Health Care Providers Research Articles

Data-Driven Revenue Cycle Management: Optimizing claims denial resolution and under payment for healthcare providers through SaaS Solution

The healthcare industry is increasingly under financial pressure due to high rates of claims denials, leading to substantial revenue loss and operational inefficiencies. Claims denials result from various factors, including coding errors, incomplete documentation, and regulatory non-compliance, all of which contribute to revenue leakage that often reaches 5–10% annually for healthcare providers. This paper explores a proprietary Software-as-a-Service (SaaS) solution that leverages data analytics, machine learning, and real-time reporting to enhance the claims denial management process. Through predictive and prescriptive analytics, the proposed solution enables healthcare providers to identify denial trends, reduce denial rates, optimize claims resolution, and increase revenue retention. The paper includes system architecture, data security protocols, pilot implementation findings, and a comparative analysis of performance metrics. The paper concludes with a discussion on future developments, including real- time denial prediction, automated appeals generation, and enhanced integration capabilities with existing Electronic Health Record (EHR) systems. Keywords: Revenue Cycle Management, healthcare claims denial, claim under payment, SaaS, data analytics, machine learning, real-time reporting, financial sustainability, healthcare providers

Navigating Mpox: Call for the Development of Guidelines for Safe and Effective Physiotherapy Practices

I am writing to highlight the need for consensus-based guidelines addressing mpox (formerly known as monkeypox) in the field of physiotherapy. The recent declaration of a public health emergency by the World Health Organization (WHO) due to the rapid spread of mpox [1] emphasizes the necessity for clear protocols to protect patients and healthcare providers.

A Case Report of Dorsal Pancreatic Agenesis and Uterus Didelphys in a Young Woman: A Seldom- reported Association

Agenesis of the dorsal pancreas is a rare congenital anomaly that often remains asymptomatic and is frequently discovered incidentally during imaging for other conditions. Its association with Müllerian anomalies, such as uterus didelphys, suggests that both conditions may stem from similar embryological disruptions during early fetal development. This report aims to raise awareness of Agenesis of the Dorsal Pancreas (ADP) and its potential associations with Müllerian anomalies. By presenting a detailed case study, we seek to address the diagnostic challenges faced by healthcare professionals and the implications for patient management, emphasizing the importance of early detection and appropriate intervention. We present a case involving a 24-year-old Iranian female who presented with a 10-day history of abdominal pain and vomiting. Initial ultrasound imaging revealed moderate hydroureteronephrosis in the right kidney, prompting further investigation. A contrast-enhanced CT scan was performed, which not only confirmed ureteropelvic junction obstruction but also unexpectedly revealed dorsal pancreatic agenesis. In addition to these findings, the patient was diagnosed with uterus didelphys, highlighting a significant developmental anomaly. This case underscores the necessity for increased awareness of ADP and its associations with Müllerian anomalies among healthcare providers. Early and accurate diagnosis through advanced imaging modalities significantly improves patient outcomes and facilitates better management strategies for associated complications.

An artificial intelligence-enabled consumables tracking system for medical laboratories

Abstract The medical laboratory plays a crucial role within a hospital setting and is responsible for the examination and analysis of patient specimens to accurately diagnose various ailments. The burden on medical laboratory personnel has significantly increased, particularly in the context of the ongoing global COVID-19 pandemic. Worldwide, the implementation of comprehensive and extended COVID-19 screening programs has placed a significant strain on healthcare professionals. This burden has led to exhaustion among medical employees, limiting their ability to effectively track laboratory resources, such as medical equipment and consumables. Therefore, this study proposed an artificial intelligence (AI)-based solution that contributes to a more efficient and less labor-intensive workflow for medical workers in laboratory settings. With the ultimate goal to reduce the burden on healthcare providers by streamlining the process of monitoring and managing these resources, the objective of this study is to design and develop an AI-based system for consumables tracking in medical laboratories. In this work, the effectiveness of two object detection models, namely, YOLOv5x6 and YOLOv8l, for the administration of consumables in medical laboratories was evaluated and analyzed. A total of 570 photographs were used to create the dataset, capturing the objects in a variety of settings. The findings indicate that both detection models demonstrate a notable capability to achieve a high mean average precision. This underscores the effectiveness of computer vision in the context of consumable goods detection scenarios and provides a reference for the application of real-time detection models in tracking systems within medical laboratories.

The Impact of Color in Healthcare Environments: A Systematic Review and Research Agenda

: Color plays a significant role in shaping the atmosphere and experience within healthcare environments. This systematic review examines the existing literature on the effects of color in healthcare settings, aiming to provide insights into its influence on patient outcomes, staff well-being, and overall healthcare experiences. By synthesizing findings from various studies, this review identifies key themes, explores methodological approaches, and proposes a comprehensive research agenda to better understand the complex relationship between color and health outcomes. The review involved a systematic search of databases such as PubMed, Scopus, and Web of Science, as well as internet search engines including Google and Yahoo. The search focused on empirical studies, theoretical papers, and industry guidelines related to color in healthcare settings. Over 3 000 titles were screened, and relevant studies were critically evaluated for their methodological rigor and findings. A PRISMA form was used to extract the necessary information. The synthesis of existing literature highlights the importance of considering color selection, application, and environmental context in healthcare design to optimize patient care and enhance the well-being of both patients and healthcare providers. Although the existing literature underscores the importance of color in healthcare design, empirical evidence remains limited. Future research should aim to address these gaps by exploring the nuanced ways in which color influences health outcomes and by developing evidence-based guidelines for the application of color in healthcare settings.

Drug Interaction-Informed Approaches to Inflammatory Bowel Disease Management

Inflammatory bowel disease (IBD) is a complex and chronic condition that requires the use of various pharmacological agents for its management. Despite advancements in IBD research, the multifaceted mechanisms involved continue to pose significant challenges for strategic prevention. Therefore, it is crucial to prioritize safe and effective treatment strategies using the currently available pharmacological agents. Given that patients with IBD often require multiple medications due to combination therapy or other underlying conditions, a comprehensive understanding of drug interactions is essential for optimizing treatment regimens. In this review, we examined the pharmacological treatment options recommended in the current IBD management guidelines and provided a comprehensive analysis of the known pharmacokinetic interactions associated with these medications. In particular, this review includes recent research results for the impact of anti-drug antibodies (ADAs) on the concentrations of biological agents used in IBD treatment. By leveraging detailed interaction data and employing personalized dosing strategies, healthcare providers can improve therapeutic outcomes and minimize adverse effects, ultimately improving the quality of care for patients with IBD.

Psychosocial, physical problems and coping strategies of patients having long term / permanent tracheostomy

BackgroundTracheostomy is a common surgical procedure in which a stoma is created in trachea by direct incision over the anterior aspect of the neck, which can cause disfigurement of the anterior neck and many other associated physical and psychosocial issues. Patients with long-term/permanent tracheostomy have to live with tracheostomy even after getting discharged from the hospital, which can further complicate the condition of the patients as they are unable to cope up with the problems associated with long-term tracheostomy. There is dearth of literature related to intensity of problems among patients having long term/ permanent tracheostomy in India. Therefore, the aim of the study is to assess psychosocial, physical problems and coping mechanism in patients with long-term/permanent tracheostomy.MethodsA cross-sectional descriptive study was conducted at ENT outpatient department and ENT Minor operation theatre, tertiary care hospital India. Total of 100 patients having long term/permanent tracheostomy were enrolled by convenient sampling. Data regarding demographics and clinical characteristics, Physical and Psychosocial problems, and Coping strategies were collected by structured questionnaires.ResultThe majority of individuals who had long-term or permanent tracheostomies had only minor health issues. Patients experienced more psychosocial issues than people in the general healthy population. The majority of patients employed active coping, acceptance, and religion as coping mechanisms, whereas the coping mechanisms which were minimally used includes: humor and substance abuse. Patients' coping strategies vary significantly according on their age, employment status, marital status, and the duration of their tracheostomy.ConclusionLong-term/Permanent tracheostomy can cause multiple physical and psychosocial issues in patients, but eventually, patients get adapted to it. Support from family members and significant others plays a vital role in better coping with tracheostomy in situ, also it is critical for health care providers to be aware of their problems and coping mechanisms so that they can provide required care and assistance.

Gross Hematuria Following Fetal Head Engagement in a Pregnant Woman with Glanzman Syndrome

Glanzmann’s thrombasthenia (GT) is a rare genetic platelet disorder that leads tobleeding problems in affected individuals. We present a 28-year-old woman withGT who experienced a rare symptom of painless gross hematuria in the last monthof pregnancy. To provide the best care, an interdisciplinary approach was followedby a team of obstetricians and gynecologists, hematologists, neonatologists, andanesthesiologists. The IUGR fetus was delivered by cesarean section and had mildacidosis and thrombocytopenia at birth. Both the baby and the mother were carefullycared for and treated. Hematuria also improved spontaneously within two weeks afterdelivery.Gross hematuria during pregnancy rarely occurs due to the pressure of the presentingpart of the fetus on the mother’s bladder (due to engagement). Aggravation of anyclinical symptoms in pregnant women with GT should alert maternal and fetal healthcare providers to make individualized decisions.

Cyber Hacking Breaches Detection Using Machine Learning

Cyber hacking breach prediction is one of the emerging technologies and detecting and predicting breaches through computer algorithms has become a very challenging task To make malware detection more effective, scalable and more efficient than traditional system calls human involvement Machine learning to be used for breach detection and prediction The main goal is a series of cyber hacking attacks each of which will harm the person’s information and financial reputation. Government and non-profit organizations’ data, such as user and company information,, can be compromised, posing a risk to their finances and reputation if they collect information from websites and social networks it can trigger a cyber attack. Organizations such as the healthcare sector are capable of holding sensitive information that must be handled discreetly and securely. Data breaches can lead to identity theft, fraud, and other losses. The findings show that 70% of breaches affect a wide range of organisations, including healthcare providers. The investigation indicates a possible data breach. Due to the heavy usage of computer programs and security on the host and network, there is a risk of data breach. Machine learning can be used to detect these attacks. Research uses machine learning models to protect against web security flaws. The data set is available from the Privacy Rights Clearing House. Teaching employees how to use modern security measures can reduce data breaches. This can help to understand attack detection and data security. Machine learning models such as Random Forest, Decision Tree, k-means and Multi- layer Perceptron are used to predict data violations

Pioneering sustainable treatment delivery in childhood leukemia through synchronous telemedicine-A pilot study.

Cancer care places a heavy economic burden on families and health systems, driven by high treatment costs, lengthy hospital stays, and the necessity for extensive travel to specialized facilities. To address this challenge, an integrated health care network (IHCN) was implemented for maintenance treatment in acute leukemia. The IHCN encompassed outpatient services provided by local physicians and synchronous telemedicine consultation with pediatric oncologists. This study included twenty-two pediatric patients (eleven [50.0%] females; twenty [90.9%] with B-ALL and two [9.1%] with AML). The IHCN was offered to all rural patients (n = 17) with a one-way driving distance more than 30 km, while urban patients (n = 5) received regular cancer care. Throughout the study, rural patients had a total of 510 routine clinical visits, with 367 (72%) conducted through the IHCN. Physical examinations revealed similar frequency of new abnormal findings for urban and rural patients (22.4% vs. 17.8%; p = .31). Laboratory tests indicated no significant difference in the frequency of abnormal values for various parameters between both groups. Similarly, there was no discrepancy of drug modifications or interruption in maintenance therapy between the two settings (p = .85). Moreover, patients' health-related quality of life remained within the normative range, and user satisfaction with the IHCN was notably high. The implementation of the IHCN resulted in savings of 70,158 km, 950 h of travel, and 12,277 kg CO2 emissions. This pilot study underscores the efficacy of a telemedicine-based IHCN, ensuring safety, quality of care, cost reduction, and satisfaction for both families and health care providers in pediatric leukemia management.

Menopause Matters: Results of a National Survey of Rheumatoid Arthritis Patients in the UK.

The effects of the menopause have received a lot of attention in the press recently. Anecdotally, patients report changes in their arthritis around the menopause, either onset or aggravation of symptoms. Clearly, there are hormonal influences on arthritis with the female predominance, onset of RA around times of hormonal change and improvement during pregnancy. We were interested in exploring the patient perspective to inform future research and educational needs. A national survey was organised through the National Rheumatoid Arthritis Society (NRAS), using their database of people with RA and online community who self-selected as peri menopausal, menopausal or post-menopausal. A questionnaire was developed by the steering group seeking responses on the effects of the menopause, changes in the arthritis at the time, use of hormone replacement therapy (HRT) and any discussions they had had with their healthcare providers. Free text comments were analysed qualitatively. A total of 779 people responded during September/October 2023. Respondents were 95% Caucasian mainly in their 50s with onset of menopausal symptoms in their 40s. 80% responded that their arthritis was worse during the menopause with 10% being much worse. 47% had taken HRT. Of these, 80% experienced an improvement in their menopausal symptoms and 30% had a moderate or large improvement in their arthritis symptoms. A standout statistic was that 93% of respondents had had no medical discussion about the menopause. For those who did, this was most frequently with the GP in relation to HRT and osteoporosis. 84% of participants felt that the rheumatology team should receive more education and training about the menopause in relation to RA. The qualitative analysis revealed several themes: Discussion about the menopause only occurred if the patient raised it. There was conflicting advice about HRT. There is overlap and confusion of symptoms between RA and the menopause. Participants expressed a perceived link between menopause and onset or deterioration of their arthritis. This study was long overdue. Patients perceive a strong association between the menopause and onset or deterioration of their arthritis, with confusion over what is due to arthritis and what is being caused by the menopause. Patients would like much more discussion about the menopause, but this is not currently happening. They are getting conflicting advice on HRT. Further research is necessary to clarify the impact of the menopause on people with arthritis.

Epilepsy care pathway: The Finnish model.

Integrated care pathways are essential for consistent, effective epilepsy care, offering equal access and quality regardless of socioeconomic status. They must align with the WHO Global Action Plan on Epilepsy, ensuring best practices and cost-effective management. We describe the Finnish national epilepsy care pathway, which includes multiple levels of care, from initial diagnosis to long-term care for all types of epilepsy, with a specific focus on rare and complex cases integrated with the European Reference Network (ERN) for Rare and Complex Epilepsies EpiCARE. In 2017, the Finnish government nominated Kuopio University Hospital to coordinate diagnostics and care for severe epilepsy in Finland. A national multidisciplinary consensus panel, including specialists from both adult and pediatric neurology departments across all five Finnish university hospitals and from the patient organization, was established. The resulting pathway was adopted into the current Finnish evidence-based current care guidelines for epilepsy. The Finnish epilepsy care pathway focuses on timely referrals, continuity of care and enhanced communication between healthcare providers at different levels of care. Patient involvement is assured with an individualized digital application offering secure online messaging, a seizure calendar, and remote visits. The pathway enhances virtual consultations and includes regular national diagnostic multidisciplinary meetings for severe epilepsies before selected cases are consulted in ERN EpiCARE meetings. This Finnish model for epilepsy care provides a streamlined, multidisciplinary approach to diagnosis and treatment and combines modern digital tools, data sharing, and peer support. This pathway can serve to model how integrated healthcare systems can effectively manage complex conditions. We describe the Finnish national epilepsy care pathway, which includes multiple levels of care, from initial diagnosis to long-term care for all types of epilepsy, with a specific focus on rare and complex cases integrated with the European Reference Network (ERN) for Rare and Complex Epilepsies EpiCARE. Finnish model for epilepsy care provides a streamlined, multidisciplinary approach to diagnosis and long-term treatment of epilepsy. The pathway enhances virtual consultations and includes national and European-level diagnostic multidisciplinary meetings for severe epilepsies. To improve outcomes, we emphasize the use of modern digital tools, data sharing, and peer support.

Patients’ perspective and practices of heart failure recurrence prevention in Yancheng City

Effective self-management is essential for patients with heart failure, but many struggle with acquiring the necessary skills. Given the complexity of heart failure management and the importance of patient adherence to prescribed regimens, this study aims to investigate the knowledge, attitudes, and practices (KAP) concerning the prevention of heart failure recurrence among patients. A cross-sectional study was conducted at the Third People’s Hospital of Yancheng City from September 1, 2023, to December 31, 2023, employing a self-administered KAP questionnaire. The study included 421 heart failure patients, of whom 230 (54.6%) were male. Median scores for knowledge, attitudes, and practices were 12.00 [10.00, 13.00] (possible range: 1–18), 20.00 [19.00, 21.00] (possible range: 5–25), and 16.00 [15.00, 17.00] (possible range: 5–22), respectively. Pearson’s correlation analysis indicated a positive correlation between knowledge and attitude scores (r = 0.183, P < 0.001), as well as between knowledge and practice scores (r = 0.169, P < 0.001). A higher attitude score was significantly associated with a higher practice score (r = 0.245, P < 0.001), as supported by structural equation modelling. Multivariate logistic regression revealed that attitude score (OR = 1.238), suburban residence (OR = 2.524), monthly household income exceeding 5000 RMB (OR = 3.539), BMI less than 20 kg/m2 (OR = 2.155, P = 0.029), BMI between 20 and 24 kg/m2 (OR = 2.387), and BMI between 25 and 29 kg/m2 (OR = 4.063) were independently linked to proactive practices (all P < 0.05). Additionally, Structural Equation Modelling (SEM) elucidated the intricate relationship between sociodemographic factors and KAP dimensions. Despite positive attitudes and proactive prevention efforts, heart failure patients exhibit a knowledge gap. Tailored educational interventions by healthcare providers could effectively bridge this gap, leveraging patients’ positive attitudes and proactive behaviours to reinforce preventive measures.

Ehealth interactive intervention in promoting safer sex among men who have sex with men

Men who have sex with men (MSM) who use dating applications (apps) have higher rates of engaging in condomless anal sex than those who do not. Therefore, we conducted a two-arm randomized controlled trial to evaluate the effectiveness of an interactive web-based intervention in promoting safer sex among this population. The intervention was guided by the Theory of Planned Behavior and co-designed by researchers, healthcare providers, and MSM participants. The primary outcome was the frequency of condomless anal sex in past three months. Secondary outcomes included five other behavioral outcomes and two psychological outcomes. This trial was registered on ISRCTN (ISRCTN16681863) on 2020/04/28. A total of 480 MSM were enrolled and randomly assigned to the intervention or control group. Our findings indicate that the intervention significantly reduced condomless anal sex behaviors by enhancing self-efficacy and attitudes toward condom use among MSM dating app users, with the effects sustained at both three and six months.

Evaluation of the Safety Rate in the Diagnostic Radiology Departments in Alkhoms City, Libya

Diagnostic radiation such as X-rays and CT scans play a central role in the diagnosis of diseases. Excessive radiation exposure poses a high risk for healthcare providers as well as patients, which may cause serious diseases such as cancer. Providing protection requirements in the radiation departments and continuous inspection to prevent radiation leakage is the right way to provide human protection. The current study aimed to evaluate the safety rate in the diagnostic radiology departments in Alkhoms City. The questionnaire designed for the study in Arabic language, presented to experts for verification and review, then distributed to eleven medical centres in the Alkhoms region containing many relevant questions regarding the radiology department such as the name and address of a medical centre, in-formation about users and safety. Lead plates are present in 91% of health centres 36% of health centres installed lead plates for 1-5 years, 27% for 6-10 years, and 36% for 21 years or more. Lead plates are inspected once in 27%, three times in 9%, and four times or more in 9% of medical centres, on the other hand, 56% of medical centres didn’t inspect lead plates since installed. The lead plates last examined in 27% of medical centres a year ago, in 9% examined less than five years ago, and in 9% examined less than twenty years ago. On the other hand, 56% of medical centres have not performed any check-ups since installation. Protection glass and lead plates are present in 82% of medical centres, a radiation protection gown is present in 36%, and a dosimeter is present in 9% of medical centres only. Only 18% of health centres have organised a training programme for their radiology department staff. The safety rate in radiology departments in Alkhoms City- Libya is low because most medical centres lack protective equipment, and if they do, there is no regular inspection or testing of this equipment.

Self-Efficacy of Nurses and Physicians in the Emergency Department and Its Influence on the Outcomes of Trauma Patients

The purpose of this study was to examine the effect of self-efficacy on the implementation of the adult trauma clinical practice guidelines (ATCPGs) on improving trauma patient outcomes, including missed injuries, and ED LOS. Nurses’ and physicians’ self-efficacy in performing ATCPGs skills were evaluated three months prior to and three months after the intervention’s implementation. Multiple strategies of ATCPGs implementation improved the length of stay (LOS) in the ED for multiple trauma patients. The quasi-experimental design has been implemented in this interventional study. Post-intervention, the self-efficacy of ED healthcare providers in performing ATCPGs skills has increased. Implementation of the ATCPGs has improved the outcomes of patients with multiple traumas. There were 66 patients in this study, and 53 (80.3%) of them were male. The ATCPGs intervention resulted in a statistically significant decrease in the amount of time spent in the ED, as shown by a comparison of the ED LOS in minutes between the two groups (t = 2.56; p = 0.013). Implementing the ATCPGs has improved multiple trauma patients’ outcomes. The results will help decision-makers at hospitals to facilitate interdisciplinary ATCPGs training sessions and establish policies and procedures to introduce adult trauma sheet in the ED to improve multiple trauma patients’ outcomes.

Fermatean fuzzy distance and Sugeno–Weber operators-based SPC-MARCOS approach for sustainable supplier evaluation in the healthcare supply chain

The present work proposes a new decision support tool for assessing the sustainable suppliers in the healthcare supply chain. For this purpose, the classical Measurement of Alternatives and Ranking according to Compromise Solution (MARCOS) model is integrated with the Sugeno–Weber weighted averaging operators, modified symmetry point of criterion (SPC) model, rank sum (RS) tool and Fermatean fuzzy sets (FFSs), and named as the ‘FF-SPC-RS-MARCOS’ framework. The developed model firstly determines the decision experts’ weights through RS model. Second, novel Sugeno–Weber weighted operators are introduced to combine the experts’ opinions. Third, a unified weighting procedure is presented based on the combination of modified SPC approach for objective weight and RS method for subjective weight of attributes. To this aim, a novel distance measure is introduced for FFSs and further applied to compute the distance between aggregated Fermatean fuzzy numbers and symmetry point value of an attribute in the modified SPC approach. Further, a hybrid FF-SPC-RS-MARCOS approach is proposed to tackle the decision-making problems on FFSs setting. To elucidate the efficacy of the developed method, it is applied to a case study of sustainable supplier selection problem in the healthcare supply chain. The paper further conducts sensitivity investigation and comparison with existent approaches to test the stability and robustness of the ranking outcomes. This study shows how the proposed MARCOS method in combination with SPC and RS models can be used to prioritize the alternative suppliers in the healthcare supply chain. The introduced work provides a new methodology, which can help the practitioners and academics to evaluate suppliers with uncertain information and can also be employed to other areas facing similar types of decision-making problems.

Talk2Care: Facilitating Asynchronous Patient-Provider Communication with Large-Language-Model

Despite the plethora of telehealth applications to assist home-based older adults and healthcare providers, basic messaging and phone calls are still the most common communication methods, which suffer from limited availability, information loss, and process inefficiencies. One promising solution to facilitate patient-provider communication is to leverage large language models (LLMs) with their powerful natural conversation and summarization capability. However, there is a limited understanding of LLMs' role during the communication. We first conducted two interview studies with both older adults (N=10) and healthcare providers (N=9) to understand their needs and opportunities for LLMs in patient-provider asynchronous communication. Based on the insights, we built an LLM-powered communication system, Talk2Care, and designed interactive components for both groups: (1) For older adults, we leveraged the convenience and accessibility of voice assistants (VAs) and built an LLM-powered conversational interface for effective information collection. (2) For health providers, we built an LLM-based dashboard to summarize and present important health information based on older adults' conversations with the VA. We further conducted two user studies with older adults and providers to evaluate the usability of the system. The results showed that Talk2Care could facilitate the communication process, enrich the health information collected from older adults, and considerably save providers' efforts and time. We envision our work as an initial exploration of LLMs' capability in the intersection of healthcare and interpersonal communication.

Factors influencing direct payment exemption in the user fee elimination project in the Far North of Cameroon

On January 1, 2020, the State of Cameroon instituted a policy to eliminate direct payments by people living with human immunodeficiency virus (PLHIV). However, limited data are available on the implementation of this policy. This study aims to identify the determinants of the improper implementation of this policy by healthcare providers. To this end, a cross-sectional study was conducted with 164 medical and paramedical staff involved in the care of PLHIV. Data were collected using a Google Forms questionnaire and administered in health facility forums. Determinants were assessed using multiple logistic regression analysis. The study found that the job profile of a doctor or pharmacist (odds ratio adjusted [AOR] = 9.64 [95% confidence interval (CI): 2.32 &amp;ndash; 44.09]; p = 0.002), access to policy guidelines (AOR = 2.81 [95% CI: 1.02 &amp;ndash; 7.86]; p = 0.045), perception of the policy&amp;rsquo;s impact on quality of care (AOR = 4.26 [95% CI: 0.79 &amp;ndash; 26.95]; p = 0.034), and the context of working in a system in which the policy is partially effective (AOR = 4.0 [95% CI: 1.53 &amp;ndash; 11.08]; p = 0.005) significantly increased the chances of improper practices related to policy implementation. Awareness-raising and capacity-building strategies must be developed to policy implementation by healthcare providers in Cameroon. The policy of &amp;ldquo;user fees elimination&amp;rdquo; marks the first step toward universal health coverage, and this study also provides a basis for reflection to facilitate its optimal implementation.

Weight-based disparities in perinatal care: quantitative findings of respect, autonomy, mistreatment, and body mass index in a national Canadian survey

BackgroundQualitative studies document episodes of weight-related disrespectful care, particularly for people with high body mass index (BMI ≥ 30) and reveal implicit and explicit biases in health care providers. No large quantitative studies document the pervasiveness of weight stigma or if experiences change with increasing BMI.MethodsThe multi-stakeholder RESPCCT study team designed and distributed a cross-sectional survey on the experiences of perinatal services in all provinces and territories in Canada. From July 2020 to August 2021, participants who had a pregnancy within ten years responded to closed and open-ended questions. Chi square analysis assessed differences in mean scores derived from three patient-reported experience measures of autonomy (MADM), respect (MOR), and mistreatment (MIST). Controlling for socio-demographic factors, multivariate logistic regression analysis explored relationships between different BMI categories and respectful care.ResultsOf 4,815 Canadians who participated, 3,280 with a BMI of ≥ 18.5 completed all the questions. Pre-pregnancy BMI was significantly associated with race/ethnicity, income sufficiency, and education but not with age. Individuals with higher BMIs were more likely to experience income insufficiency, have lower levels of education, and more frequently self-identified as Indigenous or White. Those with BMI ≥ 35 exhibited notably higher odds of reduced autonomy (MADM) scores, with an unadjusted odds ratio of 1.62 and an adjusted odds ratio of 1.45 compared to individuals with a normal weight. Individuals with BMIs of 25–25.9, 30–34.9, and ≥ 35 exhibited odds of falling into the lower tercile of respect (MOR) scores of 1.34, 1.51, and 2.04, respectively (p < .01). The odds of reporting higher rates of mistreatment (top 33% MIST scores) increased as BMI increased.ConclusionsWhile socio-demographic factors like race and income play significant roles in influencing perinatal care experiences, BMI remains a critical determinant even after accounting for these variables. This study reveals pronounced disparities in the provision of respectful perinatal care to pregnant individuals with higher BMIs in Canada. Data suggest that those with higher BMIs face disrespect, discrimination, and mistreatment. Identification of implicit and explicit weight bias may give providers insight enabling them to provide more respectful care.