Health Services Optimization, Improvement, and Management: Worldwide Experiences

Topic Information

Dear Colleagues,

In recent years, health systems have encountered several challenges, and particularly with the COVID-19 pandemic, they have had to undertake a restructuring process to enhance cooperation across all levels of healthcare. This is a worldwide problem that impacts all nations, irrespective of the type of funding, whether it is public or private, which is committed to healthcare.

This topic aims to examine various international instances of care integration, improvement, optimization, and management, both horizontally (between healthcare units of similar care levels or different departments within a hospital) and vertically (between health units operating at different care levels), with a focus on outcomes related to access, efficiency, productivity, and quality of health outcomes, as well as user and/or professional satisfaction.

The Topic “Health Services Optimization, Improvement, and Management: Worldwide Experiences” provides a platform for publishing reviews and original research papers on all aspects of nursing, health services, and health policies. Please join us in creating a diverse collection of articles for a variety of topics. We look forward to receiving contributions.

Dr. Alexandre Morais Nunes
Dr. Diogo Filipe da Cunha Ferreira
Topic Editors

Keywords

Participating Journals

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Hospitals hospitals	-	-	2024	15.0 days *	CHF 1000	Submit
International Journal of Environmental Research and Public Health ijerph	-	8.5	2004	27.8 Days	CHF 2500	Submit
Nursing Reports nursrep	2.0	2.8	2011	27.5 Days	CHF 1800	Submit
Healthcare healthcare	2.7	4.7	2013	21.5 Days	CHF 2700	Submit

* Median value for all MDPI journals in the first half of 2025.

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Published Papers (2 papers)

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All Hospitals IJERPH Nursing Reports Healthcare

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15 pages, 382 KiB  

Open AccessFeature PaperArticle

Multidisciplinary Care in a Public University Family Medicine Group in Québec (Canada): Data on Patients’ Follow-Up and Cardiometabolic Risk Management

by Lise Leblay, Léanne Day Pelland, Josée Gagnon, Valérie Guay, Sophie Desroches, Jean-Philippe Drouin-Chartier and Jean-Sébastien Paquette

Healthcare 2025, 13(14), 1704; https://doi.org/10.3390/healthcare13141704 - 15 Jul 2025

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Abstract

Background/Objectives: Generating real-world data on the efficacy of multidisciplinary care in cardiometabolic risk management is essential to ensure that guidelines are both applicable and effective, especially in public healthcare settings, where organizational structures may impede healthcare professionals’ agility. This study aimed to generate [...] Read more.

Background/Objectives: Generating real-world data on the efficacy of multidisciplinary care in cardiometabolic risk management is essential to ensure that guidelines are both applicable and effective, especially in public healthcare settings, where organizational structures may impede healthcare professionals’ agility. This study aimed to generate data on patient follow-up and cardiometabolic risk management during the early years of a public university family medicine group in Québec (Canada) that provides multidisciplinary care to adults with cardiometabolic conditions, in order to evaluate the implementation and effectiveness of its care model. Methods: This was a retrospective longitudinal study. Patients treated at the clinic from 31 January 2020 (clinic opening) to 8 May 2024 (n = 96) were invited to consent to the use of their medical data for research. Results: A total of 52 patients consented and were included in the study. Upon entry at the clinic, >90% of patients had anthropometry and blood pressure (BP) measured, but plasma glucose and lipids were assessed among 50% and 79% of patients, respectively. A total of 36 patients completed the personalized multidisciplinary care program. No evidence of associations between the total number of appointments or appointments with the registered dietitian specifically with changes in BMI, waist circumference, and BP was found. However, each pharmaceutical intervention was associated with a −0.51 cm (95%CI: −1.03, 0.02; p = 0.06) change in waist circumference and a −1.49 mm Hg (95%CI: −2.56, −0.43, p = 0.01) change in diastolic BP. Conclusions: These data highlight the challenges of implementing a research-oriented clinic within Québec’s public healthcare system. Full article

(This article belongs to the Topic Health Services Optimization, Improvement, and Management: Worldwide Experiences)

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14 pages, 718 KiB  

Open AccessArticle

Enhancing Healthcare Integrity Using Simple Statistical Methods: Detecting Irregularities in Historical Dermatology Services Payments

by Andrej F. Plesničar, Nena Bagari Bizjak and Pika Jazbinšek

Healthcare 2025, 13(12), 1464; https://doi.org/10.3390/healthcare13121464 - 18 Jun 2025

Viewed by 259

Abstract

Background and Objectives: Healthcare payment systems face challenges such as fraud and overbilling, which often require costly and resource-intensive detection tools. In response, the utility of simple statistical tests was explored in this study as a practical alternative for identifying irregularities in dermatology [...] Read more.

Background and Objectives: Healthcare payment systems face challenges such as fraud and overbilling, which often require costly and resource-intensive detection tools. In response, the utility of simple statistical tests was explored in this study as a practical alternative for identifying irregularities in dermatology service payments within the Health Insurance Institute of Slovenia (HIIS). Materials and Methods: Ten-year-old anonymized billing data from 30 dermatology providers in Slovenia (with a population of 2 million) were analyzed to evaluate the effectiveness of the proposed methodology while aiming to avoid reputational harm to current providers. The dataset from 2014 included variables such as the “number of services charged”, “total number of points charged” (under Slovenia’s point-based tariff system at the time), “number of points per examination”, “average examination values (EUR)”, “number of first examinations”, and “total number of first/follow-up examinations”. Data credibility was assessed using Benford’s Law (for calculating χ² values and testing null hypothesis rejection at the 95% level), and Grubbs’ test, Hampel’s test, and T-test were used to identify outliers. Results: An analysis using Benford’s Law revealed significant deviations for the “number of services charged” (p < 0.005), “total number of points charged” (p < 0.01), “number of points per examination” (p < 0.0005), and “average examination values (EUR)” (p < 0.005), suggesting anomalies. Conversely, data on the numbers of “first” (p < 0.7) and “total first/follow-up examinations” (p < 0.3) were found to align with Benford’s Law, indicating authenticity. Outlier detection consistently identified two institutions with unusually high values for points per examination and average examination monetary value. Conclusions: Simple statistical tests can effectively identify potential irregularities in healthcare payment data, providing a cost-effective screening method for further investigation. Identifying outlier providers highlights areas needing detailed scrutiny to understand anomaly causes. Full article

(This article belongs to the Topic Health Services Optimization, Improvement, and Management: Worldwide Experiences)

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