Qi Huang, Peipei Yan, Chunbei Zhou, Fan Zhang, Ying Xiong
Objective
To investigate the prevalence and influencing factors of scoliosis among primary and secondary school students in Chongqing, China, in order to provide a theoretical basis for the prevention and control of the disease.
Methods
From September to October 2022, primary and secondary school students in Chongqing were selected for scoliosis screening and questionnaire survey using a multistage sampling method. The scoliosis group and the normal group (the control group) were matched by propensity score matching (PSM) according to a ratio of 1:4. Individual characteristics were compared before and after matching, and conditional logistic regression analyses was used to analyze the influencing factors of scoliosis after matching.
Results
The detection rate of scoliosis was 0.91% among 13,605 respondents. Differences in scoliosis detection rates by gender, age, and educational stage were statistically significant (p < 0.05). The results of the conditional logistic regression analysis after PSM showed that the time of outdoor activities, physical education classes, computer use, reading and writing time after school, regular adjustment of the height of desks and chairs according to the height of the students, the weight of the school bag and mattress softness were the factors influencing scoliosis.
Conclusion
Scoliosis is affected by a combination of factors, many of which are preventable. Therefore, families, schools and relevant authorities should pay attention to it and should strengthen the development of early screening, prevention and control.
{"title":"Prevalence and Influencing Factors of Scoliosis Among Primary and Secondary School Students: A School-Based Cross-Sectional Study in Chongqing, China","authors":"Qi Huang, Peipei Yan, Chunbei Zhou, Fan Zhang, Ying Xiong","doi":"10.1002/hpm.70044","DOIUrl":"10.1002/hpm.70044","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the prevalence and influencing factors of scoliosis among primary and secondary school students in Chongqing, China, in order to provide a theoretical basis for the prevention and control of the disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From September to October 2022, primary and secondary school students in Chongqing were selected for scoliosis screening and questionnaire survey using a multistage sampling method. The scoliosis group and the normal group (the control group) were matched by propensity score matching (PSM) according to a ratio of 1:4. Individual characteristics were compared before and after matching, and conditional logistic regression analyses was used to analyze the influencing factors of scoliosis after matching.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The detection rate of scoliosis was 0.91% among 13,605 respondents. Differences in scoliosis detection rates by gender, age, and educational stage were statistically significant (<i>p</i> < 0.05). The results of the conditional logistic regression analysis after PSM showed that the time of outdoor activities, physical education classes, computer use, reading and writing time after school, regular adjustment of the height of desks and chairs according to the height of the students, the weight of the school bag and mattress softness were the factors influencing scoliosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Scoliosis is affected by a combination of factors, many of which are preventable. Therefore, families, schools and relevant authorities should pay attention to it and should strengthen the development of early screening, prevention and control.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 1","pages":"193-203"},"PeriodicalIF":1.8,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study investigates patients' goal-oriented experiences in the context of home dialysis for chronic kidney disease (CKD). The aim is to understand how the home care context can be designed to support chronic patients in achieving their goals. Drawing on goal-oriented experience theory, we explore how patients' motivations, desired outcomes, and lived experiences shape their perceptions of home health care. To do so, we employed a co-design-based qualitative methodology, including postal kits, photo diaries, ethnographic observations, in-depth interviews, and participatory workshops with 22 stakeholders (patients, healthcare professionals, and caregivers) in public and private healthcare institutions in France. Seven key design features vital to patient experience and goal fulfilment were identified: patient participation, social support, training, food quality, home layout, interactions with medical staff, and consumable supply. These features enhance the cognitive (control and expertise), emotional (safety and comfort), and physical (fitness) dimensions of patient well-being. Patients' main goals were survival, freedom, mobility, and maintaining normalcy in life. This study contributes to the literature on healthcare design and the patient journey by emphasizing goal-oriented care and demonstrating how experiential knowledge and higher-order goals can inform system design beyond conventional ‘goals of care.’ Healthcare systems should integrate patient-defined goals into service design to promote autonomy and quality of life. Involving multiple stakeholders can foster deeper insights and more effective, user-centric care models. This research pioneers a patient-centric, goal-oriented design framework in home healthcare, emphasizing the value of co-design methods.
{"title":"Designing the Healthcare System for the Fulfilment of Patient Goals: A Patient-Centric Exploration in the Home Dialysis Context","authors":"Frederic Ponsignon, Marie-Julie Catoir Brisson, Susana Paixão-Barradas, Corinne Grenier, Corinne Isnard Bagnis","doi":"10.1002/hpm.70042","DOIUrl":"10.1002/hpm.70042","url":null,"abstract":"<p>This study investigates patients' goal-oriented experiences in the context of home dialysis for chronic kidney disease (CKD). The aim is to understand how the home care context can be designed to support chronic patients in achieving their goals. Drawing on goal-oriented experience theory, we explore how patients' motivations, desired outcomes, and lived experiences shape their perceptions of home health care. To do so, we employed a co-design-based qualitative methodology, including postal kits, photo diaries, ethnographic observations, in-depth interviews, and participatory workshops with 22 stakeholders (patients, healthcare professionals, and caregivers) in public and private healthcare institutions in France. Seven key design features vital to patient experience and goal fulfilment were identified: patient participation, social support, training, food quality, home layout, interactions with medical staff, and consumable supply. These features enhance the cognitive (control and expertise), emotional (safety and comfort), and physical (fitness) dimensions of patient well-being. Patients' main goals were survival, freedom, mobility, and maintaining normalcy in life. This study contributes to the literature on healthcare design and the patient journey by emphasizing goal-oriented care and demonstrating how experiential knowledge and higher-order goals can inform system design beyond conventional ‘goals of care.’ Healthcare systems should integrate patient-defined goals into service design to promote autonomy and quality of life. Involving multiple stakeholders can foster deeper insights and more effective, user-centric care models. This research pioneers a patient-centric, goal-oriented design framework in home healthcare, emphasizing the value of co-design methods.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 1","pages":"171-181"},"PeriodicalIF":1.8,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12794134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145641163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Strikes by health workers have become a recurring feature of many health systems across sub-Saharan Africa [<span>1, 2</span>]. Although often framed as isolated national crises, these events expose deeper structural deficiencies in the governance of public health systems and labour relations [<span>2, 3</span>]. Based on the case of Mozambique [<span>4</span>], this editorial argues that both governments and health professionals tend to favour tactical responses, such as legal threats, dismissals, public appeals, or one-off negotiations, instead of adopting long-term strategies that could promote stability and trust. Overreliance on tactics, while politically expedient, perpetuates fragility and fails to break the cycle of confrontation. The Mozambican experience is not unique. Similar reactive and fragmented responses were documented during the prolonged health worker strikes in Kenya and Nigeria, where institutional weaknesses and the absence of structured dialogue exacerbated the crisis [<span>5, 6</span>].</p><p>Mozambique has witnessed successive strikes involving doctors, nurses, and other health workers since 2013. These actions have often followed a similar script: governments respond tactically, aiming to suppress unrest, while underlying causes remain unaddressed. At the same time, health workers failed to build durable platforms for negotiation. Their mobilisations have focused on immediate demands related to pay or conditions, without broader engagement with structural reform. Like in other countries, this limited scope, combined with state resistance, has entrenched a dynamic of short-term escalation, and temporary resolution and recurrent conflicts [<span>5, 6</span>].</p><p>The 2013 doctors' strike in Mozambique is particularly illustrative. It began with specific demands from a small group of physicians but accelerated after the government refused to acknowledge the legitimacy of their grievances. Rather than engage in structured dialogue, authorities employed coercive measures, including dismissals and public accusations. These responses intensified mistrust and triggered wider participation from other professional groups [<span>4</span>]. In the absence of institutional mechanisms for collective bargaining or conflict resolution, further strikes followed in subsequent years. More than a decade later, the situation remains unresolved.</p><p>Similarly in Kenya, Nigeria, South Africa and other countries, authorities have frequently relied on legal instruments, court injunctions, suspension of salaries, or deployment of military personnel to contain health worker protests. Although such responses may achieve short-term order, they rarely result in sustainable agreements. In parallel, the fragmentation of professional associations, the lack of coordinated leadership, and the absence of institutionalised grievance mechanisms prevent workers from engaging in long-term negotiation processes. In many settings, labour relations become
{"title":"Health Worker Strikes in Africa: Tactical Reactions Are Not Enough","authors":"Alexandre Lourenço Jaime Manguele, Isabel Craveiro, Mohsin Sidat, Jorge Cabral, Tiago Correia, Paulo Ferrinho","doi":"10.1002/hpm.70037","DOIUrl":"10.1002/hpm.70037","url":null,"abstract":"<p>Strikes by health workers have become a recurring feature of many health systems across sub-Saharan Africa [<span>1, 2</span>]. Although often framed as isolated national crises, these events expose deeper structural deficiencies in the governance of public health systems and labour relations [<span>2, 3</span>]. Based on the case of Mozambique [<span>4</span>], this editorial argues that both governments and health professionals tend to favour tactical responses, such as legal threats, dismissals, public appeals, or one-off negotiations, instead of adopting long-term strategies that could promote stability and trust. Overreliance on tactics, while politically expedient, perpetuates fragility and fails to break the cycle of confrontation. The Mozambican experience is not unique. Similar reactive and fragmented responses were documented during the prolonged health worker strikes in Kenya and Nigeria, where institutional weaknesses and the absence of structured dialogue exacerbated the crisis [<span>5, 6</span>].</p><p>Mozambique has witnessed successive strikes involving doctors, nurses, and other health workers since 2013. These actions have often followed a similar script: governments respond tactically, aiming to suppress unrest, while underlying causes remain unaddressed. At the same time, health workers failed to build durable platforms for negotiation. Their mobilisations have focused on immediate demands related to pay or conditions, without broader engagement with structural reform. Like in other countries, this limited scope, combined with state resistance, has entrenched a dynamic of short-term escalation, and temporary resolution and recurrent conflicts [<span>5, 6</span>].</p><p>The 2013 doctors' strike in Mozambique is particularly illustrative. It began with specific demands from a small group of physicians but accelerated after the government refused to acknowledge the legitimacy of their grievances. Rather than engage in structured dialogue, authorities employed coercive measures, including dismissals and public accusations. These responses intensified mistrust and triggered wider participation from other professional groups [<span>4</span>]. In the absence of institutional mechanisms for collective bargaining or conflict resolution, further strikes followed in subsequent years. More than a decade later, the situation remains unresolved.</p><p>Similarly in Kenya, Nigeria, South Africa and other countries, authorities have frequently relied on legal instruments, court injunctions, suspension of salaries, or deployment of military personnel to contain health worker protests. Although such responses may achieve short-term order, they rarely result in sustainable agreements. In parallel, the fragmentation of professional associations, the lack of coordinated leadership, and the absence of institutionalised grievance mechanisms prevent workers from engaging in long-term negotiation processes. In many settings, labour relations become","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 1","pages":"4-6"},"PeriodicalIF":1.8,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.70037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145641172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shehla Zaidi, Shifa Salman Habib, Asad Shoaib, Zakir Shah, Karl Blanchet, Rosemary Jouhad, Natasha Palmer, Valery Ridde, Sophie Witter
There is increasing global discourse on Global Health Initiatives' (GHIs) role and the need for better alignment with universal health coverage (UHC), which is particularly salient given recent rapid reductions in global aid. However, tensions within national ecosystems of GHI assistance and country alignment towards UHC are less well understood. We identify challenges and leverage points for aligning GHIs' assistance towards UHC-focused health systems in Pakistan, drawing from the perspective of country stakeholders. A political economy approach was applied to unpack the context of national aid architecture, country discourse on strengths and weakness of GHI country ecosystem and stakeholders' power, positioning and interests for future reforms. Key informant interviews were conducted with constituencies of country-based stakeholders in federal and provincial health systems, supplemented by a desk review of health financing data and policy-programmatic documents.
The findings highlight a context of expanding GHI mandate, despite Pakistan's trajectory towards middle income country status, but weak alignment with national primary health care (PHC) budgeting and planning processes. Country discourse acknowledged improved disease coverage but surfaced tensions with the off-budget parallel grant model, comprising of several GHI intermediaries, headquarters-driven planning and selective system support, that was not positioned to build sustainability resulting in duplicative resourcing, questionable value for money, clouding of accountability roles and poor preparedness for transition. Competing interests between federal and provincial governments, and between disease managers and PHC planners, was perceived to further weaken country stewardship of GHI assistance. The prospect of an impending decline in aid funding was a common interest for change across all stakeholder constituencies. Stakeholders were positioned for a continuation of GHI assistance but with fundamental changes involving integration with national PHC budgeting, re-balancing power through shared accountability, and calibrated federal-provincial incentives for coordinated working, but most felt disempowered to bring about change.
We conclude that addressing power imbalances must be at the centre of paradigm shifts in country assistance by GHIs, although contextual modalities will differ across LMICs. Direct engagement with UHC stakeholders under the ambit of national PHC reforms, fewer intermediaries, on-budget incentives to sustainably grow domestic financing and PFM technical assistance for aid management emerged as key areas for efficient, sustainable alignment in Pakistan and similar LMICs. Urgent actions are required within the current context of changes in global aid to build local capability for systematically easing dependence on GHIs while protecting equitable gains in disease outcomes.
{"title":"Global Health Initiatives and Universal Health Coverage in Pakistan-Aligned for the Future?","authors":"Shehla Zaidi, Shifa Salman Habib, Asad Shoaib, Zakir Shah, Karl Blanchet, Rosemary Jouhad, Natasha Palmer, Valery Ridde, Sophie Witter","doi":"10.1002/hpm.70038","DOIUrl":"10.1002/hpm.70038","url":null,"abstract":"<p>There is increasing global discourse on Global Health Initiatives' (GHIs) role and the need for better alignment with universal health coverage (UHC), which is particularly salient given recent rapid reductions in global aid. However, tensions within national ecosystems of GHI assistance and country alignment towards UHC are less well understood. We identify challenges and leverage points for aligning GHIs' assistance towards UHC-focused health systems in Pakistan, drawing from the perspective of country stakeholders. A political economy approach was applied to unpack the context of national aid architecture, country discourse on strengths and weakness of GHI country ecosystem and stakeholders' power, positioning and interests for future reforms. Key informant interviews were conducted with constituencies of country-based stakeholders in federal and provincial health systems, supplemented by a desk review of health financing data and policy-programmatic documents.</p><p>The findings highlight a context of expanding GHI mandate, despite Pakistan's trajectory towards middle income country status, but weak alignment with national primary health care (PHC) budgeting and planning processes. Country discourse acknowledged improved disease coverage but surfaced tensions with the off-budget parallel grant model, comprising of several GHI intermediaries, headquarters-driven planning and selective system support, that was not positioned to build sustainability resulting in duplicative resourcing, questionable value for money, clouding of accountability roles and poor preparedness for transition. Competing interests between federal and provincial governments, and between disease managers and PHC planners, was perceived to further weaken country stewardship of GHI assistance. The prospect of an impending decline in aid funding was a common interest for change across all stakeholder constituencies. Stakeholders were positioned for a continuation of GHI assistance but with fundamental changes involving integration with national PHC budgeting, re-balancing power through shared accountability, and calibrated federal-provincial incentives for coordinated working, but most felt disempowered to bring about change.</p><p>We conclude that addressing power imbalances must be at the centre of paradigm shifts in country assistance by GHIs, although contextual modalities will differ across LMICs. Direct engagement with UHC stakeholders under the ambit of national PHC reforms, fewer intermediaries, on-budget incentives to sustainably grow domestic financing and PFM technical assistance for aid management emerged as key areas for efficient, sustainable alignment in Pakistan and similar LMICs. Urgent actions are required within the current context of changes in global aid to build local capability for systematically easing dependence on GHIs while protecting equitable gains in disease outcomes.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 1","pages":"156-170"},"PeriodicalIF":1.8,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12794120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The biopharmaceutical industry in Iran has made significant progress in recent years, supported by multiple innovation policies aimed at its development. Nevertheless, challenges such as limited resources, skill and managerial gaps, weak networking, and restricted access to funding and incentives have hindered sustainable innovation.
Purpose
This study aims to examine the role of intermediaries in supporting biopharmaceutical companies and to analyze how innovation policies influence technological capabilities, networking, human capital development, and access to funding and incentives in Iran.
Approach and Methods
A qualitative approach was employed, using purposive sampling to select 19 participants from the governmental, academic, and industrial sectors. Data were collected through semi-structured interviews and analyzed using Braun and Clarke's six-step thematic analysis (2006). Data credibility and validity were ensured through member checking, triangulation, and independent coding by two researchers.
Findings
The findings indicate that innovation policies have advanced across four main dimensions—exploitation of results and production, networking and facilitation, human capital, and funding and incentives—but each dimension faces specific challenges. Intermediaries, including accelerators, technology centers, industry associations, and specialized investment funds, play a key role in addressing these challenges by providing practical training, financial and technical support, facilitating cross-sector collaborations, and establishing professional networks, thereby fostering sustainable development and innovation in the biopharmaceutical sector.
Policy Implications
Strengthening intermediaries and implementing targeted policies based on companies' real needs can enhance the effectiveness of innovation policies, reduce import dependence, and improve the global competitiveness of Iran's biopharmaceutical industry.
{"title":"Intermediaries and Development of Biopharmaceuticals: Evidence From the Innovation Policy in a Developing Country","authors":"Atiyeh Safardoust, Fereidoun Mahboudi, Soode Mirmohammadi, Mohsen Pourqasem","doi":"10.1002/hpm.70034","DOIUrl":"10.1002/hpm.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Motivation</h3>\u0000 \u0000 <p>The biopharmaceutical industry in Iran has made significant progress in recent years, supported by multiple innovation policies aimed at its development. Nevertheless, challenges such as limited resources, skill and managerial gaps, weak networking, and restricted access to funding and incentives have hindered sustainable innovation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aims to examine the role of intermediaries in supporting biopharmaceutical companies and to analyze how innovation policies influence technological capabilities, networking, human capital development, and access to funding and incentives in Iran.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach and Methods</h3>\u0000 \u0000 <p>A qualitative approach was employed, using purposive sampling to select 19 participants from the governmental, academic, and industrial sectors. Data were collected through semi-structured interviews and analyzed using Braun and Clarke's six-step thematic analysis (2006). Data credibility and validity were ensured through member checking, triangulation, and independent coding by two researchers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The findings indicate that innovation policies have advanced across four main dimensions—exploitation of results and production, networking and facilitation, human capital, and funding and incentives—but each dimension faces specific challenges. Intermediaries, including accelerators, technology centers, industry associations, and specialized investment funds, play a key role in addressing these challenges by providing practical training, financial and technical support, facilitating cross-sector collaborations, and establishing professional networks, thereby fostering sustainable development and innovation in the biopharmaceutical sector.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Policy Implications</h3>\u0000 \u0000 <p>Strengthening intermediaries and implementing targeted policies based on companies' real needs can enhance the effectiveness of innovation policies, reduce import dependence, and improve the global competitiveness of Iran's biopharmaceutical industry.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 1","pages":"132-155"},"PeriodicalIF":1.8,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Haoran Wu, Yueyuan Cai, Yuefang Chen, Li Xia, Lin Yao
This study aims to optimise operating room scheduling and improve hospital operational efficiency by predicting surgery durations using machine learning algorithms. Traditional methods often face challenges in accuracy, while machine learning models offer superior predictive performance. Using real-world operating room data from a large general hospital in China, the study compares various machine learning algorithms and selects the XGBoost model as the most effective predictive framework. Three types of models were developed: an all-inclusive model, a department-specific model, and a doctor-specific model. The department-specific model demonstrated the highest accuracy, outperforming the others. The results were applied to the hospital's surgical centre scheduling process, significantly enhancing operating room resource utilisation. The study highlights the importance of data preprocessing and feature selection in improving prediction accuracy. Overall, machine learning-based surgery duration prediction can effectively address challenges in surgical scheduling and provide data-driven support for hospital operational management.
{"title":"Prediction of Surgery Duration Based on Machine Learning Algorithms and Its Practical Application in a General Hospital in China","authors":"Haoran Wu, Yueyuan Cai, Yuefang Chen, Li Xia, Lin Yao","doi":"10.1002/hpm.70032","DOIUrl":"10.1002/hpm.70032","url":null,"abstract":"<div>\u0000 \u0000 <p>This study aims to optimise operating room scheduling and improve hospital operational efficiency by predicting surgery durations using machine learning algorithms. Traditional methods often face challenges in accuracy, while machine learning models offer superior predictive performance. Using real-world operating room data from a large general hospital in China, the study compares various machine learning algorithms and selects the XGBoost model as the most effective predictive framework. Three types of models were developed: an all-inclusive model, a department-specific model, and a doctor-specific model. The department-specific model demonstrated the highest accuracy, outperforming the others. The results were applied to the hospital's surgical centre scheduling process, significantly enhancing operating room resource utilisation. The study highlights the importance of data preprocessing and feature selection in improving prediction accuracy. Overall, machine learning-based surgery duration prediction can effectively address challenges in surgical scheduling and provide data-driven support for hospital operational management.</p>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 1","pages":"121-131"},"PeriodicalIF":1.8,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study examines the sustainability performance of health care Public-Private Partnerships (PPPs) in emerging economies across economic, social, and environmental dimensions. Using panel data from 148 projects in 22 countries (2005–2022) and a multilayer network framework, it compares PPPs with traditional procurement. Results show that PPPs improve financing, access, and patient satisfaction, with moderate environmental gains. Governance quality and macroeconomic stability enhance these effects, while interdependencies reveal how advances in one area reinforce those in others. The analysis links PPP outcomes to Sustainable Development Goals (SDGs 3, 9, 10, 12, 13, and 16) and confirms robustness through alternative indices and models. This is the first integrated evaluation of health care PPPs in emerging economies, offering guidance for embedding ESG standards, resilience clauses, and monitoring benchmarks.
{"title":"Sustainable Health Care Public-Private Partnerships in Emerging Economies","authors":"Roberto Moro-Visconti","doi":"10.1002/hpm.70036","DOIUrl":"10.1002/hpm.70036","url":null,"abstract":"<p>This study examines the sustainability performance of health care Public-Private Partnerships (PPPs) in emerging economies across economic, social, and environmental dimensions. Using panel data from 148 projects in 22 countries (2005–2022) and a multilayer network framework, it compares PPPs with traditional procurement. Results show that PPPs improve financing, access, and patient satisfaction, with moderate environmental gains. Governance quality and macroeconomic stability enhance these effects, while interdependencies reveal how advances in one area reinforce those in others. The analysis links PPP outcomes to Sustainable Development Goals (SDGs 3, 9, 10, 12, 13, and 16) and confirms robustness through alternative indices and models. This is the first integrated evaluation of health care PPPs in emerging economies, offering guidance for embedding ESG standards, resilience clauses, and monitoring benchmarks.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 1","pages":"107-120"},"PeriodicalIF":1.8,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12794126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Calina Leonhardt, Christina Bjørk Petersen, Marie Broholm-Holst, Sigurd Lauridsen, Morten Hulvej Rod, Ditte Heering Holt
Prioritisation in public health is complex, as decision-makers must allocate limited resources across diverse health concerns, risk factors, and target groups. In Denmark, municipalities play a central role under the Danish Health Act §119, which mandates health promotion and preventive services. However, municipalities face challenges in balancing competing needs without clear guidance. This qualitative study explores how municipalities navigate public health prioritisation, through in-depth interviews with 21 health directors and managers from 15 municipalities, selected for demographic, socio-economic, and geographical diversity. Data were analysed using systematic text condensation (STC). The findings highlight the following six themes which are central to understanding how municipalities prioritise within health promotion and prevention: (1) Economic considerations: Prioritising short-term, patient-focused services under budget constraints, (2) Public health data: Prioritising services based on locally identified health challenges, (3) Legal frameworks: Focusing on mandated services amid ambiguous legislation, (4) Evidence and evaluation: Selecting interventions with perceived effectiveness, (5) Political context: Aligning health priorities with agendas and ideological acceptability, and (6) Demographic and geographic conditions: Adapting services to local realities. We find that municipalities adopt a pragmatic, consensus-driven approach, but prioritisation processes vary, leading to disparities in service provision. Using Kingdon's Multiple Streams Framework, we discuss how municipalities frame health issues, select policy solutions, and navigate political contexts. The study highlights the need for clearer national frameworks to promote equitable public health access.
{"title":"Prioritising Public Health Services in Danish Municipalities: A Political Balancing Act","authors":"Calina Leonhardt, Christina Bjørk Petersen, Marie Broholm-Holst, Sigurd Lauridsen, Morten Hulvej Rod, Ditte Heering Holt","doi":"10.1002/hpm.70033","DOIUrl":"10.1002/hpm.70033","url":null,"abstract":"<div>\u0000 \u0000 <p>Prioritisation in public health is complex, as decision-makers must allocate limited resources across diverse health concerns, risk factors, and target groups. In Denmark, municipalities play a central role under the Danish Health Act §119, which mandates health promotion and preventive services. However, municipalities face challenges in balancing competing needs without clear guidance. This qualitative study explores how municipalities navigate public health prioritisation, through in-depth interviews with 21 health directors and managers from 15 municipalities, selected for demographic, socio-economic, and geographical diversity. Data were analysed using systematic text condensation (STC). The findings highlight the following six themes which are central to understanding how municipalities prioritise within health promotion and prevention: (1) Economic considerations: Prioritising short-term, patient-focused services under budget constraints, (2) Public health data: Prioritising services based on locally identified health challenges, (3) Legal frameworks: Focusing on mandated services amid ambiguous legislation, (4) Evidence and evaluation: Selecting interventions with perceived effectiveness, (5) Political context: Aligning health priorities with agendas and ideological acceptability, and (6) Demographic and geographic conditions: Adapting services to local realities. We find that municipalities adopt a pragmatic, consensus-driven approach, but prioritisation processes vary, leading to disparities in service provision. Using Kingdon's Multiple Streams Framework, we discuss how municipalities frame health issues, select policy solutions, and navigate political contexts. The study highlights the need for clearer national frameworks to promote equitable public health access.</p>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 1","pages":"94-106"},"PeriodicalIF":1.8,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Home-based end-of-life care has gained policy attention in Japan. However, its fiscal consequences remain unclear. Rising healthcare costs and rapid population ageing heighten the policy relevance of such evidence.
Objectives
To assess how the municipal home-based death rate relates to per capita medical and long-term care insurance (LTCI) spending, and whether ageing modifies these associations.
Methods
We analysed panel data from 1741 municipalities (2015–2022). Outcomes were log-transformed total and inpatient medical spending per resident and LTCI spending per certified individual. The exposure was the one-year-lagged home-based death rate, defined as home deaths divided by all deaths. Fixed-effects regressions controlled for year, ageing rate, population density (per km2 of habitable land), income-tax revenue, and health and long-term care resources. Cluster-robust standard errors addressed within-municipality serial correlation. All analyses were conducted in Python 3.11 using the linearmodels package.
Results
The mean home-based death rate was 12.3% (SD = 5.72). Each one-percentage-point increase predicted 0.001 (95% CI: 1.178 × 10^−4–0.0018) and 0.001 (95% CI: 1.900 × 10^10–0.001) log-point increases in total and inpatient spending, with no association for LTCI. Ageing moderated this relationship: at approximately 39.5% ageing, higher home-based death rates predicted lower medical costs. Greater population density (total only) and lower taxable income were also associated with higher medical spending.
Conclusion
The fiscal impact of home-based deaths is context dependent. In more aged municipalities, promoting home dying may yield medical savings, whereas younger areas may face short-term cost growth. Distinct cost dynamics between medical and LTCI systems warrant locally tailored end-of-life policies.
{"title":"Demographic Moderation of Healthcare Expenditure Associated With Home-Based Deaths: A Longitudinal Ecological Study in Japanese Municipalities, 2015–2022","authors":"Takemasa Ishikawa, Yoshiyuki Takashima","doi":"10.1002/hpm.70031","DOIUrl":"10.1002/hpm.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Home-based end-of-life care has gained policy attention in Japan. However, its fiscal consequences remain unclear. Rising healthcare costs and rapid population ageing heighten the policy relevance of such evidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess how the municipal home-based death rate relates to per capita medical and long-term care insurance (LTCI) spending, and whether ageing modifies these associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed panel data from 1741 municipalities (2015–2022). Outcomes were log-transformed total and inpatient medical spending per resident and LTCI spending per certified individual. The exposure was the one-year-lagged home-based death rate, defined as home deaths divided by all deaths. Fixed-effects regressions controlled for year, ageing rate, population density (per km<sup>2</sup> of habitable land), income-tax revenue, and health and long-term care resources. Cluster-robust standard errors addressed within-municipality serial correlation. All analyses were conducted in Python 3.11 using the <i>linearmodels</i> package.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean home-based death rate was 12.3% (SD = 5.72). Each one-percentage-point increase predicted 0.001 (95% CI: 1.178 × 10^−4–0.0018) and 0.001 (95% CI: 1.900 × 10^10–0.001) log-point increases in total and inpatient spending, with no association for LTCI. Ageing moderated this relationship: at approximately 39.5% ageing, higher home-based death rates predicted lower medical costs. Greater population density (total only) and lower taxable income were also associated with higher medical spending.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The fiscal impact of home-based deaths is context dependent. In more aged municipalities, promoting home dying may yield medical savings, whereas younger areas may face short-term cost growth. Distinct cost dynamics between medical and LTCI systems warrant locally tailored end-of-life policies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 1","pages":"82-93"},"PeriodicalIF":1.8,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luc D. Govedarica, Ella Hobbs, Jordan South, Tori Lowe, Saravana Kumar
Background
As the demand for health services continues to surge, maximising the existing health workforce to its full scope of practice is critical. It is in this context, allied health professionals (AHPs) have a long history of working in advanced and extended scope of practice (AESP). Despite proven effectiveness, implementation of these roles continues to face challenges. A scoping review of the literature was conducted to map the barriers and enablers to allied health professionals working in AESP roles.
Methods
An apriori protocol was developed and the methodology was informed by the ‘Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews’. Quantitative and qualitative studies were included. The search was conducted using OVID (MEDLINE, EmCare, EmBase, PsycINFO) CINAHL, Cochrane Library, Scopus and Google Scholar in April 2025. Two reviewers independently screened records, following which data extraction was undertaken. Normalisation Process Theory was used as an overarching framework for descriptive synthesis.
Results
Nineteen studies of varying designs and methodologies were included. Barriers and enablers to AESP implementation were mapped across three overarching themes: Personal, Organisational, and System-level factors, reflecting the complexity of embedding such roles into routine practice. The identified enablers and barriers were multifactorial and interconnected, highlighting the critical need for strong organisational support and leadership, long-term workforce planning, and context-specific strategies to ensure the sustainability of AESP roles.
Conclusion
As many barriers and enablers appeared to be two sides of the same coin, this duality underscores the need for context-specific, stakeholder-informed, and multifaceted implementation strategies.
{"title":"Barriers and Enablers to Allied Health Professionals Working in Advanced and Extended Scope of Practice in Healthcare Settings: A Scoping Review","authors":"Luc D. Govedarica, Ella Hobbs, Jordan South, Tori Lowe, Saravana Kumar","doi":"10.1002/hpm.70030","DOIUrl":"10.1002/hpm.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>As the demand for health services continues to surge, maximising the existing health workforce to its full scope of practice is critical. It is in this context, allied health professionals (AHPs) have a long history of working in advanced and extended scope of practice (AESP). Despite proven effectiveness, implementation of these roles continues to face challenges. A scoping review of the literature was conducted to map the barriers and enablers to allied health professionals working in AESP roles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An apriori protocol was developed and the methodology was informed by the ‘Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews’. Quantitative and qualitative studies were included. The search was conducted using OVID (MEDLINE, EmCare, EmBase, PsycINFO) CINAHL, Cochrane Library, Scopus and Google Scholar in April 2025. Two reviewers independently screened records, following which data extraction was undertaken. Normalisation Process Theory was used as an overarching framework for descriptive synthesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nineteen studies of varying designs and methodologies were included. Barriers and enablers to AESP implementation were mapped across three overarching themes: Personal, Organisational, and System-level factors, reflecting the complexity of embedding such roles into routine practice. The identified enablers and barriers were multifactorial and interconnected, highlighting the critical need for strong organisational support and leadership, long-term workforce planning, and context-specific strategies to ensure the sustainability of AESP roles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>As many barriers and enablers appeared to be two sides of the same coin, this duality underscores the need for context-specific, stakeholder-informed, and multifaceted implementation strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 1","pages":"234-252"},"PeriodicalIF":1.8,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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