Healthcare

Research

17 pages, 233 KB

Open AccessArticle

Missed Infection-Control Nursing Care from the Early Pandemic to the Post-Pandemic Era: Policy and Management Implications for Safer Healthcare

by Eftychia Evangelidou, Evridiki Papastavrou, Georgios Efstathiou and Chryssoula Lemonidou

Healthcare 2026, 14(14), 2077; https://doi.org/10.3390/healthcare14142077 - 10 Jul 2026

Viewed by 364

Abstract

Background: Missed nursing care related to infection prevention and control compromises patient safety and reflects clinical practice gaps and organizational constraints. The COVID-19 pandemic intensified awareness of infection-control practices; however, whether this translated into sustained reductions remains unclear. Aim: To compare missed infection-control [...] Read more.

Background: Missed nursing care related to infection prevention and control compromises patient safety and reflects clinical practice gaps and organizational constraints. The COVID-19 pandemic intensified awareness of infection-control practices; however, whether this translated into sustained reductions remains unclear. Aim: To compare missed infection-control nursing care between the pre-/early-pandemic period (2019–2020) and the post-pandemic period (2026) and identify persistent omissions with implications for healthcare policy and management. Methods: A descriptive study was conducted among 1570 nurses, including 774 participants in Group A (2019–2020) and 796 in Group B (2026). Data were collected online using the Missed Infection Control Nursing Care Questionnaire, tested for reliability and validity in Greek. Data were analyzed using SPSS 25.0, with statistical significance set at α = 0.05. Results: Item-level analysis showed lower mean omission scores in 34/37 infection-control nursing care practices, with 26 statistically significant reductions. The largest decreases were observed for glove use during antibiotic preparation/administration (1.493 to 1.070), hand hygiene before medication administration (1.340 to 0.962), multidrug-resistant organism (MDRO) admission screening (1.849 to 1.481), and intravenous access hub disinfection (1.978 to 1.668). In 2026, key residual omissions involved urinary catheter care (31.2%), hub disinfection (33.2%), oral hygiene (30.9%), and environmental hygiene before meals (29.1%). Conclusions: Missed infection-control nursing care declined in the post-pandemic period, but system-dependent omissions persisted, highlighting the need for staffing adequacy, balanced workload allocation, environmental support, and routine integration of infection-prevention practices. Full article

(This article belongs to the Special Issue Implications for Healthcare Policy and Management)

20 pages, 5505 KB

Open AccessArticle

Defensive Medical Practice in Dentistry: A Dual-Perspective Cross-Sectional Analysis of Dentists and Patients in Romania

by Ana Cernega, Marina Imre, Alexandra Ripszky, Bogdan Dimitriu, Vlad Gabriel Vasilescu and Silviu-Mirel Pițuru

Healthcare 2026, 14(13), 1992; https://doi.org/10.3390/healthcare14131992 - 4 Jul 2026

Cited by 1 | Viewed by 404

Abstract

Background: Fear of malpractice and its potential legal, financial, and reputational consequences are associated with one of the most complex phenomena in the medical community: defensive medical practice (DMP). DMP is frequently analyzed in the specialized literature from the physician’s perspective; however, [...] Read more.

Background: Fear of malpractice and its potential legal, financial, and reputational consequences are associated with one of the most complex phenomena in the medical community: defensive medical practice (DMP). DMP is frequently analyzed in the specialized literature from the physician’s perspective; however, the patient’s role in triggering and maintaining defensive behaviors remains under-explored. Methods: This cross-sectional study examined contextual factors associated with fear of malpractice and the convergences between doctors’ and patients’ perspectives within a bilateral model (error–fear–perceived risk–prevention behaviors), without assuming direct causal relationship. Two questionnaires were administered in Romania to 240 dentists (March–June 2023) and 344 patients (June–December 2023). Associations were tested with chi-square and Fisher’s exact tests (reporting Cramér’s V and odds ratios), multivariate binary logistic regression, and post hoc power analysis. Results: Over half of dentists (53.3%) reported fear of malpractice despite minimal actual legal exposure (0.8%); this fear was associated with awareness of its potential consequences and perceiving patients as more demanding. In multivariate analysis, fear was the strongest independent predictor of perceiving patients as a threat (aOR = 3.98, 95% CI [1.67–9.48]). On the patient side, 57.9% would avoid a dentist with a known malpractice case and 34.0% had requested additional procedures for reassurance. Conclusions: The interaction between physician fear and patient pressure suggests the existence of a “reassurance loop”, in which the patient’s need for safety and the doctor’s fear can mutually reinforce each other, fostering defensive behaviors. We propose an exploratory typology of patient-induced DMP—direct induction (explicit requests for additional investigations/procedures) and indirect induction (relational pressure and reassurance seeking)—to guide future research. By integrating the dentist and patient perspectives within a bilateral model, the study provides a context-specific account of patient-induced defensive practice in Romanian dentistry and identifies dual-target educational interventions (addressing both clinician communication and patient health literacy) as a potential preventive direction. Full article

(This article belongs to the Special Issue Implications for Healthcare Policy and Management)

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43 pages, 4161 KB

Open AccessArticle

Designing Governance Boundaries for Hospital Bed Management: Balancing Centralized Pooling and Local Protection

by Shao Wang, Feng Xiao, Kin Keung Lai and Yang Xu

Healthcare 2026, 14(13), 1949; https://doi.org/10.3390/healthcare14131949 - 1 Jul 2026

Viewed by 277

Abstract

Background/Objectives: Hospital-wide bed pooling is widely used in bed-management reform to reduce ward-level mismatch and improve the use of scarce inpatient capacity. However, formally pooled beds are not automatically usable beds. Cross-ward reassignment may require coordination, placement judgment, and timely execution, especially when [...] Read more.

Background/Objectives: Hospital-wide bed pooling is widely used in bed-management reform to reduce ward-level mismatch and improve the use of scarce inpatient capacity. However, formally pooled beds are not automatically usable beds. Cross-ward reassignment may require coordination, placement judgment, and timely execution, especially when several wards are under pressure. This study examines hospital bed governance as a healthcare management problem of where to draw the boundary between local protection and centralized pooling. Methods: We develop an

α

-based governance framework that places full decentralization, bounded centralization, and full centralization within a common design space. The parameter

α

determines how much ward-level capacity is pooled and how much remains locally protected. The analysis first establishes a frictionless pooling benchmark, and then introduces coordination friction, stress-state pooled-allocation imperfection, and the protective value of local capacity. Scenario-based computational experiments examine the mechanism across operating conditions, alternative friction specifications, and multi-ward extensions. Results: In the frictionless benchmark, full centralization weakly dominates because it has the broadest feasible allocation set. When pooled allocation remains fully effective, full centralization is not substantively outperformed. Coordination friction can move the raw maximizing boundary inward, but this movement does not necessarily imply a meaningful improvement over full centralization. When reassignment becomes less reliable in high-pressure states, however, an interior governance boundary can become substantively attractive by preserving some locally accessible capacity. Conclusions: The findings do not reject centralized pooling. They suggest that bed reform should evaluate both the formal scope of pooling and the operational usability of pooled capacity under pressure. Full article

(This article belongs to the Special Issue Implications for Healthcare Policy and Management)

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19 pages, 767 KB

Open AccessArticle

Structural Accountability and Practice-Level Governance as Dual Pathways to Accreditation-Seeking Intention in Private Dental Practice: Evidence from a Mixed Public–Private Healthcare System

by Radu Ilinca, Laura Iosif, Dan Adrian Luțescu, Iulia Ioana Stănescu Spînu, Albert Zsolt Barabas, Ruxandra Ionela Sfeatcu, Ionela Ganea, Ana-Maria Cristina Ţâncu and Tudor-Claudiu Spînu

Healthcare 2026, 14(13), 1922; https://doi.org/10.3390/healthcare14131922 - 1 Jul 2026

Viewed by 536

Abstract

Background/Objectives: Private dental markets operating under fee-for-service arrangements lack the structural accountability mechanisms that typically drive quality governance adoption in publicly funded systems. In Romania, where no private dental office currently holds formal accreditation, accreditation-seeking reflects a genuine behavioral choice rather than [...] Read more.

Background/Objectives: Private dental markets operating under fee-for-service arrangements lack the structural accountability mechanisms that typically drive quality governance adoption in publicly funded systems. In Romania, where no private dental office currently holds formal accreditation, accreditation-seeking reflects a genuine behavioral choice rather than a regulatory compliance. This study examined whether financing structure and Professional Governance behavior operate as distinct determinants of accreditation-seeking intention among private dental practitioners and which pathway offers a more tractable entry point for quality policy intervention. Methods: A cross-sectional survey was conducted among 98 licensed private dental practitioners in Romania (November 2025–January 2026). Three domain composites were derived from a 31-item de novo instrument anchored in JCI, ANMCS, and EN ISO 9001:2015 standards: Professional Governance, Patient Rights and Ethics, and Patient Safety Behaviors. The financing profile was operationalized as engagement with the national public insurance system (CNAS). Binary logistic regression modeled high accreditation-seeking intention (Q31 ≥ 4) against standardized domain scores and financing engagement, with bootstrap confidence intervals from 2000 replicates. Results: Two predictors independently and significantly predicted high accreditation-seeking intention. CNAS engagement showed the strongest association (OR = 5.05, 95% bootstrap CI [1.87–17.91], and p = 0.003), while the Professional Governance score remained independently associated (OR = 2.68, 95% bootstrap CI [1.63–5.63], and p = 0.003). The Patient Rights and Ethics score was not significant. Practitioners actively exploring CNAS contracting showed the highest accreditation-seeking intention (exceeding that of established contractors), suggesting a possible transitional accountability dynamic during financing transition, though this interpretation requires prospective longitudinal validation. Model performance was good (AUC = 0.788; Nagelkerke R² = 0.339). Conclusions: Both financing engagement and governance behavior predicted accreditation-seeking intention after mutual adjustment, representing distinct pathways to voluntary quality adoption in private dental practice. Policy interventions aligned with entry into public contracting and with practice-level governance development are more likely to support accreditation uptake than normative appeals to professional ethics alone. Full article

(This article belongs to the Special Issue Implications for Healthcare Policy and Management)

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11 pages, 1650 KB

Open AccessArticle

A National Initiative to Support Internationally Educated Nurses: Implementation and Policy Insights from the PNAA Cy Pres Program

by Mary Joy Garcia-Dia, Reynaldo R. Rivera, Maria Luisa B. Ramira, Marife Sevilla, Lolita B. Compas, Laarni C. Florencio, Madelyn D. Yu and Lorraine S. Evangelista

Healthcare 2026, 14(12), 1742; https://doi.org/10.3390/healthcare14121742 - 17 Jun 2026

Viewed by 1006

Abstract

Background: The integration of internationally educated nurses (IENs) into healthcare workforces is expanding globally, yet organization-led support models remain understudied. Successful IEN integration requires ethical recruitment, structured onboarding, workforce support, and stakeholder engagement in policy discussions related to transition and retention. Objective [...] Read more.

Background: The integration of internationally educated nurses (IENs) into healthcare workforces is expanding globally, yet organization-led support models remain understudied. Successful IEN integration requires ethical recruitment, structured onboarding, workforce support, and stakeholder engagement in policy discussions related to transition and retention. Objective: To examine the conceptualization, implementation, and policy implications of the Philippine Nurses Association of America Cy Pres Task Force’s national initiative to support IEN onboarding and transition into U.S. healthcare. Methods: This descriptive program evaluation utilized governance documents, program planning records, policy summit materials, aggregated survey findings, PNAA Human Rights Committee resources, and the Handbook for Filipino Nurses Immigrating to the United States to examine initiative development, implementation processes, and program outputs. A descriptive narrative synthesis was used to characterize program structure, stakeholder engagement, and policy priorities. Findings: The PNAA Cy Pres governance model was built around ethical recruiting, workforce integration, and advocacy. The work began with policy summits with nurse leaders, health care organizations, recruitment agencies, and policy experts, focusing on hiring, onboarding, legal issues, and staff retention. Stakeholder engagement, interdisciplinary collaboration, and appreciative inquiry were used to identify best practices and goals. Key outputs included the establishment of a national governance structure, implementation of national and regional policy summits, and identification of policy priorities related to ethical recruitment, onboarding, workforce integration, and governance. Conclusions: The PNAA Cy Pres initiative provides an implementation-informed approach that may help guide future workforce integration efforts. The study illustrates how ethical recruitment, workforce integration, and stakeholder engagement can help translate workforce policy principles into practice. Policy & Practice Implications: Healthcare institutions, policymakers, and professional organizations need to work together to standardize onboarding, ethical recruitment, and support mechanisms to facilitate the integration and sustainability of the IEN workforce. Full article

(This article belongs to the Special Issue Implications for Healthcare Policy and Management)

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21 pages, 1609 KB

Open AccessArticle

When Research Evidence and Healthcare Policy Collide: Synergising Results and Policy into BRIGHTLIGHT Guidance to Improve Coordinated Care for Adolescents and Young Adults with Cancer

by Rachel M. Taylor, Alexandra Pollitt, Gabriel Lawson, Ross Pow, Rachael Hough, Louise Soanes, Amy Riley, Maria Lawal, Lorna A. Fern, BRIGHTLIGHT Study Group, Young Advisory Panel and the Policy Lab Participants

Healthcare 2025, 13(15), 1821; https://doi.org/10.3390/healthcare13151821 - 26 Jul 2025

Viewed by 1124

Abstract

Background/Objectives: BRIGHTLIGHT was the national evaluation of adolescent and young adult (AYA) cancer services in England. BRIGHTLIGHT results were not available when the most recent healthcare policy (NHSE service specifications for AYA Cancer) for AYA was drafted and therefore did not consider BRIGHTLIGHT [...] Read more.

Background/Objectives: BRIGHTLIGHT was the national evaluation of adolescent and young adult (AYA) cancer services in England. BRIGHTLIGHT results were not available when the most recent healthcare policy (NHSE service specifications for AYA Cancer) for AYA was drafted and therefore did not consider BRIGHTLIGHT findings and recommendations. We describe the co-development and delivery of a Policy Lab to expedite the implementation of the new service specification in the context of BRIGHTLIGHT results, examining the roles of multi-stakeholders to ensure service delivery is optimised to benefit AYA patients. We address the key question, “What is the roadmap for empowering different stakeholders to shape how the AYA service specifications are implemented?”. Methods: A 1-day face-to-face policy lab was facilitated, utilising a unique, user-centric engagement approach by bringing diverse AYA stakeholders together to co-design strategies to translate BRIGHTLIGHT evidence into policy and impact. This was accompanied by an online workshop and prioritisation survey, individual interviews, and an AYA patient workshop. Workshop outputs were analysed thematically and survey data quantitatively. Results: Eighteen professionals and five AYAs attended the face-to-face Policy Lab, 16 surveys were completed, 13 attended the online workshop, three professionals were interviewed, and three AYAs attended the patient workshop. The Policy Lab generated eight national and six local recommendations, which were prioritised into three national priorities: 1. Launching the service specification supported by compelling communication; 2. Harnessing the ideas of young people; and 3. Evaluation of AYA patient outcomes/experiences and establishing a national dashboard of AYA cancer network performance. An animation was created by AYAs to inform local hospitals what matters to them most in the service specification. Conclusions: Policy and research evidence are not always aligned, so when emerging evidence does not support current guidance, further exploration is required. We have shown through multi-stakeholder involvement including young people that it was possible to gain a different interpretation based on current knowledge and context. This additional insight enabled practical recommendations to be identified to support the implementation of the service specification. Full article

(This article belongs to the Special Issue Implications for Healthcare Policy and Management)

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18 pages, 226 KB

Open AccessArticle

Knowledge, Attitude, and Practice Regarding Antibiotic Prescription Among Dentists in Saudi Arabia—A Cross-Sectional Survey

by Kiran Iyer, Jawaher Alhababi, Alanoud Aldhafayan, Amal Albarrak, Faey Alburidy, Fatimah Alanazi, Fatimah Albawardi and Abdulmohsen Alfadley

Healthcare 2025, 13(10), 1198; https://doi.org/10.3390/healthcare13101198 - 20 May 2025

Cited by 5 | Viewed by 2622

Abstract

Background/Objectives: Prescription challenges in antibiotics contribute to the global prevalence of antimicrobial resistance (AMR). We are rapidly moving into an age of ‘resistome’, which has grave consequences. Dentists frequently prescribe antibiotics for intraoral infections and as prophylaxis, particularly for immunocompromised patients, although the [...] Read more.

Background/Objectives: Prescription challenges in antibiotics contribute to the global prevalence of antimicrobial resistance (AMR). We are rapidly moving into an age of ‘resistome’, which has grave consequences. Dentists frequently prescribe antibiotics for intraoral infections and as prophylaxis, particularly for immunocompromised patients, although the clinical justification for these prescriptions remains a point of concern. This study aimed to evaluate the knowledge, attitudes, and practices of dental practitioners in Saudi Arabia regarding antibiotic prescription. Methods: A cross-sectional survey was conducted from October to November 2024, involving 252 dentists from various regions of Saudi Arabia. Data were gathered through social media. Results: The dentists were likely to agree to prescribe antibiotics post-procedurally to be safe [OR 0.18, p = 0.42, CI −0.94]. Contrastingly, the knowledge of less experienced dentists [OR 9.60, p = 0.03, CI 1.21–76.15] was updated regarding prescribing penicillin for women in the third trimester of pregnancy than that of experienced dentists (>10 years). Conclusions: Although the knowledge level of practitioners in the public sector is reasonably good, there are concerns about antibiotic prescription practice among private dental practitioners. Full article

(This article belongs to the Special Issue Implications for Healthcare Policy and Management)

12 pages, 2175 KB

Open AccessArticle

Determinants of Appointment Planning in Physical Therapy: Insights from Saudi Arabia

by Saad A. Alhammad, Omar Khalid Almuhanna, Abdulaziz Riyadh Aljumaah and Muteb Safar Aldosari

Healthcare 2025, 13(8), 893; https://doi.org/10.3390/healthcare13080893 - 13 Apr 2025

Cited by 2 | Viewed by 2693

Abstract

Background/Objectives: Appointment planning in physical therapy (PT) is crucial for optimizing patient outcomes and resource efficiency, yet determinants of these plans and deviations from them remain underexplored. This study aimed to explore how physical therapists in Saudi Arabia determine appointment numbers, their preferred [...] Read more.

Background/Objectives: Appointment planning in physical therapy (PT) is crucial for optimizing patient outcomes and resource efficiency, yet determinants of these plans and deviations from them remain underexplored. This study aimed to explore how physical therapists in Saudi Arabia determine appointment numbers, their preferred planning methods, and the prevalence and contributing factors of deviations from planned appointments. Methods: A cross-sectional observational study was conducted using an electronic questionnaire distributed to PTs practicing in outpatient departments and homecare settings across Saudi Arabia. Descriptive statistics were used to summarize therapists’ methods, preferences, and the prevalence of and potential reasons for deviations. Results: A total of 434 responses were collected. Most therapists (66%) relied on their evaluation to determine the number of appointments, and this was their preferred method (76%). However, 50% reported patients usually requiring more appointments than initially planned, and 14% did not complete all the planned appointments. Faster-than-expected progress (61%) and slower-than-expected progress (58%) were the primary reasons for deviations. Conclusions: Despite most therapists determining the number of appointments based on their evaluation, the majority reported usual deviations from planned appointments, highlighting a gap in appointment planning. Future research should investigate the impact of deviations on patient outcomes and healthcare costs. Strategies to reduce deviations, such as improving adherence to clinical practice guidelines (CPGs), are warranted. Full article

(This article belongs to the Special Issue Implications for Healthcare Policy and Management)

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17 pages, 2692 KB

Open AccessArticle

The Predictability of the Dental Practitioner in a Volatile Healthcare System: A 25-Year Study of Dental Care Policies in Romania (1999–2023)

by Ana Cernega, Dana Galieta Mincă, Florentina Ligia Furtunescu, Ciprian-Paul Radu, Simona Pârvu and Silviu-Mirel Pițuru

Healthcare 2025, 13(3), 249; https://doi.org/10.3390/healthcare13030249 - 26 Jan 2025

Cited by 9 | Viewed by 3603

Abstract

Background/Objectives: This paper brings to light the results of extensive research on the dimension of dental care in Romania in terms of priorities and policies defined at the governmental level for a 25-year period (1999–2023). This research aims to present both individual and [...] Read more.

Background/Objectives: This paper brings to light the results of extensive research on the dimension of dental care in Romania in terms of priorities and policies defined at the governmental level for a 25-year period (1999–2023). This research aims to present both individual and ecosystem perspectives on the influence of the way oral health strategies are shaped in Romania. Methods: The data collected are analyzed through the prism of the “iron triangle of healthcare”, focusing on the evolution of dental care from the perspective of the interrelationship of three important components: cost, quality, and access to healthcare services. Results: The paper provides insight and clarity into the context in which the doctor–patient relationship is constructed and developed, as well as a vision of how oral health policies should be designed to meet the individual needs of the patient, which will have an impact on the health and quality of life of the whole community. Conclusions: This study emphasizes the need to reconfigure oral health policies in Romania. Despite some input achievements like a considerable number of dentists, the systemic challenges that developed over these 25 years (such as insufficient funding, the reduced reimbursed procedures, and the limited dentists contracting with NHIH) have significantly contributed to a stagnation or decline of the oral health outcomes at the societal level. Full article

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Review

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11 pages, 218 KB

Open AccessReview

Digital Healthcare Innovative Services in Times of Crisis: A Literature Review

by Olympia Anastasiadou, Markos Tsipouras, Panagiotis Mpogiatzidis and Pantelis Angelidis

Healthcare 2025, 13(8), 889; https://doi.org/10.3390/healthcare13080889 - 12 Apr 2025

Cited by 9 | Viewed by 2391

Abstract

Objectives: The transformation of healthcare systems during crises, particularly demonstrated during the COVID-19 pandemic, emphasizes the urgent need for effective research methodologies to evaluate digital healthcare innovations. These methodologies are essential in addressing the rapid shift in healthcare service delivery modalities, responding to [...] Read more.

Objectives: The transformation of healthcare systems during crises, particularly demonstrated during the COVID-19 pandemic, emphasizes the urgent need for effective research methodologies to evaluate digital healthcare innovations. These methodologies are essential in addressing the rapid shift in healthcare service delivery modalities, responding to unprecedented challenges that have revealed both opportunities and barriers within the digital ecosystem. Methods: For this review, research was carried out on the Medline/PubMed, Scopus, and Google Scholar databases to locate articles published from 2015 to 2024, using the search terms digital health, digital technologies, management implications, and digital platforms. The inclusion criteria referred to studies that were directly related to the topic, available in the English language, and published in peer-reviewed scientific journals. The exclusion parameters were as follows: (a) articles not relevant to the topic as defined in the purpose of the review, (b) systematic reviews and meta-analyses, and (c) articles published in a language other than English. Results: Key findings indicate that, while digital health technologies have the potential to mitigate healthcare disparities, they often exacerbate existing inequities, especially among vulnerable populations lacking consistent access to technology. Furthermore, the shift towards digital platforms has revealed significant gaps in workforce training and support, which are essential for effective implementation. Conclusions: This review underscores the financial implications, with expenditures rising significantly due to the increased use of digital services, reflecting a broader trend noted in studies of related health conditions. Moreover, discussions on public health governance suggest a critical need for democratic frameworks to support such digital transformations effectively. Full article

(This article belongs to the Special Issue Implications for Healthcare Policy and Management)

18 pages, 685 KB

Open AccessReview

Intersectionality of the Gender Wage Gap Among Healthcare Professionals: A Scoping Review

by Neeru Gupta and Jonathan Zoungrana

Healthcare 2025, 13(3), 273; https://doi.org/10.3390/healthcare13030273 - 30 Jan 2025

Cited by 4 | Viewed by 7131

Abstract

Background: A growing body of research has documented persistent wage gaps between women and men in the healthcare workforce, a pattern widely observed across cadres and countries. Less well known is whether various intersecting characteristics often associated with social discrimination may exacerbate or [...] Read more.

Background: A growing body of research has documented persistent wage gaps between women and men in the healthcare workforce, a pattern widely observed across cadres and countries. Less well known is whether various intersecting characteristics often associated with social discrimination may exacerbate or attenuate gendered disparities. This review scopes contemporary research from diverse settings focusing on how race, ethnicity, and sexual and gender minority status may intersect in shaping earnings differentials among healthcare practitioners to help inform policy and management decisions. Methods: Studies quantifying the intersecting axes of gender and other postulated social drivers of differed practitioner earnings were identified by systematically searching five bibliographic databases (Embase, CINAHL, EconLit, SocIndex, and PsychInfo) and scanning the reference lists of review articles and other forms of the global health literature. A total of 2123 reports were retrieved; after screening, 21 articles were retained for narrative synthesis. Results: The studies covered data from four countries (Brazil, Norway, the United Kingdom, and the United States). Physicians were researched most often (43% of the synthesized articles) followed by nurses (38%). No uniform patterns were found in gendered earnings variations stratified by race, ethnicity, and/or ancestry; however, wide variations were seen in the way the relationships were operationalized across studies and contexts. One investigation included sexual orientation as a factor in earnings gaps, but presented results combined with other personal characteristics. None of the studies examined wage data by gender minority status. Conclusions: This review highlighted notable limitations in the available research in relation to disaggregated measures of ethnocultural heterogeneity, robust methodologies and transparent reporting, and the underlying health workforce information systems for incorporating more diversity elements and enhancing cross-national comparability in assessments of structural wage gaps among healthcare practitioners. Full article

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Other

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10 pages, 195 KB

Open AccessBrief Report

Digital Divide: Contrasting Provider and User Insights on Healthcare Services During the COVID-19 Pandemic

by Olympia Anastasiadou, Panagiotis Mpogiatzidis, Katerina D. Tzimourta and Pantelis Angelidis

Healthcare 2025, 13(15), 1803; https://doi.org/10.3390/healthcare13151803 - 25 Jul 2025

Cited by 2 | Viewed by 1337

Abstract

Introduction: This prospective descriptive study explored the disparities in perceptions and experiences regarding healthcare services between providers and users during the COVID-19 pandemic, with a specific focus on the impact of the digital divide on access to and quality of care. The study [...] Read more.

Introduction: This prospective descriptive study explored the disparities in perceptions and experiences regarding healthcare services between providers and users during the COVID-19 pandemic, with a specific focus on the impact of the digital divide on access to and quality of care. The study revealed significant inconsistencies in the experiences of healthcare providers and patients, particularly regarding the effectiveness of digital health interventions. Methods: This study was a prospective descriptive analysis conducted to evaluate and compare the use of electronic healthcare services between healthcare employees (HΕs) (N = 290) and consumers (Cs) (N = 263) from December 2024 to May 2025, utilizing an electronic survey after the COVID-19 pandemic. To ensure the statistical validity of the sample size, a power analysis was performed using G*Power 3.1.9.2 software. A questionnaire was developed to evaluate the readiness of healthcare employees and consumers for electronic healthcare services. It was validated to ensure reliability within this population and comprised 49 questions. Results: The response rate of the participants was 89.19%, and the Cronbach’s alpha for the questionnaire was 0.738. The study revealed notable differences in perceptions regarding health-related information and digital health technologies across genders and age groups. Specifically, 28.8% of females and 27.3% of males considered it important to be well-informed about health issues (χ² = 8.83, df = 3, p = 0.032). Conclusions: This research contributes to filling a gap in comparative analyses of provider and user perspectives, offering a comprehensive view of how digital health was adopted and experienced during a global crisis. Practically, it provides an evidence base to guide future interventions aimed at fostering more equitable, resilient, and user-friendly digital healthcare systems. Full article

(This article belongs to the Special Issue Implications for Healthcare Policy and Management)

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