Service Model Research Articles

A Review Study on the Construction of Medical Institution Service Quality Performance Evaluation System under the Background of Internet Plus

With the advent of the "Internet Plus" era, the medical service industry is undergoing a significant transformation. This paper systematically reviews and analyzes the construction process of the medical institution service quality performance evaluation system, aiming to provide theoretical support and practical guidance for the improvement of service quality in internet hospitals. The article first introduces the challenges and opportunities faced by the medical service industry under the "Internet Plus" background, then discusses the definition, dimensions, and theoretical framework of medical service quality evaluation. Through a comparative analysis of the service quality evaluation systems of Chinese and American medical institutions, the similarities and differences in the construction of medical service evaluation systems between the two countries are revealed. Finally, based on the "Internet Plus" background, the paper proposes principles, objectives, indicator system design, and implementation and feedback mechanisms for constructing a service quality performance evaluation system. The research results indicate that constructing a comprehensive and objective service quality evaluation system is of great significance for optimizing resource allocation, innovating service models, improving service efficiency, and reducing service costs, which helps to promote the implementation of the Healthy China strategy.

Describing Caregiver and Clinician Experiences with Pediatric Telerehabilitation Across Clinical Disciplines

Scope: This study describes the high and low points of caregiver and clinician experiences with pediatric telerehabilitation with consideration for the sustainable adoption of pediatric telerehabilitation beyond the COVID-19 pandemic context. Methods: As part of a larger study, this project analyzed data from qualitative interviews to describe caregivers’ (n = 27) and clinicians’ (n = 27) experiences with pediatric telerehabilitation. Findings: Caregiver and clinician experiences with pediatric telerehabilitation are described according to four touchpoints identified: (1) child engagement in telerehabilitation; (2) perceived value of telerehabilitation services and caregiver engagement; (3) preparing the people and environment for telerehabilitation services; (4) fit of using a telerehabilitation model; and (5) providing family with choice. Discussion: Findings highlight the importance of being informed about the telerehabilitation service model, feeling prepared for telerehabilitation appointments and being responsive to families’ choice. Recommendations to address these areas are discussed.

The impact of long-term care insurance on the health status and healthcare expenditure of older adults in China

ObjectiveLong-term care needs have grown with population aging. This study explores the relationships among health status, healthcare expenditure, and long-term care insurance (LTCI) among the older adults.MethodsUsing data from the China Health and Retirement Longitudinal Study (CHARLS 2011, 2013, 2015, 2018, and 2020) and based on the demand model for healthcare services, this study employed the difference-in-difference (DID) method to assess how the implementation of LTCI contributed to the health status and healthcare expenditures of the older adults. The propensity score matching DID method (PSM-DID) and other tests were used to conduct further robustness checks.ResultsThe findings demonstrate a significant positive impact of LTCI on improving the health status and reducing healthcare expenditures in the elderly population. The PSM-DID indicates that LTCI can effectively improve the health status of the elderly population and reduce their healthcare spending.ConclusionsBased on the findings, the development of relevant policy frameworks for LTCI in China is recommended. These include consider the differences among the various pilot cities and social strata to allow policy adjustments and improvements in a timely, establish a dynamic and diversified long-term care insurance financing mechanism, encourage collaboration between medical institutions and elder care facilities, establish effective contact between LTCI and medical institutions, and use incentive policies such as tax relief to provide financial support and subsidies.

Sub-District Level Spatiotemporal Changes of Carbon Storage and Driving Factor Analysis: A Case Study in Beijing

Analyzing the current trends and causes of carbon storage changes and accurately predicting future land use and carbon storage changes under different climate scenarios is crucial for regional land use decision-making and carbon management. This study focuses on Beijing as its study area and introduces a framework that combines the Markov model, the Patch-based Land Use Simulation (PLUS) model, and the Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) model to assess carbon storage at the sub-district level. This framework allows for a systematic analysis of land use and carbon storage spatiotemporal evolution in Beijing from 2000 to 2020, including the influence of driving factors on carbon storage. Moreover, it enables the simulation and prediction of land use and carbon storage changes in Beijing from 2025 to 2040 under various scenarios. The results show the following: (1) From 2000 to 2020, the overall land use change in Beijing showed a trend of “Significant decrease in cropland area; Forest increase gradually; Shrub and grassland area increase first and then decrease; Decrease and then increase in water; Impervious expands in a large scale”. (2) From 2000 to 2020, the carbon storage in Beijing showed a “decrease-increase” fluctuation, with an overall decrease of 1.3 Tg. In future carbon storage prediction, the ecological protection scenario will contribute to achieving the goals of carbon peak and carbon neutrality. (3) Among the various driving factors, slope has the strongest impact on the overall carbon storage in Beijing, followed by Human Activity Intensity (HAI) and Nighttime Light Data (NTL). In the analysis of carbon storage in the built-up areas, it was found that HAI and DEM (Digital Elevation Model) have the strongest effect, followed by NTL and Fractional Vegetation Cover (FVC). The findings from this study offer valuable insights for the sustainable advancement of ecological conservation and urban development in Beijing.

Evaluation of a Program Designed to Support Implementation of Prescribing Medication for Treatment of Opioid Use Disorder in Primary Care Practices.

Offering medication for opioid use disorder (MOUD) in primary care can increase access to effective opioid use disorder treatment and help address the US opioid crisis. We describe a primary care office-based opioid treatment program and addiction consultation service model designed to support small, rural clinics to increase their capacity for MOUD. This is an evaluation of an intervention to increase clinic capacity to offer MOUD. The intervention consists of a standardized curriculum, addiction medicine consultants, practice facilitation, and financial incentives. Fifteen Colorado primary care practices participated from January 2022 through January 2023. Primary outcomes included overall change in the number of active buprenorphine prescriptions and implementation of MOUD milestones before and after the intervention. The mean number of active buprenorphine prescriptions in the 3 months preceding the intervention (baseline) increased from 2.1 (SD = 7.7) to 11.3 (SD = 11.2) at 13 months. Adjusted means from the Poisson model demonstrated significant improvement over time (P <.001). Mean implementation of MOUD milestones ranged from 23% to 40% at baseline and grew to 84% to 93% by the end of the program (P <.001). This model supported primary care practices that were initially doing little to no MOUD prescribing, to prescribe at significantly higher levels by the end of the program. This scalable model for addiction consultation in primary care settings illustrates how education and support to clinical teams can help practices makes changes, especially those with limited MOUD experience.

Optimizing Policy for Online Seaman Book Services at the Class III Gorontalo Port Authority and Harbor Master's Office

This study aims to evaluate and analyze the development of online Seafarer Book services at the Port Authority and Syahbandar Class III Gorontalo Office, focusing on various aspects of public service theory indicators such as tangibles, empathy, reliability, responsiveness, and assurance. This research uses a qualitative approach with a case study design, focusing on implementing the online Seafarer Book service. Data is collected through interviews, observations, and document reviews from various stakeholders involved in providing services. The findings show that the online Sailor Book service has improved service efficiency but faces challenges regarding system reliability, user education, and infrastructure support. The study identifies key areas for improvement, including improving the reliability of online systems, better training for users in using the system and improving the physical and technical infrastructure to support services. The study concluded that while online Seafarer’s Book services have the potential to significantly improve seafarers’ documentation processes, ongoing improvements and adjustments are needed to address the challenges identified. Improving system reliability and user support is critical to the success of the online service model.

Factors associated with preventive health services use by older war-displaced Japanese returning from China and by older Korean residents of Japan: a descriptive correlational study

BackgroundAmong the people with diverse backgrounds and cultural customs living in Japan, two important groups, namely, war-displaced Japanese returning from China and South and North Korean nationals who are naturalized citizens residing in Japan, will experience population aging in the same way as the general Japanese population. In old age, physical function generally declines, multiple diseases are more likely to occur, and health issues that need to be addressed increase in number. The aim of this study was to identify the factors associated with the use of preventive health services in Japan by older Korean residents and war-displaced Japanese returning from China.MethodsThe study conducted a cross-sectional study in Japan using a self-administered questionnaire. Respondents comprised 754 people aged 65 or over, including 220 Japanese, 200 war-displaced Japanese returnees from China, and 334 Korean residents of Japan. The behavioral model of health services use served as the analytical framework. Questionnaire items were based on predisposing factors, enabling factors, and need factors. Logistic regression analysis was used to examine the relationship between preventive health services use and each factor.ResultsThe results of the logistic regression analysis showed that being ethnically a war-displaced Japanese returning from China (OR = 0.04; 95% CI [0.00, 0.74]) and being ethnically Korean residents of Japan (OR = 0.13; 95% CI [0.03, 0.62]) were associated with the use of preventive health services.ConclusionsThe use of preventive health services by older people in Japan is influenced by ethnicity. For these reasons, war-displaced Japanese returning from China and Korean residents of Japan need support to encourage their greater use of preventive health services.

Residents' willingness and awareness to participate in internet+nursing service in China: A meta-analysis.

The internet + nursing service is an important initiative for implementing the strategy of healthy China and actively responding to the aging of the population. However, the current literature on residents' awareness and willingness to participate is insufficient and presents large variations and limitations. Therefore, this study aims to systematically evaluate the awareness and willingness of Chinese residents to participate in internet + nursing service to comprehensively understand the level of awareness and acceptance of this emerging service model among Chinese residents and to provide strong support for relevant policy formulation and service optimization. The PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, SinoMed, and VIP databases were electronically searched to collect cross-sectional studies related to the awareness and willingness of Chinese residents to participate in internet + nursing service from inception to January 2024. Two reviewers independently screened the literature, extracted the data, and assessed the risk of bias of the included studies. A total of 27 cross-sectional studies involving 11,761 subjects were included. The results of the meta-analysis showed that the percentage of Chinese residents willing to participate in internet + nursing service was 76.3% (95% CI [71.2%, 81.3%]). The results of the subgroup analysis showed that residents who lived in Western regions (82.1%), had employee medical insurance (85.9%), were suffering from other diseases (89.2%), were under the age of 60 (87.8%), were not married (78.9%), and had an undergraduate degree or above (85.5%) had a relatively high willingness to participate in internet + nursing service. The rate of awareness of internet + nursing service among Chinese residents was 48.6% (95% CI [24.1%, 73.2%]), which shows a downwards trend over time (67.4% in 2019, 56.1% in 2020, and 45.1% in 2021). The willingness to participate in internet + nursing service among Chinese residents is high, but the awareness rate is low. It is necessary to improve the awareness and willingness of Chinese residents to use internet + nursing service through various channels and aspects of publicity and promotion to achieve the goal of innovating the health service model, accurately connecting with the diverse health needs of people, and actively responding to the aging population.

Systematic review of integrated mental and physical health services for children and young people with eating and functional symptoms.

Evidence suggests that by recognising the psychosocial component of illness as equally important to the biological components, care becomes more holistic, and patients can benefit. Providing this type of care requires collaboration among health professionals, rather than working in isolation, to achieve better outcomes. However, there is a lack of evidence about the implementation of integrated health care. This review focuses on children and young people experiencing eating disorders (i.e. disorders related to feeding and eating) or functional symptom disorders (i.e. medically unexplained symptoms). The present review is part of a larger study that will inform the development of a new children's hospital in England. Both eating disorders and functional symptom disorders are conditions that may be particularly likely to benefit from an integrated approach to health care, and this review aims to investigate what service models have been used to integrate care, what factors influence their implementation, and what effects these integrated models have on access to and outcomes from care. We conducted a systematic review of studies based on children and young people with eating disorders or functional symptom disorders, investigating the effectiveness of integrated mental and physical health services versus any other type of services provided in these populations. We searched MEDLINE, EMBASE and PsycInfo® (American Psychological Association, Washington, DC, USA) electronic bibliographic databases in July 2024 without restriction on the date of publication or country of interest. We reviewed only studies written in English. We identified 2668 citations which resulted in 1939 papers eligible for title screening. Only one single-site Australian evaluation of an integrated care model from over 20 years ago was included in our review. The study reported significantly higher number of total admissions and total bed-days utilised in the integrated approach. However, the burden of care shifted from psychiatric wards to medical wards and as a result, the cost per admission and the cost per inpatient decreased. The lack of conceptual consistency about the definition of integrated care may have driven false screening and loss of some evidence. The same limitation applies in terms of the definition of functional symptom disorders. The review identified a gap in the evidence base relating to integrated secondary service provision for children and adolescents with eating disorders or functional symptom disorders in comparison with generic services. No similar studies were identified for children and young people with functional symptom disorders. Our findings align with previous evidence and show that despite the existence of studies describing aspects of integrated care, integration of physical and mental health services for children and young people with eating disorders or functional symptom disorders is underexplored and the limited available evidence is of weak quality. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR133613.

Assessment of Pluvial Flood Mitigation Ecosystem Service in a Riverside City Using the Integrated Valuation of Ecosystem Services and Tradeoffs Model for Ecological Corridor Mapping

Assessment of Pluvial Flood Mitigation Ecosystem Service in a Riverside City Using the Integrated Valuation of Ecosystem Services and Tradeoffs Model for Ecological Corridor Mapping

Enhancing Cloud Computing Efficiency with Crocodile Optimization Algorithm: A Novel Approach to Distributed Workload and VM Management

Cloud computing has introduced itself as a mighty mechanism for delivering customers through the service model with on-demand, scalable, and instant access to computer resources. It will conduct effective load balancing and resource management, high importance so that the cloud system works with optimized performance and resource utilization. This gives a new strategy in load balancing and virtual machine (VM) control in cloud computing applied in the field using the Crocodile Optimization Algorithm (COA) for better performance. Inspired by crocodile hunting behaviors, the COA-based strategy is adopted to balance loads and manage VMs. This approach seeks to balance the number of the workload given to VMs with respect to the processing power of VMs and also the distribution of workload. It best uses resources in such a way that tasks are dynamically distributed to VMs in such a way that response time is at its minimum, and thus overall efficiency is enhanced in cloud computing. On the other hand, COA-based load balancing incorporates VM management techniques like migration and scaling to be adjustable in relation to the changing conditions of the workload. This allows dynamically adjusting the allocation of resources with respect to current demands, in such a way that assures optimal utilization of computational resources with high performance. The proposed approach was evaluated using simulations through CloudSim, one of the most adopted tools for simulating cloud computing. The COA effectively works are divided between the VM, which in turn will lead to better response time for the user request and improve cloud resource utilization. That is to mean, subsequent research would be some type of unique attempt in the area of load balancing and VM management in cloud computing, based on the Crocodile Optimization Algorithm. This approach improves efficient cloud computing through the balancing of load distribution, maximization of resource utilization, and lowering of response time.

E-servicescape and customer equity based customer loyalty model for digital services

E-servicescape and customer equity based customer loyalty model for digital services

The Quality Evaluation Model of Open Education Learning Support Services under the Background of Digital Transformation

The Quality Evaluation Model of Open Education Learning Support Services under the Background of Digital Transformation

Carbon Storage Response to Land Use/Land Cover Changes and SSP-RCP Scenarios Simulation: A Case Study in Yunnan Province, China.

Changes in terrestrial ecosystem carbon storage (CS) affect the global carbon cycle, thereby influencing global climate change. Land use/land cover (LULC) shifts are key drivers of CS changes, making it crucial to predict their impact on CS for low-carbon development. Most studies model future LULC by adjusting change proportions, leading to overly subjective simulations. We integrated the Integrated Valuation of Ecosystem Services and Trade-offs (InVEST) model, the Patch-generating Land Use Simulation (PLUS) model, and the Land Use Harmonization 2 (LUH2) dataset to simulate future LULC in Yunnan under different SSP-RCP scenarios of climate and economic development. Within the new PLUS-InVEST-LUH2 framework, we systematically analyzed LULC alterations and their effects on CS from 1980 to 2040. Results demonstrated that: (1) Forestland had the highest CS, whereas built-up land and water showed minimal levels. Western areas boast higher CS, while the east has lower. From 1980 to 2020, CS continuously decreased by 29.55 Tg. In the wake of population increase and economic advancement, the area of built-up land expanded by 2.75 times. Built-up land encroaches on other land categories and is a key cause of the reduction in CS. (2) From 2020 to 2040, mainly due to an increase in forestland, CS rose to 3934.65 Tg under the SSP1-2.6 scenario, whereas under the SSP2-4.5 scenario, primarily due to a reduction in forestland and grassland areas, CS declined to 3800.86 Tg. (3) Forestland is the primary contributor to CS, whereas the ongoing enlargement of built-up land is causing a sustained decline in CS. Scenario simulations indicate that future LULC changes under different scenarios will have a significant impact on CS in Yunnan. Under a green sustainable development pathway, Yunnan can exhibit significant carbon sink potential. Overall, this research offers a scientific reference for optimizing land management and sustainable development in Yunnan, aiding China's "double carbon" goals.

Integrating river transport processes and seasonal dynamics to assess watershed nitrogen export risk.

Excessive nitrogen exported to water bodies affects the balance of ecosystem and poses a threat to human health. Although the concept of water purification service helps quantify nitrogen export, the impact of river transport remains unclear. This study focused on nitrogen as a pollutant by utilizing the Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) model to assess nitrogen export in the Dongting Lake Basin, taking into account both the processes of sub-basin nitrogen export and river transport. Additionally, the monthly variations within the year were further explored, together with the identification of the priority area of returning cropland to forest land. The results showed that in 2021, the total nitrogen load outside the Dongting Lake was 11.34×108 kg·year-1, with the sub-basins retaining a total of 9.02×108 kg·year-1, accounting for 79.57% of the total nitrogen load. Notably, the total nitrogen retention by the river made up 16.87% of the total nitrogen retention, up to 1.83×108 kg·year-1. In view of monthly variation, water purification service based on the entire process was higher in winter and late autumn, and lower in summer and early autumn. The priority areas for ecological project were mainly distributed around the Dongting Lake, achieving an improvement of 58.15% in water purification service with approximately 7.02% of the total returnable cropland. This study proposed a new approach of water purification service assessment through integrating river transport processes and seasonal dynamics, aiming to assess watershed nitrogen export risk more accurately.

The effect of a team-based service model on treatment processes and outcomes and healthcare usage among people with type 2 diabetes in North Karelia, Finland

The effect of a team-based service model on treatment processes and outcomes and healthcare usage among people with type 2 diabetes in North Karelia, Finland

SECURITY THREATS AND COUNTERMEASURES IN CLOUD

Cloud computing refers to the continuous availability of computer infrastructure technology, enabling the handling and storage of information without direct client management. People are given the ability to access private as well as public information preservation on a single digital infrastructure via the use of the Internet. However, this convenience comes with certain security issues and risks, which have led to the widespread adoption of cloud-dependent computing models. This research delves into various security problems, challenges, methods, and perspectives in one comprehensive article. In addition, a number of upcoming technologies, are dependent on services related to cloud computing to process and store their data. As a consequence of this, a variety of enterprises are expanding their utilization of these technologies, which in turn exacerbates the weaknesses and security challenges inherent to the cloud model. The term "cloud computing" refers to an approach that incorporates all of its constituent parts, such as end users, connections, access management systems, and infrastructures. If security teams do not have a comprehensive grasp of the architecture of the cloud, they might run into problems such as the sluggish identification of security threats, the resulting duplication of data, and a loss of control over accessing the information and protection in order to maintain regulatory compliance. The article begins by briefly introducing the architecture of cloud computing, highlighting its key features, service models, deployment methods, and cloud server virtualization. This paper's primary findings include the growing popularity of cloud computing, security challenges in cloud computing, the importance of investigating security challenges, categorizing security challenges, and proposing developing solutions. Through an extensive review, it analyzes and summarizes scholarly efforts to address these security concerns, followed by information on cloud computing safety concerns and frameworks. Understanding security challenges, addressing data migration challenges, improving security measures, offering a systematic approach, enabling risk detection and prevention, and facilitating the development of preventive methods are the primary significance of this work. The text then categorizes various cloud attacks and privacy issues, before outlining the literature's efforts to provide mitigation and protection mechanisms for security assessment. Finally, it examines unresolved cloud security challenges and proposes potential solutions.

‘The tablets make a certain noise’: uncovering barriers and enablers related to providing PMTCT services to adolescents and young women living with HIV in Zimbabwe

Background Zimbabwe antenatal HIV prevalence rate is 16.1%. HIV-positive pregnant adolescent girls and young women (AYW) are at high risk to experience perinatal mental health challenges, attributed to a combination of factors including HIV status, stigma and perinatal depression. Perinatal depression and stigma among AYW is understudied in Zimbabwe and may affect short- and long-term health of HIV positive mothers and their children, and can impact treatment adherence. Methods Qualitative data was gathered from four focus group discussions with (2 urban and 2 rural) PMTCT providers (N = 17). Focus group discussions were also conducted among AYW clients (N = 20) from two clinics in Mashonaland East. Results Qualitative analyses identified patterns related to: (1) drop out and loss to follow up, (2) retention and adherence, (3) recurring feelings of internalized stigma; and (4) acceptability of potential MH interventions. MH services are not available and AYW have limited access to adherence counseling (1–2 times at onset). Psychological support was not available at either clinic, despite both providers and clients perceiving high rates of stigma, discrimination, and challenges with disclosure. Challenges related to long waits for ART distribution and gaps in disclosure support emerged as barriers. Providers noted that AYW present as anxious (non-diagnosed), and attribute depression to those clients who are lost to follow up, stating lack of time to screen for MH related issues or actively refer them for services. Challenges related to the ability to provide strong advice and support for disclosure also emerged among providers. Conclusions This study can contribute to policy and practice recommendations to better integrate MH into HIV services and develop person-centered service models for HIV positive AYW. HIGHLIGHTS Perinatal adolescents and young women (AYW) living with HIV have gaps in retention and care in the current Zimbabwe PMTCT service model. Mental health stigma must be addressed to integrate mental health into HIV services. HIV providers are aware of the need to provide mental health support to reduce loss to follow-up. Mental health screening and referrals for services are not part of standard care for perinatal HIV positive AYW in Zimbabwe. Linkages between disclosure and AYW mental health was identified as a challenge by HIV providers. Context responsive interventions can support integration of mental health screening, services, and referrals.

A COMPARATIVE STUDY OF INTEGRATED LONG-TERM CARE SERVICES IN TAIPEI CITY AND NINGBO CITY

Abstract This study aims to compare the integrated long-term care service models in Taipei and Ningbo, exploring their similarities, differences, and experiences for mutual learning. Through literature review and field research, it was found that Taiwan’s long-term care system has advantages such as comprehensive coverage, diversified services, professional teams, smart technology applications, community participation, policy support, and a supportive social and cultural environment. On the other hand, Ningbo’s integrated long-term care services also have unique features in terms of service content and format, emphasizing family care, promoting the integration of medical care and older people care, and developing community rehabilitation services. The comparative study reveals that Taiwan’s long-term care system is more mature and comprehensive, with higher service quality and coverage, while Ningbo has certain advantages in the integration of medical care and older people care, as well as in community rehabilitation services. Based on this, the study proposes recommendations for the complementary development of long-term care service models in Taipei and Ningbo, including strengthening policy coordination, promoting inter-departmental cooperation, and enhancing service quality and efficiency, aiming to provide reference for the improvement and development of long-term care services in both regions.

Impact of Regional Structure and Topography on the Effectiveness of Public Transportation Services

This study investigates the impact of urban structure and topography on public transportation effectiveness in developing countries. Using structural equation modeling analysis of survey data from 500 public transit users across five diverse cities, we examine how these geographical factors influence accessibility, reliability, comfort, and user satisfaction. Results indicate that both urban structure and topography significantly affect transportation effectiveness, with urban structure having a slightly stronger influence. Polycentric urban designs and moderate topography were associated with higher public transit effectiveness. User perceptions highlighted the importance of integrated planning approaches. The findings suggest policymakers should consider geographical contexts when designing public transportation systems, potentially through adaptive infrastructure and context-specific service models. This research contributes to a more nuanced understanding of public transit planning in varied urban environments of developing nations.