Health Care Analysis最新文献

This study aimed to compare how healthcare professionals and laypeople from the UK engaged with and confronted misinformation about masks on social media and some of the barriers encountered, applying connectivism as a theoretical lens to interpret findings. Using thematic framework analysis, 12 in-depth interviews were conducted with participants consisting of seven healthcare professionals and five laypeople who actively use the social media website Twitter (now known as X). Interviews were recorded, transcribed verbatim and analysed iteratively using constant comparison and line-by-line coding. After coding of the first few interviews a working analytical framework was developed by comparing codes and grouping them together into categories. This was later applied to the subsequent interview transcripts. Analysis revealed six key categories: social capital (e.g., celebrity status), emotion (e.g., fear, anger, and burnout), culture (e.g., politics and toxic social media culture), social media dynamics (e.g., information overload), communication (e.g., managing cognitive load), and belief (e.g., beliefs being fixed and difficult to change). Our study suggests that healthcare professionals must actively engage with the public on social media by providing clear, evidence-based information, correcting false claims, and fostering trust through transparent communication. Interpreting our findings through a connectivist perspective highlights how digital networks shape trust and learning in online health discourse. Wider society, including tech companies and policymakers, should implement stronger fact-checking mechanisms, promote digital literacy, and support regulations that curb the spread of harmful health misinformation.

Non-invasive prenatal testing (NIPT) is offered on a user-pays basis in Australia, with a range of providers and services available. A key concern raised about NIPT provision is the impact on informed consent of possible routinization of testing. Given these concerns, the documents, forms and informational material used in clinical practice are of critical importance. Test-specific request forms produced by commercial providers are frequently used in Australia, but there is a lack of clarity about the function or role of these forms. Some are labelled as "request forms", while others include references to "informed consent". Our aim in this study was to assess the range of functions that these forms may serve. We performed an online search for forms available from Australian providers in 2024 and applied a modified version of the Evaluative Linguistic Framework to a final list of eight forms. Our findings indicate significant heterogeneity and ambiguity in the function of these forms. We suggest these forms play a role in the performance of informed consent as a clinical ritual. Documents and forms can play a supportive role in counselling related to NIPT, but this supportive role should be recognized and articulated. These findings can inform the way healthcare professionals in Australia and other settings approach NIPT provision.

Voice biomarker research is fueling a growing health-tech market, largely driven by start-ups. Yet, there is limited scholarship on how start-ups navigate the legal uncertainty surrounding voice data protection and the rising expectations for responsible AI. This study reviews the ethical, legal and regulatory practices as stated on the websites of 27 start-ups using voice as a biomarker in health-tech. The review reveals substantial disparities in the availability, readability and content of the information disclosed, especially regarding privacy policies, with only a few websites offering product-specific, transparent, and comprehensive privacy policies. Significant differences also emerged in the start-ups' terms of use and regulatory compliance statements, likely reflecting the novelty of the field, disparity in legal and regulatory requirements, and the absence of sector-specific ethical guidance. For example, while most start-ups reference compliance with data protection frameworks (e.g., HIPAA, GDPR), many fall short of best practices for transparency, accountability, and user-centered communication. We argue that the success of start-ups in health-tech depends on their capacity to capture and retain the attention of potential end-users and investors. By adopting accessible, transparent and forward-looking communication on how they frame their legal and ethical responsibilities in practice, start-ups can not only ensure legal and regulatory compliance but build trust and support sustainable innovation. This work identifies key best practices for voice AI start-ups to consider and lays the foundation for future research, including surveys and longitudinal tracking, to better understand the evolving landscape of ethical and legal practices in voice biomarker and voice AI health-tech.

The US healthcare system is characterized by a persistent deadlock, where high costs, low efficiency, and inequity resist fundamental reform. This stalemate is rooted in deep ideological divides, political polarization, a fragmented fiscal structure, and the power of entrenched interest groups. This article analyzes how recent trade protectionist policies, specifically tariffs on pharmaceuticals and their inputs, intersect with this domestic gridlock. It posits a central paradox: a political system incapable of enacting major domestic health reform can simultaneously deploy assertive trade interventions in the same sector. The article argues that these tariffs should not be misconstrued as flawed instruments of healthcare reform. Instead, they represent the application of a distinct sovereigntist and protectionist logic, driven by national security concerns. The consequence is not a failed attempt at a solution, but a collision of policy agendas that actively exacerbates the healthcare system's core dysfunctions. By increasing costs, destabilizing supply chains, and creating new arenas for interest group conflict, tariffs intensify partisan strife and further entrench the reform deadlock. This process, marked by the "securitization" of the pharmaceutical industry, signals a critical shift in global health governance, where geopolitical strategy now overrides and complicates the pursuit of domestic public health goals.

The ongoing war in Ukraine, which began in 2022, has displaced millions of people, creating immense challenges for healthcare systems in refugee-receiving countries. While temporary protection aims to grant refugees access to medical care, significant structural barriers and ethical shortcomings exist in refugee healthcare. To meet this challenge, the authors propose considering the integration of displaced physicians into the medical care systems of host countries. This solution not only meets the immediate healthcare demands but also leverages the expertise of Ukrainian doctors. The implementation in Germany and Poland exemplifies the current heterogeneity of regulations governing the professional practice of Ukrainian physicians, with individual workarounds such as the possibility of treating fellow Ukrainians while waiting for the approval of the license. From an ethical perspective, the dilemma between the urgent need for additional physicians and ensuring patient safety by thoroughly assessing all doctors' qualifications is a critical concern. Considering all the analyzed aspects, the authors advocate for harmonizing the regulations across the EU and removing barriers that limit healthcare access for refugees. They further stress the importance of developing comprehensive long-term strategies to ensure sustained healthcare access for Ukrainian refugees.

Despotic leadership harms both employee motivation and well-being. It has been studied using several theories, including social exchange and social learning theory, the latter suggesting learning stems from imitation. This study explores dark side of leadership, particularly in current healthcare reforms in Pakistan, such as Medical Teaching Institute (MTI). The need to review changing structural hierarchies is emphasized, as unilateral decisions often lead to defensive silence rather than workplace aggression and bullying. This study investigated the moderating role of neuroticism in the relationship between despotic leader- ship and workplace deviance, with emotional exhaustion mediating factor among healthcare sector employees. This study involved 294 professionals from public healthcare centres in Pakistan, achieving a 73% response rate. Five hypotheses were tested using Smart PLS for model testing and structural measurement along with SPSS and Preacher Hayes process models for moderated-mediation analysis. Results of linear regression analysis revealed that despotic leadership, mediated by emotional exhaustion, significantly impacts interpersonal and organizational deviance. Interestingly, neuroticism does not moderate this relationship, challenging previous literature. This study sheds light on despotic leadership's broader influence beyond personality attributes, offering new theoretical and practical implications and guiding future research directions.

In October 2024, Türkiye was shocked by the "Newborn Gang" scandal, in which a network of healthcare professionals allegedly exploited newborns for financial gain in private hospitals. The accused are charged with intentionally neglecting, mistreating or even killing of healthy infants in neonatal intensive care units to prolong their stays and maximize government reimbursements. This paper critically examines the structural and ethical failures exposed by the 2024 "Newborn Gang" scandal in Türkiye, in which healthcare professionals in private hospitals allegedly allowed or caused the deaths of newborns to profit from the state's healthcare reimbursement system. Drawing on the frameworks of neoliberal critique and medical humanities, the study argues that such extreme violations are not isolated incidents of individual misconduct, but manifestations of deeper systemic vulnerabilities fostered by the neoliberalization of healthcare. It explores how deregulation, market incentives, and the erosion of ethical values-exacerbated by Türkiye's Health Transformation Program-have created an environment where financial gain is prioritized over patient welfare. Comparative case studies are employed to contextualize these findings within broader global patterns of ethical collapse in healthcare systems influenced by market logic. The paper contends that merely strengthening oversight is insufficient; rather, a structural reorientation is needed. As a potential alternative, the study introduces Value-Based Healthcare as a model that aligns clinical outcomes with ethical imperatives. Ultimately, the paper calls for a fundamental moral recalibration of healthcare-one that affirms care, integrity, and justice as core values over profit and efficiency.

Compliance and regulatory bodies often encourage health care providers' disclosure of and apologies for wrongdoing. Patients may perceive that forgiveness is expected and feel pressure to grant it. However, forgiveness carries consequences, which can bring limits to forgiveness. Understanding these limits is crucial for understanding when forgiveness can either heal or add to trauma. This paper explores 10 context-dependent limits to forgiveness across four categories. The first category outlines conceptual limits: not all harm requires forgiveness, some evil acts may be beyond human forgiveness, and blame can be incompatible with forgiveness. Secondly, moral and ethical limits result from how accountability strains forgiveness, how moral absolutism can hinder it, and how proxy forgiveness may lack moral legitimacy. The third category identifies relational and social limits. Forced reconciliation can undermine forgiveness. System negligence diffuses culpability, hindering individual forgiveness, and requires prioritizing the victim's healing and benefit despite the diluted accountability. Finally, the fourth category highlights temporal and process-related limits. It emphasizes that ongoing or unaddressed harm can obstruct forgiveness, while variations in healing trajectories may delay or complicate it. Updating current understanding, this framework adds insight into when forgiveness may be inappropriate. It offers providers ethical guidance in navigating this terrain through a person-centred approach balancing empathy and accountability. The framework aims to facilitate healing for the patient and provider, regardless of whether forgiveness occurs.

About one-third of Australians use the services of complementary and alternative medicine (CAM); but debate about the role of CAM in public healthcare is vociferous. Despite this, the mechanisms driving CAM healthcare choices are not well understood, especially in rural Australia. From 2016 to 2018, 2,679 persons from the Goulburn Valley, northern Victoria, were surveyed, 28% (755) of whom reporting visiting CAM practitioners. A Generalized Linear Mixed Model was used to assess associations between various socio-demographic variables and the use of CAM services. The strongest significant inverse (p < 0.05) association with CAM use overall was being unemployed, with markedly lower odds of using CAM than those employed full-time (OR 0.22 [0.12, 0.41]). The next strongest inverse relationship was being retired (OR 0.44 [0.30, 0.65]). The strongest positive associations were with English spoken at home (OR 2.38 [1.34, 4.24]), private health insurance (hospital cover) (1.57 [1.28, 1.91]), being Australian born (OR 1.61 [1.14, 2.28]), and female sex (1.25 [1.02, 1.52])). Females had significantly higher odds of using osteopathy than males (OR 1.98 [1.33, 2.96]) but there were no significant sex differences for chiropractic or massage. This is the first such study conducted solely for a rural Australian population. The drivers of CAM use differed from previous nation-wide studies and they varied across modalities. The factors identified here as being associated with CAM use could be used by CAM practitioners in developing person-centred services. Similarly, the findings are relevant to primary-care services in understanding what sectors of society might eschew conventional health care for CAM in rural regions, where health services are often limited.