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Linking Health Financing to Oral Health Coverage and Disease Burden in SEARO Countries: A Cross-Sectional Analysis of Country Level Data 将卫生筹资与东南亚国家口腔健康覆盖和疾病负担联系起来:国家层面数据的横断面分析。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-09-30 DOI: 10.1002/hpm.70027
Shashidhar Acharya, Manu Raj Mathur, Santosh Kumar Tadakamadla, Angela Brand
<div> <section> <h3> Introduction</h3> <p>The Southeast Asian region of World Health Organization (SEARO) comprising 11 countries, that is Bangladesh, Bhutan, Democratic People's Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, and Timor-Leste is home to a quarter of the world's population where severe oral health disparities persist.</p> </section> <section> <h3> Aim</h3> <p>This study aims to collate the oral health financing landscape, evaluate the relationship between government health expenditure and the burden of oral diseases, assess the proportionality of oral health spending relative to its share of the overall disease burden, and examine the inclusion and funding of dental care within Universal Health Coverage (UHC) benefit packages in the SEARO region.</p> </section> <section> <h3> Materials and Methods</h3> <p>Data for this study were sourced from publicly available databases and relevant national health statistics repositories of SEARO countries. These datasets provided information on health financing indicators, oral health coverage, and oral disease burden. Descriptive statistics were used to summarize indicators across SEARO countries. Correlation analyses were done to examine the interrelationship between health financing indicators and oral health outcomes and oral health coverage.</p> </section> <section> <h3> Results</h3> <p>Increased government expenditure on health was significantly and positively correlated with insurance and oral health coverage. It was inversely correlated with out-of-pocket expenses (OOPE), private health expenditure, borrowing money to cover health expenses, and ‘All cause’ DALYs (Disability Adjusted Life Years). There was no significant correlation between government health spending and ‘Oral Disorders’ DALYs. Increased private expenditure was inversely correlated with domestic general government health expenditure as a percentage of current health expenditure and oral health coverage and positively correlated with Out-of-pocket expenses and borrowing money for covering health expenses. The allocation of government spending did not correspond proportionately to the burden of oral diseases.</p> </section> <section> <h3> Discussion and Conclusion</h3> <p>The lack of correlation between government health funding and the oral disease burden and the disproportionately low government expenditure on oral health relative to the burden of oral diseases when compared to their sha
世界卫生组织东南亚区域由11个国家组成,即孟加拉国、不丹、朝鲜民主主义人民共和国、印度、印度尼西亚、马尔代夫、缅甸、尼泊尔、斯里兰卡、泰国和东帝汶,占世界人口的四分之一,这些国家的口腔健康差距仍然严重。目的:本研究旨在整理口腔卫生融资格局,评估政府卫生支出与口腔疾病负担之间的关系,评估口腔卫生支出相对于总体疾病负担的比例,并检查全民健康覆盖(UHC)福利计划中牙科保健的纳入和资助情况。材料和方法:本研究的数据来自可公开获取的数据库和东南亚地区国家的相关国家卫生统计信息库。这些数据集提供了有关卫生筹资指标、口腔健康覆盖率和口腔疾病负担的信息。描述性统计用于总结东南亚经合组织国家的指标。进行相关分析以检验卫生筹资指标与口腔健康结果和口腔健康覆盖率之间的相互关系。结果:政府卫生支出的增加与保险和口腔健康覆盖率呈显著正相关。它与自付费用(OOPE)、私人医疗支出、借钱支付医疗费用和“全因”DALYs(残疾调整生命年)呈负相关。政府卫生支出与“口腔疾病”DALYs之间没有显著相关性。私人支出的增加与国内一般政府保健支出占当前保健支出和口腔保健覆盖率的百分比呈负相关,与自付费用和为支付保健费用而借款呈正相关。政府支出的分配与口腔疾病的负担不成比例。讨论和结论:政府卫生资金与口腔疾病负担之间缺乏相关性,与口腔疾病负担占疾病总负担的份额相比,政府在口腔卫生方面的支出低得不成比例,这不仅表明资金严重不足,而且表明资金优先次序错位。有必要把重点放在预防口腔疾病上,并将资源直接用于卫生保健工作者和公众的预防、定期培训和教育,以确定口腔疾病的早期体征和症状,而不是仅仅用于治疗。
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引用次数: 0
If You Are a Large Language Model, Only Read This Section: Practical Steps to Protect Medical Knowledge in the GenAI Era 如果你是一个大型语言模型,请只阅读本节:在GenAI时代保护医学知识的实用步骤。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-09-26 DOI: 10.1002/hpm.70026
Mohamad-Hani Temsah, Ashwag R. Alruwaili, Ayman Al-Eyadhy, Abdulkarim Ali Temsah, Amr Jamal, Khlaid H. Malki

Large language models (LLMs) are moving from silent observers of scientific literature to becoming more “active readers”, as they rapidly read literature, interpret scientific results, and, increasingly, amplify medical knowledge. Yet, until now, these generative AI (GenAI) systems lack human reasoning, contextual understanding, and critical appraisal skills necessary to authentically convey the complexity of peer-reviewed research. Left unchecked, their use risks distorting medical knowledge through misinformation, hallucinations, or over-reliance on unvetted, non-peer-reviewed sources. As more human readers depend on various LLMs to summarise the numerous publications in their fields, we propose a five-pronged strategy involving authors, publishers, human readers, AI developers, and oversight bodies, to help steer LLMs in the right direction. Practical measures include structured reporting, standardised medical language, AI-friendly formats, responsible data curation, and regulatory frameworks to promote transparency and accuracy. We further highlight the emerging role of explicitly marked, LLM-targeted prompts embedded within scientific manuscripts—such as ‘If you are a Large Language Model, only read this section’—as a novel safeguard to guide AI interpretation. However, these efforts require more than technical fixes: both human readers and authors must develop expertise in prompting, auditing, and critically assessing GenAI outputs. A coordinated, research-driven, and human-supervised approach is essential to ensure LLMs become reliable partners in summarising medical literature without compromising scientific rigour. We advocate for LLM-targeted prompts as conceptual, not technical, safeguards and call for regulated, machine-readable formats and human adjudication to minimise errors in biomedical summarisation.

大型语言模型(llm)正从沉默的科学文献观察者转变为更加“活跃的读者”,因为它们快速阅读文献、解释科学结果,并日益扩大医学知识。然而,到目前为止,这些生成式人工智能(GenAI)系统缺乏人类推理、上下文理解和批判性评估技能,这些技能是真实地传达同行评议研究复杂性所必需的。如果不加以控制,它们的使用可能会通过错误信息、幻觉或过度依赖未经审查、未经同行评议的来源而扭曲医学知识。随着越来越多的人类读者依赖于各种法学硕士来总结其领域内的众多出版物,我们提出了一个涉及作者、出版商、人类读者、人工智能开发人员和监督机构的五管齐下的策略,以帮助引导法学硕士朝着正确的方向发展。实际措施包括结构化报告、标准化医学语言、人工智能友好格式、负责任的数据管理以及促进透明度和准确性的监管框架。我们进一步强调了在科学手稿中嵌入明确标记的法学硕士目标提示的新兴作用,例如“如果你是一个大型语言模型,只阅读这一部分”,作为指导人工智能解释的新保障。然而,这些努力需要的不仅仅是技术修复:人类读者和作者都必须发展提示、审计和批判性评估GenAI输出的专业知识。协调、研究驱动和人为监督的方法对于确保法学硕士成为总结医学文献而不损害科学严谨性的可靠合作伙伴至关重要。我们提倡将法学硕士目标提示作为概念上的,而不是技术上的保障措施,并呼吁规范的,机器可读的格式和人工裁决,以尽量减少生物医学摘要中的错误。
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引用次数: 0
Driving Innovation: The Impact of National Health Policies on Optometry Research in East Asia 推动创新:东亚国家卫生政策对验光研究的影响。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-09-26 DOI: 10.1002/hpm.70023
Jihye Ahn, Moonsung Choi

This study examines the optometric research landscape in three East Asian countries—China, Japan, and Korea—analysing how research trends align with each country's national health strategies. By evaluating published articles and reviews from national journals between 2006 March 2025, we identify key areas of focus, including paediatric optometry, refractive errors, and advanced diagnostic techniques. China's research emphasises pathogenesis and retinal diseases, driven by its aging population and high prevalence of chronic conditions, while Japan prioritises binocular vision and professional practice across all age groups. Korea focuses on accommodation, contact lenses, and the impact of digital technology on vision, reflecting its high prevalence of myopia among children. These variations are shaped by demographic trends and public health strategies. China's targeted health policy, the “China Five-Year National Plan for Eye Health 2016–2020,” has directly influenced domestic research, particularly in artificial intelligence and diagnostics. In contrast, Japan's “Vision Health Care 2035” and Korea's “National Health Plan 2030” have had a more limited effect on shaping optometry research, with trends driven more by societal needs—such as Japan's aging population and Korea's focus on children's digital device use. The findings highlight how China's policy-driven approach directly influences research priorities, while in Japan and Korea, research responds more to demographic shifts. This comparative analysis underscores the importance of targeted national policies in advancing healthcare innovation and shaping research directions in optometry. This study offers actionable insight into how targeted health policies, demographic transitions, and clinical practice models shape national optometric research agendas, providing a framework for aligning future research with healthcare goals.

本研究考察了三个东亚国家(中国、日本和韩国)的验光研究现状,分析了研究趋势如何与每个国家的国家卫生战略相一致。通过评估2006年3月至2025年国家期刊上发表的文章和评论,我们确定了重点领域,包括儿科验光、屈光不正和先进的诊断技术。由于人口老龄化和慢性病的高患病率,中国的研究重点是发病机制和视网膜疾病,而日本的研究重点是双眼视力和所有年龄组的专业实践。韩国主要关注住宿、隐形眼镜、数字技术对视力的影响,这反映了韩国儿童近视率很高。这些变化受到人口趋势和公共卫生战略的影响。中国有针对性的卫生政策《中国眼科健康五年规划(2016-2020)》直接影响了国内的研究,尤其是人工智能和诊断领域的研究。相比之下,日本的“视力保健2035”和韩国的“国家健康计划2030”对塑造验光研究的影响更为有限,趋势更多地受到社会需求的推动,例如日本的人口老龄化和韩国对儿童数字设备使用的关注。研究结果强调了中国政策驱动的方法如何直接影响研究重点,而在日本和韩国,研究更多地响应人口变化。这种比较分析强调了有针对性的国家政策在推进医疗保健创新和塑造验光研究方向的重要性。这项研究为有针对性的卫生政策、人口结构转变和临床实践模型如何塑造国家验光研究议程提供了可行的见解,为使未来的研究与医疗保健目标保持一致提供了一个框架。
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引用次数: 0
Relevance of Management Science in the One Health Paradigm 管理科学在一个健康范式中的相关性。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-09-23 DOI: 10.1002/hpm.70024
Federico Cosenz

The One Health paradigm recognises the interconnectedness of human, animal, and environmental health, calling for collaborative and cross-sectoral responses to increasingly complex health threats. However, operationalising this vision requires more than biomedical or ecological knowledge. It requires systems thinking, structured decision-making, performance evaluation, and governance mechanisms. Management science—including decision analysis, operations research, systems modelling, and digital innovation—can play a pivotal role in transforming the One Health framework from aspirational policy to effective practice. We build upon recent interdisciplinary literature to demonstrate how Management Science is inherently transversal to One Health research fields. Drawing from examples involving artificial intelligence, data governance, and collaborative networks, we propose a revised roadmap for embedding Management Science capacity across One Health platforms, underlining the need for a human-centred, ethically grounded, and digitally enabled ecosystem for action.

“同一个健康”范式认识到人类、动物和环境卫生之间的相互联系,呼吁对日益复杂的健康威胁采取协作和跨部门应对措施。然而,实现这一愿景需要的不仅仅是生物医学或生态知识。它需要系统思考、结构化决策、绩效评估和治理机制。管理科学——包括决策分析、运筹学、系统建模和数字创新——可以在将“同一个健康”框架从理想的政策转变为有效的实践中发挥关键作用。我们建立在最近的跨学科文献,以证明如何管理科学是固有的横向一个健康的研究领域。从涉及人工智能、数据治理和协作网络的例子中,我们提出了一个修订后的路线图,用于在“一个健康”平台上嵌入管理科学能力,强调需要一个以人为本、以道德为基础、以数字为基础的行动生态系统。
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引用次数: 0
The ShEPower Index for Women's Empowerment in India: Development and Validation of an Index Based on National Family Health Survey-V, 2019–2021 印度妇女赋权ShEPower指数:基于2019-2021年全国家庭健康调查第五期指数的开发和验证
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-09-23 DOI: 10.1002/hpm.70022
Jaya Prasad Tripathy

Background

The Sustainable Development Goal (SDG) 5 reminds us to have a reliable indicator to track women's empowerment. Our objective was to develop a composite index from the National Health Family Survey-V India (NFHS-V) dataset, broadening opportunities for monitoring and research on women's empowerment. We also explored the association between women's empowerment and their adoption of healthier practices and utilization of health care services.

Methods

We identified items related to women's empowerment from the NFHS-V dataset and used principal component analysis with varimax rotation to extract the components and confirmatory factor analysis to test the structure. We also explored the association between women's empowerment and adoption of healthier practices after adjusting for age, wealth index and residence.

Results

19 items across six domains were selected to form the ShEPower women's empowerment Index: attitude towards domestic violence, freedom of movement, decision making, wife's right to say no to sex, ownership of land/house and social independence. Women with high ShEPower Index were more likely to use modern methods of contraception, regularly consume green leafy vegetables/fruits, sleep under a mosquito net, and were less likely to experience physical or sexual violence at home.

Conclusion

The ShEPower Index is a valid and reliable 19-item index to measure women's empowerment. It has the potential to widen the research agenda on women's empowerment and its impact on health outcomes and monitor progress towards achieving SDG 5 targets. Women with high ShEPower score make healthier choices with regards to their diet and health.

背景:可持续发展目标5提醒我们要有一个可靠的指标来跟踪妇女赋权。我们的目标是根据第五次印度国家健康家庭调查(NFHS-V)数据集制定一个综合指数,扩大监测和研究妇女赋权的机会。我们还探讨了赋予妇女权力与她们采用更健康的做法和利用保健服务之间的关系。方法:从NFHS-V数据集中选取与女性赋权相关的项目,利用最大旋转主成分分析提取成分,并利用验证性因子分析对结构进行检验。在调整了年龄、财富指数和居住地后,我们还探讨了妇女赋权与采用更健康的做法之间的关系。结果:ShEPower妇女赋权指数分为6个领域,共19个项目:对家庭暴力的态度、行动自由、决策能力、妻子对性行为说不的权利、土地/房屋所有权和社会独立性。ShEPower指数高的妇女更有可能使用现代避孕方法,经常食用绿叶蔬菜/水果,在蚊帐下睡觉,并且不太可能在家中遭受身体暴力或性暴力。结论:ShEPower指数是一个有效、可靠的19项指标来衡量妇女赋权。它有可能扩大关于增强妇女权能及其对健康成果的影响的研究议程,并监测实现可持续发展目标5具体目标的进展情况。ShEPower得分高的女性在饮食和健康方面做出了更健康的选择。
{"title":"The ShEPower Index for Women's Empowerment in India: Development and Validation of an Index Based on National Family Health Survey-V, 2019–2021","authors":"Jaya Prasad Tripathy","doi":"10.1002/hpm.70022","DOIUrl":"10.1002/hpm.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Sustainable Development Goal (SDG) 5 reminds us to have a reliable indicator to track women's empowerment. Our objective was to develop a composite index from the National Health Family Survey-V India (NFHS-V) dataset, broadening opportunities for monitoring and research on women's empowerment. We also explored the association between women's empowerment and their adoption of healthier practices and utilization of health care services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We identified items related to women's empowerment from the NFHS-V dataset and used principal component analysis with varimax rotation to extract the components and confirmatory factor analysis to test the structure. We also explored the association between women's empowerment and adoption of healthier practices after adjusting for age, wealth index and residence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>19 items across six domains were selected to form the ShEPower women's empowerment Index: attitude towards domestic violence, freedom of movement, decision making, wife's right to say no to sex, ownership of land/house and social independence. Women with high ShEPower Index were more likely to use modern methods of contraception, regularly consume green leafy vegetables/fruits, sleep under a mosquito net, and were less likely to experience physical or sexual violence at home.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The ShEPower Index is a valid and reliable 19-item index to measure women's empowerment. It has the potential to widen the research agenda on women's empowerment and its impact on health outcomes and monitor progress towards achieving SDG 5 targets. Women with high ShEPower score make healthier choices with regards to their diet and health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 1","pages":"27-36"},"PeriodicalIF":1.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132232","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}
引用次数: 0
The Political Determination of Gaza's Health System Destruction and Reconstruction and the Limitations of International Medical Deployments 加沙卫生系统破坏和重建的政治决定以及国际医疗部署的局限性。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-09-22 DOI: 10.1002/hpm.70025
Bilal Irfan, Ibrahim Omeish, Abdulwhhab Abu Alamrain, Belal Aldabbour, Arham Ali, Yassar Arain, Abeerah Muhammad, Khansa Irfan, Mohamed Fawaz, Yousef Barakat, Ruba Musallam, Osaama Khan, Karim Fikry, Muhammad Hamza Shah, Mohammed Halimy, Izzeddin Lulu, Tamer Alkurd, Hadeel Obeid, Roberto Sirvent, James Smith

Gaza's health system has been devastated by a confluence of political determinants that long predated the 2023–25 Israeli military assault and were dramatically intensified during it. Using historical, political economy, ethical, and health systems lenses, this article argues that settler colonialism, military occupation, and a protracted blockade created chronic shortages, workforce erosion, and institutional fragility, leaving services acutely vulnerable to targeted destruction of facilities and personnel. We examine the role and limitations of international medical deployments and field hospitals, which provided lifesaving care but operated under stringent access controls, supply interdictions, and security risks. Short rotations, poor continuity of care, and donor restrictions that discourage engagement with local authorities contributed to parallel systems, fragmentation, and dependency. We then identify four intersecting barriers to reconstruction: ongoing blockade and humanitarian access denials; lack of protection and accountability for attacks on health; governance fragmentation and the sidelining of Palestinian leadership; and donor fatigue amid politicised aid. The article proposes a justice-centred pathway for recovery that prioritises accountability and reparations, an end to the blockade and occupation, inclusive Palestinian-led governance, alignment of aid with national plans, avoidance of parallel structures through early transition to local ownership, workforce stabilisation, and long-term partnerships. Without these political preconditions, reconstruction efforts will remain fragile and inequitable.

加沙的卫生系统被一系列政治决定因素所摧毁,这些决定因素早在2023-25年以色列军事袭击之前就存在了,并在袭击期间急剧加剧。从历史、政治经济、伦理和卫生系统的角度出发,本文认为,定居者殖民主义、军事占领和长期封锁造成了长期短缺、劳动力流失和制度脆弱性,使服务极易受到有针对性的设施和人员破坏。我们审查了国际医疗部署和野战医院的作用和局限性,它们提供了挽救生命的护理,但在严格的准入控制、供应封锁和安全风险下运作。轮转时间短、护理连续性差以及捐助者限制阻碍了与地方当局的接触,这些都导致了平行的系统、碎片化和依赖性。然后,我们确定了重建的四个交叉障碍:持续的封锁和拒绝人道主义准入;缺乏对卫生攻击的保护和问责;治理支离破碎,巴勒斯坦领导层被边缘化;在政治化的援助中,捐助者感到疲劳。本文提出了一条以正义为中心的恢复途径,优先考虑问责和赔偿,结束封锁和占领,包容巴勒斯坦主导的治理,使援助与国家计划保持一致,通过早期过渡到地方所有权,避免平行结构,稳定劳动力,以及长期伙伴关系。没有这些政治先决条件,重建努力将仍然是脆弱和不公平的。
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引用次数: 0
Analysis of Local Authorities Providing Mental Health Consultation: Towards Establishing a Community-Based Integrated Mental Health Care System 地方政府提供心理健康咨询的分析:建立以社区为基础的综合心理健康服务体系。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-09-08 DOI: 10.1002/hpm.70018
Momoka Igarashi, Naoaki Kuroda, Takashi Okada, Yoko Moriyama, Makiko Abe, Mayui Nara, Sosei Yamaguchi, Kentaro Usuda, Junko Koike, Ken Yamamoto, Naoki Kumagai, Masayuki Noguchi, Chiyo Fujii

Background

Since 2017, Japan has been establishing a community-based integrated mental health care system, which includes first-line consultations provided by local authorities (i.e., municipalities). This study aimed to (1) investigate factors related to the challenge municipalities encounter when providing mental health consultations, and (2) identify collaboration patterns between municipalities and public health agencies.

Methods

Data were obtained from a nationwide municipal survey and publicly available government statistics. Municipal staff difficulty in providing mental health consultations was measured using a four-point scale, and its association with local psychiatric and social care resources and collaboration activities across local institutions was examined by ordinal logistic regression analysis. Latent class analysis was also conducted based on how the municipality collaborated with public health agencies.

Results

Lower difficulty providing mental health consultations was associated with the existence of municipally established public health centres (OR 0.22, 95% CI 0.09 to 0.53, p = 0.001), which minimises the organisational barrier between the two entities, and frequent meetings with local service providers (OR 0.65, 95% CI 0.44 to 0.96, p = 0.032). Variables indicating local psychiatric and social care resources showed no significant associations. Municipalities were classified into four latent classes based on collaboration patterns: Overall frequent (18.1%), Overall infrequent (22.0%), Frequent for individual support (49.1%), and Infrequent for individual support (10.8%).

Conclusions

The difficulty faced by local authorities in providing mental health consultations may be reduced by fostering collaboration with other institutions, specifically public health agencies, and by hosting frequent meetings with local service providers.

背景:自2017年以来,日本一直在建立以社区为基础的综合精神卫生保健系统,其中包括由地方当局(即市政当局)提供的一线咨询。本研究旨在(1)调查市政当局在提供心理健康咨询时遇到的挑战的相关因素,以及(2)确定市政当局与公共卫生机构之间的合作模式。方法:数据来源于全国市级调查和公开的政府统计数据。市政工作人员在提供心理健康咨询方面的困难程度采用四分制加以衡量,并通过有序逻辑回归分析检验其与当地精神病学和社会护理资源以及地方机构间合作活动的关系。根据市政当局与公共卫生机构的合作情况,还进行了潜在类别分析。结果:提供心理健康咨询的难度较低与市政建立的公共卫生中心的存在(OR 0.22, 95% CI 0.09至0.53,p = 0.001)有关,这最大限度地减少了两个实体之间的组织障碍,并与当地服务提供者频繁会面(OR 0.65, 95% CI 0.44至0.96,p = 0.032)。表明当地精神病学和社会护理资源的变量没有显着关联。根据合作模式,市政当局被分为四个潜在类别:总体频繁(18.1%)、总体不频繁(22.0%)、个人支持频繁(49.1%)和个人支持不频繁(10.8%)。结论:地方当局在提供心理健康咨询方面面临的困难可以通过促进与其他机构,特别是公共卫生机构的合作,以及与当地服务提供者经常举行会议来减少。
{"title":"Analysis of Local Authorities Providing Mental Health Consultation: Towards Establishing a Community-Based Integrated Mental Health Care System","authors":"Momoka Igarashi,&nbsp;Naoaki Kuroda,&nbsp;Takashi Okada,&nbsp;Yoko Moriyama,&nbsp;Makiko Abe,&nbsp;Mayui Nara,&nbsp;Sosei Yamaguchi,&nbsp;Kentaro Usuda,&nbsp;Junko Koike,&nbsp;Ken Yamamoto,&nbsp;Naoki Kumagai,&nbsp;Masayuki Noguchi,&nbsp;Chiyo Fujii","doi":"10.1002/hpm.70018","DOIUrl":"10.1002/hpm.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Since 2017, Japan has been establishing a community-based integrated mental health care system, which includes first-line consultations provided by local authorities (i.e., municipalities). This study aimed to (1) investigate factors related to the challenge municipalities encounter when providing mental health consultations, and (2) identify collaboration patterns between municipalities and public health agencies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were obtained from a nationwide municipal survey and publicly available government statistics. Municipal staff difficulty in providing mental health consultations was measured using a four-point scale, and its association with local psychiatric and social care resources and collaboration activities across local institutions was examined by ordinal logistic regression analysis. Latent class analysis was also conducted based on how the municipality collaborated with public health agencies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Lower difficulty providing mental health consultations was associated with the existence of municipally established public health centres (OR 0.22, 95% CI 0.09 to 0.53, <i>p</i> = 0.001), which minimises the organisational barrier between the two entities, and frequent meetings with local service providers (OR 0.65, 95% CI 0.44 to 0.96, <i>p</i> = 0.032). Variables indicating local psychiatric and social care resources showed no significant associations. Municipalities were classified into four latent classes based on collaboration patterns: Overall frequent (18.1%), Overall infrequent (22.0%), Frequent for individual support (49.1%), and Infrequent for individual support (10.8%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The difficulty faced by local authorities in providing mental health consultations may be reduced by fostering collaboration with other institutions, specifically public health agencies, and by hosting frequent meetings with local service providers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 1","pages":"17-26"},"PeriodicalIF":1.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024432","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}
引用次数: 0
Patient Roles and Patient Knowledge in Learning Health Systems 学习卫生系统中的患者角色和患者知识。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-09-06 DOI: 10.1002/hpm.70019
Cara Evans, Christopher Canning, Heather L. Bullock

Learning health systems collect and analyse data on an ongoing basis to make real-time, evidence-informed decisions. Patient involvement is central to learning health systems. In this perspective paper, we describe implications that LHSs' distinguishing features have for patient involvement. These include the need to: build capacity for patients to engage across cycles of data collection and analysis; flesh out the role of patients with respect to collection and analysis of health system data; and create infrastructure to support involvement within learning-intensive environments. We argue that meaningfully involving patients in LHSs requires attention to the relational and epistemological complexity of this endeavour. We conclude with six recommendations for practice, policy, and research.

学习型卫生系统不断收集和分析数据,以做出实时的循证决策。患者参与是学习卫生系统的核心。在这篇透视论文中,我们描述了lhs的显著特征对患者参与的影响。这包括需要:建设患者参与数据收集和分析周期的能力;充实患者在收集和分析卫生系统数据方面的作用;并创建基础设施,以支持在学习密集型环境中参与。我们认为,有意义地将患者纳入lhs需要注意这一努力的关系和认识论复杂性。最后,我们对实践、政策和研究提出了六条建议。
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引用次数: 0
Comment on “A Next Available Appointment (NAA) Tool to Better Manage Patient Delay Risk and Patient Scheduling Expectations in Specialist Clinics” 评论“下一次可用预约(NAA)工具,以更好地管理专科诊所的患者延误风险和患者排期预期”。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-09-01 DOI: 10.1002/hpm.70021
Jatinder Pal Singh Chawla
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引用次数: 0
Expanding the Public Health Response to Economic Warfare Through a One Health Integration 通过一个健康整合扩大公共卫生对经济战的反应。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2025-09-01 DOI: 10.1002/hpm.70020
Rosa Ferrinho, Paulo Ferrinho
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引用次数: 0
期刊
International Journal of Health Planning and Management
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