BMC Health Services Research最新文献

{"title":"No effect of learning from excellence on patient safety culture in a postanaesthesia care unit: a longitudinal quasi-experimental study.","authors":"Gørill Birkeli, Owen Matthew Truscott Thomas, Randi Ballangrud, Ellen Catharina Tveter Deilkås, Anne Karin Lindahl","doi":"10.1186/s12913-026-15405-1","DOIUrl":"10.1186/s12913-026-15405-1","url":null,"abstract":"<p><strong>Background: </strong>The prevailing strategy for combating surgically related adverse events (AEs) is to anticipate and prevent them by learning from adverse events (Safety-I). However, not all AEs can be anticipated or prevented in complex systems. This requires more focus on how daily work succeeds, that is, resilient and adaptive behaviour (Safety-II). Learning from success and promoting a positive patient safety culture (PSC) are key global strategies for eliminating preventable AEs. As a patient safety initiative, Learning from Excellence (LfE) captures episodes of successful everyday work and is thus, a system for applying a Safety-II perspective. However, its effect on PSC has not been evaluated. This study aimed to explore whether the implementation of LfE in a postanaesthesia care unit over a 16-month period changed the nurses' perceptions of the measurable PSC dimensions 'work engagement', 'teamwork climate', 'working conditions' and 'safety climate'.</p><p><strong>Methods: </strong>This longitudinal two-group, controlled quasi-experimental study used an annual 'Hospital Staff Survey' to measure PSC factors before (2021-2022) and after (2023-2024) the implementation of LfE. The study included nurses from the surgical department of a Norwegian university hospital working in units specialised in postoperative care (intervention unit) and intensive care (comparison unit). The primary outcomes were binarised versions of individuals' positive responses to Likert-type statements regarding 'work engagement', 'teamwork climate', 'working conditions' and 'safety climate'. The data were analysed using logistic regression methods.</p><p><strong>Results: </strong>Relative to the changes in the comparison unit, the results within the intervention unit indicated non-significant small positive changes in 'work engagement', 'teamwork climate' and 'working conditions' and a non-significant small negative change in 'safety climate'.</p><p><strong>Conclusions: </strong>LfE did not have a significant effect on PSC after 16 months implementation. Further longitudinal experimental studies are needed to measure the effect of LfE on PSC. Future research should focus on the role of psychological safety in LfE and assess whether reflexive spaces add value to LfE.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05794490; registered date: 4 March 2023.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036255","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":"Empowering health service providers in health center in low- and middle-income countries: results of a participatory action research study in Iran.","authors":"Marzieh Kargar Jahromi, Fatemeh Vizeshfar, Camellia Torabizadeh, Shahrzad Yektatalab","doi":"10.1186/s12913-026-15321-4","DOIUrl":"10.1186/s12913-026-15321-4","url":null,"abstract":"<p><strong>Introduction: </strong>Empowering health-care providers is a key strategy for improving the quality of primary health care. Insufficient competencies may reduce job satisfaction, motivation, and performance, ultimately affecting service quality. This study aimed to empower health-care providers at the Vali-Asr Comprehensive Health Center in Shiraz.</p><p><strong>Methods: </strong>This participatory action research study was conducted over 22 months (2022-2024) using two consecutive cycles based on the Kemmis and McTaggart model. Twenty-four health-care providers, two family physicians, and two supervisors participated in the study. Quantitative and qualitative methods were used to assess the existing situation, develop and implement action plans, and evaluate outcomes. Quantitative data were analyzed using descriptive and inferential statistics, while qualitative data were analyzed through conventional content analysis.</p><p><strong>Results: </strong>Quantitative and qualitative findings demonstrated consistent improvements following implementation of the action plans. Participants showed increased psychological empowerment, enhanced professional performance, greater satisfaction with educational programs, and improved client satisfaction. Qualitative findings indicated substantial progress in scientific and practical competence, supportive workplace culture, and psychological well-being among health-care providers.</p><p><strong>Conclusion: </strong>Participatory action research was effective in strengthening the empowerment of health-care providers through collaborative identification of challenges and implementation of context-specific solutions. The findings suggest that involving health-care staff in planning and decision-making processes can enhance workforce capacity, workplace well-being, and the quality of primary health-care services.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849754","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":"Mapping the extent and nature of research examining health literacy and ethnic inequalities in maternity care: a scoping review.","authors":"B McEvoy, K Watson, E Aalai, G Rowlands, H Soltani, A E P Heazell","doi":"10.1186/s12913-026-15233-3","DOIUrl":"10.1186/s12913-026-15233-3","url":null,"abstract":"<p><strong>Background: </strong>Globally, women from ethnic minority groups experience stark disparities in maternity care outcomes. While ethnic inequalities are complex, health literacy is a contributing factor. This scoping review aimed to map the extent and nature of research examining health literacy and ethnic inequalities in maternity care. The review sought to identify evidence gaps and inform the direction of future research in this area.</p><p><strong>Methods: </strong>This scoping review followed methodological guidance published by Arksey and O'Malley (2005). A comprehensive search across 5 key databases and relevant grey literature identified 1,024 citations. Papers were reviewed against criteria for inclusion. Key study features were collated in a standardised data extraction form. Thematic analysis summarised key findings across the studies.</p><p><strong>Results: </strong>The review included 14 papers that directly explored health literacy and ethnic inequalities in maternity care. The research had a wide geographical distribution and included quantitative (n = 7), qualitative (n = 4) and mixed methods research designs (n = 3). Data were collected using a range of health literacy assessment tools. The focus of the research varied across the scope of maternity care, including pregnancy (n = 7), the postnatal period (n = 2) and the whole maternity continuum (n = 5). Thematic analysis summarised four key findings: (i) Diverse definitions of health literacy; (ii) Health literacy challenges can disproportionately affect minority ethnic women; (iii) Poor health literacy can contribute to adverse outcomes and ethnic inequalities and (iv) Limited evaluation of health literacy interventions.</p><p><strong>Conclusions: </strong>Health literacy is an important but understudied contributor to ethnic inequalities in maternity care. There is a need for high-quality in-depth research to explore health literacy and ethnic inequalities in maternity care. This will support the development of targeted, equity focused interventions. Optimisation of health literacy may serve to reduce persistent inequalities experienced by minority ethnic groups in maternity care outcomes.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849869","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":"Mismatch between urban eco-sanitation improvement and health service supply capacity: evidence from Chinese city panel data and interpretable machine learning.","authors":"Zhen Peng, Lin Wang","doi":"10.1186/s12913-026-15444-8","DOIUrl":"10.1186/s12913-026-15444-8","url":null,"abstract":"<p><strong>Background: </strong>Health service supply capacity depends not only on medical resource stocks but also on urban eco-sanitation conditions and resource-allocation mechanisms. Existing studies focus mainly on environmental exposure and health outcomes, with limited attention to whether eco-sanitation improvements can be converted into health service supply capacity.</p><p><strong>Methods: </strong>This study constructed a panel of Chinese prefecture-level and above cities for 2002-2024, using the health service supply capacity index as the dependent variable and the eco-sanitation environment index as the core explanatory variable. Two-way fixed effects models, dimension-specific analysis, mechanism tests, heterogeneity analysis, robustness checks, and interpretable machine learning identified mismatch mechanisms and boundary conditions. The mechanism analysis was extended to two- and three-year ESE lags and one- and two-year lagged investment variables. Carbon-emission comparability was reassessed on exact CEADs-matched samples for 2002-2019. Hu Huanyong line subgroup models were additionally estimated with city and province-year fixed effects.</p><p><strong>Results: </strong>The eco-sanitation environment, green infrastructure, and municipal sanitation facilities improved continuously, whereas health service supply capacity increased more slowly. The baseline model does not support a stable positive conversion from eco-sanitation improvement to stronger supply capacity. Dimension-specific results reveal differentiated roles. The positive PPI coefficient must not be read as a pollution benefit; it is consistent with a demand-induced or compensatory resource-allocation response. Neither two- to three-year ESE lags nor one- to two-year lagged investment variables produced a stable urban construction investment transmission chain. The positive CEADs interaction was confirmed only within the 2002-2019 matched sample and therefore represents pre-pandemic evidence. The southeastern Hu-line coefficient attenuated and lost conventional significance after province-year policy shocks were absorbed. Machine learning indicates the relationship is shaped by development stage, population size, fiscal capacity, and nonlinear boundaries.</p><p><strong>Conclusions: </strong>Eco-sanitation improvement is not a sufficient condition for enhancing health service supply capacity. Healthy city development should integrate eco-sanitation governance, infrastructure investment, workforce allocation, and fiscal arrangements into a unified governance framework. Because HSC is a supply-side proxy based on resource counts, these implications concern resource availability and network density rather than quality of care, realized utilization, accessibility, or overall health-system performance.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179223","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":"Linking health literacy to malaria prevention and treatment behaviours: evidence from a community-based study in Gabon.","authors":"Caroline Namubiru, Saidou Mahmoudou, Ynous Djida, Bertrand Lell","doi":"10.1186/s12913-026-15138-1","DOIUrl":"10.1186/s12913-026-15138-1","url":null,"abstract":"<p><strong>Background: </strong>Health literacy (HL) affects how individuals engage in preventive behaviours, seek prompt treatment, select appropriate malaria prevention or treatment options, adhere to care and act on health information. Little is known about its role in malaria prevention and treatment behaviours. Therefore, this study investigated the extent to which HL relates to malaria health behaviours.</p><p><strong>Methods: </strong>A cross-sectional household survey across urban and rural areas of Gabon using a sample of 504 respondents. HL was measured using the French HLS-EU-Q16 and scored as well as categorised as inadequate, problematic, or sufficient. Malaria health behaviours included regular utilisation of bed nets, uptake of indoor residual spraying (IRS), treatment-seeking for illness, medication adherence, bush clearing, asking medical practitioners questions and Dosage knowledge. The HL scale was first assessed for psychometric suitability within the study sample before conducting subsequent regression analyses. Multivariable logistic regression models were employed to assess associations between HL and malaria-related behaviours, with adjustment for demographic, socioeconomic, and health-environment factors.</p><p><strong>Results: </strong>59.7 per cent of respondents demonstrated sufficient HL with higher proportions among those with at least secondary education (above 65%), urban residents (61.4%), those aged between 25 and 34 years of age (66.4%) and those using formal health information sources (60.2%). Significant bivariate associations were revealed between HL and dosing knowledge, medication adherence, prompt treatment seeking and asking questions. No bivariate associations were observed for Bednet use or bush clearing. However, multivariate logistic regression adjusting for demographic, socio-economics and health environment factors revealed significant associations of HL with dosing knowledge (AME = 0.022, p < 0.001), medication adherence (AME = 0.013, p < 0.01; OR = 1.089), asking questions (AME = 0.018, p < 0.001; OR = 1.092), and bednet use (AME = 0.012, p < 0.05). Treatment-seeking behaviours, bush clearing and indoor spraying were not significantly associated with HL (p > 0.05).</p><p><strong>Conclusion: </strong>HL has associations with knowledge-dependent and communicative aspects of malaria management. Therefore, literacy-focused interventions in malaria-endemic regions should be prioritised alongside structural approaches addressing net access and healthcare availability to maximise impact on malaria-related outcomes.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13508316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817217","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":"Domestic violence among healthcare professionals in Sweden - Prevalence, associations with asking older patients about abuse and reactions to participating in training on abuse of older people.","authors":"Johanna Simmons, Mikael Ludvigsson","doi":"10.1186/s12913-026-15440-y","DOIUrl":"10.1186/s12913-026-15440-y","url":null,"abstract":"<p><strong>Background: </strong>Different forms of domestic violence, including abuse of older people (AOP), are prevalent and associated with poor health outcomes. The healthcare system is therefore often considered an important context for identifying victims of violence and providing referrals. However, healthcare professionals may also have their own experiences of domestic violence. The aims of this study were to: (1) investigate the prevalence of domestic violence, specifically intimate partner violence (IPV) and violence by other family members, among healthcare professionals in Sweden; (2) examine whether such exposure was associated with asking older patients about abuse, and (3) explore whether (a) experiences of domestic violence were associated with negative feelings when participating in AOP training and, (b) whether such negative feelings were associated with perceiving the training as valuable.</p><p><strong>Methods: </strong>Cross-sectional survey data were collected from healthcare professionals who participated in the Responding to Elder Abuse in GERiAtric care educational intervention trial (REAGERA Edu).</p><p><strong>Results: </strong>IPV was reported by 21.2% of participants (women 23.0%, men 8.8%), while 20.7% reported experiences of violence by other family members (women 21.6%, men 14.7%). Reporting multiple victimisation, i.e., both IPV and family violence, was associated with increased odds of asking patients about AOP (OR 2.45; 95% CI 1.14-5.28). Further, experiences of IPV only (OR = 2.98; 95% CI 1.54-5.77) and multiple victimisation (OR = 3.43; 95% CI 1.43-8.21) was associated with reporting negative feelings when participating in AOP training, but most respondents who reported negative feelings also recognised the value of the training.</p><p><strong>Conclusions: </strong>Experiences of domestic violence are common among healthcare professionals and are associated with a greater likelihood of asking patients questions about AOP and with negative feelings when participating in AOP training. A trauma-informed approach is important in training professionals to improve readiness to care for victims of AOP in healthcare while simultaneously avoiding re-traumatising healthcare professionals.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier NCT05065281. Retrospectively registered on September 28, 2021. The trial registration concerns the primary outcomes of the REAGERA educational intervention, i.e., effects of the intervention, while the current study report on secondary aims not mentioned in study protocol.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13508338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817243","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":"Tiered diagnosis and value-based healthcare: can the outpatient reimbursement policy for medical costs in retail pharmacies promote both?","authors":"Kairan Zhang, Qian Zhang, Hongbo Wang","doi":"10.1186/s12913-026-15371-8","DOIUrl":"10.1186/s12913-026-15371-8","url":null,"abstract":"<p><strong>Background: </strong>Amid growing health demands and tight welfare budgets, guiding rational healthcare-seeking behavior to improve health while controlling costs has become a global challenge. This study aims to examine whether the reform of medical insurance on the cost-sharing of pharmacy can promote tiered diagnosis and value-based healthcare.</p><p><strong>Methods: </strong>Using 2011-2018 China Health and Retirement Longitudinal Study data and the Staggered DID method, this paper estimates the effects of the Retail Pharmacies Outpatient Reimbursement (RPOR) reform in the Urban Employee Basic Medical Insurance (UEBMI).</p><p><strong>Results: </strong>The RPOR indeed promoted the pharmacy visits (0.119) and the proportion of its expenditures in the total medical expenses (0.439**). However, its crowding-out of lower-level outpatient services (-0.670***) may pose certain obstacles to the tiered diagnosis system. Although the reform controlled the increase of total health expenditure (-0.490**) and adjusted the structure of medical expenditures, its effect on health improvement and value-based healthcare still needs to be realized. The above effects vary with policy design, regional resources, as well as individuals' age and income.</p><p><strong>Conclusions: </strong>This study demonstrates that while the cost-sharing reform effectively controls total expenditures, the resulting substitution of primary care with pharmacy services and its limitation on health gains call for a more effective policy design to achieve tiered diagnosis and value-based healthcare.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886009","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":"Governance configurations of coordination in municipal health promotion: insights from an egocentric network analysis.","authors":"Hanna Richter, Tatiana Mamontova, Lisa Kühne","doi":"10.1186/s12913-026-15347-8","DOIUrl":"10.1186/s12913-026-15347-8","url":null,"abstract":"<p><strong>Background: </strong>Municipal health promotion requires coordination across organizational and sectoral boundaries. Fragmented responsibilities, strong organizational autonomy and limited formal authority can make sustained cross-sectoral coordination challenging. Although research on Health in All Policies and governance capacity has highlighted the organizational conditions necessary for coordination, little is known about how coordination functions are embedded within municipal governance networks. This study examines the structural conditions that shape cross-sectoral coordination in municipal health promotion.</p><p><strong>Methods: </strong>Egocentric social network analysis was used to map the professional networks of 14 health professionals working in primary schools and neighborhood settings in a single German municipality. Data were collected through semi-structured interviews combined with structured network elicitation, capturing 662 individuals, their reported interconnections and organizational attributes. Network measures of structural integration, modular differentiation, local cohesion and relational dependency were combined with modularity analysis and ego-removal comparisons. Qualitative interview data contextualized the structural findings and supported the functional interpretation of network modules.</p><p><strong>Results: </strong>The networks varied considerably in terms of the structural organization of cross-sectoral coordination. Modularity analysis revealed the following recurring governance domains: education; neighborhoods and social spaces; professional coordination and peer networks. The combined analysis identified three governance configurations. In ego-dependent integration, internally cohesive network areas remained intact after the removal of the ego, but lost connections to other areas. In substitutable coordination, connectivity persisted through alternative individual or collective coordination hubs or relational pathways. In distributed integration, cross-module connectivity was supported by multiple relationships and remained largely intact even without the focal actor. Therefore, network connectedness and local cohesion alone did not determine how strongly coordination depended on individual brokers.</p><p><strong>Conclusion: </strong>Municipal coordination capacity depends not only on coordinating professionals and their resources, but also on how brokerage and cross-sectoral relationships are structurally embedded in governance networks. Therefore, strengthening municipal health promotion requires the establishment of adequately resourced and formally supported coordination roles, as well as investment in collective coordination arenas, alternative coordination pathways, and direct cross-sectoral relationships. Recognizing network work as a continuous strategic function can help to create governance structures that are less vulnerable to the loss of individual actors.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13508432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817214","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":"Quantifying spatial accessibility to inpatient hospices in Germany.","authors":"Theresa Petzold, Friedemann Nauck, Christian Banse, Jobst Augustin, Birgit Jaspers, Maximiliane Jansky","doi":"10.1186/s12913-026-15337-w","DOIUrl":"10.1186/s12913-026-15337-w","url":null,"abstract":"<p><strong>Background: </strong>Spatial access is an important indicator to assess quality of healthcare services and healthcare situation, with accessibility and availability as central components. Using inpatient hospices as an example of specialist palliative care in Germany, different indicators are used to measure spatial accessibility, which vary in complexity and considered variables. We compare four widely used methods, identify regional differences, and discuss possible differences in the results caused by methodological characteristics.</p><p><strong>Methods: </strong>Locations of inpatient hospices were identified using a freely accessible online self-disclosure database, supplemented by lists from regional associations and own research. Spatial access was examined using provider-to-population ratios based on district level, and network-based travel time of 15, 30 and 60 min as used in literature. Further, Two-Step Floating Catchment Area (2SFCA) and Enhanced Two-Step Floating Catchment Area (E2SFCA) were applied using geocoded locations, hospice bed capacities, population data, and road network data.</p><p><strong>Results: </strong>295 inpatient hospices were identified. 211 of 401 districts have at least one hospice, resulting in an availability of 36.4 beds per 1 million inhabitants nationally. 90.3% of the population can reach a hospice by car within 30 min (network-based travel time). The results of the FCA methods show a heterogeneous pattern in spatial accessibility index (SPAI_i). Using 2SFCA method results in uniform accessibility within the catchment areas of the hospices. While E2SFCA method with a slow distance decay function generates smoother transition zones within catchment areas, the sharp distance decay function induces higher spatial differentiation, particularly in rural areas, where accessibility declines sharply with distance.</p><p><strong>Conclusions: </strong>The results indicate that inpatient hospices in Germany are timely accessible via private transport, if available, though rural areas have lower accessibility. However, the chosen method significantly influences the results. Indicators such as provider-to-population ratios and network-based travel time can provide a basic analysis of the care situation due to their ease of interpretation. This study can raise awareness among decision-makers planning new hospices to consider more advanced methods, such as FCA methods, as these take both dimensions of accessibility equally into account.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817237","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":"Correlates of working conditions and affect balance among healthcare workers in Upper Egypt.","authors":"Shimaa Hosny Hassan Mahmoud, Doaa Mohamed Osman, Taher M Darwish, Shaimaa S Abdelrheem","doi":"10.1186/s12913-026-15238-y","DOIUrl":"10.1186/s12913-026-15238-y","url":null,"abstract":"<p><strong>Background: </strong>Working conditions and emotional health of healthcare workers (HCWs) are essential aspects in the delivery of qualified health services. This study aimed to explore the working conditions and the experienced positive and negative emotions among HCWs in Upper Egypt.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among HCWs in Aswan University Hospital. The studied population included 400 HCWs (215 nurses and 185 physicians). Data was collected using an interviewer-administered questionnaire. It inquired about demographic and job characteristics, working conditions, and the positive and negative experiences of HCWs.</p><p><strong>Results: </strong>Physicians had significantly higher mean values of the total poor working conditions scale and all its domains than nurses except relationships with similar co-workers. HCWs of surgical specialty have significantly worse perceptions of total working conditions than those of medical specialty. There was no significant difference in mean values of positive and negative experience and affect balance scales between physicians and nurses (P > 0.05). The adjusted linear regression models revealed being a physician was a significant predictor of poor working conditions. The increase in age was a significant positive predictor of affect balance score. Poor working conditions and the affect balance were significantly positively intercorrelated with each other.</p><p><strong>Conclusion and recommendations: </strong>Poor perceptions of working conditions were perceived by physicians more than nurses and by HCWs in surgical than in medical specialty. Poor working conditions and the affect balance have a positive impact on each other. There is a necessity for improving the working conditions of HCWs especially physicians in Upper Egypt. This improvement may enhance HCWs' positive emotions.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787900","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}