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Forecasting emergency medical service (EMS) call volumes is critical for resource allocation and planning. The development of many commercial and free software packages has made a variety of forecasting methods accessible. Practitioners, however, are left with little guidance on selecting the most appropriate method for their needs. Using 5 years of data from 3 cities in Alberta, we compute exponential smoothing and benchmark forecasts for 8-hour periods for each ambulance station catchment area and with a forecast horizon of two weeks—a spatio-temporal resolution appropriate for tactical planning. The methods that we consider differ on three spectra: the number and type of time-series components, whether forecasts are computed individually or jointly, and the way in which forecasts at a specific resolution are converted to forecasts at the resolution of interest. We find that it is important to include a weekly seasonal component when forecasting EMS demand. Multiplicative seasonality, however, shows no benefit over additive seasonality. Adding other time-series components (e.g., trend, ARMA errors, Box-Cox transformation) does not improve performance. Spatial resolutions of station catchment area and lower, and temporal resolution of 4–24 hours perform similarly. We adapt an existing hierarchical forecasting framework to a two-dimensional spatio-temporal hierarchy, but find that hierarchical reconciliation of forecasts does not improve performance at the forecast resolution of interest for tactical planning. Neither does jointly forecasting time series. We show that added complexity does not materially improve forecasting performance. The simple methods that we find perform well are easy to implement and interpret, making implementation in practice more likely. In a simulation study we alter the empirical weekly patterns and demonstrate how extreme differences between the weekly seasonality patterns of different regions cause hierarchically-reconciled bottom-up approaches to outperform top-down approaches. [ABSTRACT FROM AUTHOR]

Abstract The COVID‐19 pandemic presented unparalleled challenges to prompt and adaptive responses from nations worldwide. This review examines China's multifaceted approach to the crisis, focusing on five key areas of response: infrastructure and system design, medical care and treatment, disease prevention and control, economic and social resilience, and China's engagement in global health. This review demonstrates the effectiveness of a top‐down command system at the national level, intersectoral coordination, a legal framework, and public social governance. This study also examines medical care and treatment strategies, highlighting the importance of rapid emergency response, evidence‐based treatment, and well‐planned vaccination rollout. Further discussion on disease prevention and control measures emphasizes the importance of adaptive measures, timely infection control, transmission interruption, population herd immunity, and technology applications. Socioeconomic impact was also assessed, detailing strategies for disease prevention, material supply, livelihood preservation, and social economy revival. Lastly, we examine China's contributions to the global health community, with a focus on knowledge‐sharing, information exchange, and multilateral assistance. While it is true that each nation's response must be tailored to its own context, there are universal lessons to be drawn from China's approach. These insights are pivotal for enhancing global health security, especially as the world navigates evolving health crises.

Background Aims Study Design Results Conclusions Relevance to Clinical Practice Evidence suggests that 8%–10% of ICU patients receive renal replacement therapy. However, there is a high rate of unplanned CRRT interruption, ranging between 17% and 74%. Studies on unplanned interruption of CRRT mainly focused on the retrospective investigation of related risk factors and conclusions have been diverse.This article aims to clarify the main influencing factors related to unplanned interruption of continuous renal replacement therapy (CRRT) in adult patients in intensive care units (ICUs).A literature review and meta‐analysis were undertaken. Following the application of the Newcastle–Ottawa Scale (NOS), a total of 15 articles were included in a total of 2132 patients who underwent 3690 CRRT procedures and 2181 unplanned interruption times. The methodological guideline of a scoping review was applied for the evidence synthesis while applying the meta‐analysis quantitative methodological guideline to identify and clarify main influencing factors related to unplanned interruption of CRRT. The reporting Prisma Protocol was followed.Longer filter life and prothrombin activation time, higher red blood cell count, greater transmembrane pressure, faster blood flow rate, intermittent saline irrigation, lower creatinine level, low prothrombin activity and pre‐dilution are factors identified to potentially affect unplanned CRRT in ICU patients.Available evidence suggests four clinical challenges associated with unplanned CRRT interruption, namely: (a) effects of red blood cell count, filter life, cross‐mode pressure, blood flow velocity, prothrombin activity and activated partial thrombin time on unplanned interruption; (b) influence of dilution mode on unplanned interruption; (c) influence of intermittent saline irrigation on unplanned interruption; (d) influence of Scr level on unplanned interruption.The potential to increase the ability to better manage unplanned CRRT in ICUs has been identified in this article and constitutes a relevant potential health care management contribution that can be implemented by nurses. [ABSTRACT FROM AUTHOR]

Mistreatment of frontline staff is a widespread issue across all industries, but is particularly prevalent in Emergency Departments (EDs). This paper examines how the orientation toward individualism vs. collectivism of outsiders--namely, patients and their escorts--affects their perceptions of justice within EDs and subsequent mistreatment of frontline staff. We conducted two field studies in major hospitals to test our hypotheses. The first study validated our model, and revealed that mistreatment was particularly likely by outsiders oriented toward individualism. The second study replicated our findings and implemented an intervention that significantly enhanced justice perceptions among these outsiders, subsequently reducing their propensity to mistreat ED staff. Our results offer new insights into the dynamics of mistreatment within EDs, emphasizing the impact of outsider expectations on their perceptions of justice and subsequent behavior. [ABSTRACT FROM AUTHOR]

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IntroductionSociety commonly believes that research knowledge is complementary to public decision-making. This study aimed to understand the perspectives and implications of dementia researchers communicating with policymakers and public research decision-makers (public officials).MethodsThis study uses 24 questions from an anonymous, online survey, which was received by 392 members of nine European, Latin American, and United States medical researcher associations/networks in the fields of age-related neurological degeneration and dementia medicine. The data were analyzed via crosstab analysis, two group comparison analyses, and a logistic regression model.ResultsIn total, 91 (23.2%) respondents completed the questionnaire. Eight independent variables were related to researchers’ research discipline, research remuneration, experience, authorship, H-index, and research grants. The statistically significant variables determining whether the respondents had contact with public officials were “Years of research experience” (p = 0.004), “Number of articles first-authored in the last 5 years” (p = 0.007), and “Average H-index in the last 5 years” (p = 0.048) [median (IQR)]; 47% of the surveyed researchers had been in contact with public officials in the last 12 months. The most frequently communicated topics were the importance of their own research to society (61%) and their own funding (60%); 87% (n = 79) of the researchers did not believe that public officials had a very good understanding of their dementia research.ConclusionLess than half (47%) of dementia researchers communicate with public officials, and they communicate mostly about the importance of their own research and funding their own research. Nine of 10 researchers do not believe that public officials understand their research well.

With the improvement of economic conditions and the increase in living standards, people's attention in regard to health is also continuously increasing. They are beginning to place their hopes on machines, expecting artificial intelligence (AI) to provide a more humanized medical environment and personalized services, thus greatly expanding the supply and bridging the gap between resource supply and demand. With the development of IoT technology, the arrival of the 5G and 6G communication era, and the enhancement of computing capabilities in particular, the development and application of AI-assisted healthcare have been further promoted. Currently, research on and the application of artificial intelligence in the field of medical assistance are continuously deepening and expanding. AI holds immense economic value and has many potential applications in regard to medical institutions, patients, and healthcare professionals. It has the ability to enhance medical efficiency, reduce healthcare costs, improve the quality of healthcare services, and provide a more intelligent and humanized service experience for healthcare professionals and patients. This study elaborates on AI development history and development timelines in the medical field, types of AI technologies in healthcare informatics, the application of AI in the medical field, and opportunities and challenges of AI in the field of medicine. The combination of healthcare and artificial intelligence has a profound impact on human life, improving human health levels and quality of life and changing human lifestyles. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusions Health care professionals often generate novel solutions to solve problems during day‐to‐day patient care. However, less is known about generating novel and useful (i.e., creative) ideas in the face of health care system failure. System failures are high‐impact and increasingly frequent events in health care organizations, and front‐line professionals may have uniquely valuable expertise to address such occurrences.Our interdisciplinary team, blending expertise in health care management, economics, psychology, and clinical practice, reviewed the literature on creativity and system failures in health care to generate a conceptual model that describes this process. Drawing on appraisal theory, we iteratively refined the model by integrating various theories with key concepts of system failures, creativity, and health care worker's well‐being.The SFC model provides a conceptualization of creativity from front‐line care professionals as it emerges in situations of failure or crisis. It describes the pathways by which professionals respond proactively to a systems failure with creative ideas to effectively address the situation and affect these workers' well‐being.Our conceptual model guides health care managers and leaders to use managerial practices to shape their systems and support creativity, especially when facing system failures. It introduces a framework for examining system‐failing creativity (SFC) and general creativity, aiming to improve health care quality, health care workers' well‐being, and organizational outcomes. [ABSTRACT FROM AUTHOR]

KEY CLINICAL MESSAGE: Even in the era of technology‐guided medicine, the clinician must integrate into his daily practice a careful anamnesis and physical examination to be conducted within a close doctor–patient relationship. All these elements, together with tools such as teleconsultation and digitalized medical records, are able to significantly increase the effectiveness of health care action. [ABSTRACT FROM AUTHOR]

Kidney exchange programs (KEPs) aim to find compatible kidneys for recipients with incompatible donors. Patients without a living donor depend upon deceased donor (DD) donations to get a kidney transplant. In India, a ©DD donates kidneys directly to a©DD wait-list. The idea of initiating an exchange chain starting from a ©DD kidney is proposed in a few articles (and executed in Italy in 2018), but no mathematical formulation has been given for this merger. We have introduced an integer programming formulation that creates ©DD-initiated chains, considering both paired exchange registry and ©DD allocations simultaneously and addressing the overlap issue between the exchange registry and ©DD wait-list as recipients can register for both registries independently. A long-term simulation study is done to ©analyse the gain of these DD-initiated chains over time. It suggests that even with small numbers of ©DDs, these chains can significantly increase potential transplants. [ABSTRACT FROM AUTHOR]

Background: The global pandemic has significantly increased the use of e-learning. In the project “Knowledge modules and case studies in the digital transformation” (Wissensbausteine und Fallstudien in der digitalen Transformation – WFDT), digital learning content is created in H5P and integrated into the Learning Management System (LMS) to be made available as Open Source Material. The teleradiology content is presented through case studies oriented towards case-based learning. Aim: The objective of usability testing is to identify potential areas for improvement and ensure these are incorporated into subsequent development and quality assurance processes. Methods: The usability test is carried out with the SUS to obtain an overview of usability within 10 items, complemented by questions on font size and qualitative feedback on the presentation. In an asynchronous setting, students work on the case study, model a teleradiology process with software, and answer the SUS and additional questions. Results: A total of 20 students from the Health Care Management and Medical Informatics degree programme participated in the usability test. The case study usability was rated as M = 59.63. Eleven students rated the font size as exactly right. The tasks, examples, and clarity of the presentation were positively rated. Further criticism was made of the task elements and the design of the presentation. Conclusions: The content structure, integration of tasks, and examples will be retained for this and other case studies. The design of the case studies will be fundamentally transformed into an H5P-proprietary format.

Abstract Background The Covid-19 pandemic has tested health care organizations worldwide. Responses have demonstrated great variation and Sweden has been an outlier in terms of both strategy and how it was enacted, making it an interesting case for further study. The aim of this study was to explore how health care leaders experienced the challenges and responses that emerged during the initial wave of the Covid-19 pandemic, and to analyze these experiences through an organizational resilience lens. Methods A qualitative interview study with 12 senior staff members who worked directly with or supervised pandemic efforts. Transcripts were analyzed using traditional content analysis and the codes directed to the Integrated Resilience Attributes Framework to understand what contributed to or hindered organizational resilience, i.e. how organizations achieve their goals by utilizing existing resources during crises. Results/Findings Organizational resilience was found at the micro (situated) and meso (structural) system levels as individuals and organizations dealt with acute shortages and were forced to rapidly adapt through individual sacrifices, resource management, process management, and communications and relational capacity. Poor systemic resilience related to misaligned responses and a lack of learning from previous experiences, negatively impacted the anticipatory phase and placed greater pressure on individuals and organizations to respond. Conventional crisis leadership could hamper innovation, further cement chronic challenges, and generate a moral tension between centralized directives and clinical microsystem experiences. Conclusions The pandemic tested the resilience of the health care system, placing undue pressure on micro and meso systems responses. With improved learning capabilities, some of this pressure may be mitigated as it could raise the anticipatory resilience potential, i.e. with better health systems learning, we may need fewer heroes. How crisis leadership could better align decision-making with frontline needs and temper short-term acute needs with a longer-term infinite mindset is worth further study.

Previous studies of healthcare organizations' workforces and their performance have focused on burnout and its impact on care. The aim of this research is to expand on this and examine the association of positive organizational states, engagement and recommendation of employer as a place to work, in comparison to burnout on Hospital performance. Methods: This was a panel study of the respondents to the 2012-2019 yearly Staff Surveys of the English National Health Service (NHS) hospital Trusts with hospital performance measured by the adjusted inpatient Summary Hospital-level Mortality Indicator (SHMI). Results: In univariable regression, all three organizational states significantly and negatively correlated with SHMI, with recommendation and engagement showing a nonlinear effect. In multivariable analysis, all three states remained significant predictors of SHMI. Engagement and recommendation showed mutual correlation, with engagement being a more prevalent state than recommendation. Conclusion: Our study indicates that organizations could benefit from monitoring multiple workforce variables to preserve or enhance workforce well-being, while optimizing organizational performance. The surprising finding that higher burnout was associated with improved short-term performance requires further investigation, as does the finding of less frequent staff recommendation of work compared to staff engagement with their work. [ABSTRACT FROM AUTHOR]

Background: The global pandemic has significantly increased the use of e-learning. In the project “Knowledge modules and case studies in the digital transformation” (Wissensbausteine und Fallstudien in der digitalen Transformation – WFDT), digital learning content is created in H5P and integrated into the Learning Management System (LMS) to be made available as Open Source Material. The teleradiology content is presented through case studies oriented towards case-based learning. Aim: The objective of usability testing is to identify potential areas for improvement and ensure these are incorporated into subsequent development and quality assurance processes. Methods: The usability test is carried out with the SUS to obtain an overview of usability within 10 items, complemented by questions on font size and qualitative feedback on the presentation. In an asynchronous setting, students work on the case study, model a teleradiology process with software, and answer the SUS and additional questions. Results: A total of 20 students from the Health Care Management and Medical Informatics degree programme participated in the usability test. The case study usability was rated as M = 59.63. Eleven students rated the font size as exactly right. The tasks, examples, and clarity of the presentation were positively rated. Further criticism was made of the task elements and the design of the presentation. Conclusions: The content structure, integration of tasks, and examples will be retained for this and other case studies. The design of the case studies will be fundamentally transformed into an H5P-proprietary format. [ABSTRACT FROM AUTHOR]

Background: The Covid-19 pandemic has tested health care organizations worldwide. Responses have demonstrated great variation and Sweden has been an outlier in terms of both strategy and how it was enacted, making it an interesting case for further study. The aim of this study was to explore how health care leaders experienced the challenges and responses that emerged during the initial wave of the Covid-19 pandemic, and to analyze these experiences through an organizational resilience lens. Methods: A qualitative interview study with 12 senior staff members who worked directly with or supervised pandemic efforts. Transcripts were analyzed using traditional content analysis and the codes directed to the Integrated Resilience Attributes Framework to understand what contributed to or hindered organizational resilience, i.e. how organizations achieve their goals by utilizing existing resources during crises. Results/Findings: Organizational resilience was found at the micro (situated) and meso (structural) system levels as individuals and organizations dealt with acute shortages and were forced to rapidly adapt through individual sacrifices, resource management, process management, and communications and relational capacity. Poor systemic resilience related to misaligned responses and a lack of learning from previous experiences, negatively impacted the anticipatory phase and placed greater pressure on individuals and organizations to respond. Conventional crisis leadership could hamper innovation, further cement chronic challenges, and generate a moral tension between centralized directives and clinical microsystem experiences. Conclusions: The pandemic tested the resilience of the health care system, placing undue pressure on micro and meso systems responses. With improved learning capabilities, some of this pressure may be mitigated as it could raise the anticipatory resilience potential, i.e. with better health systems learning, we may need fewer heroes. How crisis leadership could better align decision-making with frontline needs and temper short-term acute needs with a longer-term infinite mindset is worth further study. [ABSTRACT FROM AUTHOR]

Mobile dental clinics (MDCs) are suitable solutions for servicing people living in rural and urban areas that require dental healthcare. MDCs can provide dental care to the most vulnerable high-school students. However, scheduling MDCs to visit patients is critical to developing efficient dental programs. Here, we study a mobile dental clinic scheduling problem that arises from the real-life logistics management challenge faced by a school-based mobile dental care program in Southern Chile. This problem involves scheduling MDCs to treat high-school students at public schools while considering a fairness constraint among districts. Schools are circumscribed into districts, and by program regulations, at least 50% of the students in each district must receive dental care during the first semester. Fairness prevents some districts from waiting more time to receive dental care than others. We model the problem as a parallel machine scheduling problem with sequence-dependent setup costs and batch due dates and propose a mathematical model and a genetic algorithm-based solution to solve the problem. Our computational results demonstrate the effectiveness of our approaches in obtaining near-optimal solutions. Finally, dental program managers can use the methodologies presented in this work to schedule mobile dental clinics and improve their operations. [ABSTRACT FROM AUTHOR]

Background: Leaders are tasked with making decisions that have substantial impact on an organization's well-being. Decision making requires critical thinking. Clinical environments are becoming more complex and demanding nowadays. Acquisition of critical thinking skills seems crucial in order to provide effective and safe services in these climates. There are various general definitions regarding critical thinking in the context of health care management which mostly have no positive correlation with clinical performance. The aim of this study is to provide an evolved perspective on critical thinking in health care managers. Methods: Eight-step Rodgers’ concept analysis approach was adopted in this analysis to provide a clear definition about critical thinking in health care managers as well as searching and analyzing online databases. The inclusion criterion included articles published during 2005-2022 in English and Persian languages (just in English or in Persian). Finally, 57 articles, 3 dissertations, were included in the analysis. Results: The extracted attributes of critical thinking were as follows: responsibility for strategic planning and thinking, making accurate and hesitant decisions and problem solving skills, using professional and inter professional communication skills, applying knowledge in managing clinical settings, organizing human and financial resources, growing of mindsets and disposition for better performances in health care managers, and supervision for insurance of health quality. Provision of critical thinking leads to positive outcomes such as effective and patient-centered care, creativity, evidence-based practices, and professionalism. Conclusion: A clear and comprehensive definition of critical thinking in health care management context was developed. This definition can correct many misconceptions and conceptual misuses about critical thinking in health care managers.

Abstract Objectives The main objective of this manuscript was to identify the methods used to create process maps for care pathways that utilized the time-driven activity-based costing method. Methods This is a systematic mapping review. Searches were performed in the Embase, PubMed, CINAHL, Scopus, and Web of Science electronic literature databases from 2004 to September 25, 2022. The included studies reported practical cases from healthcare institutions in all medical fields as long as the time-driven activity-based costing method was employed. We used the time-driven activity-based costing method and analyzed the created process maps and a qualitative approach to identify the main fields. Results A total of 412 studies were retrieved, and 70 articles were included. Most of the articles are related to the fields of orthopedics and childbirth-related to hospital surgical procedures. We also identified various studies in the field of oncology and telemedicine services. The main methods for creating the process maps were direct observational practices, complemented by the involvement of multidisciplinary teams through surveys and interviews. Only 33% of the studies used hospital documents or healthcare data records to integrate with the process maps, and in 67% of the studies, the created maps were not validated by specialists. Conclusions The application of process mining techniques effectively automates models generated through clinical pathways. They are applied to the time-driven activity-based costing method, making the process more agile and contributing to the visualization of high degrees of variations encountered in processes, thereby making it possible to enhance and achieve continual improvements in processes.

BACKGROUND: Telemedicine refers to using electronic information and telecommunication technologies to support numerous aspects of healthcare, including clinical care, patient and professional education and training, public health, and health administration. However, many challenges hinder the widespread adoption of telemedicine by healthcare providers. This study aimed to assess the perspectives and barriers in telemedicine and information technology in health care management among nursing students. MATERIALS AND METHODS: A cross-sectional study was conducted among 60 nursing students enrolled in the third and fourth years. The sample was selected using a nonprobability purposive sampling technique from students studying at the Applied Medical Science Colleges for Females, University of Bisha. Data collection was facilitated through a structured questionnaire, and the gathered data were analyzed using SPSS version 22. The study was conducted between August 15, 2022 and November 20, 2022. RESULTS: 61% of students believe that telemedicine will lead to a reduction in travel time, costs, and effort. Approximately two-fourths of the sample’s perspectives revolve around concerns regarding privacy, medical errors, and camera comfort. However, more than 30% of participants agree that telemedicine will improve the quality of patient care, decrease waiting times, be beneficial for patient care in remote areas, and assist in providing appropriate information during emergency. 59% of respondents identified the lack of time or busy schedules as the most frequently reported barrier to using telemedicine. Following this, concerns regarding privacy, confidentiality, unreliable Internet connections, and inadequate knowledge about computer technology and Information Management Systems were also commonly cited as barriers. These factors were identified as the primary obstacles hindering the progress of telemedicine. CONCLUSION: This study concluded that telemedicine is a critical tool to address the challenges of limited medical resources in healthcare facilities. However, reduced healthcare costs and waiting time and improved patient access to healthcare in remote areas all helped promote telemedicine implementation. In these remote areas, telemedicine has the potential to bridge this distance and facilitate healthcare.

Abstract Background A significant and growing portion of the global burden of diseases is caused by neurological disorders. Tele-neurology has the potential to improve access to health care services and the quality of care, particularly in rural and underserved areas. The economic evaluation of the stepped wedge randomised controlled trial NeTKoH aims to ascertain the cost-effectiveness and cost-utility regarding the effects of a tele-neurologic intervention in primary care in a rural area in Germany. Methods This protocol outlines the methods used when conducting the trial-based economic evaluation of NeTKoH. The outcomes used in our economic analysis are all prespecified endpoints of the NeTKoH trial. Outcomes considered for the cost-utility and cost-effectiveness analyses will be quality-adjusted life years (QALYs) derived from the EQ-5D-5L, proportion of neurologic problems being solved at the GP’s office (primary outcome), hospital length-of-stay and number of hospital stays. Costs will be prospectively collected during the trial by the participating statutory health insurances, and will be analysed from a statutory health insurance perspective within the German health care system. This economic evaluation will be reported complying with the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Discussion This within-trial economic evaluation relaying the costs and outcomes of an interdisciplinary tele-consulting intervention will provide high-quality evidence for cost-effectiveness and policy implications of a tele-neurological programme, including the potential for application in other rural areas in Germany or other jurisdictions with a comparable health system. Trial registration German Clinical Trials Register (DRKS00024492), date registered: September 28, 2021.

E-prescription, introduced on February 16, 2018, as part of a pilot program in two cities, initially met many barriers (resistance and doubts of medical staff, incompatibility of IT systems and inappropriate computer equipment or its lack in medical offices), and is currently one of the most well-known and the most frequently used e-tools in medical services. The usage of e-prescribing was crucial during the COVID-19 pandemic, when forced isolation made contacts with medical staff difficult or even impossible. Patients, left without medical care, could use health care services to a very limited extent. Then, teleconsultations and digital prescriptions turned out to be an excellent remedy for such a problematic situation. In fact, we owe the development of many e-tools and the spread of their use to the COVID-19 pandemic. The importance of e-prescription for the system and medical service providers cannot be overestimated. Through it, the system and health care entities receive reliable and accurate information (e.g. about the number of prescribed drugs, the health condition of Polish patients, or the amount of reimbursement). An e-prescription is not only a record of what medicine the patient should take, but a set of data that, when used in an appropriate manner, can constitute a guide for the further development of medical services, preventive programs and directions of changes in the health care system. The article presents information on the implementation and use of e-prescriptions by medical staff in Poland in 2018-2022. The information contained in the article may constitute the basis for subsequent studies in Poland and abroad, for international comparative analyses, due to their timeliness and detail. The aim of the article is to present the degree of use of e-prescriptions by medical staff in health care entities. To achieve the goal, the fol-lowing research methods were used: critical analysis of literature and websites presenting digital solutions for the health care system, analysis of source materials and numerical data from the e-Health Center (CeZ).

Background: Evidence-based decision-making is essential to improve public health benefits and resources, especially in low- and middle-income countries (LMICs), but the mechanisms of its implementation remain less straightforward. The availability of high-quality, reliable, and sufficient data in LMICs can be challenging due to issues such as a lack of human resource capacity and weak digital infrastructure, among others. Health information systems (HISs) have been critical for aggregating and integrating health-related data from different sources to support evidence-based decision-making. Nutrition information systems (NISs), which are nutrition-focused HISs, collect and report on nutrition-related indicators to improve issues related to malnutrition and food security—and can assist in improving populations' nutritional statuses and the integration of nutrition programming into routine health services. Data visualization tools (DVTs) such as dashboards have been recommended to support evidence-based decision-making, leveraging data from HISs or NISs. The use of such DVTs to support decision-making has largely been unexplored within LMIC contexts. In Bangladesh, the Mukto dashboard was developed to display and visualize nutrition-related performance indicators at the national and subnational levels. However, despite this effort, the current use of nutrition data to guide priorities and decisions remains relatively nascent and underused. Objective: The goal of this study is to better understand how Bangladesh's NIS, including the Mukto dashboard, has been used and areas for improvement to facilitate its use for evidence-based decision-making toward ameliorating nutrition-related service delivery and the health status of communities in Bangladesh. Methods: Primary data collection was conducted through qualitative semistructured interviews with key policy-level stakeholders (n=24). Key informants were identified through purposive sampling and were asked questions about the experiences and challenges with the NIS and related nutrition dashboards. Results: Main themes such as trust, data usability, personal power, and data use for decision-making emerged from the data. Trust in both data collection and quality was lacking among many stakeholders. Poor data usability stemmed from unstandardized indicators, irregular data collection, and differences between rural and urban data. Insufficient personal power and staff training coupled with infrastructural challenges can negatively affect data at the input stage. While stakeholders understood and expressed the importance of evidence-based decision-making, ultimately, they noted that the data were not being used to their maximum potential. Conclusions: Leveraging DVTs can improve the use of data for evidence-based decision-making, but decision makers must trust that the data are believable, credible, timely, and responsive. The results support the significance of a tailored data ecosystem, which has not reached its full potential in Bangladesh. Recommendations to reach this potential include ensuring a clear intended user base and accountable stakeholders are present. Systems should also have the capacity to ensure data credibility and support ongoing personal power requirements. [ABSTRACT FROM AUTHOR]

Background: Leadership is recognized as an essential competency in health care and science, being central for professionals to face health challenges. Few physicians feel prepared to serve as leaders in the health care environment, and few receive training in the leadership skills needed to be successful. Teaching leadership skills together with extensive, longitudinal, clinical education in an authentic and nurturing environment can effectively develop students for leadership in medicine. Studies on the subject still do not show the best way to implement it in medical education, and an updated review is necessary. Objective: The aim of this study is to identify the types of available evidence on the teaching of leadership skills in undergraduate courses in the health area, analyze them, determine knowledge gaps, and disseminate the research results. Methods: This is a scoping review that will consider studies on leadership skills in medical and health undergraduate courses. Primary studies published in English, Spanish, and Portuguese since 2019 will be considered. The search will be performed in 8 databases, and reference lists will be searched for additional studies. Duplicates will be removed, and 2 independent reviewers will examine the titles, abstracts, and full texts of the selected studies. Data extraction will be performed using a tool developed by the researchers. Results: The scoping review is currently in progress. The preliminary database search has been completed, yielding a total of 1213 articles across multiple databases. The next stages, including deduplication, title and abstract screening, and full-text review, are scheduled to be completed by December 2024. Data extraction and analysis are expected to be finalized by March 2025, with the final report anticipated to be ready for submission by June 2025. Conclusions: This scoping review on leadership in the medical curriculum can significantly contribute to the literature by organizing and synthesizing the available evidence on teaching leadership skills in undergraduate courses in the health area. Furthermore, by analyzing evidence and identifying knowledge gaps, the study can provide valuable insights to develop more efficient and comprehensive medical education programs, thus preparing students to take on leadership roles in the complex environment of health care. Trial Registration: Open Science Framework YEXKB; https://osf.io/yexkb International Registered Report Identifier (IRRID): PRR1-10.2196/62810 [ABSTRACT FROM AUTHOR]

Background: ChatGPT (OpenAI) is a powerful tool for a wide range of tasks, from entertainment and creativity to health care queries. There are potential risks and benefits associated with this technology. In the discourse concerning the deployment of ChatGPT and similar large language models, it is sensible to recommend their use primarily for tasks a human user can execute accurately. As we transition into the subsequent phase of ChatGPT deployment, establishing realistic performance expectations and understanding users' perceptions of risk associated with its use are crucial in determining the successful integration of this artificial intelligence (AI) technology. Objective: The aim of the study is to explore how perceived workload, satisfaction, performance expectancy, and risk-benefit perception influence users' trust in ChatGPT. Methods: A semistructured, web-based survey was conducted with 607 adults in the United States who actively use ChatGPT. The survey questions were adapted from constructs used in various models and theories such as the technology acceptance model, the theory of planned behavior, the unified theory of acceptance and use of technology, and research on trust and security in digital environments. To test our hypotheses and structural model, we used the partial least squares structural equation modeling method, a widely used approach for multivariate analysis. Results: A total of 607 people responded to our survey. A significant portion of the participants held at least a high school diploma (n=204, 33.6%), and the majority had a bachelor's degree (n=262, 43.1%). The primary motivations for participants to use ChatGPT were for acquiring information (n=219, 36.1%), amusement (n=203, 33.4%), and addressing problems (n=135, 22.2%). Some participants used it for health-related inquiries (n=44, 7.2%), while a few others (n=6, 1%) used it for miscellaneous activities such as brainstorming, grammar verification, and blog content creation. Our model explained 64.6% of the variance in trust. Our analysis indicated a significant relationship between (1) workload and satisfaction, (2) trust and satisfaction, (3) performance expectations and trust, and (4) risk-benefit perception and trust. Conclusions: The findings underscore the importance of ensuring user-friendly design and functionality in AI-based applications to reduce workload and enhance user satisfaction, thereby increasing user trust. Future research should further explore the relationship between risk-benefit perception and trust in the context of AI chatbots. [ABSTRACT FROM AUTHOR]

Abstract Background Neurological disorders account for a large and increasing proportion of the global burden of disease. Therefore, it is important to strengthen the management of neurologic care, particularly in rural areas. The use of tele-neurology in primary care in rural areas is internationally considered to have the potential to increase access to health care services and improve the quality of care in these underserved areas. NeTKoH aims to address the existing knowledge gap regarding the effects of a tele-neurologic intervention in primary care under real-world conditions in a rural area in Germany. Methods NeTKoH is a cluster-randomized controlled trial with a stepped-wedge design involving 33 outpatient general practitioner’s (GP) offices (clusters) in a rural area in Northeast Germany. During 11 predetermined steps, all clusters are randomized before they cross over into groups from the control to the intervention arm. The targeted sample size is 1,089 patients with neurologic symptoms that are continuously being recruited. In the intervention arm, tele-neurologic consultations will be provided via a face-to-face video conferencing system with a neurologic expert at a university hospital. The control arm will receive usual care. The primary outcome is the proportion of neurologic problems being solved at the GP’s office. Secondary outcomes will comprise hospital stays and days, time until neurologic specialist appointments and diagnostics, patients’ health status and quality of life, outpatient and inpatient referrals. A concurrent observational study, together with a process, implementation, and health economic evaluation, will also be conducted. Discussion Using a stepped-wedge cluster design in a real-life situation can help with logistic challenges and enhance the motivation of the participating GPs, as all, at some point, will be in the intervention phase. With the additional implementation evaluation pertaining to external validity, an observational study, and a health economic evaluation, NeTKoH will be able to provide an extensive evaluation for health policy decision-makers regarding the uptake into standard care. Trial registration German Clinical Trials Register (DRKS00024492). Date registered: September 28, 2021. Date and protocol version: June 2023, version 1.

This study evaluates the management capacity ability and profitable capacity of eight public-private partnership hospitals in Taiwan from 2015 to 2020. By conducting various ratio analyses of the financial statement, this study found these hospitals have achieved a balance between management efficiency and profitability, thereby confirming the viability of the PPP model for hospital management. In addition, the subject hospitals play a vital role as isolation hospitals during the COVID-19 pandemic. Beyond offering medical assistance to infected individuals, these hospitals contribute to the integrity of Taiwan's medical network, mitigating the impact of the pandemic. Overall, establishing and managing hospitals with PPP partnership is a feasible solution as it alleviates governmental financial burdens related to medical welfare and achieves profitability. [ABSTRACT FROM AUTHOR]

This research aims to advance the understanding of gamification in health care management using a systematic review of the literature through a multiphase analysis. To do so, first, we extract the relevant bibliographic data for our research according to a methodology of data generation structured in six stages and a descriptive analysis oriented to the technical characterization of the data. Then, we codify all the information, identify the main attributes with the collaboration of two independent experts and check their validity using the evaluation of two focus groups of professionals in gamification and health care management. We found seven attributes: (1) health care users, (2) psychology, (3) behavior, (4) activities, (5) health field, (6) technology, and (7) gamification elements. Within each of these seven attributes, there are a series of main elements that are detailed in the following for each of them. (1) Health care users: their age and the role they play in the health system. (2) Psychology: cognition, positive and negative emotions. (3) Behavior: healthy behavior encouragement, such as compliance, collaboration and responsibility. (4) Activities: physical activity and food. (5) Health field: preventive medicine and chronic diseases. (6) Technology: cell phones. (7) Gamification elements: different elements, but the number of articles in which these elements and their interactions are studied in depth is limited. Our results point toward a promising present and future research agenda that is in parallel with the development of relevant fields for the sector, such as chronic diseases, health education and preventive medicine. Plain Language Summary: Gamification, Health Care Management and Systematic Literature Review This research aims to advance the knowledge of gamification in healthcare management using a systematic literature review through a multiphase analysis. Our results point to a promising present and future research agenda parallel to developing fields relevant to the sector, such as chronic diseases, health education, and preventive medicine. [ABSTRACT FROM AUTHOR]

Aims: To investigate which work‐related factors are associated with work–family conflict of care workers in nursing homes, this study aimed to: (a) describe the prevalence of work–family conflict of care workers in nursing homes and (b) assess the association of work‐related factors with work–family conflict. Design: Cross‐sectional multicentre sub‐study based on data from the Swiss Nursing Homes Human Resources Project 2018. Methods: Data were collected between September 2018 and October 2019. Work–family conflict of care workers was assessed with the Work–Family Conflict Scale (range 1–5). Prevalence was described in percentages. We used multilevel linear regression to assess the association of time‐based factors (working overtime or during one's free time, employment percentage, presenteeism, shift working) and strain‐based factors (staffing adequacy, leadership support) with work–family conflict. Results: Our study sample consisted of 4324 care workers working in a total of 114 nursing homes. Overall, 31.2% of respondents stated to have experienced work–family conflict (>3.0 on the Work–Family Conflict Scale). The overall mean score of the study sample for work–family conflict was 2.5. Care workers experiencing presenteeism 10 or more days per year showed the highest scores for work–family conflict (mean: 3.1). All included predictor variables were significant (p <.05). Conclusion: Work–family conflict is multifactorial. Possible intervention points to tackle work–family conflict could be strengthening care workers' influence in planning work schedules, enabling flexible planning to ensure adequate staffing, lowering presenteeism and implementing a supportive leadership style. Impact: Care workers' jobs become less desirable when workplace demands interfere with family life. This study highlights the multifaceted nature of work–family conflict and suggests intervention options to prevent care workers from experiencing work–family conflict. Action is needed at nursing home and policy level. [ABSTRACT FROM AUTHOR]

Introduction: Emergency Medical Services (EMS) are integrated services involving doctors, paramedics, nurses, and social workers. This research was carried out to synthesize the evidence concerning social work roles for EMS. The aim of this study was to synthesize literature on the social worker's role in EMS settings. Methods: The study was a systematic review. Data were collected through selected databases. The researcher used Scopus, Sociology Database, Social Science Database, and Public Health Database related to EMS and social work settings. English papers were selected, without restrictions on publication time, place, and year. The searched keywords were: "Social Work AND Emergency Medical Services AND Ambulance Services," "Social Worker AND Emergency Medical Systems AND Ambulance Services," "Social Work AND EMS," "Social Worker AND EMS," "Social Work OR Social Worker," "Social Work Role AND EMS," Social Worker AND EMS," "Emergency Medical Services OR/AND Emergency Medical Systems." Results: The study synthesized the literature about the social work role in pre-EMS, during emergency, and post-EMS. The following themes were highlighted: social workers act as cultural liaisons, effective communicators, emergency workers, and mental health practitioners, collaborating with other disciplines and researchers, for this study. In pre-emergency stages, social workers have roles as educators, communicators, advocates, and awareness builders. During an emergency, social workers act as search and rescue workers, advocates, facilitators, networkers, psychosocial assessors, consultants, counselors, and liaisons for referral activities. And in the post-emergency period, social workers have roles as planners, liaisons, interdisciplinary collaborators, researchers, evaluators, and individuals responsible for follow up. Conclusion: This study synthesizes the roles of social workers in EMS settings. It is the first study on this topic, aiming to produce new knowledge, evidence, and an EMS practice framework for the social worker. [ABSTRACT FROM AUTHOR]

Background: A significant and growing portion of the global burden of diseases is caused by neurological disorders. Tele-neurology has the potential to improve access to health care services and the quality of care, particularly in rural and underserved areas. The economic evaluation of the stepped wedge randomised controlled trial NeTKoH aims to ascertain the cost-effectiveness and cost-utility regarding the effects of a tele-neurologic intervention in primary care in a rural area in Germany. Methods: This protocol outlines the methods used when conducting the trial-based economic evaluation of NeTKoH. The outcomes used in our economic analysis are all prespecified endpoints of the NeTKoH trial. Outcomes considered for the cost-utility and cost-effectiveness analyses will be quality-adjusted life years (QALYs) derived from the EQ-5D-5L, proportion of neurologic problems being solved at the GP's office (primary outcome), hospital length-of-stay and number of hospital stays. Costs will be prospectively collected during the trial by the participating statutory health insurances, and will be analysed from a statutory health insurance perspective within the German health care system. This economic evaluation will be reported complying with the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Discussion: This within-trial economic evaluation relaying the costs and outcomes of an interdisciplinary tele-consulting intervention will provide high-quality evidence for cost-effectiveness and policy implications of a tele-neurological programme, including the potential for application in other rural areas in Germany or other jurisdictions with a comparable health system. Trial registration: German Clinical Trials Register (DRKS00024492), date registered: September 28, 2021. [ABSTRACT FROM AUTHOR]

Background: Neurological disorders account for a large and increasing proportion of the global burden of disease. Therefore, it is important to strengthen the management of neurologic care, particularly in rural areas. The use of tele-neurology in primary care in rural areas is internationally considered to have the potential to increase access to health care services and improve the quality of care in these underserved areas. NeTKoH aims to address the existing knowledge gap regarding the effects of a tele-neurologic intervention in primary care under real-world conditions in a rural area in Germany. Methods: NeTKoH is a cluster-randomized controlled trial with a stepped-wedge design involving 33 outpatient general practitioner's (GP) offices (clusters) in a rural area in Northeast Germany. During 11 predetermined steps, all clusters are randomized before they cross over into groups from the control to the intervention arm. The targeted sample size is 1,089 patients with neurologic symptoms that are continuously being recruited. In the intervention arm, tele-neurologic consultations will be provided via a face-to-face video conferencing system with a neurologic expert at a university hospital. The control arm will receive usual care. The primary outcome is the proportion of neurologic problems being solved at the GP's office. Secondary outcomes will comprise hospital stays and days, time until neurologic specialist appointments and diagnostics, patients' health status and quality of life, outpatient and inpatient referrals. A concurrent observational study, together with a process, implementation, and health economic evaluation, will also be conducted. Discussion: Using a stepped-wedge cluster design in a real-life situation can help with logistic challenges and enhance the motivation of the participating GPs, as all, at some point, will be in the intervention phase. With the additional implementation evaluation pertaining to external validity, an observational study, and a health economic evaluation, NeTKoH will be able to provide an extensive evaluation for health policy decision-makers regarding the uptake into standard care. Trial registration: German Clinical Trials Register (DRKS00024492). Date registered: September 28, 2021. Date and protocol version: June 2023, version 1. [ABSTRACT FROM AUTHOR]

Problem definition: The Centers for Medicare & Medicaid Services launched the Primary Care First (PCF) initiative in January 2021. The initiative builds upon prior innovative payment models and aims at incentivizing a redesign of primary care delivery, including new modes of delivery, such as remote care. To achieve this goal, the initiative blends capitation and fee-for-service (FFS) payments and includes performance-based adjustments linked to service quality and health outcomes. We analyze a model motivated by this new payment system, and its impact on the different stakeholders, and derive insights on how to design it to reach the best possible outcome. Methodology/results: We propose an analytical model that captures patient heterogeneity in terms of health complexity, provider choice of care-delivery mode (referral to a specialist, in-person visit, or remote care), and quality of service (health outcomes and wait time). We analyze the provider decision on the mode of care delivery under both FFS and PCF and study whether PCF can be designed to yield a socially optimal outcome. We characterize analytically when patients, payer, and providers are better off under PCF and show that, in many cases, PCF can be designed to yield a socially optimal outcome. We numerically calibrate our model for 14 states in the United States. We observe that the average health status in a state is a source of heterogeneity that crucially drives the performance of PCF. We find that the model motivated by the current PCF implementation results in too much adoption of referral care and too little adoption of remote care. In addition, states with poor average health status may use more in-person care than socially optimal under a baseline (low) level of capitation. Moreover, relying on high levels of capitation leads to low adoption of in-person care. Managerial implications: Our results have health policy implications by shedding light on how PCF might impact patients, payer, and providers. Under the current performance-based adjustments, low levels of capitation should be preferred. PCF has the potential to be designed to achieve socially optimal outcomes. However, the fee per visit may need to be tailored to the local population's health status. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2023.1207. [ABSTRACT FROM AUTHOR]

Objevtive: to identify and systematize the main approaches to planning health care provider network used in foreign countries.Material and methods. Preliminary search for countries who had an experience of systematical planning of health care provider network and tools that they used for planning was conducted in regular health system reviews made by the European Observatory on Health Systems and Policies. Identified tools became a subject of general Internet search for the official publications about goals, mechanisms and results of their usage. The findings were analysed to reveal the similarities and differences between national health care provider network planning policies as well as the objective preconditions for the formation of such policies.Results. Three main approaches to health care provider network planning were identified in the analysis: (1) through establishing state-owned health care providers, (2) through granting the right to deliver guaranteed health care or (3) through granting the right to deliver health care of all categories. A close relationship between the choice of prevailing approach to planning and specific planning tools and the national health care model and structure of health services supply was shown. The typical policy of countries most similar to Russia on these parameters (“young” insurance systems, operating under conditions of predominant state supply of medical services) is the protection of key providers on the basis of minimum activity or income guarantees with the gradual development of a competitive health care market based on the rest of the Compulsory Health Insurance program.Conclusion. Current Russian health care provider network planning regulation based on the direct control over the state-owned health care providers does not correspond to the changed health care model and does not allow taking full advantages of the social health insurance. The results of the review can be used to develop new tools for planning health care provider network spanning on non-state providers.

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There is widespread perception that bureaucracy is omnipresent in Portuguese health care management. This is despite bureaucracy being heavily deprecated. This paper addresses this dissonance by studying the Portuguese Public Enterprise Entity Hospitals context. It seeks to understand how a bureaucratic approach prevails. The study is based on document analysis and extends the Institutional Logics Perspective to the health care context. Three institutional logics were observed: State, community, and profession. The need to resolve conflicts between the different logics induces a neo-bureaucratic approach to management. This paper contributes by identifying the institutional drivers of bureaucratic logic in health care settings. [ABSTRACT FROM AUTHOR]

Problem definition: We consider the rostering decisions—that is, the assignment of workers scheduled for a shift to units—of a long-term care facility. The facility's objective is to minimize the monthly inconsistency level, a widely promoted quality metric representing the number of different caregivers working in each unit over one month. Methodology/results: We introduce simple rostering heuristics that prioritize either part-time or full-time workers and present a stochastic model of the repeated rostering problem to compare the performance of different strategies analytically. Our analysis shows that in order to minimize the inconsistency level, part-time workers should receive higher priority than full-time workers for assignment to their home units. We also establish an analytical upper bound for a threshold on the time horizon above which a policy giving assignment priority to part-time workers is guaranteed to outperform one giving priority to full-time workers. Using data from more than 15,000 shifts worked by nursing assistants at three nursing homes, we compare the actual rosters to the hindsight optimal consistency-maximizing schedules, demonstrating a significant opportunity for improvement. We then compare the performance of our rostering heuristics via trace-based simulation of the historical schedules. This reinforces the superiority of prioritizing part-time workers, yielding reductions in the inconsistency level between 20% and 30% compared with the historical rosters. Managerial implications: Contrary to popular guidance, our results show that managers should focus on part-time workers and assign them as consistently as possible. Even if some full-time workers are always assigned to their home units (because of preferences or work rules), assignment flexibility among the remaining full-time workers still enables significant improvements in the consistency of care. This flexibility among full-time workers helps because their higher work frequency tends to make a reassignment away from their home unit contribute less to inconsistency, because they are able to work multiple shifts in these nonhome units. Supplemental Material: The e-companion is available at https://doi.org/10.1287/msom.2022.1174. [ABSTRACT FROM AUTHOR]

Abstract Background Ukraine is reforming its health care system to improve quality of health care. Insight into how primary health care managers perceive quality is important for the ongoing reform as well as for the improvement of medical services. Methods An online survey was conducted as part of the Ukrainian-Swiss project “Medical Educational Development” in April–May 2019 based on the contact list of USAID project “Health Reform Support”, and additionally on the database of the National Health Service of Ukraine and other channels. Data were analyzed using descriptive statistics and qualitative data analysis. Results In total, 302 health care managers took part in the study. The majority of primary health care managers perceive quality in health care as process quality. They associate quality mostly with compliance to standards. At the same time, primary health care managers prefer to assess outcome quality via a system of indicators and feedback. There appears to be a lack of consensus about health care quality. This may be due to a lack of awareness of the national strategy for better quality of health care service. Conclusions Our study provides new insights into primary care managers' perceptions of health care quality in Ukraine. The absence of a clear consensus about quality complicates the discussion about quality and how to measure quality in health care. This appears to be one of the obstacles to system-wide quality improvement.

Background: The development of the sports industry was impacted by the era of Big Data due to the rapid growth of information technology. Unfortunately, that has become an increasingly challenging Issue.

This paper deals with the modelling and optimization of health care management with particular reference to the Dietary Approaches to Stop Hypertension (DASH) diet problem in a neutrosophic environment. We have considered the degree of acceptance, indeterminacy, and rejection of objectives to express the DASH diet problem's vulnerability in modelling. Further, neutrosophic goal programming (NGP) by considering three different types of membership functions have been used to minimize the sum of deviation from the set goal. A case study has been discussed to determine an appropriate DASH diet based on cost and user preferences. The results indicated that goal programming (GP) and fuzzy goal programming (FGP) approach failed to provide the value of all the concerned decision variables related to different types of food. However, we can get all the concerned decision variables valuable for diet problems through NGP. The application developed in this study is a problem of optimization that provides users with a daily diet that contains all the necessary amounts of supplements with less expense. The fundamental fact of the DASH diet is not only to shed blood pressure however to decrease the circulatory strain of the body, and so that it can likewise enable the individuals who need to get in shape, lessen Cholesterol, and counteract diabetes.

Abstract Background All stroke patients should receive timely admission to a stroke unit (SU). Consequently, most patients with suspected strokes – including stroke mimics (SM) are admitted. The aim of this study was to estimate the current total demand for SU bed capacity today and give estimates for future (2020–2040) demand. Methods Time trend estimates for stroke incidence and time constant estimates for length of stay (LOS) were estimated from the Norwegian Patient Registry (2010–2015). Incidence and LOS models for SMs were based on data from Haukeland University Hospital (2008–2017) and Akershus University Hospital (2020), respectively. The incidence and LOS models were combined with scenarios from Statistic Norway’s population predictions to estimate SU demands for each health region. A telephone survey collected data on the number of currently available SU beds. Results In 2020, 361 SU beds are available, while demand was estimated to 302. The models predict a reduction in stroke incidence, which offsets projected demographic shifts. Still, the estimated demand for 2040 rose to 316, due to an increase in SMs. A variation of this reference scenario, where stroke incidence was frozen at the 2020-level, gave a 2040-demand of 480 beds. Conclusions While the stroke incidence is likely to continue to fall, this appears to be balanced by an increase in SMs. An important uncertainty is how long the trend of decreasing stroke incidence can be expected to continue. Since the most important uncertainty factors point toward a potential increase, which may be as large as 50%, we would recommend that the health authorities plan for a potential increase in the demand for SU bed capacity.

Objective: This study updates a 2009 study which examined uniform resource locator (URL) decay in health care management journals and seeks to determine whether continued URL availability relates to publication date, resource type, or top-level domain. The authors also provide an analysis of differences in findings between the two study periods. Methods: The authors collected the URLs of web-based resources cited in articles published in five health care management source journals from 2016 to 2018. The URLs were checked to see if they were still active and then analyzed to determine if continued availability was related to publication date, resource type, or top-level domain. Results: There were statistically significant differences in URL availability across publication date, resource type, and top-level domain. Domains with the highest rate of decay were .com and .net and the lowest rate were .edu and .gov. As expected, the older the citation, the higher the rate of decay. The overall rate of URL decay decreased from 49.3% to 36.1% between studies. Conclusion: URL decay in health care management journals has decreased in the last 15 years. Still, URL decay does continue to be a problem. Interestingly, health services policy research journals had a lower rate of decay than practitioner-oriented journals (34.8% vs. 51.7%). Authors, publishers, and librarians should continue to promote the use of digital object identifiers and web archiving and perhaps study and replicate efforts used by health services policy research journals to increase continued URL availability rates.

This article analyzes the factors influencing the utilization of antenatal care (ANC) services throughout pregnancy and the way it is managed. Antenatal care from qualified medical professionals gives expectant mothers the attention they need to achieve the best possible health for both the mother and the unborn child during pregnancy. Those care providers are supposed to facilitate women with information and assistance throughout the pregnancy and afterward. ANC services are the initial step in ensuring the health of the mother and child which is one of the basic needs during pregnancy. But for many pregnant women, notably in low- and middle-income countries, where a variety of dietary deficits typically coexist, awareness of healthy pregnancy and dietary consumption of nutritious food are frequently insufficient to meet these needs. Services of medical professionals are either inadequate or inappropriate in many of those regions. By examining the experiences of selected women from the Mountgaon district of Assam, this study looks at the factors affecting the accessibility of antenatal services for women. The study clarifies the lower-than-average use of healthcare services in the targeted area because of the non-availability of facilities, lapse in the proper healthcare management and socio-cultural peculiarities relating to women and their families. The analysis shows the impact of socio-economic and cultural factors on health-seeking behaviour as well as the usage of the available healthcare facilities. [ABSTRACT FROM AUTHOR]

Background: The Covid-19 pandemic involved the establishment of health emergency measures, among others, the suspension and subsequent progressive reopening of dental care. Purpose: Understand how health measures due to Covid-19 affected owners of dental offices and clinics in Bogotá, Colombia, and whether these aggravated the crisis of the profession. Methods: a qualitative study was conducted, interviewing seven dentists who owned dental clinics or offices. They investigated working conditions, economic changes, hiring conditions and the participation of professional organizations in the pandemic. Results: Dentistry was already in a crisis that was exacerbated by health measures in the face of the Covid-19 pandemic. Those interviewed did not perceive a quick leadership voice from government entities to establish care protocols. Administrative management is different according to the capabilities of dental clinics compared to private offices. Finally, the pandemic and mobility restrictions made it possible to establish improvements in time shared with the family; however, this affected the owners' income, leading them to seek other forms of income. Conclusions: Dentistry has been in crisis for many years, which was more evident with the confinement measures implemented to control the Covid-19 pandemic. There are differences in administrative management in favor of dental clinics that were essential in the context of the pandemic. [ABSTRACT FROM AUTHOR]