhaler devices should not be limited by reimbursement systems. Medicines support interventions should be adapted for primary and secondary care settings or include collaboration across care levels.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"899"},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551885","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":"Recruiting patients into a healthcare services trial: lessons learned from a feasibility study to investigate a patient-oriented navigation intervention for age-associated diseases.","authors":"Kathrin Gödde, Hella Fügemann, Ulrike Grittner, Raphael Kohl, Andreas Meisel, Thomas Reinhold, Nina Rieckmann, Susanne Schnitzer, P Markus Deckert, Nikolaj Frost, Christian H Nolte, Stephan J Schreiber, Ute Goerling, Christine Holmberg","doi":"10.1186/s12913-025-13023-x","DOIUrl":"10.1186/s12913-025-13023-x","url":null,"abstract":"<p><strong>Background: </strong>Interventions to improve care coordination, like patient navigation programs, aim to dismantle barriers faced by patients in accessing optimal care. A variety of interventions are currently being evaluated in Germany and internationally. A key challenge of these studies, as for trials in general, is finding an effective recruitment strategy to reach the intended sample size in the targeted population.</p><p><strong>Methods: </strong>Detailed documentation of the recruitment process was conducted as part of the process evaluation for a mixed-methods feasibility study including randomized trials and parallel cohort studies to evaluate a patient-oriented navigation program. Patients with lung cancer and stroke were actively recruited in inpatient and specialized outpatient settings in a rural and a metropolitan area in Germany between June 2021 and September 2022. Reasons for excluding or not approaching patients were documented and patients' reasons for refusal were assessed. All quantitative data were analysed in a descriptive manner. Experiences during the recruitment process were investigated through interviews with recruiting personnel and analysed through thematic analysis.</p><p><strong>Results: </strong>The data from the screening and recruitment process show that 74-76.5% of stroke patients and 91-93% of lung cancer patients were eligible to take part in the study. Of these, 44-46.9% of inpatients and 73% of outpatients were actively approached for recruitment. Reasons for not approaching patients were mainly due to organizational and contextual factors. Documented reasons for patients' refusal to participate in the study included feeling overwhelmed (stroke patients) and not perceiving the study as relevant (lung cancer patients).</p><p><strong>Conclusions: </strong>The presented experiences and barriers during the recruitment process for a feasibility study of a patient navigation program provide important lessons for future planning of appropriate recruitment strategies to enrol patients with age-associated diseases.</p><p><strong>Trial registration: </strong>The study was registered at the German Clinical Trials Register (DRKS-ID: DRKS00025476, Registration Date: 04/06/2021).</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"883"},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551886","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":"Digitalizing informed consent in healthcare: a scoping review.","authors":"Mascha Goldschmitt, Patricia Gleim, Sekina Mandelartz, Philipp Kellmeyer, Thomas Rigotti","doi":"10.1186/s12913-025-12964-7","DOIUrl":"10.1186/s12913-025-12964-7","url":null,"abstract":"<p><strong>Background: </strong>Traditional paper-based informed consent for medical procedures poses a number of challenges, such as low comprehensibility, lack of customization, and limited time for discussion with medical staff. Digitalization, especially in light of the rapid development of AI-based technologies, could provide a solution.</p><p><strong>Methods: </strong>This scoping review explores the digitalization of the consent process, focusing on the types of technologies used, their role in the consent process, evaluation results, and success factors for implementation. Following the guidance of the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis for scoping reviews, we searched various databases and platforms (Web of Science, EBSCOHost, PubMed and PubPsych) for eligible articles published between January 2012 and June 2024.</p><p><strong>Results: </strong>Title and abstract screening of 4287 records resulted in the inclusion of 27 studies for analysis. The findings suggest that digitalizing the consent process can enhance recipients' understanding of clinical procedures, potential risks and benefits, and alternative treatments. Mixed evidence exists on patient satisfaction, convenience, and perceived stress. The limited research on healthcare professionals indicates that time savings are the major benefit. AI-based technologies seem to be not yet suitable for use without medical oversight.</p><p><strong>Conclusions: </strong>Overall, few interactive technologies have been evaluated in the patient consent process, and only recently have studies started to examine the use of AI technologies. This indicates an early stage of the digitalization of patient consent for medical diagnosis and treatment. However, there is great potential to optimize the consent process for both patients and healthcare professionals. Methodologically sound studies are needed to validate these findings.</p><p><strong>Trial registration: </strong>The scoping review was initially preregistered with PROSPERO (CRD42023397681) as a systematic review. The reasons for the change to a scoping review are outlined in the registration, while the systematic approach to data extraction and analysis was maintained.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"893"},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551802","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":"Decolonizing global health: a scoping review.","authors":"Deena Mehjabeen, Kyle Patel, Rahul M Jindal","doi":"10.1186/s12913-025-12890-8","DOIUrl":"10.1186/s12913-025-12890-8","url":null,"abstract":"<p><p>We summarize research on decolonizing global health and highlight existing gaps, including the lack of a formal definition and clear aims for the movement. We examine the decolonization of global health curricula and authorship in indexed journals, aiming to build a shared understanding among global health scholars. The review included studies from all global regions to ensure comprehensive geographical representation. Of the 155 identified records, most were published from 2021 onward and predominantly originated from the Global North. Studies focusing solely on racism were excluded. Additionally, non-English publications and studies prior to 2019 were excluded, which may have limited insights from other perspectives, such as those available in Spanish from Latin America. The included studies centered on topics such as curricula, the COVID-19 pandemic, and equity in authorship for Global South scholars. However, despite these discussions, voices from the Global South remain underrepresented in indexed journals, and there is limited focus on actionable strategies for shifting power dynamics to foster true decolonization in global health governance and funding. To address these issues, we recommend mentorship programs targeted at academics from the Global South, focusing on research capacity-building, grant writing, and leadership development. We call for broader structural reforms, including equitable funding allocation, the decolonization of research agendas, and the dismantling of hierarchical systems that privilege voices from the Global North over the Global South. The creation of collaborative networks focused on decolonization is critical in demonstrating a commitment to dismantling oppressive systems and fostering equity. While some progress has been made, further research is needed to explore how funding, knowledge systems and publishing can be more equitably distributed, supporting a truly decolonized global health agenda that advances social justice and health equity.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"828"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538172","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":"Developing user-friendly ambulatory referrals: a quality improvement study in GI referral services at a large academic safety net hospital system.","authors":"Aaron Gerard Issac, Wendy Du, Alix Youngblood, Wilhelmina Prinssen, Kelly Carroll, Robert Geller, Palak Patel, Bhavin Adhyaru, Jason Brown","doi":"10.1186/s12913-025-12976-3","DOIUrl":"10.1186/s12913-025-12976-3","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"832"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538173","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":"Economic impact of TAVI pathway optimisation: the experience of the University Hospital of Parma.","authors":"Simone Fanelli, Gianluca Lanza, Lorenzo Pratici, Giorgio Benatti, Luigi Vignali","doi":"10.1186/s12913-025-13021-z","DOIUrl":"10.1186/s12913-025-13021-z","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter Aortic Valve Implantation (TAVI) has emerged as a standard of care for patients suffering from symptomatic severe aortic stenosis. However, organisational analyses and investigations of this intervention's economic impact are lacking. This study aims to assess the potential impact of implementing a process designed to optimise the TAVI pathway regarding organisational, human, material, and economic resources.</p><p><strong>Methods: </strong>The research is conducted through a case study. The methodology consisted of three stages: (1) mapping of the current TAVI pathway; (2) identification of the organisational changes necessary to optimise it and implementation of the identified action with a multidisciplinary teamwork; (3) simulations of the organisational and economic impact of the optimisation process. Data related to costs, revenues, and activities were provided by the hospital's Management Control office. The data analysed refer to a 12-month period. The TAVI pathway optimisation presented in this analysis is aligned with the best practices described in the BENCHMARK study.</p><p><strong>Results: </strong>The analysis of the current TAVI pathway in the studied hospital highlighted several critical points during the three phases of the course (pre-procedure, peri-procedure, and post-procedure). The working groups identified five areas for TAVI pathway improvement: patient and family education, coronary risk stratification, conduction disorders management, fast-track discharge eligibility, nurse-led rapid mobilisation and early discharge. The organisational solutions highlighted by the working groups outline a new TAVI pathway capable of generating a significant impact not only from an organisational point of view, but also from an economic point of view. We estimated that in our cohort TAVI optimisation would have saved approximately 112 ICCU bed-days and have led to an average cost reduction of about €3,900 per patient.</p><p><strong>Conclusions: </strong>This study showed a process of optimisation of the TAVI pathway highlighting the positive impacts for patients, caregivers, healthcare workers, and the hospital. A Clinical Valve Coordinator may help to manage the procedural programme for individual patients while maintaining seamless communication with the Heart Team throughout the patient care journey, making the process even more streamlined. The case study analysed can be useful to all hospitals wishing to undertake processes aimed at improving the TAVI pathway.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"835"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538179","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":"Work engagement: the key driver in transforming organizational commitment into enhanced work performance among midwives in Ghana - a structural equation modelling approach.","authors":"Iddrisu Sisala Mohammed, Abubakari Wuni, Brenda Abena Nyarko, Mudasir Mohammed Ibrahim, Letitia Chanayireh","doi":"10.1186/s12913-025-13062-4","DOIUrl":"10.1186/s12913-025-13062-4","url":null,"abstract":"<p><strong>Background: </strong>Midwives play a pivotal role in maternal and child health systems, yet their performance is profoundly shaped by organizational commitment and work engagement.</p><p><strong>Aim: </strong>This study examined the mediating effect of work engagement on the relationship between organizational commitment and work performance among midwives in Ghana.</p><p><strong>Method: </strong>An analytical cross-sectional design was employed in this study. Data were collected from 254 midwives using validated scales to assess organizational commitment, work engagement, and work performance. Analyses were conducted using SPSS Statistics and AMOS for structural equation modeling (SEM).</p><p><strong>Results: </strong>Most participants were female (96.9%) and aged 30-39 years (54.3%). Organizational commitment was positively correlated with work engagement (r = 0.125, p < 0.05) and work performance (r = 0.166, p < 0.05). Work engagement also showed a strong positive correlation with work performance (r = 0.662, p < 0.05). Mediation analysis confirmed that work engagement fully mediated the relationship between organizational commitment and work performance (β = 0.078, SE = 0.061, p < 0.001).</p><p><strong>Conclusion: </strong>The results of the study highlight the vital role of work engagement as a positive and significant mediator between organizational commitment and work performance among midwives. Investing in strategies that boost midwives' commitment and engagement is essential for strengthening maternal healthcare quality and workforce sustainability.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"840"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538207","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":"Classification of medical imaging technologies: results from Türkiye.","authors":"Hakan Temiz, Tuncay Kara","doi":"10.1186/s12913-025-12997-y","DOIUrl":"10.1186/s12913-025-12997-y","url":null,"abstract":"<p><strong>Background: </strong>Regional disparities in access to medical diagnostic imaging technologies (MDITs) present a significant barrier to achieving health equity, particularly in developing countries. Understanding how these technologies are distributed and utilized is essential for informing equitable health policy.</p><p><strong>Method: </strong>This study examines the distribution and utilization of MDITs across Türkiye's 12 NUTS regions using a hierarchical clustering approach. Unlike previous studies, the analysis incorporates both technological capacity and utilization (CaU) variables, evaluated jointly and independently. Imaging modalities are also stratified based on their technological complexity and investment requirements to capture nuanced regional patterns.</p><p><strong>Results: </strong>Findings indicate that although Türkiye demonstrates an overall balanced distribution of MDITs, notable regional disparities in utilization efficiency remain. Regions exhibiting similar usage patterns tend to cluster together irrespective of geographic proximity. Interestingly, the clusters often transcend geographical proximity; regions located at opposite ends of the country tend to cluster on the basis of similar utilization patterns. This may suggest that disparities between administrative centers and rural areas are less pronounced than previously assumed. These patterns imply that institutional capacity, healthcare workforce distribution, and demographic demand may have a stronger influence on utilization than spatial location.</p><p><strong>Conclusion: </strong>The study highlights a disconnect between capacity and actual use of diagnostic imaging technologies, underscoring the need for targeted policy interventions. It also suggests that regional utilization patterns may align more with functional similarities than with geographic proximity. Moreover, analyzing technological capacity and utilization variables separately-rather than as a combined index-yielded more transparent and objective insights into regional disparities. These findings contribute to optimizing health resource allocation and support evidence-based policymaking aimed at advancing equitable access to diagnostic services, aligning with Türkiye's commitment to universal health coverage.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"847"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538169","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}