Pub Date : 2025-07-03DOI: 10.1016/j.hlpt.2025.101051
Jorn Ockerman , Anke Van Bladel , Jelle Saldien , Hilde Van Waelvelde , Lynn Bar-On
Objectives
The aim of this study was to investigate the current levels of use and attitudes towards standardised measurement instruments and (rehabilitation) technology among physiotherapists in Flanders, Belgium.
Methods
This cross-sectional study used an open, online survey, accessible to physiotherapists working in Flanders.
Results
305 completed records were retrieved. Most respondents were female (73,8 %), had >11 years of clinical experience (54,1 %), and treated >10 patients per day (82,6 %). Less than half of the respondents (47,5 %) reported frequent use of standardised measurement instruments. Treating <15 patients per day and working in a rehabilitation centre were significantly associated with frequent use of measurement instruments. Lack of time and added value were most often reported as perceived barriers for systematic implementation. Regarding technology, respondents reported to lack sufficient knowledge (40,7 %), with 36,7 % using no technology in their clinical practice. Having between 3–10 years of clinical experience and frequently treating neurological disorders were significantly associated with an increased use of technology. Lack of finances, knowledge, time and skills were the most frequently perceived barriers to the use of (rehabilitation) technology.
Conclusion
Frequent use of measurement instruments among Flemish physiotherapists appears to be relatively low and one in ten frequently alters the standardised administration. Though attitudes toward (rehabilitation) technology are positive, its adoption in clinical practice appears to be relatively low. Identified barriers include financial constraints, lack of knowledge, time and skills.
Public interest summary
This study investigated how frequently physiotherapists in Flanders, Belgium use standardized measurement instruments (which assess a patient’s health status) and technology during their patients’ treatment. We surveyed 305 physiotherapists and found that fewer than half regularly use measurement instruments. Those who treated fewer patients and worked in rehabilitation centres used these tools more often. Lack of time was most often reported as a barrier for frequent use of measurement instruments.
Concerning (rehabilitation) technology, many physiotherapists felt they didn't have enough knowledge about such devices and more than one in three used no technology in their clinical practice. Those with 3–10 years of professional experience and those who often treated neurological disorders were more likely to use technology. The biggest barriers to using technology were lack of money, knowledge, time, and skills.
Stimulating the use of both standardised measurement instruments and rehabilitation technology could yield benefits for both therapist and patient.
{"title":"Use of standardised measurement instruments and technology among Flemish physiotherapists: a cross-sectional online survey on current practices, attitudes, and barriers","authors":"Jorn Ockerman , Anke Van Bladel , Jelle Saldien , Hilde Van Waelvelde , Lynn Bar-On","doi":"10.1016/j.hlpt.2025.101051","DOIUrl":"10.1016/j.hlpt.2025.101051","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this study was to investigate the current levels of use and attitudes towards standardised measurement instruments and (rehabilitation) technology among physiotherapists in Flanders, Belgium.</div></div><div><h3>Methods</h3><div>This cross-sectional study used an open, online survey, accessible to physiotherapists working in Flanders.</div></div><div><h3>Results</h3><div>305 completed records were retrieved. Most respondents were female (73,8 %), had >11 years of clinical experience (54,1 %), and treated >10 patients per day (82,6 %). Less than half of the respondents (47,5 %) reported frequent use of standardised measurement instruments. Treating <15 patients per day and working in a rehabilitation centre were significantly associated with frequent use of measurement instruments. Lack of time and added value were most often reported as perceived barriers for systematic implementation. Regarding technology, respondents reported to lack sufficient knowledge (40,7 %), with 36,7 % using no technology in their clinical practice. Having between 3–10 years of clinical experience and frequently treating neurological disorders were significantly associated with an increased use of technology. Lack of finances, knowledge, time and skills were the most frequently perceived barriers to the use of (rehabilitation) technology.</div></div><div><h3>Conclusion</h3><div>Frequent use of measurement instruments among Flemish physiotherapists appears to be relatively low and one in ten frequently alters the standardised administration. Though attitudes toward (rehabilitation) technology are positive, its adoption in clinical practice appears to be relatively low. Identified barriers include financial constraints, lack of knowledge, time and skills.</div></div><div><h3>Public interest summary</h3><div>This study investigated how frequently physiotherapists in Flanders, Belgium use standardized measurement instruments (which assess a patient’s health status) and technology during their patients’ treatment. We surveyed 305 physiotherapists and found that fewer than half regularly use measurement instruments. Those who treated fewer patients and worked in rehabilitation centres used these tools more often. Lack of time was most often reported as a barrier for frequent use of measurement instruments.</div><div>Concerning (rehabilitation) technology, many physiotherapists felt they didn't have enough knowledge about such devices and more than one in three used no technology in their clinical practice. Those with 3–10 years of professional experience and those who often treated neurological disorders were more likely to use technology. The biggest barriers to using technology were lack of money, knowledge, time, and skills.</div><div>Stimulating the use of both standardised measurement instruments and rehabilitation technology could yield benefits for both therapist and patient.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101051"},"PeriodicalIF":3.4,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604773","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}
Pub Date : 2025-07-03DOI: 10.1016/j.hlpt.2025.101067
Digby Simpson , Kabir Ahmad , Md Parvez Mosharaf , Bushra Farah Nasir , Srinivas Kondalsamy-Chennakesavan , Matthew McGrail , Katharine A Wallis , Khorshed Alam
<div><h3>Background</h3><div>Virtual healthcare services are increasingly overcoming geographical barriers and improving access to primary healthcare, especially for rural populations. This systematic review evaluates the economic value of virtual healthcare interventions in rural primary healthcare settings.</div></div><div><h3>Methods</h3><div>A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocol guidelines. The search strategy included databases such as MEDLINE, PubMed, CINAHL, PsycINFO, and ECOLIT, covering studies published between January 31, 2010, and January 31, 2024. The quality of included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 checklist.</div></div><div><h3>Results</h3><div>Fifteen studies met inclusion criteria. Studies were classified into cost–benefit analyses (<em>n</em> = 2), cost analysis (<em>n</em> = 4), and cost-effectiveness/cost-utility (<em>n</em> = 9) studies. Five studies met over 70 % of CHEERS 2022 reporting criteria. Key findings include significant cost savings and improved cost-effectiveness for interventions targeting elderly populations, Indigenous populations, war veterans, and adults in general.</div></div><div><h3>Discussion</h3><div>The review highlights the economic value of virtual healthcare in rural primary healthcare settings, derived from cost savings and cost-effective service provision. However, inconsistencies in defining ‘virtual healthcare’, limited stakeholder engagement, and incomplete reporting of economic outcomes were identified. Future research should further consider the long-term sustainability, inclusion of younger populations, and wider stakeholder consultation in economic evaluations.</div></div><div><h3>Conclusion</h3><div>Virtual healthcare is a cost-effective and sustainable solution for strengthening rural primary healthcare systems. Policymakers and healthcare providers are encouraged to scale up rural virtual healthcare models to bridge healthcare disparities and enhance equity in access to healthcare in rural settings.</div></div><div><h3>Public Interest Summary</h3><div>This systematic review critically examined the economic value of virtual healthcare interventions within rural primary healthcare settings. Synthesis of evidence reveals the substantial cost savings and cost-effectiveness of rural virtual healthcare services, particularly for interventions targeting older adults, Indigenous communities, war veterans, and the general adult population.</div><div>The findings underscore the major economic advantages of integrating virtual healthcare into rural primary care services. However, it also highlights limitations, such as inconsistent definitions for ‘virtual healthcare’, insufficient engagement with diverse stakeholders, and incomplete reporting of economic outcomes. Future research should prioritise long-term sustainability, include younger
{"title":"The economic value of virtual primary healthcare services for rural populations: A systematic review","authors":"Digby Simpson , Kabir Ahmad , Md Parvez Mosharaf , Bushra Farah Nasir , Srinivas Kondalsamy-Chennakesavan , Matthew McGrail , Katharine A Wallis , Khorshed Alam","doi":"10.1016/j.hlpt.2025.101067","DOIUrl":"10.1016/j.hlpt.2025.101067","url":null,"abstract":"<div><h3>Background</h3><div>Virtual healthcare services are increasingly overcoming geographical barriers and improving access to primary healthcare, especially for rural populations. This systematic review evaluates the economic value of virtual healthcare interventions in rural primary healthcare settings.</div></div><div><h3>Methods</h3><div>A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocol guidelines. The search strategy included databases such as MEDLINE, PubMed, CINAHL, PsycINFO, and ECOLIT, covering studies published between January 31, 2010, and January 31, 2024. The quality of included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 checklist.</div></div><div><h3>Results</h3><div>Fifteen studies met inclusion criteria. Studies were classified into cost–benefit analyses (<em>n</em> = 2), cost analysis (<em>n</em> = 4), and cost-effectiveness/cost-utility (<em>n</em> = 9) studies. Five studies met over 70 % of CHEERS 2022 reporting criteria. Key findings include significant cost savings and improved cost-effectiveness for interventions targeting elderly populations, Indigenous populations, war veterans, and adults in general.</div></div><div><h3>Discussion</h3><div>The review highlights the economic value of virtual healthcare in rural primary healthcare settings, derived from cost savings and cost-effective service provision. However, inconsistencies in defining ‘virtual healthcare’, limited stakeholder engagement, and incomplete reporting of economic outcomes were identified. Future research should further consider the long-term sustainability, inclusion of younger populations, and wider stakeholder consultation in economic evaluations.</div></div><div><h3>Conclusion</h3><div>Virtual healthcare is a cost-effective and sustainable solution for strengthening rural primary healthcare systems. Policymakers and healthcare providers are encouraged to scale up rural virtual healthcare models to bridge healthcare disparities and enhance equity in access to healthcare in rural settings.</div></div><div><h3>Public Interest Summary</h3><div>This systematic review critically examined the economic value of virtual healthcare interventions within rural primary healthcare settings. Synthesis of evidence reveals the substantial cost savings and cost-effectiveness of rural virtual healthcare services, particularly for interventions targeting older adults, Indigenous communities, war veterans, and the general adult population.</div><div>The findings underscore the major economic advantages of integrating virtual healthcare into rural primary care services. However, it also highlights limitations, such as inconsistent definitions for ‘virtual healthcare’, insufficient engagement with diverse stakeholders, and incomplete reporting of economic outcomes. Future research should prioritise long-term sustainability, include younger ","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101067"},"PeriodicalIF":3.4,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144595675","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}
Pub Date : 2025-07-03DOI: 10.1016/j.hlpt.2025.101062
Sidney Hilker , Vishwanath Koppad , Lokesh MB , Carl Britto , Ryan CL Brewster
Introduction
In-hospital cardiac arrest is a substantial cause of morbidity and mortality in low- and middle-income countries. Telemedicine intensive care units (Tele-ICUs) may expand critical care capacity, however their impact on cardiac arrest management and outcomes has not been well-defined.
Methods
A tele-ICU network established in India provides 24/7 multidisciplinary monitoring and management via real-time audiovisual technology. Between September 2022-November 2023, six partner hospitals underwent tele-ICU implementation and participated in a spaced advanced cardiac life support (ACLS) curriculum, tailored to tele-ICU workflows. The study period spanned from three months prior to the bedside ACLS training (“pre-intervention”) to six months following completion (“post-intervention”). The impact of the intervention on return of spontaneous circulation (ROSC) rates and overall hospital mortality was assessed with multivariable logistic regression and interrupted time series analysis.
Results
Among a total of 163 cardiac arrest events (n = 52 pre-intervention, n = 111 pre-intervention), most took place within 5 days of ICU admission (83.4 %) and asystole (61.3 %) was the most common precipitating rhythm. Tele-ICU sites achieved significantly greater ROSC rates during the post-intervention (38.7 %) versus the pre-intervention (19.2 %) periods (adjusted odds ratio [aOR] 3.65 [95 % confidence interval [CI] 1.40–9.53]). This corresponded with an immediate 16.1 % (95 % CI 0.7 %-31.5 %) level increase without a significant trend change (-0.10 % [-0.97 %-0.77 %]). Overall hospital survival remained similar (4.5 % vs. 3.8 %; aOR 0.69 [95 % CI 0.08–5.72]) between study periods.
Conclusions
Tele-ICU implementation coupled with targeted ACLS training was associated with improvements in immediate in-hospital cardiac arrest outcomes, highlighting the potential of low-cost, technology-enabled care delivery models to optimize resuscitation performance in LMICs.
医院内心脏骤停是低收入和中等收入国家发病率和死亡率的一个重要原因。远程医疗重症监护病房（tele - icu）可以扩大重症监护能力，但其对心脏骤停管理和结果的影响尚未明确。方法在印度建立远程icu网络，通过实时视听技术提供全天候多学科监测和管理。在2022年9月至2023年11月期间，6家合作医院实施了远程icu，并参加了针对远程icu工作流程量身定制的间隔高级心脏生命支持（ACLS）课程。研究期间从床边ACLS培训前的三个月（“干预前”）到完成后的六个月（“干预后”）。采用多变量logistic回归和中断时间序列分析评估干预对自发循环恢复（ROSC）率和总体医院死亡率的影响。结果163例心脏骤停事件（干预前52例，干预前111例）中，发生在ICU入院5 d内的发生率最高（83.4%），最常见的诱发心律为骤停（61.3%）。与干预前（19.2%）相比，远程icu站点在干预后的ROSC率（38.7%）显著更高（调整优势比[aOR] 3.65[95%可信区间[CI] 1.40-9.53]）。这相当于立即增加16.1% （95% CI 0.7% - 31.5%）的水平，而没有显著的趋势变化（- 0.10%[- 0.97% - 0.77%]）。总体住院生存率相似(4.5% vs. 3.8%；（aOR 0.69 [95% CI 0.08-5.72]）。结论：采用steli - icu配合有针对性的ACLS培训与院内即时心脏骤停结果的改善相关，突出了低成本、技术支持的护理交付模式在优化中低收入国家复苏表现方面的潜力。
{"title":"Enhancing in-hospital cardiac arrest outcomes through the Tele-ICU Model: A novel approach to CPR quality improvement in India","authors":"Sidney Hilker , Vishwanath Koppad , Lokesh MB , Carl Britto , Ryan CL Brewster","doi":"10.1016/j.hlpt.2025.101062","DOIUrl":"10.1016/j.hlpt.2025.101062","url":null,"abstract":"<div><h3>Introduction</h3><div>In-hospital cardiac arrest is a substantial cause of morbidity and mortality in low- and middle-income countries. Telemedicine intensive care units (Tele-ICUs) may expand critical care capacity, however their impact on cardiac arrest management and outcomes has not been well-defined.</div></div><div><h3>Methods</h3><div>A tele-ICU network established in India provides 24/7 multidisciplinary monitoring and management via real-time audiovisual technology. Between September 2022-November 2023, six partner hospitals underwent tele-ICU implementation and participated in a spaced advanced cardiac life support (ACLS) curriculum, tailored to tele-ICU workflows. The study period spanned from three months prior to the bedside ACLS training (“pre-intervention”) to six months following completion (“post-intervention”). The impact of the intervention on return of spontaneous circulation (ROSC) rates and overall hospital mortality was assessed with multivariable logistic regression and interrupted time series analysis.</div></div><div><h3>Results</h3><div>Among a total of 163 cardiac arrest events (<em>n</em> = 52 pre-intervention, <em>n</em> = 111 pre-intervention), most took place within 5 days of ICU admission (83.4 %) and asystole (61.3 %) was the most common precipitating rhythm. Tele-ICU sites achieved significantly greater ROSC rates during the post-intervention (38.7 %) versus the pre-intervention (19.2 %) periods (adjusted odds ratio [aOR] 3.65 [95 % confidence interval [CI] 1.40–9.53]). This corresponded with an immediate 16.1 % (95 % CI 0.7 %-31.5 %) level increase without a significant trend change (-0.10 % [-0.97 %-0.77 %]). Overall hospital survival remained similar (4.5 % vs. 3.8 %; aOR 0.69 [95 % CI 0.08–5.72]) between study periods.</div></div><div><h3>Conclusions</h3><div>Tele-ICU implementation coupled with targeted ACLS training was associated with improvements in immediate in-hospital cardiac arrest outcomes, highlighting the potential of low-cost, technology-enabled care delivery models to optimize resuscitation performance in LMICs.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101062"},"PeriodicalIF":3.4,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571212","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}
Pub Date : 2025-07-03DOI: 10.1016/j.hlpt.2025.101064
Nouran Hamza , Wael Hafez , Sara Adel Abdelkader Saed , Marina Raouf , Nesma Magdi , Sahar Allam , Rahma Sweedy , Dina Alaraby , Marwa Muhammed Abdeljawad , Nouran A. Taha
Background
The complexity and burden of hypertension management necessitate innovative strategies to improve care quality and patient outcomes. Our meta-analysis aimed to evaluate the impact of e-health interventions on hypertension patients' quality of life and medication adherence.
Methods
A systematic review and meta-analysis were conducted using medical electronic databases for literature published before June 30, 2023. Studies investigating the efficacy of mobile health applications on the quality of life of hypertension patients were included. We extracted the studies’ characteristics, patient descriptions, and efficacy outcomes of mobile health applications. Quality assessment was done using ROB 2 and ROBINS-I V2. A meta-analysis was conducted using RevMan software.
Results
The intervention significantly decreased the standardized mean difference of the systolic blood pressure (SBP) measures compared to the control (SMD=-0.43; 95 % CI= -0.52, -0.17; p < 0.01). Additionally, it significantly increased the odds of blood pressure control (OR=3.05; 95 %CI=1.42, 6.54; p < 0.01). The heterogeneity was high; therefore, sensitivity and subgroup analyses were conducted: The intervention significantly increased the quality of life score of hypertension patients compared to the control (SMD=0.19; 95 % CI=0.04, 0.33; p = 0.01). It also significantly decreased the SMD of the SBP change from baseline and the diastolic blood pressure change from baseline compared to the control [(SMD=-4.29; 95 % CI= -5.05, -3.52; p < 0.01), (SMD=-2.75; 95 % CI= -4.06, -1.45; p < 0.01), respectively].
Conclusion
Our study demonstrates the efficacy of e-health interventions in promoting hypertension self-management, highlighting their potential as a scalable and accessible tool among the mobile phone-using population.
Public Interest Summary
Hypertension is a serious disease with severe complications if left uncontrolled. Our goal was to collect all available data on using mobile health applications in hypertension patients to facilitate their medication adherence and thus improve their quality of life. Our results show a noticeable enhancement in blood pressure control and increased patients’ quality of life after using these mobile health applications. This synthesized evidence can help patients and their healthcare providers recognize the strong efficacy and promising outcomes of these applications across multiple studies, which can ultimately lead to widespread utilization and more benefits to patients.
背景：高血压管理的复杂性和负担需要创新策略来提高护理质量和患者预后。我们的荟萃分析旨在评估电子健康干预对高血压患者生活质量和药物依从性的影响。方法利用医学电子数据库对2023年6月30日前发表的文献进行系统评价和meta分析。包括调查移动健康应用程序对高血压患者生活质量的疗效的研究。我们提取了这些研究的特征、患者描述和移动医疗应用程序的疗效结果。采用rob2和ROBINS-I V2进行质量评价。采用RevMan软件进行meta分析。结果与对照组相比，干预显著降低了收缩压（SBP）测量的标准化平均差(SMD=-0.43；95% ci = -0.52, -0.17；p & lt;0.01)。此外，它显著增加血压控制的几率(OR=3.05；95% ci =1.42, 6.54；p & lt;0.01)。异质性高；因此，进行敏感性和亚组分析：干预组高血压患者的生活质量评分较对照组显著提高(SMD=0.19；95% ci =0.04, 0.33；P = 0.01)。与对照组相比，它还显著降低了收缩压变化的SMD值和舒张压变化的SMD值[(SMD=-4.29；95% ci = -5.05, -3.52；p & lt;0.01), (SMD = -2.75;95% ci = -4.06, -1.45；p & lt;0.01),分别)。结论：我们的研究证明了电子健康干预在促进高血压自我管理方面的有效性，强调了它们在使用手机的人群中作为一种可扩展和可获得的工具的潜力。高血压是一种严重的疾病，如果不加以控制，会有严重的并发症。我们的目标是收集关于高血压患者使用移动健康应用程序的所有可用数据，以促进他们的药物依从性，从而提高他们的生活质量。我们的研究结果显示，在使用这些移动健康应用程序后，血压控制明显增强，患者的生活质量也有所提高。这些综合证据可以帮助患者及其医疗保健提供者在多个研究中认识到这些应用程序的强大功效和有希望的结果，从而最终导致广泛使用并为患者带来更多益处。
{"title":"The effectiveness of mobile health applications on the quality of life of hypertension patients: A systematic review and meta-analysis","authors":"Nouran Hamza , Wael Hafez , Sara Adel Abdelkader Saed , Marina Raouf , Nesma Magdi , Sahar Allam , Rahma Sweedy , Dina Alaraby , Marwa Muhammed Abdeljawad , Nouran A. Taha","doi":"10.1016/j.hlpt.2025.101064","DOIUrl":"10.1016/j.hlpt.2025.101064","url":null,"abstract":"<div><h3>Background</h3><div>The complexity and burden of hypertension management necessitate innovative strategies to improve care quality and patient outcomes. Our meta-analysis aimed to evaluate the impact of e-health interventions on hypertension patients' quality of life and medication adherence.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted using medical electronic databases for literature published before June 30, 2023. Studies investigating the efficacy of mobile health applications on the quality of life of hypertension patients were included. We extracted the studies’ characteristics, patient descriptions, and efficacy outcomes of mobile health applications. Quality assessment was done using ROB 2 and ROBINS-I V2. A meta-analysis was conducted using RevMan software.</div></div><div><h3>Results</h3><div>The intervention significantly decreased the standardized mean difference of the systolic blood pressure (SBP) measures compared to the control (SMD=-0.43; 95 % CI= -0.52, -0.17; <em>p</em> < 0.01). Additionally, it significantly increased the odds of blood pressure control (OR=3.05; 95 %CI=1.42, 6.54; <em>p</em> < 0.01). The heterogeneity was high; therefore, sensitivity and subgroup analyses were conducted: The intervention significantly increased the quality of life score of hypertension patients compared to the control (SMD=0.19; 95 % CI=0.04, 0.33; <em>p</em> = 0.01). It also significantly decreased the SMD of the SBP change from baseline and the diastolic blood pressure change from baseline compared to the control [(SMD=-4.29; 95 % CI= -5.05, -3.52; <em>p</em> < 0.01), (SMD=-2.75; 95 % CI= -4.06, -1.45; <em>p</em> < 0.01), respectively].</div></div><div><h3>Conclusion</h3><div>Our study demonstrates the efficacy of e-health interventions in promoting hypertension self-management, highlighting their potential as a scalable and accessible tool among the mobile phone-using population.</div></div><div><h3>Public Interest Summary</h3><div>Hypertension is a serious disease with severe complications if left uncontrolled. Our goal was to collect all available data on using mobile health applications in hypertension patients to facilitate their medication adherence and thus improve their quality of life. Our results show a noticeable enhancement in blood pressure control and increased patients’ quality of life after using these mobile health applications. This synthesized evidence can help patients and their healthcare providers recognize the strong efficacy and promising outcomes of these applications across multiple studies, which can ultimately lead to widespread utilization and more benefits to patients.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101064"},"PeriodicalIF":3.4,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144595837","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}
Pub Date : 2025-07-01DOI: 10.1016/j.hlpt.2025.101065
Matthew N. Berger , Sara L. Knox , Ben Baker , Benjamin G. Stewart , Charles Ross , Erin Mathieu , Angus H. Forster , S.Rachel Skinner , Cristyn Davies
Objectives
Microarray Patches (MAPs) deliver vaccines to the upper dermis and epidermis, rich in immune cells. This study explored the perceived safety, usability, and acceptability of High-Density Microarray Patches (HD-MAPs) among older adults aged 50+.
Methods
This was a single-centre, single-arm, open-label study using excipient-coated HD-MAPs. A trained user administered two HD-MAPs to each participant’s dominant arm, and participants self-administered to their non-dominant arm. Semi-structured interviews were conducted on days 0 and 28. Thematic analysis was used to explore participant experiences.
Results
Forty-four older adults were recruited. Themes explored the benefits and challenges of HD-MAPs. Benefits included (1) mass distribution and administration, (2) reduced healthcare burden, and (3) convenience, particularly in low-resource settings due to thermostability and potential for self-administration. Participants felt that use of trained users and self-administration could reduce burden on healthcare resources. Challenges highlighted were (1) safety of unsupervised use, (2) proof of vaccination, and (3) user confidence and cost. Concerns about adverse events and correct dosage were raised, though participants felt reassured by the sensation, applicator sound, and mark after application.
Conclusion
HD-MAPs may ease healthcare burdens and improve convenience and acceptability among older adults, offering an alternative to needles and syringes, especially for vulnerable populations.
Lay summary
This study explored how older adults (aged 50+) perceived the safety, usability, and acceptability of High-Density Microarray Patches (HD-MAPs), a new, needle-free vaccine delivery method. Participants received the HD-MAP from a trained user and also tried self-administering it. Most found HD-MAPs convenient and easy to use, appreciating their potential for home use and application in remote areas without refrigeration. Participants liked the idea of reducing the burden on healthcare systems and found the HD-MAPs less intimidating than needles. However, some concerns were raised, including safety when used unsupervised, confirming successful vaccine delivery, and cost. Participants suggested using telehealth or supervised settings to enhance confidence. Overall, HD-MAPs were considered a promising vaccination alternative, especially during pandemics and in low-resource settings. The technology may help increase vaccination rates in older adults by offering more accessible, less painful options.
{"title":"Benefits and challenges of high-density microarray patches for vaccination among older adults: A qualitative study","authors":"Matthew N. Berger , Sara L. Knox , Ben Baker , Benjamin G. Stewart , Charles Ross , Erin Mathieu , Angus H. Forster , S.Rachel Skinner , Cristyn Davies","doi":"10.1016/j.hlpt.2025.101065","DOIUrl":"10.1016/j.hlpt.2025.101065","url":null,"abstract":"<div><h3>Objectives</h3><div>Microarray Patches (MAPs) deliver vaccines to the upper dermis and epidermis, rich in immune cells. This study explored the perceived safety, usability, and acceptability of High-Density Microarray Patches (HD-MAPs) among older adults aged 50+.</div></div><div><h3>Methods</h3><div>This was a single-centre, single-arm, open-label study using excipient-coated HD-MAPs. A trained user administered two HD-MAPs to each participant’s dominant arm, and participants self-administered to their non-dominant arm. Semi-structured interviews were conducted on days 0 and 28. Thematic analysis was used to explore participant experiences.</div></div><div><h3>Results</h3><div>Forty-four older adults were recruited. Themes explored the benefits and challenges of HD-MAPs. Benefits included (1) mass distribution and administration, (2) reduced healthcare burden, and (3) convenience, particularly in low-resource settings due to thermostability and potential for self-administration. Participants felt that use of trained users and self-administration could reduce burden on healthcare resources. Challenges highlighted were (1) safety of unsupervised use, (2) proof of vaccination, and (3) user confidence and cost. Concerns about adverse events and correct dosage were raised, though participants felt reassured by the sensation, applicator sound, and mark after application.</div></div><div><h3>Conclusion</h3><div>HD-MAPs may ease healthcare burdens and improve convenience and acceptability among older adults, offering an alternative to needles and syringes, especially for vulnerable populations.</div></div><div><h3>Lay summary</h3><div>This study explored how older adults (aged 50+) perceived the safety, usability, and acceptability of High-Density Microarray Patches (HD-MAPs), a new, needle-free vaccine delivery method. Participants received the HD-MAP from a trained user and also tried self-administering it. Most found HD-MAPs convenient and easy to use, appreciating their potential for home use and application in remote areas without refrigeration. Participants liked the idea of reducing the burden on healthcare systems and found the HD-MAPs less intimidating than needles. However, some concerns were raised, including safety when used unsupervised, confirming successful vaccine delivery, and cost. Participants suggested using telehealth or supervised settings to enhance confidence. Overall, HD-MAPs were considered a promising vaccination alternative, especially during pandemics and in low-resource settings. The technology may help increase vaccination rates in older adults by offering more accessible, less painful options.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101065"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581157","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}
Pub Date : 2025-06-30DOI: 10.1016/j.hlpt.2025.101063
Mees.C. Baartmans , Steffie.M. van Schoten , Bo Schouten , Linda van Eikenhorst , Renske M. Hoeben , Henk Asscheman , Cordula Wagner
Objectives
To report the incidence of potentially preventable Adverse Events involving a Medical Device (AEMD) and provide an overview of specific topics on how devices were involved in causing patient harm.
Methods
A retrospective nationwide patient record review study using randomly selected records of 2998 patients deceased during their admission in 20 Dutch hospitals in 2019.
Results
63 potentially preventable AEMDs were identified, corresponding to a weighted incidence of 1.9 % (95CI 1.5 %-2.5 %). Medical devices were involved in about half of all potentially preventable adverse events. Consequences for patients were often severe. Themes in how medical devices were involved in causing patient harm were: Endoscopes causing perforations and hemorrhages, bleedings and infections after placement of heart- and vascular implants, and respiratory harm related to naso- and orogastric tube application. In most cases, the role of the device in causing adverse events was that of prompting a known complication. Preventability in these cases often lied in the subsequent management of the bleeding, perforation or infection.
Conclusions
AEMDs occur in a small percentage of patients admitted and deceased in Dutch hospitals, but do represent a substantial part of all potentially preventable adverse events identified amongst the old and severely comorbid patient group in this study. An additional analysis of the data, provided a more thorough understanding of how the use of medical devices contributes to patient harm. Other study designs are necessary to learn more about technical and organizational issues that might trigger AEMDs.
Public interest summary
Most medical device applications are safe and effective. Though in a small number of cases an Adverse Event involving a Medical Device (AEMD) occurs. This study found that in 1.9 % (95CI 1.5 %-2.5 %) of patients deceased during their admission in 20 Dutch hospitals in 2019 a potentially preventable AEMD occurred. Identified topics in these AEMDs were perforations, bleedings, and infections after application of endoscopes, heart- and vascular implants, and tubes for enteral feeding or drainage. The role of the devices in these AEMDs was often that of prompting a known complication and considered non-preventable. Preventability in most cases lied in the subsequent management of the perforation, bleeding or infection.
{"title":"Adverse events involving medical devices in Dutch hospitals: A patient record review study","authors":"Mees.C. Baartmans , Steffie.M. van Schoten , Bo Schouten , Linda van Eikenhorst , Renske M. Hoeben , Henk Asscheman , Cordula Wagner","doi":"10.1016/j.hlpt.2025.101063","DOIUrl":"10.1016/j.hlpt.2025.101063","url":null,"abstract":"<div><h3>Objectives</h3><div>To report the incidence of potentially preventable Adverse Events involving a Medical Device (AEMD) and provide an overview of specific topics on how devices were involved in causing patient harm.</div></div><div><h3>Methods</h3><div>A retrospective nationwide patient record review study using randomly selected records of 2998 patients deceased during their admission in 20 Dutch hospitals in 2019.</div></div><div><h3>Results</h3><div>63 potentially preventable AEMDs were identified, corresponding to a weighted incidence of 1.9 % (95CI 1.5 %-2.5 %). Medical devices were involved in about half of all potentially preventable adverse events. Consequences for patients were often severe. Themes in how medical devices were involved in causing patient harm were: Endoscopes causing perforations and hemorrhages, bleedings and infections after placement of heart- and vascular implants, and respiratory harm related to naso- and orogastric tube application. In most cases, the role of the device in causing adverse events was that of prompting a known complication. Preventability in these cases often lied in the subsequent management of the bleeding, perforation or infection.</div></div><div><h3>Conclusions</h3><div>AEMDs occur in a small percentage of patients admitted and deceased in Dutch hospitals, but do represent a substantial part of all potentially preventable adverse events identified amongst the old and severely comorbid patient group in this study. An additional analysis of the data, provided a more thorough understanding of how the use of medical devices contributes to patient harm. Other study designs are necessary to learn more about technical and organizational issues that might trigger AEMDs.</div></div><div><h3>Public interest summary</h3><div>Most medical device applications are safe and effective. Though in a small number of cases an Adverse Event involving a Medical Device (AEMD) occurs. This study found that in 1.9 % (95CI 1.5 %-2.5 %) of patients deceased during their admission in 20 Dutch hospitals in 2019 a potentially preventable AEMD occurred. Identified topics in these AEMDs were perforations, bleedings, and infections after application of endoscopes, heart- and vascular implants, and tubes for enteral feeding or drainage. The role of the devices in these AEMDs was often that of prompting a known complication and considered non-preventable. Preventability in most cases lied in the subsequent management of the perforation, bleeding or infection.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101063"},"PeriodicalIF":3.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604772","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}
Pub Date : 2025-06-28DOI: 10.1016/j.hlpt.2025.101066
Sebastián Lavanderos , Andrea Morales , Camilo Riquelme , Juan Haase
Objectives
To evaluate the impact of legal changes, specifically Law 20.418, on reducing inequality in emergency contraception (EC) access in Chile between 2008 and 2013.
Methods
A longitudinal, retrospective analysis was conducted using data from the Monthly Statistical Record (REM) of the Chilean Ministry of Health. EC consultation rates were calculated for ambulatory and total consultations, including rape-related cases, across communes. Inequality was assessed using Lorenz curves and four inequality indicators: Gini index, Theil index, coefficient of variation, and 75/25 ratio.
Results
The study found a significant reduction in communal inequality in EC consultations after the implementation of Law 20.418 in 2010. Between 2008 and 2013, the Gini index for ambulatory consultations decreased by 41 %, while for total consultations, it dropped by 20 %. Other inequality indicators also showed substantial decreases, with the 75/25 ratio decreasing by 73 % for ambulatory consultations. Regional analysis revealed a consistent downward trend in inequality, with the most significant improvements occurring in areas with higher consultation rates.
Conclusions
The findings indicate that the legal reforms introduced by Law 20.418 contributed to reducing disparities in EC access across communes. Despite improvements, some residual inequalities persist, highlighting the need for further research to identify and address remaining barriers to equitable EC access in certain regions.
Lay Summary
This study evaluates the impact of Chile's Law 20.418, which mandated the provision of emergency contraception (EC) in the public health system, on reducing access inequality. Data from 2008 to 2013 show a significant decrease in inequality in EC consultations across communes. The Gini index and other inequality indicators revealed improvements, with a 41 % reduction in inequality for ambulatory consultations and a 20 % reduction for total consultations. These changes are linked to the law's implementation, which expanded EC access, particularly in rural and underserved areas. Despite the progress, some disparities remain, suggesting that while policy interventions have made access more equitable, further efforts are needed to address residual barriers. This study highlights the importance of legal frameworks in promoting health equity, particularly in reproductive healthcare.
{"title":"Lowering inequality in access to emergency contraception: The effect of a Chilean public policy","authors":"Sebastián Lavanderos , Andrea Morales , Camilo Riquelme , Juan Haase","doi":"10.1016/j.hlpt.2025.101066","DOIUrl":"10.1016/j.hlpt.2025.101066","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the impact of legal changes, specifically Law 20.418, on reducing inequality in emergency contraception (EC) access in Chile between 2008 and 2013.</div></div><div><h3>Methods</h3><div>A longitudinal, retrospective analysis was conducted using data from the Monthly Statistical Record (REM) of the Chilean Ministry of Health. EC consultation rates were calculated for ambulatory and total consultations, including rape-related cases, across communes. Inequality was assessed using Lorenz curves and four inequality indicators: Gini index, Theil index, coefficient of variation, and 75/25 ratio.</div></div><div><h3>Results</h3><div>The study found a significant reduction in communal inequality in EC consultations after the implementation of Law 20.418 in 2010. Between 2008 and 2013, the Gini index for ambulatory consultations decreased by 41 %, while for total consultations, it dropped by 20 %. Other inequality indicators also showed substantial decreases, with the 75/25 ratio decreasing by 73 % for ambulatory consultations. Regional analysis revealed a consistent downward trend in inequality, with the most significant improvements occurring in areas with higher consultation rates.</div></div><div><h3>Conclusions</h3><div>The findings indicate that the legal reforms introduced by Law 20.418 contributed to reducing disparities in EC access across communes. Despite improvements, some residual inequalities persist, highlighting the need for further research to identify and address remaining barriers to equitable EC access in certain regions.</div></div><div><h3>Lay Summary</h3><div>This study evaluates the impact of Chile's Law 20.418, which mandated the provision of emergency contraception (EC) in the public health system, on reducing access inequality. Data from 2008 to 2013 show a significant decrease in inequality in EC consultations across communes. The Gini index and other inequality indicators revealed improvements, with a 41 % reduction in inequality for ambulatory consultations and a 20 % reduction for total consultations. These changes are linked to the law's implementation, which expanded EC access, particularly in rural and underserved areas. Despite the progress, some disparities remain, suggesting that while policy interventions have made access more equitable, further efforts are needed to address residual barriers. This study highlights the importance of legal frameworks in promoting health equity, particularly in reproductive healthcare.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101066"},"PeriodicalIF":3.4,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549378","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}
Pub Date : 2025-06-23DOI: 10.1016/j.hlpt.2025.101059
John W. Murphy, Caroline Irene-Alonso Miles
Objectives
OpenNotes is a platform that allows patients and their caregivers to both review and modify case notes. Through this strategy the clinical process will be transparent and trust can be established between these persons. The aim of this paper is to shed some light on the problems that may arise from OpenNotes introducing AI into this process. Accompanying this change is the introduction of technologically mediated communication into the production of case notes.
Methods
An examination was conducted of technologically mediated communication and the impact of this mode of interaction on the collaborative relationship that OpenNotes strives to foster.
Results
Technologically mediated communication modifies significantly interaction, thereby altering the clinical setting. Specifically important is that clients may be intimidated by this technology, inadequate responses may be given to client inquiries, language use may be overly simplified, and automation may require standardization that distorts patient-caregiver dialogue.
Conclusions
The introduction of AI may undermine the trust that OpenNotes is designed to improve in the clinical setting. Patient-caregiver interaction may become transactional, if proponents of using in OpenNotes are not careful. The rush to adopting AI should be tempered, so that the impact of this technology on patient-caregiver dialogue can be critically assessed.
{"title":"The introduction of AI into OpenNotes and the prospects for dialogue","authors":"John W. Murphy, Caroline Irene-Alonso Miles","doi":"10.1016/j.hlpt.2025.101059","DOIUrl":"10.1016/j.hlpt.2025.101059","url":null,"abstract":"<div><h3>Objectives</h3><div>OpenNotes is a platform that allows patients and their caregivers to both review and modify case notes. Through this strategy the clinical process will be transparent and trust can be established between these persons. The aim of this paper is to shed some light on the problems that may arise from OpenNotes introducing AI into this process. Accompanying this change is the introduction of technologically mediated communication into the production of case notes.</div></div><div><h3>Methods</h3><div>An examination was conducted of technologically mediated communication and the impact of this mode of interaction on the collaborative relationship that OpenNotes strives to foster.</div></div><div><h3>Results</h3><div>Technologically mediated communication modifies significantly interaction, thereby altering the clinical setting. Specifically important is that clients may be intimidated by this technology, inadequate responses may be given to client inquiries, language use may be overly simplified, and automation may require standardization that distorts patient-caregiver dialogue.</div></div><div><h3>Conclusions</h3><div>The introduction of AI may undermine the trust that OpenNotes is designed to improve in the clinical setting. Patient-caregiver interaction may become transactional, if proponents of using in OpenNotes are not careful. The rush to adopting AI should be tempered, so that the impact of this technology on patient-caregiver dialogue can be critically assessed.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101059"},"PeriodicalIF":3.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596527","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}
Pub Date : 2025-06-20DOI: 10.1016/j.hlpt.2025.101060
Robert Bagngmen Bio , Patricia Akweongo , John Azaare , Francis Adane , Kasim Abdulai , Richard Ali Laar , Abraham Titiati
Objectives
Tuberculosis treatment supporters contribute crucially to tuberculosis control and prevention without financial compensation. The World Health Organization recommends direct observation of treatment, involving supporters who incurred costs for frequent health facility visits and waiting times, potentially impacting their socio-economic status. This study aims to inform tuberculosis control and prevention policy by determining the costs and psychosocial burden associated with treatment support.
Methods
A cross-sectional cost-of-illness approach, data from 385 supporters were collected through validated questionnaires. Both direct and indirect costs were assessed, with psychosocial burden measured using the Zarit Burden Interview (ZBI) 12-item questionnaire.
Results
Results reveal that, on average, supporters spent GHS 122.4 (US$21.1) monthly, constituting 19 % of their income. A significant 77.1 % experienced a high burden on the ZBI scale, with females facing a greater burden than males. Socio-demographic factors such as education, household size, income, and district of residence influenced both direct and indirect costs.
Conclusion
In conclusion, the study underscores the substantial costs and psychosocial burden on tuberculosis treatment supporters and recommends extending the livelihood empowerment against poverty program in Ghana to cover treatment support costs.
{"title":"Costs and psychosocial burden of tuberculosis to the treatment supporters in Ghana","authors":"Robert Bagngmen Bio , Patricia Akweongo , John Azaare , Francis Adane , Kasim Abdulai , Richard Ali Laar , Abraham Titiati","doi":"10.1016/j.hlpt.2025.101060","DOIUrl":"10.1016/j.hlpt.2025.101060","url":null,"abstract":"<div><h3>Objectives</h3><div>Tuberculosis treatment supporters contribute crucially to tuberculosis control and prevention without financial compensation. The World Health Organization recommends direct observation of treatment, involving supporters who incurred costs for frequent health facility visits and waiting times, potentially impacting their socio-economic status. This study aims to inform tuberculosis control and prevention policy by determining the costs and psychosocial burden associated with treatment support.</div></div><div><h3>Methods</h3><div>A cross-sectional cost-of-illness approach, data from 385 supporters were collected through validated questionnaires. Both direct and indirect costs were assessed, with psychosocial burden measured using the Zarit Burden Interview (ZBI) 12-item questionnaire.</div></div><div><h3>Results</h3><div>Results reveal that, on average, supporters spent GHS 122.4 (US$21.1) monthly, constituting 19 % of their income. A significant 77.1 % experienced a high burden on the ZBI scale, with females facing a greater burden than males. Socio-demographic factors such as education, household size, income, and district of residence influenced both direct and indirect costs.</div></div><div><h3>Conclusion</h3><div>In conclusion, the study underscores the substantial costs and psychosocial burden on tuberculosis treatment supporters and recommends extending the livelihood empowerment against poverty program in Ghana to cover treatment support costs.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101060"},"PeriodicalIF":3.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571210","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}
Pub Date : 2025-06-18DOI: 10.1016/j.hlpt.2025.101061
Amrit Kirpalani
Objectives
The rapid adoption of AI tools like ChatGPT has transformed information access, particularly in healthcare. However, engagement with AI may be influenced by factors such as healthcare accessibility and educational resources, with potential implications for misinformation in low-resource settings. This study investigates the relationship between physician density, tertiary education enrollment, and national interest in ChatGPT.
Methods
A cross-sectional analysis was conducted using global datasets. Physician density, tertiary education enrollment, GDP, and internet penetration were sourced from WHO, UNESCO, and the World Bank, respectively. The primary outcome, ChatGPT interest scores, was derived from Google Trends. Pearson correlation and multiple linear regression analyses were used to explore associations, controlling for GDP and internet penetration. Logistic regression was employed as a sensitivity analysis, categorizing variables into high and low groups.
Results
Data from 100 countries were analyzed. A significant negative correlation was observed between physician density and ChatGPT interest (r = -0.32, p = 0.012). Multiple linear regression confirmed that lower physician density was significantly associated with higher ChatGPT interest (β = -0.2857, p = 0.045). Tertiary education enrollment showed no significant association with ChatGPT interest. Logistic regression supported these findings, with higher physician density significantly reducing the likelihood of high ChatGPT interest (OR = 0.214, p = 0.001).
Conclusion
Our study suggests that regions with fewer healthcare professionals may engage more with AI tools like ChatGPT, highlighting the need for careful integration of AI into healthcare systems to prevent misinformation and support equitable access to reliable health information.
Public Interest Summary
It is well known that people who have difficulty in accessing healthcare may turn to the internet for medical advice, but it is not yet known if artificial intelligence, like ChatGPT, is being adopted by users for this same purpose. Given the widespread use of ChatGPT, this study explored whether ChatGPT interest in different countries was related to the number of physicians in those countries. We found that in countries with fewer doctors per capita, public interest in ChatGPT tends to be higher. While this does not confirm that people are using ChatGPT specifically for medical advice, it raises important questions about how AI may be filling gaps in access to healthcare. Given the potential for AI to spread inaccurate information, these findings highlight the need for careful regulation to ensure AI tools are used responsibly and do not contribute to misinformation in healthcare.
ChatGPT等人工智能工具的迅速采用改变了信息访问方式，特别是在医疗保健领域。然而，与人工智能的接触可能会受到医疗保健可及性和教育资源等因素的影响，在资源匮乏的环境中可能会产生错误信息。本研究调查了医师密度、高等教育入学率和国家对ChatGPT的兴趣之间的关系。方法采用全球数据集进行横断面分析。医生密度、高等教育入学率、GDP和互联网普及率分别来自世卫组织、联合国教科文组织和世界银行。主要结果ChatGPT兴趣评分来源于谷歌Trends。使用Pearson相关和多元线性回归分析来探索关联，控制GDP和互联网普及率。采用Logistic回归作为敏感性分析，将变量分为高组和低组。结果分析了来自100个国家的数据。医师密度与ChatGPT兴趣呈显著负相关（r = -0.32, p = 0.012）。多元线性回归证实，较低的医师密度与较高的ChatGPT兴趣显著相关（β = -0.2857, p = 0.045）。高等教育入学率与ChatGPT兴趣无显著关联。Logistic回归支持这些发现，较高的医生密度显著降低了ChatGPT高兴趣的可能性（OR = 0.214, p = 0.001）。我们的研究表明，医疗保健专业人员较少的地区可能会更多地使用ChatGPT等人工智能工具，这突出了将人工智能仔细整合到医疗保健系统中以防止错误信息并支持公平获取可靠卫生信息的必要性。公共利益摘要众所周知，难以获得医疗服务的人可能会转向互联网寻求医疗建议，但目前尚不清楚用户是否正在采用人工智能（如ChatGPT）来实现同样的目的。鉴于ChatGPT的广泛使用，本研究探讨了不同国家对ChatGPT的兴趣是否与这些国家的医生数量有关。我们发现，在人均医生人数较少的国家，公众对ChatGPT的兴趣往往更高。虽然这并不能证实人们使用ChatGPT是专门为了获得医疗建议，但它提出了一个重要的问题，即人工智能将如何填补获得医疗保健的空白。鉴于人工智能有可能传播不准确的信息，这些发现强调了谨慎监管的必要性，以确保人工智能工具得到负责任的使用，不会导致医疗保健领域的错误信息。
{"title":"Global ChatGPT interest across healthcare and education access","authors":"Amrit Kirpalani","doi":"10.1016/j.hlpt.2025.101061","DOIUrl":"10.1016/j.hlpt.2025.101061","url":null,"abstract":"<div><h3>Objectives</h3><div>The rapid adoption of AI tools like ChatGPT has transformed information access, particularly in healthcare. However, engagement with AI may be influenced by factors such as healthcare accessibility and educational resources, with potential implications for misinformation in low-resource settings. This study investigates the relationship between physician density, tertiary education enrollment, and national interest in ChatGPT.</div></div><div><h3>Methods</h3><div>A cross-sectional analysis was conducted using global datasets. Physician density, tertiary education enrollment, GDP, and internet penetration were sourced from WHO, UNESCO, and the World Bank, respectively. The primary outcome, ChatGPT interest scores, was derived from Google Trends. Pearson correlation and multiple linear regression analyses were used to explore associations, controlling for GDP and internet penetration. Logistic regression was employed as a sensitivity analysis, categorizing variables into high and low groups.</div></div><div><h3>Results</h3><div>Data from 100 countries were analyzed. A significant negative correlation was observed between physician density and ChatGPT interest (<em>r</em> = -0.32, <em>p</em> = 0.012). Multiple linear regression confirmed that lower physician density was significantly associated with higher ChatGPT interest (β = -0.2857, <em>p</em> = 0.045). Tertiary education enrollment showed no significant association with ChatGPT interest. Logistic regression supported these findings, with higher physician density significantly reducing the likelihood of high ChatGPT interest (OR = 0.214, <em>p</em> = 0.001).</div></div><div><h3>Conclusion</h3><div>Our study suggests that regions with fewer healthcare professionals may engage more with AI tools like ChatGPT, highlighting the need for careful integration of AI into healthcare systems to prevent misinformation and support equitable access to reliable health information.</div></div><div><h3>Public Interest Summary</h3><div>It is well known that people who have difficulty in accessing healthcare may turn to the internet for medical advice, but it is not yet known if artificial intelligence, like ChatGPT, is being adopted by users for this same purpose. Given the widespread use of ChatGPT, this study explored whether ChatGPT interest in different countries was related to the number of physicians in those countries. We found that in countries with fewer doctors per capita, public interest in ChatGPT tends to be higher. While this does not confirm that people are using ChatGPT specifically for medical advice, it raises important questions about how AI may be filling gaps in access to healthcare. Given the potential for AI to spread inaccurate information, these findings highlight the need for careful regulation to ensure AI tools are used responsibly and do not contribute to misinformation in healthcare.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101061"},"PeriodicalIF":3.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338968","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号