BMC Health Services Research最新文献

{"title":"Implementing trauma-informed practice across services to support people experiencing multiple disadvantage: a mixed method study.","authors":"Michelle Farr, Emily Eyles, Tracey Stone, Maria Theresa Redaniel, Thomas Traub, Jason Burrowes, Rebecca Halsley, Katherine Williams, Aileen Edwards, Sabi Redwood","doi":"10.1186/s12913-025-13339-8","DOIUrl":"10.1186/s12913-025-13339-8","url":null,"abstract":"<p><strong>Background: </strong>People facing multiple disadvantage have often experienced extensive trauma. Changing Futures Bristol was part of a national programme to improve outcomes for people who face multiple disadvantage, such as combinations of homelessness, substance misuse, mental ill-health, domestic violence and abuse or contact with the criminal justice system. Aims were to understand how services could be improved, with more trauma-informed approaches at individual, service and system levels. An in-depth mixed method evaluation of Changing Futures Bristol examined how trauma-informed approaches were implemented and linked across services supporting people experiencing multiple disadvantage.</p><p><strong>Methods: </strong>The study followed a participatory action research approach, involving research conducted in collaboration with people who have experienced multiple disadvantage, and staff partners. Collaborators actively contributed to securing funding, research design, data analysis, and write-up. A staff survey was conducted using existing measures and some tailored questions, to assess perceptions of trauma-informed approaches, equality, diversity and inclusion, and co-production. One hundred and seventeen staff responded, with 30 staff completing the survey again after one year to track any changes. Twenty-three staff members were interviewed. Qualitative data were analysed thematically, guided by trauma-informed principles and implementation domains.</p><p><strong>Results: </strong>Movement toward more trauma-informed approaches was detected, although these changes were not found to be statistically significant after one year. Barriers included short-term funding and commissioning cycles and difficulties in staff retention, due to short-term contracts, vicarious trauma, stress and pressures of the job. Managers had to hold contradicting drivers to deliver targets and manage finances whilst creating space for relational support and trauma-informed practice. To create psychological safety, staff needed to feel trust and transparency. 73% of staff reported lived experience of at least one domain of multiple disadvantage or trauma. Support for staff is needed at all levels of the organisation.</p><p><strong>Conclusions: </strong>A long-term, collaborative, and trauma-informed approach is needed at all levels, including leaders, managers, policymakers, and central government. Government and public service reforms that focus on cross-sector collaboration and devolution of power will support trauma-informed practices. Stable, long-term funding and planning will help create a motivated, skilled workforce that can build on existing good practice.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1266"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205407","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 impacts of the national volume-based procurement policy on the chronic disease medication market in China's public hospitals: a case study of medications for diabetes.","authors":"Biao Wang, Kai Xiao, Hao Xia, Qianqian Yu, Gan Wang, Rui Huang, Junyu Niu, Li Luo","doi":"10.1186/s12913-025-13449-3","DOIUrl":"10.1186/s12913-025-13449-3","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1279"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205410","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":"Benefits of workplace collaboration with a trauma-informed support service: a qualitative study.","authors":"Jacinta Evans, Katherine Piech, Samantha Stark","doi":"10.1186/s12913-025-13398-x","DOIUrl":"10.1186/s12913-025-13398-x","url":null,"abstract":"<p><strong>Background: </strong>Trauma-informed services can benefit people involved in a healthcare or legal process by supporting them to engage with systems and minimise risk of retraumatisation. Research also suggests that the integration of trauma-informed services can benefit staff members who work with these services. This study sought to explore outcomes for staff members following the introduction of a trauma-informed navigation and support service for victim-survivors involved in sexual boundary violation complaints lodged with the Australian health practitioner regulator.</p><p><strong>Methods: </strong>Researchers conducted a series of semi-structured interviews (n = 13) with regulatory staff members who had engaged with the support service. Interview transcripts were analysed using reflexive thematic analysis to qualify participant experiences and detail outcomes of working with the service.</p><p><strong>Results: </strong>Four main themes related to outcomes of collaborating with the support service were identified: (1) additional support for engagement work, (2) changes to interactions with victim-survivors (notifiers), (3) personal benefits of collaboration, and (4) improved perception of workload. These themes showed that staff identified positive collaboration with the service and benefits resulting from that collaboration. However, a negative case analysis identified perspectives that did not fit with the main interpretation of the data, where participants did not see a clear need for the service. This demonstrates some of the challenges implicit to integrating a new service within an organisation, including how perception of benefits can be limited due to conflicting personal or professional ideologies.</p><p><strong>Conclusions: </strong>Staff within a national regulator identified personal and professional benefits resulting from workplace collaboration with a trauma-informed service introduced to support victim-survivors. With the introduction of any new service, challenges can arise, and thoughtful planning is required prior and during implementation to understand individual and environmental factors that may impact integration.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1272"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205409","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 use of red flags by online symptom checkers.","authors":"Shailen Sutaria, Delanjathan Devakumar, Poppy Mallinson, Sanjay Kinra, Tamer T Malak, Andras Meczner","doi":"10.1186/s12913-025-13353-w","DOIUrl":"10.1186/s12913-025-13353-w","url":null,"abstract":"<p><strong>Background: </strong>Online Symptom Checkers (OSCs) are digital health tools providing triage, diagnostic, and self-care advice based on user reported symptoms. Amidst global trends of increasing demand and workforce shortages, OSCs have the potential to alleviate primary care workload. However, their ability to seek red flag symptoms, a critical marker of a safe consultation in primary care, remains unexplored. Using clinical vignettes, this study evaluates OSCs' performance in seeking red flag symptoms compared to Primary Care Physicians (PCPs).</p><p><strong>Methods: </strong>Four OSCs (Ada, Babylon, Symptomate, Healthily) were evaluated using 51 clinical vignettes. Two standard setters used guidelines to determine which vignettes required emergency triage and identified the relevant red flags symptoms for the remaining vignettes. Two laypersons entered data from vignettes into OSCs and outputs were collected following a standardised form. The same vignettes were independently assessed by PCPs to compare triage accuracy and red flag identification. Summary statistics and 95% confidence intervals were calculated using Wilson Score intervals, and Fisher's exact test was used to compare performance between OSCs and PCPs.</p><p><strong>Results: </strong>Of the 51 clinical vignettes, standard setters determined 14 to require emergency triage and the remaining 37 vignettes suitable for primary care triage. Of the primary care triaged vignettes, standard setters identified a total of 77 relevant red flag symptoms to be sought. Of the 14 emergency vignettes, PCPs correctly triaged 85.7% (95% CI: 74.3-92.6%) of cases compared to OSCs 76.9% (95% CI: 59.3-87.9%), with no statistically significant difference (p = 0.299). Specificity, the proportion of correctly triaged primary care vignettes, PCPs performed significantly better compared to OSCs, 91.9% (95%CI 78.9-97.0%) vs. 83.3% (95%CI 68.1-91.9%), p = 0.024.</p><p><strong>Conclusions: </strong>OSCs demonstrated comparable ability to appropriately triage clinical vignettes requiring emergency triage as PCPs, however, were less specific, triaging more primary care vignettes as emergency. OSCs do not seek the majority of red flags. This raises concerns about their safety and effectiveness in primary care. OSCs developers should focus on improving OSCs' red flag coverage to ensure safe integration into primary care settings.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1263"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205338","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":"6S management project to improve workplace productivity in Primary Health Centre in India.","authors":"Poosa Sravanthi, Ravibabu Koppala, Subhodip Mitra, Naveen Kumar Pera","doi":"10.1186/s12913-025-13379-0","DOIUrl":"10.1186/s12913-025-13379-0","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1278"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205346","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":"Information pharmacists assist in the construction of GLP-1RA prescription review rules in a tertiary hospital in China.","authors":"Li Zhou, Wenjing Duanmu, Feilong Tan, Xi Gu, Hongyi Che, Wenjie Yin","doi":"10.1186/s12913-025-13377-2","DOIUrl":"10.1186/s12913-025-13377-2","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used for type 2 diabetes mellitus (T2DM) due to their multifaceted benefits, including glycemic control and cardiovascular protection. However, variations in prescribing practices and potential adverse drug events (ADEs) necessitate standardized prescription review protocols to ensure medication safety and efficacy.</p><p><strong>Objective: </strong>This study aimed to develop and implement GLP-1RA prescription review rules through a multidisciplinary information pharmacist team, evaluate their impact on prescription rationality, and identify ADE risk signals using real-world data, thereby promoting rational clinical medication use and ensuring patient safety.</p><p><strong>Methods: </strong>A multidisciplinary information pharmacist team was established at a tertiary hospital to develop GLP-1RA prescription review protocols. China-approved GLP-1RA formulations and their clinical parameters were systematically reviewed to establish standardized prescribing criteria, including indications, dosing, and safety considerations. Adverse drug events were analyzed using FDA Adverse Event Reporting System data (2018-2023) to identify risk patterns. A dual review system integrating prospective prescription screening and retrospective evaluation was implemented. The intervention's efficacy was evaluated by comparing prescription approval rates pre- (2022) and post-implementation (2023).</p><p><strong>Results: </strong>The GLP-1RA audit rules represented by liraglutide and semaglutide were successfully created, as well as their potential adverse event signals were successfully obtained. The process of prescription review and medication monitoring enabled them to be put into clinical practice. After the rules were put in place in 2023, the pass rates of GLP-1RA prescriptions significantly improved, and the rationalization of these prescriptions was also notably enhanced compared to the same period in 2022 (p < 0.001).</p><p><strong>Conclusions: </strong>Standardized GLP-1RA review rules enhanced prescription rationality and ADE risk awareness, demonstrating the value of information pharmacists in optimizing clinical decision-making. This model is scalable for other high-risk medications, promoting safer drug use and pharmacist-led innovation in healthcare.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1276"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis of job motivation and associated factors among health workers in Ethiopia.","authors":"Desalegn Dawit Assele, Tigabu Addisu Lendado, Awoke Abraham Ako, Abera Gezume Ganta, Alemayehu Abebe Demissie, Yitayew Ewnetu Mohammed","doi":"10.1186/s12913-025-13394-1","DOIUrl":"10.1186/s12913-025-13394-1","url":null,"abstract":"<p><strong>Background: </strong>Low job motivation among healthcare workers is a significant issue in the healthcare system, particularly in low-income countries such as Ethiopia, where health professionals face low remuneration, inadequate benefits, and poor working conditions. Shortage of motivated health workers has a significantly negative impact on the quality of healthcare services. In Ethiopia, there is no representative or summarized data on the level of motivation among health workers. We synthesized the pooled level of job motivation and its determinants among Ethiopian health workers.</p><p><strong>Methods: </strong>A comprehensive search was conducted using an electronic web-based search strategy to identify studies. The search was conducted in databases such as PubMed, CINAHL, Cochrane Library, Google Scholar, and the Ethiopian University repository online. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the studies. I-squared statistics (I²) were used to determine heterogeneity between the primary studies. The funnel plot and Egger's test were used to assess publication bias. The random-effects Der Simonian-Laird method was used to estimate the pooled level of job motivation and pooled odds ratio of associated factors, and the corresponding 95% confidence interval (CI).</p><p><strong>Results: </strong>This systematic review and meta-analysis included 11 articles, involving 3974 health workers in the analysis. The pooled proportion of health workers with good motivation was 44% (95% CI 37, 51%). Availability of resource [OR 3.00; 95% CI 1.47, 6.11], training opportunities [AOR 2.57; 95% CI 1.51, 4.37], and job satisfaction [AOR 3.67, 95% CI 1.97, 6.81] were factors associated with job motivation among health workers.</p><p><strong>Conclusion: </strong>Less than half of the health workers in Ethiopia are motivated. As the provision of compassionate and high-quality care requires highly motivated health workers, health institutions should strive to create a nurturing and conducive environment. On a national level, the Ministry of Health should recognize the problem and develop a comprehensive, integrated approach to manage the health workforce. Study protocol registration: CRD420251061167.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1270"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205362","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":"Assessing organizational health literacy in hospitals by using the International Self-Assessment Tool for Organizational Health Literacy of Hospitals - a feasibility study in six European countries.","authors":"Christa Straßmayr, Hanne Søberg Finbråten, Eva Maria Bitzer, Guglielmo Bonaccorsi, Maria Gabriella Cacciuttolo, Jan Dudra, Øystein Guttersrud, Zeynep Islertas, Celine Jeitani, Dušanka Krajnović, Christopher Le, Diane Levin-Zamir, Camilla Lombardo, Chiara Lorini, Benedetta Marcozzi, Luigi Palmieri, Denise Schütze, Maria Lucia Specchia, Alena Šteflová, Ivana Stević, Petr Struk, Brigid Unim, Stephan Van den Broucke, Patrizio Zanobini","doi":"10.1186/s12913-025-13367-4","DOIUrl":"10.1186/s12913-025-13367-4","url":null,"abstract":"<p><strong>Background: </strong>Hospitals can gain valuable insights into their current level of organizational health literacy (OHL) by using self-assessment tools. OHL self-assessment tools can serve as useful instruments for supporting the planning and implementation of OHL interventions aimed at promoting health equity and improving patient outcomes. This explorative study aimed to pilot the International Self-Assessment Tool for Organizational Health Literacy (Responsiveness) of Hospitals (OHL-Hos) among hospitals across six countries.</p><p><strong>Methods: </strong>The OHL-Hos, grounded in a comprehensive theoretical framework consisting of eight standards, 21 sub-standards and 141 indicators, was piloted in seven hospitals: one in Austria, Germany, the Czech Republic, Norway and Serbia, and two in Italy. In each hospital, the feasibility of using the OHL-Hos was investigated regarding acceptability, implementation, practicality, and integration, identifying strengths and areas for improvement using descriptive analyses. The self-assessment process included individual rating of an interdisciplinary and inter-hierarchical assessment team regarding OHL-Hos indicators from their personal perspectives, followed by a joint assessment to reach a consensus on different ratings. The process and experiences were documented in semi-structured forms, while the ratings on the indicators were documented numerically.</p><p><strong>Results: </strong>All hospitals successfully self-assessed their OHL, identifying strengths and areas for improvement. The self-assessment process varied slightly among countries. While the tool was considered important but lengthy and complex, introductory workshops facilitated successful implementation. The self-assessment process raised awareness and stimulated discussions on improving OHL, highlighting the tool's potential for organizational development.</p><p><strong>Conclusions: </strong>The OHL-Hos can serve as a useful tool to identify strengths and areas for improvement in OHL in hospitals. The overall experience with the tool was positive and the joint assessment with the tool was found to foster consensus and enable reflection on OHL, but its comprehensive nature poses challenges to its implementation, leading to recommendations for developing a shortened version of the tool with simple language. Certain indicators require specific knowledge, suggesting different professional groups should address relevant parts.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1265"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205371","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":"Aging population challenges: enhancing healthy aging practices through virtual coaching systems.","authors":"Marta Pinzone, Francesco Paolo Appio, Luca Gastaldi, Emanuele Lettieri","doi":"10.1186/s12913-025-13497-9","DOIUrl":"10.1186/s12913-025-13497-9","url":null,"abstract":"<p><strong>Background: </strong>As the global population ages, society faces complex challenges in healthcare provision and medical service delivery. This study focusses on the potential of supportive digital technologies, with a particular focus on Virtual Coaching Systems (VCSs), to offer innovative solutions for improving healthy aging practices. Our research extends the existing Technology Acceptance Model (TAM) by incorporating three novel external determinants: subjective norms, health literacy, and information technology literacy. These additional factors provide a more nuanced understanding of the drivers behind technology acceptance among older adults, highlighting the importance of addressing the unique needs and preferences of this population segment.</p><p><strong>Methods: </strong>Drawing on empirical evidence from a sample of 436 Italian individuals aged 60 and above, we develop a comprehensive framework and test a structural equation model that unveils the crucial role of exploiting diverse knowledge sources through VCSs in promoting healthy aging, ultimately contributing to the sustainability of national healthcare systems.</p><p><strong>Results: </strong>In line with the TAM, perceived usefulness and perceived ease of use have a positive and significant impact on the elderly people's intention to use a VCS. Subjective norms are not found to have a significant direct impact on the intention to use a VCS, while they have an indirect influence through perceived ease of use and perceived usefulness. Health literacy is found to have a significant but negative impact on the perceived usefulness of a VCS. On the other hand, it positively and significantly affects perceived ease of use. Finally, the results of the analysis provide support for the positive relationship between information technology literacy and perceived ease of use.</p><p><strong>Conclusions: </strong>Our findings offer valuable insights for healthcare researchers, policymakers, professionals, and digital solution providers in developing targeted strategies and interventions to support the health and well-being of the aging population. This study emphasizes the need for a collaborative approach among stakeholders to harness the potential of VCSs in addressing the multifaceted challenges arising from population aging, ultimately enhancing the quality of life for older individuals and promoting the sustainability of healthcare systems worldwide.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1277"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205335","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":"Pharmacist interventions to improve hypertension management among patients with diabetes: a systematic review and meta-analysis of randomized controlled trials.","authors":"Viktoria Gastens, Stefano Tancredi, Dylan Bonnan, Blanche Kiszio, Cinzia Del Giovane, Ross T Tsuyuki, Gilles Paradis, Arnaud Chiolero, Line Guénette, Valérie Santschi","doi":"10.1186/s12913-025-13461-7","DOIUrl":"10.1186/s12913-025-13461-7","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1268"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205363","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}