{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T04:05:50Z","timestamp":1784261150285,"version":"3.55.0"},"reference-count":41,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Diabetesfonden and the Gothenburg Diabetes Association"},{"name":"Stiftelsen Gunnar Holmgrens Minne"},{"name":"Sveriges Ortopedingenj\u00f6rers F\u00f6rening"},{"name":"Adlerbertska forskningsstiftelsen"},{"name":"Health & Medical Care Committee of the V\u00e4stra G\u00f6taland Region"},{"DOI":"10.13039\/501100009758","name":"Hans Dahlbergs Stiftelse f\u00f6r Milj\u00f6 och H\u00e4lsa","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009758","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Research and Development Council of the County of G\u00f6teborg and S\u00f6dra Bohusl\u00e4n"},{"name":"IngaBritt & Arne Lundbergs Forskningsstiftelse"},{"DOI":"10.13039\/501100009756","name":"Greta och Einar Askers Stiftelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009756","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Stiftelsen Felix Neubergh"},{"DOI":"10.13039\/100009389","name":"Stiftelsen Promobilia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009389","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Stiftelsen Skobranschens Utvecklingsfond"},{"name":"Leader N\u00e4rheten, project L\u00f6nsamt Gr\u00f6nt F\u00f6retagande"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["INQUIRY"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In sustainable development, time is a physically limited resource affecting economic and social sustainability. In healthcare systems, the time of healthcare staff is linked to economic constraints, while the time patients spend travelling and receiving treatment affects social sustainability, including access to healthcare services. Reducing time costs in healthcare may contribute to several of the 17 Sustainable Development Goals (SDGs) within Agenda 2030. This exploratory study aimed to: (i) probe whether a low-budget questionnaire combined with standardised data processing could estimate time costs for patients, their employers, and healthcare personnel associated with a healthcare visit; (ii) generate initial estimates of sustainability impacts of time costs, in physical and monetary terms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study explored whether this low-budget approach could generate results of sufficient quality to inform choices aimed at improving healthcare accessibility. Patients with diabetes attending a healthcare facility for therapeutic footwear completed a questionnaire regarding time spent travelling and treatment. Healthcare staff time was recorded. Results were analysed and presented in physical and monetary terms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The questionnaire generated information that was processed into estimates of parameters of strategic importance for choices supporting sustainability and access in healthcare systems in urban and rural areas. For the 101 patients included, the total time used was 360.6 hours, of which 23% represented employers\u2019 time, 49% patients\u2019 private time, and 28% healthcare staff time. The total estimated monetary value of time consumed was SEK 142,911 (USD 13,466), with 33% related to employers\u2019 time, 13% to patients\u2019 time, and 54% to healthcare staff time. The estimated mean cost per visit ranged from SEK 1,233 (USD 116.2) to SEK 1,944 (USD 183.2).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The low-cost questionnaire and data-processing approach appears promising for estimating time costs for patients, employers, and healthcare staff, thereby supporting decisions aimed at improving healthcare accessibility and sustainability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00469580261468784","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T11:43:06Z","timestamp":1784029386000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Can a Low-Budget Questionnaire Support Improved Health Service Accessibility and Sustainability: Results from an Exploratory Study"],"prefix":"10.1177","volume":"63","author":[{"given":"Stefan","family":"Hellstrand","sequence":"first","affiliation":[{"name":"Nolby Ekostrategi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leif","family":"Sundberg","sequence":"additional","affiliation":[{"name":"Gothenburg Diabetes Association"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Karlsson","sequence":"additional","affiliation":[{"name":"University of Gothenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Tranberg","sequence":"additional","affiliation":[{"name":"University of Gothenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4278-0941","authenticated-orcid":false,"given":"Ulla","family":"Hellstrand Tang","sequence":"additional","affiliation":[{"name":"University of Gothenburg"},{"name":"Sahlgrenska University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"e_1_3_8_2_2","author":"United Nations. 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