Health Policy and Technology最新文献

{"title":"Comment on “Applying artificial intelligence to clinical decision support in mental health: What have we learned?”","authors":"Alejandro García-Rudolph , David Sanchez-Pinsach , Eloy Opisso , Beatriz Castaño","doi":"10.1016/j.hlpt.2025.101121","DOIUrl":"10.1016/j.hlpt.2025.101121","url":null,"abstract":"","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"15 1","pages":"Article 101121"},"PeriodicalIF":3.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145289816","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":"Using mental health demand to prioritize areas for improving telehealth capacity","authors":"Kendra Ratnapradipa,&nbsp;Ronnie Horner,&nbsp;Josiane Kabayundo,&nbsp;Meghan Brashear,&nbsp;Shinobu Watanabe-Galloway","doi":"10.1016/j.hlpt.2025.101119","DOIUrl":"10.1016/j.hlpt.2025.101119","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess behavioral healthcare demand relative to provider availability and identify public health regions in Nebraska that could benefit from improved broadband access to enhance telehealth services.</div></div><div><h3>Methods</h3><div>An ecological, cross-sectional design was used. Behavioral Risk Factor Surveillance System, Health Professions Tracking Service, and Federal Communications Commission broadband access data were analyzed. Behavioral health demand was measured through the age-adjusted prevalence of four indicators: binge drinking, marijuana use, diagnosed depression, and poor mental health days.</div></div><div><h3>Results</h3><div>The percentage of the population lacking broadband coverage ranged from 0.06 % to 66 % across health districts. The ratio of a health indicator (e.g., binge drinking) to the number of providers varied widely. Two health districts with a high ratio of health problems to providers, combined with low broadband coverage, stood out as potential areas that could benefit from broadband expansion.</div></div><div><h3>Conclusion</h3><div>The findings emphasize the critical need to improve broadband access in rural Nebraska to support telehealth services. Telehealth could be a valuable tool for addressing behavioral healthcare shortages in regions with adequate broadband infrastructure.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101119"},"PeriodicalIF":3.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157617","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":"Beyond checkbox participation: The radical promise of reflective stakeholder engagement in medical device assessment","authors":"Y. Tony Yang","doi":"10.1016/j.hlpt.2025.101118","DOIUrl":"10.1016/j.hlpt.2025.101118","url":null,"abstract":"","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101118"},"PeriodicalIF":3.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157616","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":"Healthcare networks and the waiting time to begin oral cancer treatment: An ecological study","authors":"M.V.C. Borges ,&nbsp;E.M. Costa ,&nbsp;V.P. Rodrigues ,&nbsp;E.B.A.F. Thomaz","doi":"10.1016/j.hlpt.2025.101116","DOIUrl":"10.1016/j.hlpt.2025.101116","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the total, direct, and indirect effects of services and work process on healthcare network points, namely, primary healthcare (PHC), secondary healthcare (SHC), and tertiary healthcare (THC), on the time to begin oral cancer treatment in Brazil.</div></div><div><h3>Study design</h3><div>Retrospective observational ecological study.</div></div><div><h3>Methods</h3><div>Data were obtained from the Brazilian Unified Health System, using health regions as units of analysis. The outcome was the proportion of oral cancer patients who waited &gt;60 days to start treatment. Independent variables were represented by PHC, SHC, and THC data. Structural equation modeling assessed total, direct, and indirect effects on the outcome using standardized factor loadings (SFLs). Analyses were conducted at a 5 % significance level.</div></div><div><h3>Results</h3><div>Health regions that performed oral biopsies in PHC tended to begin the treatment earlier (Direct effect, SFL = −0.155, <em>p</em> = 0.038), and those with better socioeconomic status had undergone higher rates of oral cancer biopsy in PHC, which decreased the mean time to begin oral cancer treatment (Indirect effect, SFL = −0.041, <em>p</em> = 0.035). Health regions with a higher proportion of advanced-stage diagnoses tended to experience greater delays in treatment (Direct effect, SFL = 0.252, <em>p</em> = 0.001).</div></div><div><h3>Conclusions</h3><div>Findings suggest associations between PHC actions, socioeconomic conditions, and treatment timeliness across health regions, but the ecological design precludes causal inference and warrants caution due to ecological fallacy. These results underscore the need for individual-level studies to clarify links between early diagnosis and timely cancer care.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101116"},"PeriodicalIF":3.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048764","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":"Association of demographic characteristics of COVID-19 patients with RPA Virtual Hospital service utilization in 2020-22","authors":"Yuetong Ren ,&nbsp;Huilan Xu ,&nbsp;Sue Amanatidis ,&nbsp;Limin Mao ,&nbsp;Miranda Shaw ,&nbsp;Lisa Simone ,&nbsp;Li Ming Wen","doi":"10.1016/j.hlpt.2025.101117","DOIUrl":"10.1016/j.hlpt.2025.101117","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;The rapid adoption of telemedicine during the COVID-19 pandemic has transformed healthcare delivery. In Australia, RPA Virtual Hospital (rpavirtual) has emerged as a key healthcare provider in telehealth. However, the uptake of virtual care among non-English-speaking patients remains understudied. This study aimed to profile COVID-19 patients cared for by rpavirtual and examine the association between patients’ demographics and service utilization.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;A retrospective study was conducted using routinely collected electronic medical records. Participants were 21,814 COVID-19 patients, registered with rpavirtual between July 1, 2020, and June 30, 2022, in Sydney Local Health District, NSW. Multiple logistic regression models were built to examine the association between service utilization and preferred language and other demographics. Subgroup analyses were conducted by patients’ age group and preferred language.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Compared to English-speaking patients, non-English-speaking patients were less likely to register with rpavirtual ≥ 2 times (adjusted odds ratio (AOR) 0.86, 95 % CI 0.77 – 0.96), receive ≥ 3 services (AOR 0.92, 95 % CI 0.85 – 1.00), and have service duration ≥76 min (AOR 0.92, 95 % CI 0.85 – 0.99). Among patients aged 50 years or older, these associations were particularly pronounced, with AOR 0.77 (95 % CI 0.66 – 0.89), AOR 0.86 (95 % CI 0.78 – 0.96), and AOR 0.86 (95 % CI 0.78 – 0.95) for number of registrations and services and total service duration, respectively. Among non-English-speaking patients, interpreter use was strongly associated with increased service utilization.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Preferred language shapes virtual care utilization patterns. Providing language support improves equitable access and engagement in virtual care platforms.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Lay summary&lt;/h3&gt;&lt;div&gt;There was a significant pivot towards virtual care during the COVID-19 pandemic. In Australia, RPA Virtual Hospital (rpavirtual) has emerged as a key healthcare provider in telehealth. This study analyzed routinely collected electronic medical records of 21,814 COVID-19 patients, registered with rpavirtual between July 1, 2020, and June 30, 2022, in Sydney Local Health District, NSW. The study found that COVID-19 patients’ demographics were associated with rpavirtual utilization, and interpreter use was strongly associated with increased service utilization. There were significant disparities in utilization between non-English-speaking and English-speaking patients. Non-English-speaking patients were less likely to register with rpavirtual multiple times, receive more services, and have longer service duration. The associations of preferred language with service utilization were particularly pronounced among patients aged 50 years or older. The results suggest that preferred language shapes virtual care utilization. Language support is","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101117"},"PeriodicalIF":3.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104704","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":"Mexico city monitoring system during the COVID-19 pandemic: A case-study","authors":"Pablo Gaitán-Rossi ,&nbsp;Jair Yañez-Santaolalla ,&nbsp;Andrea Jiménez-Ortiz ,&nbsp;Brenda Zaira Tapia-Hernández ,&nbsp;Hortensia Reyes-Morales","doi":"10.1016/j.hlpt.2025.101115","DOIUrl":"10.1016/j.hlpt.2025.101115","url":null,"abstract":"<div><h3>Objective</h3><div>Robust monitoring systems are essential for resilient health systems and effective crisis management. This study examines the design and implementation of a health monitoring system during the early months of the COVID-19 pandemic in Mexico City, highlighting lessons for future crises.</div></div><div><h3>Methods</h3><div>Using a descriptive case study approach, we triangulated official documents, press conference reviews, and 13 hour interviews with key informants.</div></div><div><h3>Results</h3><div>At the onset of the pandemic, the Mexico City government established a Health Council, necessitating a system to provide reliable information for hospital capacity management and timely decision-making. The locally developed monitoring system centralized data from multiple sources, estimated and forecasted key indicators, and served as a foundation for communicating pandemic status and guiding policy. The system’s dashboard became a critical tool for intersectoral collaboration to reduce hospital burden and improve decision-making —facilitating coordination among government ministries, non-health sectors, and the general population.</div></div><div><h3>Conclusions</h3><div>The implementation of Mexico City’s monitoring system demonstrates how a shared framework can incentivize intersectoral collaboration and provides critical insights for strengthening preparedness and resilience in future emergencies. Key lessons for fostering intersectoral collaboration included the importance of strong leadership within a governance structure, consensus on emergency assessment tools, provision of actionable information, and adaptability to partner capacities.</div></div><div><h3>Lay summary</h3><div>During the COVID-19 pandemic, Mexico City developed a health monitoring system that helped manage hospital capacity and coordinate decisions across different government sectors. This system provided reliable and timely information, making it easier for authorities to act quickly and effectively. The research shows how working together—health authorities, commerce groups, and others—can lead to better outcomes in a crisis. It also highlights the importance of clear communication and transparency. These lessons can help cities be better prepared for future health emergencies, ultimately protecting the wellbeing of the public.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101115"},"PeriodicalIF":3.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104703","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":"Computer assisted history taking in elective and acute care: Systematic review","authors":"Casper Craamer ,&nbsp;Thomas Timmers ,&nbsp;Walter van der Weegen ,&nbsp;Rudolf B Kool","doi":"10.1016/j.hlpt.2025.101108","DOIUrl":"10.1016/j.hlpt.2025.101108","url":null,"abstract":"<div><h3>Background</h3><div>Computer-assisted history taking (CAHT) could increase patient flow efficiency and healthcare resources optimization. By assessing reported clinical and patient-reported outcomes, we can clarify the benefits, limitations, and practical considerations of CAHT in clinical care. This systematic review synthesizes literature on CAHT in acute and elective care.</div></div><div><h3>Methods</h3><div>This systematic review followed PRISMA guidelines. A comprehensive search of MEDLINE, Embase, CINAHL, and Web of Science identified studies published between January 2014 and December 2024. Two reviewers independently screened articles, assessed study quality, and extracted data narratively.</div></div><div><h3>Results</h3><div>In total, 19 studies (involving 11,885 unique patients and 151 healthcare providers) were included. CAHT-questionnaire completion rates were high (75–95%) in larger samples but lower (51–67%) in smaller ones. Satisfaction was consistently high across different delivery methods and devices. Positive outcomes on patient engagement, such as active involvement and enhanced communication, were demonstrated. Clinical efficiency did improve in terms of streamlined workflows and resource utilization. Mixed results were reported on consultation duration. Finally, improved diagnostic accuracy was reported through comprehensive data capture and better alignment with clinical standards.</div></div><div><h3>Conclusion</h3><div>CAHT offers opportunities to contribute to patient engagement, workflows, and diagnostic accuracy, with high completion rates. We need sound implementation studies to explore how CAHT-systems can streamline processes and minimize needed resources. Future implementations should ensure integration into electronic health records and address digital inclusion across age groups and regions to realize CAHT’s potential in routine, patient-centered care.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101108"},"PeriodicalIF":3.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988062","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":"Wearable pre-impact fall protection system: a scoping review","authors":"Yuwen Liu,&nbsp;Zheng Zhang,&nbsp;Yige Chen,&nbsp;Kexin Du,&nbsp;Weiguang Ma","doi":"10.1016/j.hlpt.2025.101107","DOIUrl":"10.1016/j.hlpt.2025.101107","url":null,"abstract":"<div><h3>Objective</h3><div>To review wearable protective devices for individuals at high risk of falling and to analyze the feasibility of these wearable protective tools in reducing fall-related harm.</div></div><div><h3>Design</h3><div>A systematic search was conducted across 7 databases to identify studies that met the inclusion criteria for analysis.</div></div><div><h3>Results</h3><div>A total of 31 studies were included. 28 studies involved the design of pre-impact fall protective devices, while 3 studies utilized commercially available products. The primary target population was the elderly, with some designed for children, blind person, and patients with craniocerebral disease. The wearing methods mainly included clothing, accessories, and protective gears. The protective areas primarily focused on the hip or head. The core components of these tools were airbags triggered by falls or protective layers made of special materials. 11 devices included emergency call systems. 7 studies conducted clinical trials for empirical, showing protective tools had certain effectiveness in mitigating injuries caused by falls, but some of these devices exhibit poor wearing comfort and compliance among users.</div></div><div><h3>Conclusions</h3><div>The targeted design of the application population and the design of wearable pre-impact fall protection system need to be further improved. The effectiveness of these devices in practical application needs to be verified by more clinical studies.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 6","pages":"Article 101107"},"PeriodicalIF":3.7,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913282","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}