BMC Health Services Research最新文献

{"title":"Cost-effectiveness of deucravacitinib versus apremilast of moderate-to-severe plaque psoriasis in China.","authors":"Bingying Tang, Rumeng Liu, Shaofei Hu","doi":"10.1186/s12913-025-13403-3","DOIUrl":"10.1186/s12913-025-13403-3","url":null,"abstract":"<p><strong>Objectives: </strong>The study aimed to assess the cost-effectiveness of deucravacitinib versus apremilast for treating moderate-to-severe plaque psoriasis from the Chinese healthcare system's perspective.</p><p><strong>Methods: </strong>The treatment efficacy of deucravacitinib was compared with apremilast using response rates derived from the head-to-head phase 3 clinical trials, POETYK PSO-1 and PSO-2. A decision-tree (first 24-week)/ Markov model (later period) was constructed to estimate the incremental cost per quality-adjusted life-year (QALY) gained over a lifetime horizon. The efficacy inputs were based on randomized controlled trials, while adverse event rates, discontinuation probabilities, costs, and utility data were obtained from relevant literature and Chinese sources. A 5% annual discount rate was used for the analysis of outcomes and costs. Model outcomes were characterized by quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio (ICER). One-way sensitivity analysis and probability sensitivity analysis (PSA) were performed to examine the robustness of the results.</p><p><strong>Results: </strong>According to the assumed lifetime horizon and model, the ICER of deucravacitinib 6 mg once daily compared with apremilast 30 mg twice daily was 140,047 CNY per QALY. Deucravacitinib was more cost-effective than apremilast at the willingness-to-pay (WTP) threshold of 287,247 CNY per QALY. In the One-way sensitivity analysis, the cost of deucravacitinib was identified as the parameter exerting the greatest impact on the base-case results. The results of PSA showed the probability of deucravacitinib being cost-effective was 99.4%.</p><p><strong>Conclusion: </strong>At the WTP threshold of 287,247 CNY, deucravacitinib 6 mg once daily was a cost-effective treatment strategy for moderate-to-severe plaque psoriasis compared with apremilast 30 mg twice daily from the Chinese healthcare system perspective over a lifetime horizon.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1222"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197662","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 workplace violence, organizational climate, authentic leadership on job satisfaction among physicians in tertiary hospitals: the mediating role of job burnout.","authors":"Wenjun Dai, Xuemei Zhang, Zhiping Liu, Ren Chen, Jing Cheng","doi":"10.1186/s12913-025-13453-7","DOIUrl":"10.1186/s12913-025-13453-7","url":null,"abstract":"<p><strong>Background: </strong>This study aims to investigate the direct associations among workplace violence, organizational climate, authentic leadership, and physicians' job satisfaction, as well as the indirect pathways through job burnout, with the aim of offering potential preventive strategies.</p><p><strong>Methods: </strong>Through a purposive sampling method, a total of 408 questionnaires were distributed to physicians in six tertiary-level hospitals in Anhui Province, and 399 valid questionnaires were returned. Structural equation modeling was used to test the proposed model.</p><p><strong>Results: </strong>Although workplace violence did not directly influence physicians' job satisfaction, it indirectly reduced it by exacerbating burnout. A positive organizational climate was shown to enhance job satisfaction directly and indirectly by mitigating job burnout. Authentic leadership directly enhanced job satisfaction and indirectly alleviated burnout by optimizing the organizational climate. Authentic leadership also indirectly enhanced job satisfaction by improving the organizational climate and alleviating job burnout.</p><p><strong>Conclusions: </strong>This study confirms that workplace violence, authentic leadership and organizational climate influence physicians' job satisfaction through both direct and burnout-mediated indirect pathways. Interventions and programs promoting a positive work environment could potentially reduce job burnout and increase job satisfaction among Chinese physicians of tertiary hospitals.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1224"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198004","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":"Barriers to assisted reproductive technology (ART) services in Ghana: a countrywide cross-sectional quantitative survey of fertility health workers and women with infertility.","authors":"Francis Jojo Moses Kwadzo Damalie, Charles Mawunyo Senaya, Elikplim Adzo Damalie, Herbert Ekoe Dankluvi, Millicent Osaah, Beatrice Yeboah, John Jude Annan, Ellis Fleischer Djoleto, Rudolph Kantum Adageba, Alexander Tawiah Odoi","doi":"10.1186/s12913-025-13457-3","DOIUrl":"10.1186/s12913-025-13457-3","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1228"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198029","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":"Technology-Enhanced KaiāwhiNa-Based support to Optimise type 2 diabetes management in primary care (TEKNO), a randomised controlled trial study protocol.","authors":"Lynne Chepulis, Noleen van Zyl, Suzanne Moorhouse, Stanely Koshy, Rawiri Keenan, Chunhuan Lao, Hilde Mullins, Tim Kenealy, Ryan Paul, Hamish Crocket","doi":"10.1186/s12913-025-13277-5","DOIUrl":"10.1186/s12913-025-13277-5","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1247"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198044","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 development and validation of the Research for Practice Tool (R4PT) for nursing and midwifery.","authors":"Se Ok Ohr, Vicki Parker, Michelle Giles, Sophie Dilworth, Jean Ball, Ashleigh Stuart, Madeleine Hinwood, Maralyn Foureur, Gena Lieschke","doi":"10.1186/s12913-025-13112-x","DOIUrl":"10.1186/s12913-025-13112-x","url":null,"abstract":"<p><strong>Background: </strong>Tools for assessing research capacity and participation for health professionals have been in use for over a decade with little change. Given the evolving research context emphasising integration into clinical practice, it is time to update or develop tools that reflect current research practices. The aim of this study was to develop and validate a questionnaire designed to examine nurses' and midwives' attitudes, capabilities, participation, and perceived impact of practice-based research.</p><p><strong>Methods: </strong>The Research for Practice Tool (R4PT) was developed using factors and items identified from an extensive literature review and analysis of existing tools. A modified Delphi method was used to confirm the factors and items. The content validity of the R4PT was determined through reviews from four research experts and six nursing and midwifery clinician researchers. The usability and acceptability of the R4PT was conducted by 12 nurses and midwives. The factors and items of the R4PT were assessed by factor analyses of responses from a target population of 8500 nurses and midwives in a Local Health District in NSW, Australia.</p><p><strong>Results: </strong>A total of 1,430 participants responded to the R4PT (17%). A seven-factor solution was identified in the exploratory factor analysis. Sixty-six out of 73 items each loaded onto a single factor, explaining 71.5% of the variance. The identified factors were research value and culture (1 and 2), research integration and relevance for practice, research translation, research impact, individual research capability and team research capability. The factors were distinct with the inter-factor correlations less than 0.8. Confirmatory factor analysis indicated that all models showed good fit, with non-significant chi-squared tests, CFIs of 1, TLIs > 0.95, RMSEAs of 0 and SRMRs < 0.8. Cronbach's alpha for all factors, except research value and culture 1, showed acceptable consistency (> 0.7).</p><p><strong>Conclusions: </strong>The R4PT is a valid and reliable means of assessing research participation, aligning with clinical practice and service delivery trends. The culture and value factors (1 and 2) need to be reworked and retested prior to inclusion in subsequent surveys. The R4PT will provide valuable information to inform capacity-building activities, workforce and work practice models that integrate research into practice.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1245"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198049","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":"Patients' and healthcare personnel's experiences of a health-literacy intervention in chronic obstructive pulmonary disease - a qualitative study.","authors":"Marie Hamilton Larsen, Astrid Klopstad Wahl, Christine Raaheim Borge","doi":"10.1186/s12913-025-13299-z","DOIUrl":"10.1186/s12913-025-13299-z","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) poses challenges to people's self-management, especially after hospital discharge. Few studies have qualitatively examined the experiences of patients and healthcare personnel following a nurse-led health literacy intervention to prevent readmission.</p><p><strong>Methods: </strong>This exploratory qualitative process evaluation was conducted within a randomized controlled trial aimed at understanding the perspectives of both patients and professionals following the implementation of a health literacy intervention. The intervention includes home visits conducted by nurses trained in COPD, employing motivational interviewing techniques and supporting the development of individualised treatment plans post-hospital discharge. Eight semi-structured interviews with patients, one focus group, and one individual interview with healthcare providers (n = 6) were analysed using inductive thematic analysis.</p><p><strong>Results: </strong>Two main themes arose among patients: \"Building health literacy through personalized nursing support\" and \"From knowledge to action: Strengthening health literacy through motivational support\" - and two among healthcare professionals; \"Health professionals' experience of developing health literacy competency\" and \"Perceived shifts in understanding, roles, and relationships through health literacy awareness\".</p><p><strong>Conclusion: </strong>The nurse-led health literacy intervention was perceived as valuable by both patients and healthcare professionals. Patients described how home-based support from competent nurses may have contributed to a better understanding of post-discharge care and fostered a sense of preparedness. Professionals reported gaining insights into patient needs, which they felt enabled more tailored communication and care planning. While the findings are based on a small qualitative sample, they suggest that such interventions may support the transition from hospital to home.</p><p><strong>Trial registration: </strong>The RCT study is registered on ClinicalTrials.gov (ID: NCT03216603 (registered first 7/7-2017).</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1256"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198061","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":"Factors shaping user involvement in social and health services in Poland: the perspective of persons with disabilities.","authors":"Izabela Grabowska, Agnieszka Wołowicz, Agnieszka Naumiuk, Magdalena Kuleta-Hulboj","doi":"10.1186/s12913-025-13314-3","DOIUrl":"10.1186/s12913-025-13314-3","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1219"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197896","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 turning point after FACT: a qualitative study of family members' experiences and follow-up provided by flexible assertive community treatment.","authors":"Randi Martinsen, Anne Signe Landheim, Berit Arnesveen Bronken","doi":"10.1186/s12913-025-13485-z","DOIUrl":"10.1186/s12913-025-13485-z","url":null,"abstract":"<p><strong>Background: </strong>Service users living with severe mental illness are often in need of treatment from different health care professionals. Their family members play an important but underreported role in their treatment and care. Following the implementation of the flexible assertive community treatment (FACT) model in Norway since 2013, FACT teams have been evaluated from different perspectives. The overall aim of this study was to explore how family members of people living with SMI experience their situation and the follow-up provided by FACT teams.</p><p><strong>Methods: </strong>Forty-one family members aged 31 to 78 years took part in nine focus groups representing seven FACT teams from both rural and urban areas in Norway. Most of the participants had parental roles. The data was analysed using qualitative content analysis.</p><p><strong>Results: </strong>The results revealed the following two main themes and five sub-themes: (1) An all-consuming and demanding role (A life of love, care and despair and A life affecting health and well-being), and (2) A turning point after FACT (From a patchwork to more integration and continuity, Family involvement as a vital part of care and Availability of support outside regular opening hours).</p><p><strong>Conclusions: </strong>Being family members of service users with SMI are experienced as an all-consuming and demanding role. The family members experience the FACT team as an important support in their day-to-day life. However, they wish to receive more support and inclusion in the treatment than they currently do. Further strengthening the involvement and collaboration between the family members and the FACT teams is recommended. Psychoeducational interventions arranged by the FACT team could support family members' situations. To share their stories with professionals and/or peers would further contribute to their well-being. Extending the opening hours of FACT is recommended as it might mitigate family members' everyday challenges and improve their subjective well-being.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1254"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197990","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":"Cost-benefit analysis of universal screening for HCV infection in China: a Markov modelling study.","authors":"Dachuang Zhou, Liangxiu Xu, Yimei Zhong, Zhehong Xu, Jun Wang, Yuntian Wang, Yiyang Gao, Jing Xie, Yuting Xia, Wenxi Tang","doi":"10.1186/s12913-025-13349-6","DOIUrl":"10.1186/s12913-025-13349-6","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis C virus (HCV) infection remains a major public health concern in China, contributing substantially to global HCV-related morbidity and mortality. In line with the World Health Organization (WHO) targets for HCV elimination by 2030, this study aimed to evaluate the long-term health and economic outcomes of universal HCV screening strategies in China.</p><p><strong>Methods: </strong>A decision-analytic Markov model was developed to simulate HCV disease progression and healthcare costs over a 30-year time horizon (2026-2055). A total of 81 scenarios were assessed, including 80 universal screening strategies and a no-screening comparator. Strategies varied by age group (3-10, 20-60, 60-80, or 3-80 years), screening duration (10 or 30 years), and frequency (once in 2026, or repeated every 10, 5, 3, 2 years, or annually). Model inputs were derived from published literature and national data. Cost-effectiveness was evaluated using a willingness-to-pay (WTP) threshold based on China's 2023 per capita gross domestic product, with future costs and health outcomes discounted at 5% annually. Deterministic and probabilistic sensitivity analyses were conducted.</p><p><strong>Results: </strong>Universal HCV screening was both effective and cost-effective in the majority of scenarios, with 74 out of 80 strategies demonstrating favorable cost-effectiveness ratios. Eighteen strategies met the WHO target for HCV-related mortality reduction before 2040. The most cost-effective approach-screening individuals aged 3-80 years every 5 years for 10 years-yielded an incremental net monetary benefit of US$98.99 billion (95% CI: US$10.18-190.15 billion), while reducing healthcare expenditures by US$126.67 billion compared to no screening. The required investment for screening was US$3.24 billion. Findings were robust in sensitivity analyses.</p><p><strong>Conclusions: </strong>Universal HCV screening every 5 years for individuals aged 3-80 years over a 10-year period is highly cost-effective in China and supports national efforts toward achieving WHO HCV elimination targets. These results provide evidence to inform policy decisions in China and other middle-income settings.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1230"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198008","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 heuristic model for the cost of capital of healthcare facilities: estimates for five countries.","authors":"Sergio Zuniga-Jara, Sofia Ruiz-Campo, Karla Soria-Barreto","doi":"10.1186/s12913-025-13451-9","DOIUrl":"10.1186/s12913-025-13451-9","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1242"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198056","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}