搜索结果：Health systems in transition

The Oregon Health Insurance Experiment (OHIE) offers a unique opportunity to examine the causal relationship between Medicaid coverage and happiness among low-income adults, using an experimental design. This study leverages data from comprehensive surveys conducted at 0 and 12 months post-treatment. Previous studies based on OHIE have shown that individuals receiving Medicaid exhibited a significant improvement in mental health compared to those who did not receive coverage. The primary objective is to explore how Medicaid coverage impacts happiness, specifically analyzing in which direction variations in healthcare spending significantly improve mental health: higher spending or lower spending after Medicaid. Utilizing instrumental variable (IV) regression, I conducted six separate regressions across subgroups categorized by expenditure levels and happiness ratings, and the results reveal distinct patterns. Enrolling in OHP has significantly decreased the probability of experiencing unhappiness, regardless of whether individuals had high or low medical spending. Additionally, it decreased the probability of being pretty happy and having high medical expenses, while increasing the

Prognostics is concerned with predicting the future health of the equipment and any potential failures. With the advances in the Internet of Things (IoT), data-driven approaches for prognostics that leverage the power of machine learning models are gaining popularity. One of the most important categories of data-driven approaches relies on a predefined or learned health indicator to characterize the equipment condition up to the present time and make inference on how it is likely to evolve in the future. In these approaches, health indicator forecasting that constructs the health indicator curve over the lifespan using partially observed measurements (i.e., health indicator values within an initial period) plays a key role. Existing health indicator forecasting algorithms, such as the functional Empirical Bayesian approach, the regression-based formulation, a naive scenario matching based on the nearest neighbor, have certain limitations. In this paper, we propose a new `generative + scenario matching' algorithm for health indicator forecasting. The key idea behind the proposed approach is to first non-parametrically fit the underlying health indicator curve with a continuous Gauss

This study introduces an inverse behavioral optimization framework that integrates QALY-based health outcomes, ROI-driven incentives, and adaptive behavioral learning to quantify how policy design shapes national healthcare performance. Building on the FOSSIL (Flexible Optimization via Sample-Sensitive Importance Learning) paradigm, the model embeds a regret-minimizing behavioral weighting mechanism that enables dynamic learning from heterogeneous policy environments. It recovers latent behavioral sensitivities (efficiency, fairness, and temporal responsiveness T) from observed QALY-ROI trade-offs, providing an analytical bridge between individual incentive responses and aggregate system productivity. We formalize this mapping through the proposed System Impact Index (SII), which links behavioral elasticity to measurable macro-level efficiency and equity outcomes. Using OECD-WHO panel data, the framework empirically demonstrates that modern health systems operate near an efficiency-saturated frontier, where incremental fairness adjustments yield stabilizing but diminishing returns. Simulation and sensitivity analyses further show how small changes in behavioral parameters propagate

Adopting a good health information system (HIS) is essential for providing high-quality healthcare. With rapid advances in technology in the healthcare industry in recent years, healthcare providers seek effective options to deal with numerous diseases and a growing number of patients, adopting advanced HIS such as for clinical decision support. While the clinical decision support systems (CDSS) can help medical personnel make better decisions, they may bring negative results due to a lack of understanding of the elements that influence GP's adoption of CDSS. This paper focuses on discovering obstacles that may contribute to the problems surrounding CDSS adoption. Thirty general practitioners were interviewed from different primary health centers in Saudi Arabia in order to determine the challenges and obstacles in the sector. While the outcome confirms that there are obstacles that affect the aspects, such as time risk, quality of the system used, slow Internet speed, user interface, lack of training, high costs, patient satisfaction, multiple systems used, technical support, computer skills, lack of flexibility, system update, professional skills and knowledge, computer efficienc

Selecting the right monitoring level in Remote Patient Monitoring (RPM) systems for e-healthcare is crucial for balancing patient outcomes, various resources, and patient's quality of life. A prior work has used one-dimensional health representations, but patient health is inherently multidimensional and typically consists of many measurable physiological factors. In this paper, we introduce a multidimensional health state model within the RPM framework and use dynamic programming to study optimal monitoring strategies. Our analysis reveals that the optimal control is characterized by switching curves (for two-dimensional health states) or switching hyper-surfaces (in general): patients switch to intensive monitoring when health measurements cross a specific multidimensional surface. We further study how the optimal switching curve varies for different medical conditions and model parameters. This finding of the optimal control structure provides actionable insights for clinicians and aids in resource planning. The tunable modeling framework enhances the applicability and effectiveness of RPM services across various medical conditions.

Mobile health has the potential to revolutionize health care delivery and patient engagement. In this work, we discuss how integrating Artificial Intelligence into digital health applications-focused on supply chain, patient management, and capacity building, among other use cases-can improve the health system and public health performance. We present an Artificial Intelligence and Reinforcement Learning platform that allows the delivery of adaptive interventions whose impact can be optimized through experimentation and real-time monitoring. The system can integrate multiple data sources and digital health applications. The flexibility of this platform to connect to various mobile health applications and digital devices and send personalized recommendations based on past data and predictions can significantly improve the impact of digital tools on health system outcomes. The potential for resource-poor settings, where the impact of this approach on health outcomes could be more decisive, is discussed specifically. This framework is, however, similarly applicable to improving efficiency in health systems where scarcity is not an issue.

For the past two decades, the discussion regarding the effect of ICT on health systems is becoming apparent. However, past studies have mainly focused on ICT impact on specific social-economic phenomena. Little empirical research on ICT and health systems exists. Many African countries have invested in ICT and there is a need to examine if such investments have impacted on health system of these countries. Using a multi-method approach, data for 27 African countries were analysed. We employed Data Envelopment Analysis, Cluster Analysis and Partial Least Squares to examine the impact. The findings indicate that the 27 countries can be grouped into three clusters based on their relative efficiency scores of ICT and health systems. More compelling, the findings indicate that countries that performed efficiently in ICT inputs also do so in their health systems. Further, findings indicate that ICT significantly improves life expectancy at birth and reduces infant mortality rate. African countries must significantly invest in ICT to improve their health systems so as to achieve socio-economic development. The current study has theoretical, methodological and policy implications.

Electronic Health Record (EHR) has become an essential tool in the healthcare ecosystem, providing authorized clinicians with patients' health-related information for better treatment. While most developed countries are taking advantage of EHRs to improve their healthcare system, it remains challenging in developing countries to support clinical decision-making and public health using a computerized patient healthcare information system. This paper proposes a novel EHR architecture suitable for developing countries--an architecture that fosters inclusion and provides solutions tailored to all social classes and socioeconomic statuses. Our architecture foresees an internet-free (offline) solution to allow medical transactions between healthcare organizations, and the storage of EHRs in geographically underserved and rural areas. Moreover, we discuss how artificial intelligence can leverage anonymous health-related information to enable better public health policy and surveillance.

This paper presents a holistic systems informatics approach, i.e., Define, Measure, Analyze, Improve, and Control (DMAIC), for epidemic response and management through the intensive use of data, statistics and optimization. Despite the sustained successes of system informatics in a variety of established industries such as manufacturing, logistics, services and beyond, there is a dearth of concentrated review and application of the data-driven DMAIC approach in the context of epidemic outbreaks. First, we define specific challenges posed by epidemic outbreaks to populational health, health systems, as well as economic challenges to different industries such as retailing, education and manufacturing. Second, we present a review of medical testing and statistical sampling methods for data collection, as well as existing efforts in data management and data visualization. Third, we discuss the importance to realizing the full potential of data for epidemic insights, and emphasize the need to leverage analytical methods and tools for decision support. Fourth, an epidemic brings imperative changes to health systems. We discuss the new trend of healthcare solutions to improve system resil

Previous studies have shown that health information technologies have a positive impact on health systems. Electronic health record (EHR) systems are one of the most promising applications, demonstrating a positive effect in high income countries. On the other hand, robust evidence for low and middle income countries is still spare. The aim of this study is to initiate a carefully planned nationwide EHR system in Vietnam by assessing the core readiness. The assessment structure is mainly based on previous research, which recommends a readiness assessment prior to to an EHR system implementation. To collect data, participant observation, document analysis and an in-depth interview were used. This study has revealed new insights into the current situation on EHR in Vietnam. The Ministry of Health is currently working on improving the conditions for future implementation of a Vietnamese EHR system. There are issues with the current way of handling health records. These issues are encouraging the Ministry of Health to work on identifying the next steps for an EHR system implementation. The integration of an EHR system with current systems seems to be challenging as most systems are com

The notion of integration in the context of health information systems is ill-defined yet in wide-spread use. We identify a variety of meanings spanning from purely technical integration of information systems to integration of services. This ambiguity (or interpretative flexibility), we argue, is inherent rather accidental: it a necessary prerequisite for mobilising political and ideological support among stakeholders for integrated health information systems. Building on this, our aim is to trace out the career dynamics of the vision of integration/ integrated. The career dynamics is the transformation of both the imagery and material (technological) realisations of the unfolding implementation of the vision of integrated care. Empirically we draw on a large, ongoing project at the University hospital of North Norway (UNN) to establish an integrated health information system

The growing demand for home healthcare calls for tools that can support care delivery. In this study, we explore automatic health assessment from voice using real-world home care visit data, leveraging the diverse patient information it contains. First, we utilize Large Language Models (LLMs) to integrate Subjective, Objective, Assessment, and Plan (SOAP) notes derived from unstructured audio transcripts and structured vital signs into a holistic illness score that reflects a patient's overall health. This compact representation facilitates cross-visit health status comparisons and downstream analysis. Next, we design a multi-stage preprocessing pipeline to extract short speech segments from target speakers in home care recordings for acoustic analysis. We then employ an Audio Language Model (ALM) to produce plain-language descriptions of vocal biomarkers and examine their association with individuals' health status. Our experimental results benchmark both commercial and open-source LLMs in estimating illness scores, demonstrating their alignment with actual clinical outcomes, and revealing that SOAP notes are substantially more informative than vital signs. Building on the illness

YouTube has rapidly emerged as a predominant platform for content consumption, effectively displacing conventional media such as television and news outlets. A part of the enormous video stream uploaded to this platform includes health-related content, both from official public health organizations, and from any individual or group that can make an account. The quality of information available on YouTube is a critical point of public health safety, especially when concerning major interventions, such as vaccination. This study differentiates itself from previous efforts of auditing YouTube videos on this topic by conducting a systematic daily collection of posted videos mentioning vaccination for the duration of 3 months. We show that the competition for the public's attention is between public health messaging by institutions and individual educators on one side, and commentators on society and politics on the other, the latest contributing the most to the videos expressing stances against vaccination. Videos opposing vaccination are more likely to mention politicians and publication media such as podcasts, reports, and news analysis, on the other hand, videos in favor are more li

While the applications and demands of Machine learning (ML) systems in mental health are growing, there is little discussion nor consensus regarding a uniquely challenging aspect: building security methods and requirements into these ML systems, and keep the ML system usable for end-users. This question of usable security is very important, because the lack of consideration in either security or usability would hinder large-scale user adoption and active usage of ML systems in mental health applications. In this short paper, we introduce a framework of four pillars, and a set of desired properties which can be used to systematically guide and evaluate security-related designs, implementations, and deployments of ML systems for mental health. We aim to weave together threads from different domains, incorporate existing views, and propose new principles and requirements, in an effort to lay out a clear framework where criteria and expectations are established, and are used to make security mechanisms usable for end-users of those ML systems in mental health. Together with this framework, we present several concrete scenarios where different usable security cases and profiles in ML-sy

Nowadays, prognostics-aware systems are increasingly used in many systems and it is critical for sustaining autonomy. All engineering systems, especially robots, are not perfect. Absence of failures in a certain time is the perfect system and it is impossible practically. In all engineering works, we must try to predict or minimize/prevent failures in the system. Failures in the systems are generally unknown, so prediction of these failures and reliability of the system is made by prediction process. Reliability analysis is important for the improving the system performance, extending system lifetime, etc. Prognostic and Health Management (PHM) includes reliability, safety, predictive fault detection / isolation, advanced diagnostics / prognostics, component lifecycle tracking, health reporting and information management, etc. This study proposes an open source robot prognostic and health management tool using model-based methodology namely "Prognostics and Health Management tool for ROS". This tool is a generic tool for using with any kind of robot (mobile robot, robot arm, drone etc.) with compatible with ROS. Some features of this tool are managing / monitoring robots' health, R

Growth of the older adult population has led to an increasing interest in technology-supported aged care. However, the area has some challenges such as a lack of caregivers and limitations in understanding the emotional, social, physical, and mental well-being needs of seniors. Furthermore, there is a gap in the understanding between developers and ageing people of their requirements. Digital health can be important in supporting older adults wellbeing, emotional requirements, and social needs. Requirements Engineering (RE) is a major software engineering field, which can help to identify, elicit and prioritize the requirements of stakeholders and ensure that the systems meet standards for performance, reliability, and usability. We carried out a systematic review of the literature on RE for older adult digital health software. This was necessary to show the representatives of the current stage of understanding the needs of older adults in aged care digital health. Using established guidelines outlined by the Kitchenham method, the PRISMA and the PICO guideline, we developed a protocol, followed by the systematic exploration of eight databases. This resulted in 69 primary studies o

Large Language Models (LLMs) hold promise in addressing complex medical problems. However, while most prior studies focus on improving accuracy and reasoning abilities, a significant bottleneck in developing effective healthcare agents lies in the readability of LLM-generated responses, specifically, their ability to answer public health problems clearly and simply to people without medical backgrounds. In this work, we introduce RephQA, a benchmark for evaluating the readability of LLMs in public health question answering (QA). It contains 533 expert-reviewed QA pairs from 27 sources across 13 topics, and includes a proxy multiple-choice task to assess informativeness, along with two readability metrics: Flesch-Kincaid grade level and professional score. Evaluation of 25 LLMs reveals that most fail to meet readability standards, highlighting a gap between reasoning and effective communication. To address this, we explore four readability-enhancing strategies-standard prompting, chain-of-thought prompting, Group Relative Policy Optimization (GRPO), and a token-adapted variant. Token-adapted GRPO achieves the best results, advancing the development of more practical and user-friendl

This research paper presents a meta-analysis of the multifaceted role of technology in mental health. The pervasive influence of technology on daily lives necessitates a deep understanding of its impact on mental health services. This study synthesizes literature covering Behavioral Intervention Technologies (BITs), digital mental health interventions during COVID-19, young men's attitudes toward mental health technologies, technology-based interventions for university students, and the applicability of mobile health technologies for individuals with serious mental illnesses. BITs are recognized for their potential to provide evidence-based interventions for mental health conditions, especially anxiety disorders. The COVID-19 pandemic acted as a catalyst for the adoption of digital mental health services, underscoring their crucial role in providing accessible and quality care; however, their efficacy needs to be reinforced by workforce training, high-quality evidence, and digital equity. A nuanced understanding of young men's attitudes toward mental health is imperative for devising effective online services. Technology-based interventions for university students are promising, al

Sonification can provide valuable insights about data but most existing approaches are not designed to be controlled by the user in an interactive fashion. Interactions enable the designer of the sonification to more rapidly experiment with sound design and allow the sonification to be modified in real-time by interacting with various control parameters. In this paper, we describe two case studies of interactive sonification that utilize publicly available datasets that have been described recently in the International Conference on Auditory Display (ICAD). They are from the health and energy domains: electroencephalogram (EEG) alpha wave data and air pollutant data consisting of nitrogen dioxide, sulfur dioxide, carbon monoxide, and ozone. We show how these sonfications can be recreated to support interaction utilizing a general interactive sonification framework built using ChucK, Unity, and Chunity. In addition to supporting typical sonification methods that are common in existing sonification toolkits, our framework introduces novel methods such as supporting discrete events, interleaved playback of multiple data streams for comparison, and using frequency modulation (FM) synth