In the history of public health, space has evolved through several stages driven by shifts in concepts of disease control. The history of public health is summarized by George Rosen in six phases: Origins (before 500 CE), Middle Ages (500–1500), Mercantilism and Absolutism (1500–1750), Enlightenment and Revolution (1750–1830), Industrialism and the Sanitary Movement (1830–1875), and the Bacteriological Era (1875–present). By integrating architectural sociology—a temporal lens examining the interplay between architecture, individuals, and society—this study investigates how architects historically responded to public health challenges, offering critical insights for contemporary healthy habitat design. Architecture not only addresses survival needs but also materializes societal consciousness. The progression of health-related cognition (e.g., germ theory), behavioural norms (e.g., hygiene practices), infrastructure systems (e.g., sanitation networks), and scientific advancements collectively redefined spatial paradigms. Architects constructed temples, thermae, lazarettos, Beitian Yangbingfang (charitable infirmaries), anatomical theaters, quarantine hospitals, tenements, mass housing, and biosafety laboratories. These cases exemplify the co-evolution of “Concept” (disease control ideologies), “Technology” (construction methods), and “Space” (built environments). By synthesizing centuries of public health spatial practices, this research deciphers the dynamic interplay among “Concept, Technology, and Space”. Leveraging historical patterns, we propose a predictive framework to refine future spatial strategies in anticipation of emerging health crises.

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.

This qualitative research aimed to study the effectiveness of the local health constitution in controlling the spread of COVID-19. It reports the role of local communities, government agencies, and healthcare providers in implementing and enforcing local health constitutions and how their engagement can be improved to enhance surveillance. We also reported factors that influence compliance and strategies for improving compliance. We also evaluated the long-term sustainability of local health institutions beyond the pandemic. The population and sample group consisted of key members of the local health constitution teams at the provincial, sub-district, and village levels in the rural area of Ubon Ratchathani. Participants were purposively selected and volunteered to provide information. It included health science professionals, public health volunteers, community leaders, and local government officials, totaling 157 individuals. The study was conducted from December 2022 to September 2023. Our research shows that local health constitutions can better engage and educate communities to actively participate in pandemic surveillance and prevention. This approach is a learning experience for responding to emergencies, such as new infectious diseases that may arise in the future. This simplifies the work of officials, as everyone understands the guidelines for action. Relevant organizations contribute to disease prevention efforts, and there is sustainable improvement in work operations.

This study analyses the long-run relationship between, and the direction and magnitude of impact of sectoral economic growth and fiscal capacity on government health expenditure. The study was carried out to validates the Wagner hypothesis from sectoral perspective and revenue-expenditure hypothesis for South Africa for the period 1984–2020. Fully modified least squares and dynamic least squares and canonical cointegration regression were used to achieve the objectives of the study. Empirical regression results showed that there is a negative impact of the secondary sector GDP on public health expenditure. Thus, invalidating the Wagner hypothesis and suggesting that secondary sector GDP cannot serves as an answer for public health expenditure. However, there was a positive relationship between tertiary sector GDP and public health expenditure. The study make case for unceasing provision of an enabling environment that continuously support growth of the tertiary sector.

The COVID-19 outbreak on international cruise ships during the early stages of the pandemic has exposed deficiencies in the governance of public health emergencies within the framework of existing international law. These deficiencies encompass various aspects, including the shortcomings of the system of flag state jurisdiction, the vague definition and reasonableness of governments’ “additional health measures” as stipulated in the International Health Regulations (IHR) of 2005, the role of World Health Organization (WHO) in the protection of the fundamental rights of passengers and crew members during epidemic outbreaks on cruise ships, the application of the free pratique rule under the international health law, and other challenges that have not been adequately addressed in current international law. In the post-COVID era, it is essential to revisit these core issues of international law and reassess the allocation of responsibilities among all evolving actors to foster effective multilateral cooperation in epidemic control. This paper adopts the “Diamond Princess” incident as a case study, examining how such public health emergencies pose challenges to international laws, particularly when they occur within the context of a cruise ship. The paper argues that cooperation on global health emergencies will continue to be a challenge until responsibility is more clearly allocated among stakeholders. Additionally, the paper formulates three principles for enhancing governmental cooperation, namely the fairness principle, the nationality principle, and the principle of common but differentiated responsibilities. It is advisable to carefully consider these key principles when reevaluating the international laws on public health emergencies in the post-COVID era.

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.