ArticleRisk management and healthcare policy2026
Stakeholder Perspectives on the Adaptability of Hospital Drug Formularies to Disease Patterns: A Modified Q-Methodology Study in Vietnam.
Article in Risk management and healthcare policy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Hospital drug formularies function within Complex Adaptive Systems (CAS), where the alignment between drug supply and disease patterns is critical for patient care and cost-effectiveness. However, measuring this responsiveness is challenging due to conflicting stakeholder priorities and a lack of standardized assessment tools. Objective: This study aims to analyze the perspectives of three key stakeholder groups Methods: We employed a modified Q-methodology approach involving 69 experts (20 non-clinical, 28 clinical, and 21 policymakers). A Q-set of 92 indicators across 9 criteria was developed. Participants evaluated these indicators using a 5-point Likert scale to determine levels of consensus and discordance, rather than a orced-distribution sort, to assess the absolute importance of adaptability metrics. Results: Most criteria achieved consensus with a Mean > 4.0, particularly for "Usage" and "Storage" adaptations. However, significant discordance was observed regarding "Drug availability", "Procurement", and "Outputs and outcomes". Notably, the correlation for "Outputs and outcomes" between non-clinical and policy stakeholders was statistically weak (r=0.09, p=0.356), highlighting a profound strategic gap. Conclusion: The study proposes a management framework that monitors drug list adaptability across four levels: non-adaptive, passive, active, and advanced adaptive. Success requires enhanced collaboration between specialized teams and a shift from efficiency-based to resilience-based performance metrics.
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