{
  "abstract": "Objective: To assess the implementation of quality-of-care and patient-safety policies across the WHO European Region and their association with population health outcomes.\n\nMethods: This study used an exploratory, ecological cross-sectional design. We constructed a summary count (0–9) of nine national quality-of-care and patient-safety policies to capture the breadth of policy adoption, and used exploratory multivariable linear regression to examine cross-sectional associations with selected outcomes, adjusting for health-workforce density and public spending on health.\n\nResults: Many countries lacked national action plans for quality and patient safety, with only around one-third implementing both. Implementation of a national quality-of-care plan was associated with higher healthy life expectancy (1.68 additional years; punadjusted = 0.033, p = 0.144), a lower probability of premature death from cardiovascular disease, cancer, diabetes and chronic respiratory diseases (−3.33 percentage points; punadjusted = 0.049, p = 0.144), and reduced under-five mortality (−4.06 deaths per 1,000 live births; punadjusted = 0.023, p = 0.144). Implementing a greater number of national policies was associated with small increases in healthy life expectancy (0.29 years per additional policy; punadjusted = 0.043, p = 0.167) and lower under-five mortality (−0.72 deaths per 1,000 live births per additional policy; punadjusted = 0.018, p = 0.162), while associations with other outcomes were weaker and often non-significant.\n\nConclusion: Given the ecological cross-sectional design, limited adjustment and multiple testing, these findings should be treated as exploratory and non-causal and used as a basis for more detailed longitudinal research.",
  "abstract_shown": true,
  "affiliations": [
    "Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, Naples, Italy"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Liesbeth Borgermans"
    },
    {
      "affs": [
        0
      ],
      "name": "Ana Marques Domingues"
    },
    {
      "affs": [
        0
      ],
      "name": "Anna Crispo"
    },
    {
      "affs": [
        0
      ],
      "name": "Válter R. Fonseca"
    },
    {
      "affs": [
        0
      ],
      "name": "Lenio Capsaskis"
    },
    {
      "affs": [
        0
      ],
      "name": "Jennifer Hall"
    },
    {
      "affs": [
        0
      ],
      "name": "João Breda"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/b4gxw41dm6xhq.bib",
  "cited_by": 0,
  "doi": "10.3389/fpubh.2026.1904393",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13696396/",
  "id": "b4gxw41dm6xhq",
  "issns": [
    "2296-2565"
  ],
  "landing_url": "https://doi.org/10.3389/fpubh.2026.1904393",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "3605|Healthcare Quality and Management"
    ]
  ],
  "openalex": "W7221542944",
  "pdf_url": "https://europepmc.org/articles/PMC13696396?pdf=render",
  "pmcid": "PMC13696396",
  "pmid": "42935894",
  "published": "2026-10-12",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/b4gxw41dm6xhq.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:45Z",
      "native_id": "PMC13696396",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fpubh.2026.1904393"
    },
    {
      "first_seen": "2026-10-30T12:20:22Z",
      "native_id": "10.3389/fpubh.2026.1904393",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fpubh.2026.1904393/full"
    },
    {
      "first_seen": "2026-10-30T12:22:24Z",
      "native_id": "MED:42935894",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42935894"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2296-2565",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Use of quality-of-care and patient-safety policies in the WHO European region: an ecological cross-sectional exploratory analysis of policy adoption and health outcomes",
  "title_text": "Use of quality-of-care and patient-safety policies in the WHO European region: an ecological cross-sectional exploratory analysis of policy adoption and health outcomes",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:33:44Z",
  "url": "https://research.draconitic.com/paper/b4gxw41dm6xhq",
  "venue": "Frontiers in Public Health",
  "versions": []
}