BMC Health Services Research最新文献

{"title":"Determinants of mammography screening uptake among women attending family health centers in Ankara, Türkiye: a cross-sectional study.","authors":"Fatıma Betül Topcu, Sultan Pınar Çetintepe, Caner Baysan, Kübra Nur Türk, Seçil Özkan","doi":"10.1186/s12913-026-15334-z","DOIUrl":"10.1186/s12913-026-15334-z","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess sociodemographic characteristics, health-seeking behaviors, and breast cancer screening beliefs among women aged 18-69 years attending Family Health Centers (FHCs) in Ankara, Türkiye, and to determine predictors of participation in mammography screening. It is design as a descriptive, cross-sectional study.</p><p><strong>Methods: </strong>Between April 2024 and January 2025, data were collected from 718 women using a sociodemographic questionnaire and the Turkish-adapted Breast Cancer Screening Beliefs Scale (originally developed by Kwok et al., validated by Türkoğlu et al.). Descriptive analyses, Chi-square tests, and binary logistic regression were performed with IBM SPSS 25.0. Variables with p < 0.20 in univariate analyses were entered into multivariate modeling, and statistical significance was defined as p < 0.05.</p><p><strong>Results: </strong>Statistically significant differences were found between age groups in terms of marital status, education level, housing situation, presence of chronic disease, general health perception, and history of non-breast cancer screening (p < 0.001). According to the logistic regression analysis, women who are aware of screening programs are 8.50 times more likely to have a mammogram, those who have undergone non-breast cancer screening are 5.52 times more likely, those with chronic diseases are 1.98 times more likely, and those who describe their health perception as \"good/very good\" are 1.90 times more likely. (Nagelkerke R² = 0.465).</p><p><strong>Conclusion: </strong>Mammography participation is influenced by both structural and personal determinants. Enhancing awareness, strengthening primary-care education, and addressing financial barriers could substantially improve screening uptake and facilitate earlier breast cancer diagnosis among Turkish women.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697008","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":"Caught between worlds: West African immigrant mothers` experiences with the Finnish healthcare system: a qualitative study using the socioecological model.","authors":"Emmaculate Tamankag, Tiina Valkendorff, Riikka Lämsä","doi":"10.1186/s12913-026-15253-z","DOIUrl":"10.1186/s12913-026-15253-z","url":null,"abstract":"<p><strong>Background: </strong>The rising number of African immigrants in Finland correlates with increasing healthcare needs, yet little attention has been given to West African immigrant mothers. The study aimed to explore how West African immigrant mothers experience and navigate the Finnish healthcare system, with their accounts primarily situated within maternity and child health services. A qualitative cross-sectional design was used to collect data using an in-depth pilot-tested semi-structured interview guide with (N = 29) West African immigrant mothers living in the Helsinki Metropolitan Area in Finland. Snowball and purposive sampling methods were used to recruit participants who met the following inclusion criteria: (1) were single or married; (2) were biological or adoptive mothers with African partners; (3) had lived in Finland for between 1 and 30 years; and (4) spoke English, Finnish, or Pidgin English. The interviews were recorded and transcribed using an edited transcription approach. An inductive content analysis was first conducted using ATLAS.ti, after which the analysis continued deductively by applying the Socioecological Model.</p><p><strong>Results: </strong>The findings revealed that participants´ experiences with the Finnish healthcare system are influenced at the intrapersonal, community, institutional and policy levels. Mothers reported: (1) Bias, racism, and discrimination during healthcare encounters, (2) Cultural expectations of physicians' competence, (3) Challenges in expressing healthcare needs, (4) Postpartum cultural expectations and experiences of maternity and child health services, (5) Trust in the Finnish healthcare system, (6) Community narratives and healthcare encounters, (7) Healthcare encounters that undermined trust, (8) Perceived cultural competence of healthcare professionals, (9) Language barriers during healthcare encounters, (10) Navigating health and social services, and (11) Impact of immigration policies on postpartum support.</p><p><strong>Conclusion: </strong>Although the findings are grounded mainly in maternity and child health contexts, they point to broader implications for trust and healthcare engagement that may extend to non-communicable disease prevention and management. They also highlight opportunities to strengthen culturally responsive policies and practices, build trust through community-based approaches, enhance healthcare professionals' cultural competence, and develop interventions responsive to the needs of West African immigrant mothers.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079584","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":"Time analysis of hospital costs for respiratory diseases in Brazil, 1998-2021.","authors":"Maryelli Laynara Barbosa de Aquino Santos, Luiza Gabriela de Araújo Fonseca, João Pedro de Santana Silva, Lucien Peroni Gualdi, Saint-Clair Gomes Bernardes Neto, Íllia Nadinne Dantas Florentino Lima","doi":"10.1186/s12913-026-15223-5","DOIUrl":"10.1186/s12913-026-15223-5","url":null,"abstract":"<p><strong>Background: </strong>Respiratory diseases (RD) affect individuals of all age groups, negatively impacting patients' quality of life and incurring significant costs to healthcare services. If not managed properly, they can also lead to mortality. Information provided by DATASUS on RD can be utilized to facilitate professional decision-making, set targets for approach and treatment, and support the creation of public policies aimed at this population.</p><p><strong>Objective: </strong>To assess the financial costs of hospital admissions in the Brazilian population caused by respiratory diseases from 1998 to 2021.</p><p><strong>Methods: </strong>This is a retrospective, population-based, ecological time-series study using secondary administrative hospital data in the Hospital Information System of the Unified Health System (SIH/SUS), regarding the costs generated by respiratory diseases in Brazil, including individuals aged 0 to 80 years. The data were analyzed using GraphPad Prism software version 8.0, and the significance level was set at 5%.</p><p><strong>Results: </strong>A total of 34,749,023 hospitalizations due to respiratory diseases were recorded in Brazil, resulting in an accumulated expenditure of R$23.65 billion and an average cost of R$760.62 per hospitalization. Adults aged 20 to 80 years accounted for the highest number of admissions and total costs. Among respiratory conditions, pneumonia represented the greatest financial burden to the public health system across all age groups. Regionally, the South region showed the highest population-adjusted hospital costs, while men presented higher in-hospital mortality rates, and the Southeast region exhibited the longest average length of hospital stay, particularly among older adults.</p><p><strong>Conclusion: </strong>Respiratory diseases, in addition to representing a public health problem, impose a significant financial burden on the Brazilian Unified Health System (SUS). It is essential to prioritize strategic planning and targeted actions to address these conditions, particularly pneumonia, considering the higher population-adjusted costs in the South, greater in-hospital mortality among men, and the longer hospital length of stay in the Southeast, aiming to reduce public health inequalities.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975738","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":"Socioeconomic disparities in age at entry into Korea's Long-Term Care Insurance: a descriptive analysis of 1.07 million adults, 2008-2022.","authors":"Jin-Won Noh, Jinseok Kim, Min-Hee Heo, Young Dae Kwon","doi":"10.1186/s12913-026-15304-5","DOIUrl":"10.1186/s12913-026-15304-5","url":null,"abstract":"<p><strong>Background: </strong>This study examined how individual socioeconomic and health characteristics shape the timing of entry into Korea's Long-Term Care Insurance (LTCI) system by comparing the ages at application and approval.</p><p><strong>Methods: </strong>Using the National Health Information Database, a nationally representative Korean claims dataset, we analyzed data from 1,068,669 adults aged ≥ 41 years who were followed from 2008 to 2022. This exploratory descriptive study used administrative records to determine ages at LTCI application and approval. Associations with gender, disability, income level, insurance type, and multimorbidity were assessed using descriptive statistics, bivariate comparisons (t-tests, F-tests), and kernel density plots to visualize distributional patterns across subgroups.</p><p><strong>Results: </strong>The mean age at LTCI application was 79.98 years, and the mean age at approval was 80.95 years, indicating that most beneficiaries enter the system well beyond the initial eligibility age of 65 years. Women, people without disabilities, and individuals with fewer chronic conditions tended to enter and be approved later, whereas individuals with greater disease burden entered earlier and were typically approved earlier. Both the lowest- and highest National Health Insurance contribution groups showed later entry than middle-income groups, while Medical Aid beneficiaries entered earlier than those covered by employment-based or region-based insurance.</p><p><strong>Conclusions: </strong>Among adults who survive to older ages, LTCI applications and approvals tend to occur well beyond the initial eligibility age of 65 years. Differences in mean ages at entry across subgroups may reflect both variation in help-seeking and differential survival, and our descriptive comparisons cannot disentangle these mechanisms. These patterns provide baseline evidence on ages at entry among survivors and are consistent with possible socioeconomic and informational barriers. Targeted outreach, strengthened health literacy, and more responsive administrative support are therefore best viewed as plausible policy responses and as priorities for future analytic research that explicitly accounts for competing mortality.</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":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890957","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":"Leveraging sociological systems theory: integrating transformational leadership and social capital to enhance quality of care - an exploratory longitudinal study of German hospitals.","authors":"Arno Stöcker, Jeffrey Braithwaite, Ludwig Kuntz, Verena Maschke, Holger Pfaff","doi":"10.1186/s12913-026-15268-6","DOIUrl":"10.1186/s12913-026-15268-6","url":null,"abstract":"<p><strong>Background: </strong>Numerous studies have examined ways to improve care quality and patient safety. Further progress could be achieved by leveraging underexplored sociological concepts. To date, transformational leadership and social capital have been examined primarily as isolated factors in healthcare research to explain variations in hospital care quality. Yet, these concepts have rarely been integrated into a broader theoretical framework. Drawing on Parsons' AGIL framework, we identified two key social prerequisites for effective healthcare organizations: goal attainment and integration. We hypothesized that hospitals meeting both criteria would deliver better care quality.</p><p><strong>Methods: </strong>Using a 2008 survey of medical directors in German hospitals, we measured transformational leadership (as a proxy for goal attainment) and social capital (as a proxy for integration). Data were matched with quality metrics from nationwide reports (2012-2019) on quality irregularities and quality deficiencies. Hospitals were grouped into high and low categories for both factors using a median split, and longitudinal panel analyses were conducted on 508 hospitals.</p><p><strong>Results: </strong>The combination of strong transformational leadership and high social capital was associated with significantly fewer quality irregularities, but not with quality deficiencies.</p><p><strong>Conclusions: </strong>Our findings suggest that hospital leadership should strategically strengthen both factors to improve organizational capacity for quality improvement. This synergy likely fosters goal-oriented collective action, particularly the collaborative efforts required to enhance care quality and patient safety. Additionally, we propose that applying sociological theory offers valuable insights into the social dynamics essential for maintaining and enhancing quality and safety in healthcare settings.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148688568","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":"What is required for digital care and support technologies to be experienced as good care by community-dwelling older adults? A qualitative study.","authors":"Kasper Kruithof, Vivianne Dörenberg, Brenda Frederiks","doi":"10.1186/s12913-026-15255-x","DOIUrl":"https://doi.org/10.1186/s12913-026-15255-x","url":null,"abstract":"<p><strong>Background: </strong>Digital care and support technologies may support independent and healthy aging, and are promoted as means to reduce healthcare costs and improve access. Yet realizing this potential in practice remains challenging, particularly given the variability in how older persons experience these technologies. Therefore, to better understand their perceived value and, indirectly, support efficient and equitable elderly care, we explored what is required for such technologies to be experienced as good care by community-dwelling older persons.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with 27 community-dwelling older persons about their experiences with digital care and support technologies and analyzed the data thematically.</p><p><strong>Results: </strong>Respondents described technologies as contributing to good care when they aligned with (1) their needs and habits, (2) their capabilities, and (3) their values. When older persons had an active role in choosing technologies, these were often experienced as supporting aging-in-place and enhancing accessibility, safety and autonomy. In contrast, technologies introduced by caregivers were frequently perceived as unnecessary and therefore often not used. Some respondents experienced technologies as hindering good care due to reduced human contact, while misalignment with users' capabilities hampered access.</p><p><strong>Conclusions: </strong>Addressing the three proposed areas of alignment can help healthcare providers and welfare organizations implement technologies that contribute to experienced good care for older persons, which in turn can support the efficient and equitable delivery of care. Our findings underscore the need for analogue alternatives and operational support to prevent exclusion of the most vulnerable and ensure a minimum standard of accessibility.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975736","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":"Structural alignment and thematic complementarity between ISO 7101:2023 and Türkiye's hospital quality standards: a qualitative document analysis.","authors":"Furkan Karahüseyinoğlu","doi":"10.1186/s12913-026-15273-9","DOIUrl":"https://doi.org/10.1186/s12913-026-15273-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;ISO 7101:2023, adopted in Türkiye as TS ISO 7101:2023, is an international management system standard for healthcare quality management published by the International Organization for Standardization (ISO) in October 2023 and structured according to ISO's harmonised high-level architecture. SKS Hastane Sürüm 6.1 (Sağlıkta Kalite Standartları Hastane Sürüm 6.1) is Türkiye's national hospital quality standards framework, comprising 5 dimensions, 46 sections, 523 standards, and 1,599 assessment criteria calibrated to hospital practice. Both documents coexisted within the Turkish health system at the time of this analysis: TS ISO 7101:2023 was adopted by the Turkish Standards Institution (TSE) in November 2023, while SKS Hastane Sürüm 6.1 has been in use since its publication in 2021. Despite the potential relevance of both frameworks to hospital quality governance, to the author's knowledge, no published study has systematically compared the structural and thematic alignment of ISO 7101:2023 and SKS Hastane Sürüm 6.1. This study aimed to examine the degree and nature of correspondence between ISO 7101:2023 and SKS Hastane Sürüm 6.1 across a comprehensive set of hospital quality management domains.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A qualitative document analysis with structured comparative mapping was conducted using the primary texts of ISO 7101:2023 (accessed as TS ISO 7101:2023) and SKS Hastane Sürüm 6.1. Fourteen analytical dimensions were specified a priori, covering organisational context, leadership and governance, quality planning, patient/person-centred care, patient safety and risk management, workforce competence, clinical and service delivery processes, information management, resource and infrastructure management, external provider management, performance measurement, incident reporting and learning, continuous improvement, and accessibility and equity. A seven-category coding scheme was applied to each dimension: Full Convergence (FC), Partial Convergence (PC), ISO-Dominant Management System Emphasis (ISO-D), SKS-Dominant Operational Specificity (SKS-D), Complementarity (COMP), Limited Explicit Correspondence (LEC), and No Direct Correspondence (NDC). Coding categories are analytical, not evaluative. Standard-level verification extending to confirmed standard codes and assessment-criteria-level content was conducted for five dimensions (D2, D3, D5, D8, D11). ISO 7101:2023 text is paraphrased with clause references; the document is copyrighted and is not extensively quoted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Thirteen of the fourteen analytical dimensions were classified as Partial Convergence (PC). Dimension 7 (Clinical and Service Delivery Processes) was classified as Complementarity (COMP). No dimension was classified as Full Convergence or No Direct Correspondence. The Partial Convergence pattern reflects shared quality management intent across all domains, accompanied by systematic differences in document","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787910","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":"Infertility service availability, geographic accessibility, and use: results from linked facility-female cross-sectional data in Burkina Faso, Côte d'Ivoire, Niger, and Uganda.","authors":"Haley L Thomas, Fredrick Makumbi, Philip Anglewicz, Simon P S Kibira, Caroline Moreau, Georges Guiella, Rosine Mosso, Suzanne O Bell","doi":"10.1186/s12913-026-15214-6","DOIUrl":"10.1186/s12913-026-15214-6","url":null,"abstract":"<p><strong>Background: </strong>Infertility affects millions of people globally, with the highest prevalence in Africa (16%). Despite strong evidence linking sexually transmitted infections (STIs) to infertility in sub-Saharan Africa, evidence on the availability of and accessibility to infertility-related services-including STI testing and broader infertility care-remains limited across the region. This study aims to: (1) assess availability by estimating the proportion of facilities offering STI testing and infertility services; (2) assess geographic accessibility by examining women's proximity to service-offering facilities; and (3) assess use by evaluating whether geographic proximity is associated with biomedical care-seeking for difficulties conceiving.</p><p><strong>Methods: </strong>We used nationally representative cross-sectional survey data from women aged 15-49 and the health facilities that serve them in Burkina Faso, Côte d'Ivoire, Niger, and Uganda (2021-2024). We estimated the proportion of facilities offering STI testing and infertility services, the latter being a broad facility-reported measure of the availability of any service, without specification on the type of service. Using geospatial analysis, we linked facility data to women's residences and calculated the proportion of women living within 5 and 10 km of STI testing and infertility services, respectively. We fit multivariable logistic regression models to examine associations between women's characteristics and geographic access to services, and between geographic access and women's biomedical care-seeking.</p><p><strong>Results: </strong>STI testing was widely available across countries (68.5-92.6% of facilities), while infertility services were limited (28.4-44.0%), except in Burkina Faso (78.3%). Women with higher education, greater wealth, and urban residence had higher odds of geographic access to services. In Burkina Faso and Niger, women living within 5 km of STI testing facilities had increased odds of biomedical care-seeking (aOR 2.94 and aOR 7.19, respectively), and in Niger, women within 10 km of infertility services had increased odds of biomedical care-seeking (aOR 8.46).</p><p><strong>Conclusions: </strong>Infertility service availability and accessibility remain limited, and women's proximity to services is associated with biomedical care-seeking, underscoring the importance of service expansion. Governments and NGOs should prioritize investments in STI prevention and treatment and, where feasible, more advanced infertility evaluation and treatment, including referral pathways to higher-level care, to address the region's unmet need for infertility services.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872993","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":"What helps and what hinders? Perspectives of perinatal women and healthcare providers on perinatal mental health screening in a metropolitan city in Southern India.","authors":"Parama Basu, Pracheth Raghuveer, Sundarnag Ganjekar, Girish Nagaraja Rao","doi":"10.1186/s12913-026-15235-1","DOIUrl":"10.1186/s12913-026-15235-1","url":null,"abstract":"<p><strong>Background: </strong>Common perinatal mental disorders, including depression, anxiety, and stress-related conditions, significantly impact maternal and child health. Despite their high prevalence, CPMDs often go undetected and untreated, particularly in low- and middle-income countries. Integrating mental health screening into routine maternal care is crucial for early identification and intervention. However, implementation faces multiple challenges. This study aims to explore the facilitators and barriers to screening perinatal women for CMDs in healthcare facilities in Bengaluru, India, from the perspectives of healthcare providers and perinatal women.</p><p><strong>Methods: </strong>A qualitative study was conducted between October 2024 and March 2025 among 20 participants, including 10 healthcare providers and 10 perinatal women from public and private healthcare facilities in a zonal administrative unit of an Indian city, Bengaluru. Key informant interviews (KIIs) were conducted, and the data were analyzed to identify key system-level and individual-level facilitators and barriers.</p><p><strong>Results: </strong>Facilitators included a well-established referral system, drug availability, provider willingness to screen, privacy in consultations, and the integration of screening questions into the Thayi (Mother and Child Protection) Card. We identified several barriers, including fragmentation between maternal and mental health services, high provider workload, lack of dedicated mental health professionals, and inadequate training on mental health screening. Perinatal women faced stigma, limited awareness of mental health, reluctance to seek help, and misconceptions about treatment. The presence of family members during consultations further hindered open discussions.</p><p><strong>Conclusion: </strong>These findings highlight the need for context-specific, integrated strategies, including workforce strengthening and stigma reduction, to improve perinatal mental health screening and care.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001245","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":"Combining the optimization of the CT examination process with a vial sharing strategy for contrast agents: an economical and practical method for hospitals.","authors":"Yanchao Yin, Wei Fu, Lin Qiu, Feie Li, Dong Liu, Juan Li","doi":"10.1186/s12913-026-15251-1","DOIUrl":"10.1186/s12913-026-15251-1","url":null,"abstract":"<p><strong>Background: </strong>Drug wastage is a global concern that not only imposes an economic burden on healthcare systems but may also lead to inefficient resource allocation and environmental degradation, specifically through pharmaceutical residues in wastewater and carbon emissions from incineration. To address this issue, this study optimized the computed tomography (CT) examination process through multidisciplinary collaboration and changed the billing method for contrast agents from single-vial billing to vial-sharing billing. We aimed to quantify the difference in drug cost and waste volume between single-vial billing and vial-sharing billing for CT contrast agents in a tertiary hospital.</p><p><strong>Methods: </strong>This retrospective study was conducted at Tongji Hospital of Huazhong University of Science and Technology, Hubei province, China. Data were obtained from the Hospital Information System (HIS) for contrast-agent prescriptions from July 2023 to June 2024. We collected information on 9 types of drugs, including their names, unit prices per vial, drug specifications, and actual dosages. Drug costs and waste volumes were calculated using hospital procurement price lists.</p><p><strong>Results: </strong>The multidisciplinary optimization of the CT examination process was implemented. Via the vial-sharing billing method, a total of 2,906,398.8 mL of contrast agent was saved annually, corresponding to a cost reduction of 9,181,958.83 CNY. On average, each patient's prescription cost was reduced by 66.93 CNY.</p><p><strong>Conclusion: </strong>The vial-sharing strategy has substantially reduced drug waste, alleviated the economic burden on patients, improved drug utilization efficiency, and conserved medical resources.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148928812","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}