104 papers
Improving health systems means finding smarter ways to deliver care, reduce errors, and ensure patients receive the best possible treatment. This field explores how hospitals and clinics can function more effectively, focusing on the practical changes that lead to better outcomes for everyone involved. It is less about discovering new drugs and more about refining the everyday processes that keep our healthcare networks running smoothly.
At Gist.Science, we track every new preprint in this category from medRxiv to bring you the latest research immediately. Our team processes these papers to provide both detailed technical summaries for experts and clear, plain-language explanations for anyone interested in how healthcare can improve. We believe that understanding these systemic changes is vital for building a more resilient future.
Below are the latest studies and insights from the health systems and quality improvement community, sorted by their recent submission dates.
This paper describes a participatory co-design process in West Cameroon that successfully developed a context-specific, multi-component intervention to improve informed consent and debriefing for caesarean sections by integrating the distinct priorities of women, healthcare providers, and hospital directors into a feasible quality-improvement framework.
This mixed-methods pilot study demonstrates that three co-created peer support interventions (peer counselling, telesupport groups, and participatory video) are acceptable and effective in improving knowledge, self-efficacy, and mental well-being for people with leprosy reactions in Indonesia, though their impact varies by setting due to specific contextual barriers like time constraints and digital access.
This 42-year cohort study demonstrates that among individuals with a family history of colorectal cancer, those who show no advanced neoplasia during the first decade of colonoscopic screening can be stratified into a low-risk group with a 30-year cancer risk lower than the general population, thereby enabling more personalized and cost-effective surveillance programs.
This retrospective study of 371 stroke patients in Ondo State, Nigeria, reveals that the majority experience significant delays in reaching tertiary care due to complex, multi-step pathways often beginning with non-hospital providers, highlighting the urgent need for interventions that improve public stroke awareness and strengthen referral linkages across all healthcare sectors.
Using data from the 2024 Nigeria Demographic and Health Survey, this study reveals that DHS-defined infecund/menopausal status among women aged 45–49 is strongly associated with marital history, parity, and socioeconomic factors, though these cross-sectional correlations should not be interpreted as causal due to the survey's reliance on self-reported rather than clinically confirmed menopause.
This mixed-methods case study of Argentina's REMEDIAR program over two decades reveals that while the initiative successfully ensured free access to essential medicines for the uninsured through a hybrid financing model, its long-term sustainability and effectiveness depend on transitioning from external conditionalities to a nationally funded, institutionally redesigned system that integrates federal coordination with subnational strategies to withstand macroeconomic volatility.
This paper introduces QFIRE, a high-performance Rust-based prompt firewall that addresses critical gaps in healthcare AI safety by combining positive security scope constraints, PHI-specific detection, and de-obfuscation techniques to effectively block legitimate-looking data exfiltration and out-of-scope requests that state-of-the-art injection classifiers miss, all while maintaining low latency and deterministic auditability.
This study demonstrates that large language models generate discharge summaries for longer, complex hospitalizations that are preferred by both hospitalists and primary care physicians over human-authored versions, offering superior quality, readability, and completeness while reducing omissions and supporting better post-discharge care transitions.
This registry-based observational study in Finland demonstrates that the introduction of a 24/7 chat-based digital clinic significantly increased primary care coverage and the proportion of digital encounters by 2025, with usage concentrated among younger, healthier individuals managing minor acute conditions, while approximately 60% of care pathways were resolved entirely within the digital channel.
This mixed-methods study of 4,258 housing referrals within New York City's WholeYouNYC network reveals a 45% acceptance rate and identifies systemic barriers such as CBO response delays, missing documentation, and client engagement challenges, prompting recommendations for standardized protocols and automated follow-ups to improve service connection.