Integrated Health Services across Different Levels: Worldwide Experiences

Topic Information

Dear Colleagues

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

This topic aims to examine various international instances of care integration, 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 the quality of health outcomes, as well as user and/or professional satisfaction.

The topic “Integrated Health Services across Different Levels: Worldwide Experiences” provides a platform to publish all reviews and original research papers. Please join us in creating a diverse collection of articles for a variety of topics. We look forward to receiving your contributions.

Keywords

Participating Journals

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Healthcare healthcare	2.4	3.5	2013	20.3 Days	CHF 2700
International Journal of Environmental Research and Public Health ijerph	-	7.3	2004	25.8 Days	CHF 2500
Nursing Reports nursrep	2.4	2.5	2011	37.1 Days	CHF 1800
Trauma Care traumacare	-	-	2021	52.8 Days	CHF 1000
Hospitals hospitals	-	-	2024	15.0 days *	CHF 1000

* Median value for all MDPI journals in the second half of 2024.

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Published Papers (5 papers)

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All Healthcare IJERPH Nursing Reports Trauma Care Hospitals

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15 pages, 654 KiB  

Open AccessArticle

An Indispensable Requirement for Medical Dosage Calculation: Basic Mathematical Skills of Baccalaureate Nursing Students

by Belal Mahmoud Hijji

Nurs. Rep. 2025, 15(5), 150; https://doi.org/10.3390/nursrep15050150 - 30 Apr 2025

Viewed by 319

Abstract

Background/Objectives: While drug dosage calculation is vital in nursing, research indicates nursing students often struggle with necessary mathematics competencies, a gap not previously explored in the Arab world. This study assessed the basic mathematical skills of baccalaureate nursing students in a branch [...] Read more.

Background/Objectives: While drug dosage calculation is vital in nursing, research indicates nursing students often struggle with necessary mathematics competencies, a gap not previously explored in the Arab world. This study assessed the basic mathematical skills of baccalaureate nursing students in a branch of a Saudi Arabian public university and compared the findings with studies conducted in other countries, which have consistently reported better performance. By highlighting these disparities, this study underscored the need for global educational reforms to ensure safe nursing practices. Methods: This was a cross-sectional study. Three hundred and thirty students were invited; consenting students completed a mathematics experts-validated 45-question test covering four key areas: numbers and operations, data interpretation, measurement, and algebraic applications. Descriptive and inferential statistics were applied. The Mann–Whitney U test was used to detect differences in scores based on gender. An independent-samples Kruskal–Wallis test was conducted to compare the three student groups simultaneously. As this test was statistically significant, post hoc pairwise comparisons were performed to assess differences in scores between the first and second, first and third, and second and third levels of study. Results: A response rate of 40.6% was achieved. Scores ranged from 3 to 58 (median: 18, 27%), with only 2% passing (≥60%). Significant differences in scores were found between genders (p = 0.037) and across study levels (p = 0.002). Overall, 25 (56%) items were difficult, while 20 (44%) were moderately difficult. Conclusions: The low median score underscored a critical need for interventions to improve mathematical competencies in nursing students, affecting medication safety in healthcare systems. Full article

(This article belongs to the Topic Integrated Health Services across Different Levels: Worldwide Experiences)

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22 pages, 640 KiB  

Open AccessArticle

Addressing Bureaucratic Burdens on the Portuguese National Health Service: A Simplification Experience Aiming for Value-Based Healthcare

by Francisco Goiana-da-Silva, Raisa Guedes, Filipa Malcata, Juliana Sá, Miguel Cabral, Rafael Vasconcelos, Soraia Costa, Inês Morais-Vilaça, Lara Pinheiro-Guedes, João Sarmento, Filipe Costa, Rita Moreira, Fátima Fonseca, Jaime Alves, Marisa Miraldo, Alexandre Morais Nunes, Hutan Ashrafian, Ara Darzi and Fernando Araújo

Healthcare 2025, 13(7), 821; https://doi.org/10.3390/healthcare13070821 - 4 Apr 2025

Viewed by 679

Abstract

Background/Objectives: The Portuguese NHS has embarked on an administrative restructuring aimed at enabling healthcare professionals, particularly family doctors, to focus on direct patient care and improve overall healthcare outcomes. This article details these measures, their initial benefits for patients and professionals, and explores [...] Read more.

Background/Objectives: The Portuguese NHS has embarked on an administrative restructuring aimed at enabling healthcare professionals, particularly family doctors, to focus on direct patient care and improve overall healthcare outcomes. This article details these measures, their initial benefits for patients and professionals, and explores future strategies to further integrate levels of care and leverage technology to enhance efficiency, patient-centeredness, and ultimately, population health. Methods: Each measure was evaluated to estimate its potential impact on the four pillars of the value-based healthcare (VBHC) framework. Results: We found that most measures aimed at reducing bureaucracy had an estimated impact on more than two of the four pillars. Conclusions: Thus, we conclude that the reduction in bureaucracy will tend to address several of the pillars of the VBHC framework and should be considered as a steppingstone in the process of increasing VBHC. Full article

(This article belongs to the Topic Integrated Health Services across Different Levels: Worldwide Experiences)

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15 pages, 2948 KiB  

Open AccessArticle

Qualitative Study of Maternity Healthcare Vulnerability Based on Women’s Experiences in Different Sociocultural Context

by Claudia Susana Silva-Fernández, Eva Garrosa and David Ramiro-Cortijo

Nurs. Rep. 2025, 15(3), 105; https://doi.org/10.3390/nursrep15030105 - 18 Mar 2025

Viewed by 306

Abstract

Background: Unfulfillment of maternity rights in healthcare is a global problem associated with abuse, neglect and discrimination, known as obstetrics and gynecology (OB/GYN) vulnerability. Women’s perceptions of their experience are a keystone to improving maternity healthcare. The aim of this study was to [...] Read more.

Background: Unfulfillment of maternity rights in healthcare is a global problem associated with abuse, neglect and discrimination, known as obstetrics and gynecology (OB/GYN) vulnerability. Women’s perceptions of their experience are a keystone to improving maternity healthcare. The aim of this study was to evaluate the women’s perceptions of the vulnerability of maternity rights and the associated risk and protective factors. Methods: This study was carried out by qualitative techniques based on the analysis of a semi-structured interview applied to six women in the postpartum period with pregnancy assistance and birth in Spain and Colombia between February and August of 2024. A triangulation analysis was performed about the perceptions of the concept, experiences and risk and protective factors of OB/GYN vulnerability. The free-access ATLAS.ti software was used. Results: OB/GYN vulnerability is generally perceived by women with a psychological impact. Women think that their own factors (emotion management, social support, attitude to change and beliefs), health professional factors (burnout, empathy and social skills) and health institution factors (workload, centralization in technical and protocols, humanization, quality and access to recourses) have an influence to modulate the vulnerability of rights in maternity healthcare. Conclusions: It is necessary for health systems to move from a protocol-centered to a person-centered model, particularly in maternity healthcare. This model should include the biopsychosocial needs of women and allow for their participation. Health institutions need to evaluate their processes and minimize burnout in health professionals. In addition, there are factors affecting OB/GYN vulnerability not only in childbirth but also during pregnancy and postpartum. Full article

(This article belongs to the Topic Integrated Health Services across Different Levels: Worldwide Experiences)

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12 pages, 629 KiB  

Open AccessStudy Protocol

Effectiveness of a Community Pharmacy-Based Health Promotion Program on Hypertension in Bangladesh and Pakistan: Study Protocol for a Cluster-Randomized Controlled Trial

by Md. Mizanur Rahman, Ryota Nakamura, Md. Monirul Islam, Md. Ashraful Alam, Syed Khurram Azmat and Motohiro Sato

Healthcare 2024, 12(14), 1402; https://doi.org/10.3390/healthcare12141402 - 15 Jul 2024

Cited by 2 | Viewed by 2649

Abstract

The aim of this multi-country, cluster-randomized trial is to test the impact of pharmacy-based health promotion to reduce the blood pressure of individuals with hypertension over a 12-month period in Bangladesh and Pakistan. The trial will be implemented with two arms. In Bangladesh, [...] Read more.

The aim of this multi-country, cluster-randomized trial is to test the impact of pharmacy-based health promotion to reduce the blood pressure of individuals with hypertension over a 12-month period in Bangladesh and Pakistan. The trial will be implemented with two arms. In Bangladesh, the estimated sample size is around 3600 hypertensive patients. In Pakistan, we will select samples equivalent to 10% of the participants from Bangladesh, comprising 360 hypertensive patients from four pharmacies. Community pharmacies will be randomized into one of two parallel groups (allocation ratio 1:1). Pharmacy professionals in the treatment arm will provide their patients with educational training and counseling, as well as phone calls/mobile text messages and care coordination in the health sector, as part of the intervention. The study will be conducted in three phases: a baseline survey with intervention, a midline survey with intervention and follow-up, and an endline survey with impact evaluation. The primary outcome of the study will be BP. The secondary outcomes will be BP controlled to target, treatment adherence, quality of life, mortality or hospital admission rates resulting from hypertension and its related complications, incremental cost per health-related quality of life gained, knowledge on healthy lifestyle and dietary behavior, and change in the prevalence of current smoking status. Full article

(This article belongs to the Topic Integrated Health Services across Different Levels: Worldwide Experiences)

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10 pages, 609 KiB  

Open AccessArticle

Pilot Study of SATELLITE Education on Nurses’ Knowledge and Confidence toward Assessing and Caring for Female Victims of Sexual Violence

by Ratchneewan Ross, Francine Hebert Sheppard, Monir M. Almotairy, Joelle Hirst and Marjorie Jenkins

Nurs. Rep. 2024, 14(2), 1287-1296; https://doi.org/10.3390/nursrep14020097 - 22 May 2024

Viewed by 1536

Abstract

Sexual violence (SV) can deeply impact victims’ physical and psychosocial well-being. Yet many healthcare providers, including registered nurses (RNs), hesitate to screen patients due to a lack of confidence and knowledge. The SATELLITE Sexual Violence Assessment and Care Guide was developed to address [...] Read more.

Sexual violence (SV) can deeply impact victims’ physical and psychosocial well-being. Yet many healthcare providers, including registered nurses (RNs), hesitate to screen patients due to a lack of confidence and knowledge. The SATELLITE Sexual Violence Assessment and Care Guide was developed to address this gap; however, the guide’s educational effectiveness remained untested. This pilot study aimed to assess the feasibility, acceptability, and efficacy of an education program based on the SATELLITE guide among RNs in clinical settings (n = 8), using a pre- and post-test design. Results indicated that the education was not only feasible and acceptable, but also demonstrated the effects as desired with significant increases in RNs’ knowledge and confidence in SV screening and care. The program’s assessment tool was reliable, and participant recruitment was feasible. Based on these findings, it is recommended that the SATELLITE education program be further tested with a larger RN sample and extended to other healthcare providers. Additionally, exploring SATELLITE’s use in different regions, cultural contexts, and healthcare settings would enhance understanding of the program’s broader applicability and effectiveness. Full article

(This article belongs to the Topic Integrated Health Services across Different Levels: Worldwide Experiences)

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