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Health systems and services in low and middle income settings

This section aims to publish research on health systems and services with a focus on research relevant to low and middle-income settings as defined by The World Bank.

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  1. Non-adherence to recommended therapy remains a challenge to achieving optimal clinical outcome with resultant economic implications.

    Authors: Aduke E. Ipingbemi, Wilson O. Erhun and Rasaq Adisa

    Citation: BMC Health Services Research 2021 21:1000

    Content type: Research article

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  2. The reduction of inequality is a key United Nations 2030 Sustainable Development Goal (WHO, Human Resources for Health: foundation for Universal Health Coverage and the post-2015 development agenda, 2014; Tran...

    Authors: Beulah Christina van Zyl, Michelle Monique Barnard, Keith Cloete, Amanda Fernandez, Matodzi Mukosi and Richard Denys Pitcher

    Citation: BMC Health Services Research 2021 21:991

    Content type: Research article

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  3. Community health worker (CHW) motivation is an important factor related to health service quality and CHW program sustainability in low- and middle-income countries. Financial and non-financial motivators may ...

    Authors: Jeffrey Glenn, Corrina Moucheraud, Denise Diaz Payán, Allison Crook, James Stagg, Haribondhu Sarma, Tahmeed Ahmed, Adrienne Epstein, Sharmin Khan Luies, Mahfuzur Rahman, Margaret E. Kruk and Thomas J. Bossert

    Citation: BMC Health Services Research 2021 21:979

    Content type: Research article

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  4. Human-centered design (HCD) is an increasingly recognized approach for engaging stakeholders and developing contextually appropriate health interventions. As a component of the ongoing STRENGTHS study (Strengthen...

    Authors: Mc Kinsey M. Pillsbury, Eunice Mwangi, Josephine Andesia, Benson Njuguna, Gerald S. Bloomfield, Agneta Chepchumba, Jemima Kamano, Tim Mercer, Juliet Miheso, Sonak D. Pastakia, Shravani Pathak, Aarti Thakkar, Violet Naanyu, Constantine Akwanalo and Rajesh Vedanthan

    Citation: BMC Health Services Research 2021 21:910

    Content type: Research article

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  5. Uncontrolled hypertension represents a substantial and growing burden in Guatemala and other low and middle-income countries. As a part of the formative phase of an implementation research study, we conducted ...

    Authors: Meredith P. Fort, William Mundo, Alejandra Paniagua-Avila, Sayra Cardona, Juan Carlos Figueroa, Diego Hernández-Galdamez, Kristyne Mansilla, Ana Peralta-García, Dina Roche, Eduardo Alberto Palacios, Russell E. Glasgow, Pablo Gulayin, Vilma Irazola, Jiang He and Manuel Ramirez-Zea

    Citation: BMC Health Services Research 2021 21:908

    Content type: Research article

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  6. In an effort to encourage Family Planning (FP) adoption, since 1952, the Government of India has been implementing various centrally sponsored schemes that offer financial incentives (FIs) to acceptors as well...

    Authors: Kamlesh Lalchandani, Aditi Gupta, Ashish Srivastava, Gulnoza Usmanova, Ashwarya Maadam and Bulbul Sood

    Citation: BMC Health Services Research 2021 21:905

    Content type: Research article

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  7. Daily doses of pre-exposure prophylaxis (PrEP) can reduce the risk of acquiring HIV by more than 95 %. In sub-Saharan Africa, adolescent girls and young women (AGYW) are at disproportionately high risk of acqu...

    Authors: Elzette Rousseau, Linda-Gail Bekker, Robin F. Julies, Connie Celum, Jennifer Morton, Rachel Johnson, Jared M. Baeten and Gabrielle O’Malley

    Citation: BMC Health Services Research 2021 21:888

    Content type: Research article

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  8. Warfarin treatment requires frequent monitoring of INR (international normalized ratio) to adjust dosage in a therapeutic range. In China, patients living in small towns usually go to tertiary hospitals to get...

    Authors: Lei Chen, Yang-Zhao Zhou, Xin-Min Zhou, Li-Ming Liu, Ping Xu, Xia Zhang and Sheng-Lan Tan

    Citation: BMC Health Services Research 2021 21:875

    Content type: Study protocol

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  9. Timely diagnosis and early initiation of life-saving antiretroviral therapy are critical factors in preventing mortality among HIV-infected infants. However, resource-limited settings experience numerous chall...

    Authors: Win Lei Yee, Hla Htay, Yasmin Mohamed, Claire E. Nightingale, Htay Htay Tin, Win Thein, Latt Latt Kyaw, Win Win Yee, Moe Myat Aye, Steven G. Badman, Andrew J. Vallely, David Anderson, Angela Kelly-Hanku and Stanley Luchters

    Citation: BMC Health Services Research 2021 21:863

    Content type: Research article

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  10. Over the past decade, global health policy has increased its focus on measures to halt further increase in tuberculosis (TB) incidence and management of diabetes mellitus (DM). However, the vertical management...

    Authors: Rita Suhuyini Salifu and Khumbulani W. Hlongwana

    Citation: BMC Health Services Research 2021 21:861

    Content type: Research article

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  11. The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the e...

    Authors: Paulo Henrique das Neves Martins Pires, Cynthia Macaringue, Ahmed Abdirazak, Jaibo Rassul Mucufo, Martins Abudo Mupueleque, David Zakus, Ronald Siemens and Celso Fernando Belo

    Citation: BMC Health Services Research 2021 21:860

    Content type: Research article

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  12. China started to cover novel medicines for the treatment of major cancers, such as trastuzumab for breast cancer by the government health insurance programs since 2016. Limited data have been published on the ...

    Authors: Yifan Diao, Mengbo Lin, Kai Xu, Ji Huang, Xiongwei Wu, Mingshuang Li, Jing Sun and Hong Li

    Citation: BMC Health Services Research 2021 21:856

    Content type: Research article

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  13. The shortage of medicines represents a complex global phenomenon that triggers patient care and safety issues. The study was undertaken to explore the impact of medicines shortages on patients in Pakistan. The...

    Authors: Muhammad Atif, Azka Sehar, Iram Malik, Irem Mushtaq, Nafees Ahmad and Zaheer-Ud-Din Babar

    Citation: BMC Health Services Research 2021 21:827

    Content type: Research article

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  14. Care bundles are a set of three to five evidence-informed practices which, when performed collectively and reliably, may improve health system performance and patient care. To date, many studies conducted to i...

    Authors: Befikadu Bitewulign, Dereje Abdissa, Zewdie Mulissa, Abiyou Kiflie, Mehiret Abate, Abera Biadgo, Haregeweyni Alemu, Meseret Zelalem, Munir Kassa, Gareth Parry and Hema Magge

    Citation: BMC Health Services Research 2021 21:821

    Content type: Research article

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  15. Cervical cancer is the leading cancer among Ugandan women, contributing to 40 % of all cancer cases recorded in the cancer registry. Having identified the substantial impact of cervical cancer among Ugandan wo...

    Authors: James Henry Obol, Sophia Lin, Mark James Obwolo, Reema Harrison and Robyn Richmond

    Citation: BMC Health Services Research 2021 21:794

    Content type: Research article

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  16. Healthcare organisations have undergone organisational change to respond to COVID-19. This pandemic has presented challenges for employee adjustment, with impacts on the availability and coordination of human ...

    Authors: Simon Turner, Natalia Niño, Carolina Segura and Natalia Botero-Tovar

    Citation: BMC Health Services Research 2021 21:792

    Content type: Research article

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  17. A large proportion of non-communicable diseases (NCDs) are treatable within primary health care (PHC) settings in a cost-effective manner. However, the utilization of PHCs for NCD care is comparatively low in ...

    Authors: Manoj Kumar Pati, Upendra Bhojani, Maya Annie Elias and Prashanth N. Srinivas

    Citation: BMC Health Services Research 2021 21:770

    Content type: Research article

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  18. The COVID-19 pandemic threatens to overwhelm the capacity of a vulnerable healthcare system in the occupied Palestinian territory (oPt). We aimed to evaluate the availability of personal protective equipment (...

    Authors: Osaid Alser, Heba Alghoul, Zahra Alkhateeb, Ayah Hamdan, Loai Albarqouni and Kiran Saini

    Citation: BMC Health Services Research 2021 21:766

    Content type: Research article

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  19. The monitoring framework for evaluating health system response to noncommunicable diseases (NCDs) include indicators to assess availability of affordable basic technologies and essential medicines to treat the...

    Authors: Anand Krishnan, Prashant Mathur, Vaitheeswaran Kulothungan, Harshal Ramesh Salve, Sravya Leburu, Ritvik Amarchand, Baridalyne Nongkynrih, Himanshu Kumar Chaturvedi, P. Ganeshkumar, Vinay Urs K S, Avula Laxmaiah, Manjit Boruah, Sanjeev Kumar, Binod Kumar Patro, Pankaja Ravi Raghav, Prabu Rajkumar…

    Citation: BMC Health Services Research 2021 21:757

    Content type: Research article

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  20. An estimated nine out of ten persons in sub-Saharan Africa (SSA) are unable to access timely, safe and affordable surgery. District hospitals (DHs) which are strategically located to provide basic (non-special...

    Authors: Martilord Ifeanyichi, Henk Broekhuizen, Mweene Cheelo, Adinan Juma, Gerald Mwapasa, Eric Borgstein, John Kachimba, Jakub Gajewski, Ruairi Brugha, Chiara Pittalis and Leon Bijlmakers

    Citation: BMC Health Services Research 2021 21:728

    Content type: Research article

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  21. Oxygen is vital in the treatment of illnesses in children and adults, yet is lacking in many low and middle-income countries health care settings. Oxygen concentrators (OCs) can increase access to oxygen, comp...

    Authors: Susan McAllister, Louise Thorn, Sainimere Boladuadua, Mireia Gil, Rick Audas, Tim Edmonds, Eric Rafai, Philip C. Hill and Stephen R. C. Howie

    Citation: BMC Health Services Research 2021 21:636

    Content type: Research article

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  22. Decentralization of healthcare services has been widely utilized, especially in developing countries, to improve the performance of healthcare systems by increasing the access and efficiency of service deliver...

    Authors: Bandar Noory, Sara Hassanain, Jeffrey Edwards and Benedikte V. Lindskog

    Citation: BMC Health Services Research 2021 21:581

    Content type: Research article

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  23. There is a disparity in outcomes between rural and urban emergency medical services (EMS) around the world. However, there is a scarcity of research that directly asks EMS staff in both rural and urban areas h...

    Authors: Ahmed Ramdan M Alanazy, John Fraser and Stuart Wark

    Citation: BMC Health Services Research 2021 21:562

    Content type: Research article

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  24. Patient engagement is effective in promoting adherence to HIV care. In an effort to promote patient-centered care, we implemented an enhanced patient care (EPC) intervention that addresses a combination of sys...

    Authors: Juddy Wachira, Becky Genberg, Diana Chemutai, Ann Mwangi, Omar Galarraga, Siika Abraham and Ira Wilson

    Citation: BMC Health Services Research 2021 21:515

    Content type: Research article

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  25. There is a need for information and healthcare support for the fertility desires and contraceptive needs of people living with HIV (PLHIV) in order to provide safer conception support for sero-discordant coupl...

    Authors: Cecilia Milford, Mags Beksinska, Ross Greener, Jacqueline Pienaar, Letitia Rambally Greener, Zonke Mabude and Jennifer Smit

    Citation: BMC Health Services Research 2021 21:509

    Content type: Research article

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  26. Asylum evaluations are highly specialized medico-legal encounters to collect physical or mental health evidence for use in immigration proceedings. Although the field of asylum medicine is growing, access to t...

    Authors: Ranit Mishori, Kathryn Hampton, Hajar Habbach, Elsa Raker, Anjali Niyogi and Dona Murphey

    Citation: BMC Health Services Research 2021 21:508

    Content type: Research article

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  27. Improving the quality of primary healthcare provision is a key goal in low-and middle-income countries (LMICs). However, to develop effective quality improvement interventions, we first need to be able to accu...

    Authors: Navneet Aujla, Temitope Ilori, Achiaka Irabor, Abimbola Obimakinde, Eme Owoaje, Olufunke Fayehun, Motunrayo M. Ajisola, Sinmisola O. Bolaji, Samuel I. Watson, Timothy P. Hofer, Akinyinka Omigbodun and Richard J. Lilford

    Citation: BMC Health Services Research 2021 21:488

    Content type: Research article

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  28. Yemen that has been devastated by war is facing various challenges to respond to the recent potential outbreaks and other public health emergencies due to lack of proper strategies and regulations, which are e...

    Authors: Hanan Noman, Fekri Dureab, Iman Ahmed, Abdulwahed Al Serouri, Taha Hussein and Albrecht Jahn

    Citation: BMC Health Services Research 2021 21:477

    Content type: Research article

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    The Correction to this article has been published in BMC Health Services Research 2021 21:677

  29. The aim of this study was to determine the feasibility of implementing and evaluating essential interventions for the management of hypertension and prevention of cardiovascular disease in primary healthcare i...

    Authors: Dylan Collins, Laura Inglin, Tiina Laatikainen, Mekhri Shoismatuloeva, Dilorom Sultonova, Bunafsha Jonova, Katoyon Faromuzova, Marifat Abdullaeva, Maisara Otambekova and Jill L. Farrington

    Citation: BMC Health Services Research 2021 21:472

    Content type: Research article

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  30. In 2015 the US President’s Emergency Plan for AIDS Relief (PEPFAR) initiated its Geographic Prioritization (GP) process whereby it prioritized high burden areas within countries, with the goal of more rapidly ...

    Authors: Daniela C. Rodríguez, Diwakar Mohan, Caroline Mackenzie, Jess Wilhelm, Ezinne Eze-Ajoku, Elizabeth Omondi, Mary Qiu and Sara Bennett

    Citation: BMC Health Services Research 2021 21:457

    Content type: Research article

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  31. The significant contribution of community-based distribution (CBD) of family planning services and contraceptives to the uptake of contraceptives in hard-to-reach communities has resulted in the scaling-up of ...

    Authors: Lucy Nyundo, Maxine Whittaker, Lynne Eagle and David R. Low

    Citation: BMC Health Services Research 2021 21:437

    Content type: Research article

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  32. Implementation research has emerged as part of evidence-based decision-making efforts to plug current gaps in the translation of research evidence into health policy and practice. While there has been a growin...

    Authors: Chukwudi A. Nnaji, Charles S. Wiysonge, Joseph C. Okeibunor, Thobile Malinga, Abdu A. Adamu, Prosper Tumusiime and Humphrey Karamagi

    Citation: BMC Health Services Research 2021 21:414

    Content type: Research article

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  33. Adequate financing is a crucial function, securing that physical rehabilitation services (i.e., physiotherapy, occupational therapy, prosthetics and orthotics) are available with no financial hardship. Like ma...

    Authors: Saeed Shahabi, Parviz Mojgani, Hosein Shabaninejad, Ahmad Ahmadi Teymourlouy, Masoud Behzadifar and Kamran Bagheri Lankarani

    Citation: BMC Health Services Research 2021 21:413

    Content type: Research article

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  34. Access to contraceptive services is a cornerstone of human well-being. While Community Health Volunteers (CHVs) promote family planning in Kenya, the unmet need for contraceptives among youth remains high. CHV...

    Authors: Hermen Ormel, George Oele, Maryse Kok, Happiness Oruko, Beatrice Oluoch, Eefje Smet and Dorcus Indalo

    Citation: BMC Health Services Research 2021 21:405

    Content type: Research article

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  35. Multi-professional obstetric emergencies training is one promising strategy to improve maternity care. Sustaining training programmes following successful implementation remains a challenge. Understanding, and...

    Authors: Kiren Ghag, Rachna Bahl, Cathy Winter, Mary Lynch, Nayda Bautista, Rogelio Ilagan, Matthew Ellis, Isabel de Salis and Timothy J. Draycott

    Citation: BMC Health Services Research 2021 21:384

    Content type: Research article

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  36. In response to the rising global NCD burden, humanitarian actors have rapidly scaled-up NCD services in crisis-affected low-and-middle income countries. Using the RE-AIM implementation framework, we evaluated ...

    Authors: Éimhín Ansbro, Tobias Homan, Jamil Qasem, Karla Bil, Mohammed Rasoul Tarawneh, Bayard Roberts, Pablo Perel and Kiran Jobanputra

    Citation: BMC Health Services Research 2021 21:381

    Content type: Research article

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  37. In Kenya, street-connected children and youth (SCY) have poor health outcomes and die prematurely due to preventable causes. This suggests they are not accessing or receiving adequately responsive healthcare t...

    Authors: Embleton Lonnie, Shah Pooja, Gayapersad Allison, Kiptui Reuben, Ayuku David, Wachira Juddy, Apondi Edith and Braitstein Paula

    Citation: BMC Health Services Research 2021 21:363

    Content type: Research article

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  38. The Integrated eDiagnosis Approach (IeDA), centred on an electronic Clinical Decision Support System (eCDSS) developed in line with national Integrated Management of Childhood Illness (IMCI) guidelines, was im...

    Authors: Sophie Sarrassat, James J. Lewis, Arsene S. Some, Serge Somda, Simon Cousens and Karl Blanchet

    Citation: BMC Health Services Research 2021 21:354

    Content type: Research article

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  39. SMS for Life was one of the earliest large-scale implementations of mHealth innovations worldwide. Its goal was to increase visibility to antimalarial stock-outs through the use of SMS technology. The objectiv...

    Authors: Carmen Sant Fruchtman, Selemani Mbuyita, Mary Mwanyika-Sando, Marcel Braun, Don de Savigny and Daniel Cobos Muñoz

    Citation: BMC Health Services Research 2021 21:343

    Content type: Research article

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  40. Patient experience is a key measure widely used to evaluate quality of healthcare, yet there is little discussion about it in China using national survey data. This study aimed to explore rural and urban diffe...

    Authors: Dantong Zhao, Zhongliang Zhou, Chi Shen, Rashed Nawaz, Dan Li, Yangling Ren, Yaxin Zhao, Dan Cao and Xiaohui Zhai

    Citation: BMC Health Services Research 2021 21:330

    Content type: Research article

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  41. Nigeria faces an increase in the burden of non-communicable diseases (NCDs), including cardiovascular diseases (CVDs), leading to an estimated 29% of all deaths in the country. Nigeria has an estimated hyperte...

    Authors: Ikechukwu A. Orji, Abigail S. Baldridge, Kasarachi Omitiran, Mainzhao Guo, Whenayon Simeon Ajisegiri, Tunde M. Ojo, Gabriel Shedul, Namratha R. Kandula, Lisa R. Hirschhorn, Mark D. Huffman and Dike B. Ojji

    Citation: BMC Health Services Research 2021 21:322

    Content type: Research article

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  42. Correctional facilities are an underutilized venue for reaching young adults who have not vaccinated for human papillomavirus (HPV). The objective of this study was to identify factors that are associated with...

    Authors: Amanda Emerson, Molly Allison, Lisa Saldana, Patricia J. Kelly and Megha Ramaswamy

    Citation: BMC Health Services Research 2021 21:309

    Content type: Research article

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  43. Rapid spread of COVID-19 forced the public to turn to community pharmacies as the most accessible points of primary healthcare, overloading pharmacy services. The objectives of this research were to detect and...

    Authors: Jelena Jovičić-Bata, Nebojša Pavlović, Nataša Milošević, Neda Gavarić, Svetlana Goločorbin-Kon, Nemanja Todorović and Mladena Lalić-Popović

    Citation: BMC Health Services Research 2021 21:304

    Content type: Research article

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  44. Although donor transitions from HIV programs are more frequent, little research exists seeking to understand the perceptions of patients and providers on this process. Between 2015 and 2017, PEPFAR implemented...

    Authors: Henry Zakumumpa, Ligia Paina, Jess Wilhelm, Freddie Ssengooba, Eric Ssegujja, Moses Mukuru and Sara Bennett

    Citation: BMC Health Services Research 2021 21:302

    Content type: Research article

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  45. Blackpool is one of the most deprived Local Authority (LA) areas in England; in April 2015 the Blackpool Better Start (BBS) Partnership was allocated £45 million over 10 years from the Big Lottery Fund (BLF) a...

    Authors: C. F. Mills, E. Lowrie, K. Kinloch and E. Hall

    Citation: BMC Health Services Research 2021 21:283

    Content type: Research article

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  46. The aim of this study was to identify the range of ways that safety net hospitals (SNHs) have been empirically operationalized in the literature and determine the extent to which patterns could be identified i...

    Authors: Jennifer L. Hefner, Tory Harper Hogan, William Opoku-Agyeman and Nir Menachemi

    Citation: BMC Health Services Research 2021 21:278

    Content type: Research article

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