Social Prescribing (SP) is an approach which aims of improving health and well-being and connecting patients to community services. Examples of these services include physical activity and cultural activities. Despite its benefits, SP has still not been fully implemented in Portugal. This case study is part of a larger study on Social Prescribing Local System (SPLS) implementation, which comprised a quantitative approach, a pilot study and a qualitative approach, and aims at exploring patients’ and healthcare workers’ perspectives on SP. The study was carried out to understand the motivations of different stakeholders for participating in the pilot project, the anticipated benefits for patients, healthcare professionals, and the health unit, as well as their perceptions and experiences within the scope of the SP project. Data collection was carried out in December 2020 through semi-structured individual interviews and a focus group. A total of seven participants were included, of which one patient, one museum representative and five healthcare professionals. Different common dimensions related to SP emerge, including health and well-being, social interaction and community engagement, accessibility and inclusivity, motivation and adherence, collaboration and coordination, and education and awareness. The patient considered the adequacy of the activity to the patient’s state of health and capabilities, adoption of a phased approach, with a focus on progress, in order to promote long-term adherence as facilitators. For the museum, disseminating its activities to healthcare professionals and patients through different channels such as posters at the health center, social media pages, and training sessions can significantly enhance visibility and engagement, while direct phone contact and digital publications can further promote adherence, ensuring a comprehensive and coordinated approach to patient participation and institutional benefit. Healthcare professionals identified several benefits, including reduction of social isolation and sedentarism, as well as a means of strengthening the therapeutic relationship with patients. The design and implementation of SP programs should be participative and involve all stakeholders participating in the process. Barriers to adherence included time for activity and the associated costs or prerequisites, availability of activities and lack of perceived interest in health.

This study introduces a model designed to improve the strategic readiness of private hospitals in Amman by incorporating strategic competencies as an independent variable and using a healthcare information system as a mediator. Targeting private hospitals with over 140 beds, the research included a population of 3263 employees across various managerial levels. Data collection methods involved interviews and electronic questionnaires, resulting in a sample size of 344. Statistical analyses comprised exploratory and confirmatory factor analysis, structural equation modeling, and hypothesis testing with SMART PLS 3.3.3 software. The results indicated medium levels of both strategic competencies and healthcare information systems, while strategic readiness was found to be low. Nevertheless, the proposed model showed a direct positive effect of strategic competencies on strategic readiness, with the healthcare information system acting as a significant partial mediator. Evaluation metrics included the arithmetic mean, standard deviation, and path analysis. This model surpasses traditional methods by effectively linking strategic competencies and information systems to enhance strategic readiness, providing a strong framework for improving hospital responses to crises and dynamic changes. The study suggests focusing on enhancing and developing strategic competencies and integrating a comprehensive healthcare information system to optimize hospital operations and increase readiness.

Good health and well-being are embedded in the 3rd Goal amongst the UN Sustainable Development Goals. The primary objective of this research was to identify the most critical economic, social, and administrative barriers to implementing the Expanded Program on Immunization (EPI) in the Punjab Province of Pakistan. A sequential exploratory design and case study technique were used, employing both qualitative and quantitative methods. In the first stage, in-depth interviews with 50 key officials were conducted to identify the most critical barriers to the EPI program. A quantitative analysis was then performed based on the results obtained from qualitative analysis, and rank orders of barriers were received from the same health department experts. The results indicate that twenty-eight barriers can cause implementation problems for this program. Still, the ten barriers that gained the maximum hits are the most important barriers, which include Shortage of vaccinators, mismanagement of vaccines’ cold chain, biometric android application, ice-lined refrigerators, communication gap, inadequate legislation of EPI program, capacity building issues with EPI staff, Misconceptions about EPI program, lack of awareness of the parents and community, refusal cases and inadequate cooperation of lady health workers (LHWs). Coordinated efforts of the government and the public are highly recommended to address these barriers.

Introduction: In Central Europe, in Hungary, the state guarantees access to health care and basic health services partly through the Semmelweis Plan adopted in 2011. The primary objectives of the Semmelweis Plan include the optimisation and transformation of the health care system, starting with the integration of hospitals and the state control of previously municipally owned hospitals. The transformation of the health care system can have an impact on health services and thus on meeting the needs of the population. In addition to reducing health inequalities and costs, the relevant benefits include improving patients’ chances of recovery and increasing patient safety. The speciality under study is decubitus care. Our hypothesis is that integration will improve the chances of recovery for decubitus patients through access to smart dressings to promote patient safety. Objective: to investigate and demonstrate the effectiveness of integration in improving the chances of recovery for decubitus ulcer patients. Material and methods: The research compared two time periods in the municipality of Kalocsa, Bács-Kiskun County, Southern Hungary. We collected the number of decubitus patients arriving and leaving the hospital from the nursing records and compared the pre-integration period when decubitus patients were provided with conventional dressings (01.01.2006–2012.12.31) and the post-integration period, which entailed the introduction of smart dressings in decubitus care (01.01.2013–2012.12.31). The target population of the study was men and women aged 0–99 years who had developed some degree of decubitus. The sample size of the study was 4456. Independent samples t-test, Chow test and linear trend statistics were used to evaluate the results. Based on the empirical evidence, a SWOT analysis was conducted to further examine the effectiveness of integration. Results: The independent samples t-test model used was significant (for Phase I: t (166) = −16.872, p < 0.001; for Phase II: t (166) = −19.928, p < 0.001; for Phase III: t (166) = −19.928, p < 0.001; for Phase III: t (166) = −16.872, p < 0.001). For stage III: t (166) = −10.078, p < 0.001; for stage IV: t (166) = −10.078, p < 0.001; for stage III: t (166) = −10.078, p < 0.001). for stage III: t (166) = −14.066, p < 0.001). For the Chow test, the p-values were highly significant, indicating a structural break. Although the explanatory power of the regression models was variable (R-squared values ranged from 0.007 to 0.617), they generally supported the change in patient dynamics after integration. Both statistical analyses and SWOT analysis supported our hypothesis and showed that integration through access to smart dressings improves patients’ chances of recovery. Conclusions: Although only one segment of the evidence on the effectiveness of hospital integration was examined in this study, integration in the study area had a positive impact on the effective care of patients with decubitus ulcers, reduced inequalities in care and supported patient safety. In the context of the results obtained, these trends may reflect different systemic changes in patient management strategies in addition to efficient allocation of resources and quality of care.

Introduction, purpose of the study: In Central Europe, in Hungary, the state guarantees access to health care and basic health services partly through the Semmelweis Plan adopted in 2011. The Health Plan aims to optimize and transform the health system. The objectives of hospital integration, as set out in the Plan, started with the state ownership of municipal hospitals in 2012, continued with the launch of integration processes in 2012–2013 and culminated today. The transformation of a health system can have an impact on health services and thus on meeting the needs of the population. We aim to study the effectiveness of integration through access to CT diagnostic testing. Our hypothesis is that integration has resulted in increased access to modern diagnostic services. The specialty under study is computed tomography (CT) diagnostic care. Our research shows that the number of people receiving CT diagnostic care has increased significantly because of integration, which has also brought a number of positive benefits, such as reduced health inequalities, reduced travel time, costs and waiting lists. Test material and method: Our quantitative retrospective research was carried out in the hospital of Kalocsa through document analysis. The research material was comparing two time periods in the Kalocsa site of Bács-Kiskun County, Southern Hungary. The number of patients attending CT examinations by area of duty of care according to postal codes was collected: Pre-integration period 2014.01.01–2017.11.30. (Kalocsa did not have CT equipment, so patients who appeared in Kecskemét Hospital but were under the care of Kalocsa), post-integration period 2017.12.01–2019.12.31. (period after the installation of CT in Kalocsa). The target group of the study consisted of women and men together, aged 0–99 years, who appeared for a CT diagnostic examination. The study sample size was 6721 persons. Linear regression statistics were used to evaluate the results. Based on empirical experience, a SWOT analysis was carried out to further investigate the effectiveness of integration. Results: As a result of the integration, the CT scan machine purchased in the Kalocsa District Hospital has enabled an average of 129.7 patients per month to receive CT scans on site without travelling. The model used is significant, explaining 86% of the change in the number of patients served (F = 43.535; p < 0.001, adjusted R² = 0.860). The variable of integration in the model is significant, with an average increase in the number of patients served of 129.7 per month (t = 22.686; p < 0.001) following the introduction of CT due to integration. None of the month variables representing seasonal effects were found to be significant, with no seasonal effect on care. The SWOT analysis has clearly identified the strengths, weaknesses, opportunities and threats related to the integration, the main outcome of which is the acquisition of a CT diagnostic tool. Conclusions: Although we only looked at one segment of the evidence for the effectiveness of hospital integration, integration in the study area has had a positive impact on CT availability, reducing disparities in care.

Many previous studies find no significant effect of health insurance on health outcome in rural areas of China. Many researchers believe this could be because of the characteristics of health care provision in those areas. In this paper, we aim to examine if urbanization will change the situation. Our research question focuses on if urbanization will change the participation and performance of health insurance on health outcome in a positive direction. Using a longitudinal sample drawn from the China Health and Nutrition Survey (CHNS), we employed multiple estimation strategies for multiple waves to handle the potential selection bias. We find that urbanization factors such as population density, transportations and housing are associated with probability of insurance participation. That is, urbanization related factors tend to increase people’s willingness of insurance participation. We also conclude that urbanization improves the performance of insurance on self-reported health outcome. Results show that the health insurance has a significant positive impact on health production in urbanized areas. Health insurance in general increases the probability of health care utilization for all areas. However, it does not lead to a significant improvement in the health outcomes in under urbanized areas because of the health provision quality or characteristics of health insurance coverage in those areas.