{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T18:55:40Z","timestamp":1793904940052,"version":"4.8.0"},"reference-count":120,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T00:00:00Z","timestamp":1710115200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Social Determinants of Health and Health Services"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:p>This study examines the health care utilization pattern, associated financial catastrophes, and inequality across Indian states to understand the subnational variations and aid the policy makers in this regard. Data from recent National Sample Survey (2017\u20132018), titled, \u201cHousehold Social Consumption: Health,\u201d covering 113,823 households, was employed in the study. Descriptive statistics, Erreygers concentration index (CI), and recentered influence function decomposition were applied in the study. We found that, in India, 7 percent of households experienced catastrophic health expenditure (CHE) and 1.9 percent of households were pushed below poverty line due to out-of-pocket expenditure on hospitalization. Notably, outpatient care was more burdensome (CHE: 12.1%; impoverishment: 4%). Substantial interstate variations were observed, with high financial burden in poorer states. Utilization of health care services from private health care providers was pro-rich (hospitalization CI 0.31; outpatient CI 0.10), while the occurrence of CHE incidence was pro-poor (hospitalization CI \u22120.10; outpatient CI \u22120.14). Education level, economic status, health insurance, and area of residence contributed significantly to inequalities in utilization of health care services from private providers and financial burden. The high financial burden of seeking health care necessitates the need to increase public health spending and strengthen public health infrastructure. Also, concerted efforts directed towards increasing awareness about health insurance and introducing comprehensive health insurance products (covering both inpatient and outpatient services) are imperative to augment financial risk protection in India.<\/jats:p>","DOI":"10.1177\/27551938241230761","type":"journal-article","created":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T06:57:49Z","timestamp":1710140269000},"page":"206-223","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["An Examination of Inter-State Variation in Utilization of Healthcare Services, Associated Financial Burden and Inequality: Evidence from Nationally Representative Survey in India"],"prefix":"10.1177","volume":"54","author":[{"family":"Aashima","sequence":"first","affiliation":[{"name":"University School of Management and Entrepreneurship, Delhi Technological University, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7468-1249","authenticated-orcid":false,"given":"Rajesh","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Humanities and Social Sciences, National Institute of Technology Kurukshetra, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,3,11]]},"reference":[{"key":"bibr1-27551938241230761","unstructured":"World Health Organization.\n                      Tracking Universal Health Coverage: 2021 Global Monitoring Report\n                      . Available: https:\/\/www.who.int\/data\/monitoring-universal-health-coverage. Date Accessed: April 27, 2022."},{"key":"bibr2-27551938241230761","unstructured":"World Health Organization and International Bank for Reconstruction and Development \/ The World Bank.\n                      Global monitoring report on financial protection in health\n                      2021. License: CC BY-NC-SA 3.0 IGO. Available: https:\/\/www.who.int\/publications\/i\/item\/9789240040953. Date Accessed: January 01, 2023."},{"key":"bibr3-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1186\/s12961-022-00886-3"},{"key":"bibr4-27551938241230761","first-page":"21","volume":"1","author":"Saksena P","year":"2010","journal-title":"World Health Report"},{"key":"bibr5-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0269113"},{"key":"bibr6-27551938241230761","unstructured":"World Health Organization.\n                      Distribution of health payments and catastrophic expenditures methodology\n                      . World Health Organization. 2005."},{"key":"bibr7-27551938241230761","unstructured":"World Health Organization & World Bank.\n                      Monitoring progress towards universal health coverage at country and global levels: framework, measures and targets\n                      . World Health Organization. 2014. Available: https:\/\/apps.who.int\/iris\/handle\/10665\/112824."},{"key":"bibr8-27551938241230761","unstructured":"The World Bank.\n                      High-Performance Health-Financing for Universal Health Coverage: Driving Sustainable, Inclusive Growth in the 21st Century\n                      . 2019. Available: https:\/\/www.worldbank.org\/en\/topic\/universalhealthcoverage\/publication\/high-performance-health-financing-for-universal-health-coverage-driving-sustainable-inclusive-growth-in-the-21st-century. Date Accessed: July 8, 2022."},{"key":"bibr9-27551938241230761","doi-asserted-by":"publisher","DOI":"10.5772\/intechopen.91414"},{"key":"bibr10-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1093\/wbro\/lkz009"},{"key":"bibr11-27551938241230761","unstructured":"World Bank; World Health Organization; JICA; The Global Fund to Fight AIDS, Tuberculosis and Malaria; and the African Development Bank.\n                      UHC in Africa: A Framework for Action\n                      . Washington, DC: World Bank. 2016. License: Creative Commons Attribution CC BY 3.0 IGO."},{"key":"bibr12-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001701"},{"key":"bibr13-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-018-0749-5"},{"issue":"1","key":"bibr14-27551938241230761","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1744-8603-10-1","volume":"10","author":"Alam K","year":"2014","journal-title":"Global Health."},{"key":"bibr15-27551938241230761","unstructured":"World Health Organization.\n                      An empirical model of access to health care, health care expenditure and impoverishment in Kenya: learning from past reforms and lessons for the future\n                      . World Health Organization. 2006."},{"key":"bibr16-27551938241230761","unstructured":"Central Bureau of Health Intelligence.\n                      National Health Profile\n                      2019. Available: http:\/\/www.cbhidghs.nic.in\/showfile.php?lid=1147. Date Accessed: July 28, 2022."},{"key":"bibr17-27551938241230761","unstructured":"World Health Organization.\n                      Global Health Expenditure Database.\n                      2019. Available: https:\/\/apps.who.int\/nha\/database\/country_profile\/Index\/en. Date Accessed: June 27, 2022."},{"key":"bibr18-27551938241230761","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_67_19"},{"key":"bibr19-27551938241230761","unstructured":"Selvaraj S, Karan KA, Srivastava S, Bhan N, Mukhopadhyay I. India health system review. New Delhi: World Health Organization, Regional Office for South-East Asia; 2022. Available: https:\/\/apo.who.int\/publications\/i\/item\/india-health-system-review#:\u223c:text=The%20India%20Health%20System%20Review%20presents%20a%20comprehensive,heterogeneity%20in%20health%20and%20development%20indicators%2C%20and%20contexts. Date Accessed: August 02, 2022."},{"key":"bibr20-27551938241230761","unstructured":"Oxfam India\n                      .\n                      Analysing Regulation of Private Healthcare in India\n                      . 2021. Available: https:\/\/www.oxfamindia.org\/knowledgehub\/workingpaper\/analysing-regulation-private-healthcare-india. Date Accessed: August 02, 2022."},{"key":"bibr21-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1080\/20479700.2019.1665882"},{"key":"bibr22-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1177\/2394481118774489"},{"key":"bibr23-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpopen.2021.100040"},{"issue":"38","key":"bibr24-27551938241230761","first-page":"49","volume":"45","author":"Baru R","year":"2010","journal-title":"Econ Polit Wkly."},{"key":"bibr25-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1016\/j.cegh.2020.03.014"},{"key":"bibr26-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32804-0"},{"key":"bibr27-27551938241230761","author":"World Bank","year":"2022","journal-title":"Healthy States Progressive India"},{"key":"bibr28-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czn046"},{"key":"bibr29-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1007\/s10389-018-0904-x"},{"key":"bibr30-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2018.02.017"},{"key":"bibr31-27551938241230761","doi-asserted-by":"crossref","unstructured":"Yadav J, Menon GR, John D. Disease-specific out-of-pocket payments, catastrophic health expenditure and impoverishment effects in India: An analysis of National Health Survey data. 2021;19(5):769\u2013782.","DOI":"10.1007\/s40258-021-00641-9"},{"key":"bibr32-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0196106"},{"key":"bibr33-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-10828-3"},{"key":"bibr34-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1007\/s11205-016-1388-0"},{"key":"bibr35-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0260628"},{"key":"bibr36-27551938241230761","doi-asserted-by":"publisher","DOI":"10.4103\/ijmr.IJMR_90_17"},{"key":"bibr37-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0166775"},{"key":"bibr38-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0205510"},{"key":"bibr39-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1002\/hpm.2649"},{"key":"bibr40-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-017-0517-y"},{"key":"bibr41-27551938241230761","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.75808.1"},{"issue":"1","key":"bibr42-27551938241230761","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12939-018-0897-7","volume":"18","author":"Bowser D","year":"2019","journal-title":"Int J Equity Health."},{"key":"bibr43-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1177\/0972063414539597"},{"key":"bibr44-27551938241230761","volume-title":"Toward Universal Health Coverage: The Role of Health Insurance System","author":"Feyisa D.","year":"2022"},{"key":"bibr45-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2023.115792"},{"key":"bibr46-27551938241230761","unstructured":"Unit Level data & Report on NSS 75th Round for Schedule- 25.0, July 2017 -June 2018, (Social Consumption: Health).\n                      Available: https:\/\/mospi.gov.in\/web\/mospi\/download-tables-data\/-\/reports\/view\/templateTwo\/16202?q=TBDCAT. Date Accessed: December 01, 2021."},{"key":"bibr47-27551938241230761","unstructured":"Central Bureau of Health Intelligence.\n                      National Health Profile\n                      2020. Available: http:\/\/www.cbhidghs.nic.in\/showfile.php?lid=1147. Date Accessed: April 28, 2022."},{"key":"bibr48-27551938241230761","unstructured":"India: Health of the Nation\u2019s States The India State-Level Disease Burden Initiative Indian council of medical research public health foundation of India institute for health metrics and evaluation. Available: https:\/\/phfi.org\/india-health-of-the-nations-states\/"},{"key":"bibr49-27551938241230761","unstructured":"CMIE States of India. Available: https:\/\/statesofindia.cmie.com\/. Date Accessed: September 01, 2023."},{"key":"bibr50-27551938241230761","unstructured":"Government of India Planning Commission.\n                      Press Note on Poverty Estimates, 2011-12.\n                      Available: https:\/\/www.niti.gov.in\/sites\/default\/files\/2020-05\/press-note-poverty-2011-12-23-08-16.pdf. Date Accessed: December 31, 2021."},{"key":"bibr51-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czp032"},{"issue":"1","key":"bibr52-27551938241230761","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1744-8603-8-1","volume":"8","author":"Engelgau MM","year":"2012","journal-title":"Global Health."},{"key":"bibr53-27551938241230761","author":"Nanda M","journal-title":"Health Policy Plan."},{"key":"bibr54-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1007\/s10389-023-01981-7"},{"key":"bibr55-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)13861-5"},{"key":"bibr56-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1596\/978-0-8213-6933-3"},{"key":"bibr57-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1177\/1536867X1601600112"},{"key":"bibr58-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2008.02.003"},{"key":"bibr59-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1002\/hec.953"},{"key":"bibr60-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-019-1106-z"},{"key":"bibr61-27551938241230761","author":"Rezaei S","journal-title":"Int J Soc Econ."},{"key":"bibr62-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-8368-7"},{"key":"bibr63-27551938241230761","doi-asserted-by":"publisher","DOI":"10.3961\/jpmph.20.035"},{"key":"bibr64-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-4076(02)00161-6"},{"key":"bibr65-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1108\/S1049-2585(2013)0000021010"},{"key":"bibr66-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1186\/s13561-016-0134-2"},{"key":"bibr67-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2016.03.006"},{"key":"bibr68-27551938241230761","unstructured":"Heckley G, Gerdtham UG, Kjellsson G.\n                      A New Approach to Decomposition of a Bivariate Rank Dependent Index Using Recentered Influence Function Regression\n                      . 2014:36. Working Paper."},{"key":"bibr69-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1007\/s10389-019-01068-2"},{"key":"bibr70-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1016\/j.seps.2021.101025"},{"key":"bibr71-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-017-0624-9"},{"key":"bibr72-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1177\/1536867X20909690"},{"key":"bibr73-27551938241230761","volume-title":"Health Service Provision in Andhra Pradesh and Telangana: Assessing Facility Capacity, Costs of Care, and Patient Perspectives","author":"Institute for Health Metrics and Evaluation (IHME), and Public Health Foundation of India (PHFI)","year":"2018"},{"key":"bibr74-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61188-9"},{"key":"bibr75-27551938241230761","author":"Nanda M","journal-title":"Health Care Science"},{"key":"bibr76-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1596\/0-8213-5029-3"},{"key":"bibr77-27551938241230761","first-page":"1","author":"Rao KD","year":"2014","journal-title":"Human Resources Background Paper"},{"key":"bibr78-27551938241230761","unstructured":"Anand S, Fan V, World Health Organization.\n                      The health workforce in India\n                      . World Health Organization. 2016."},{"key":"bibr79-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2016-000216"},{"key":"bibr80-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1080\/17516234.2019.1601065"},{"key":"bibr81-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32387-0"},{"key":"bibr82-27551938241230761","unstructured":"Mukherjee S, Chaudhuri A. Outpatient care and expenses: Can they be ignored in health insurance programmes.\n                      Institute Of Development Studies Kolkata\n                      . 2020."},{"issue":"2","key":"bibr83-27551938241230761","volume":"12","author":"Prinja S","journal-title":"PloS one"},{"key":"bibr84-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-050077"},{"issue":"4","key":"bibr85-27551938241230761","first-page":"61","volume":"52","author":"Ghosh S","year":"2017","journal-title":"Econ Polit Wkly"},{"key":"bibr86-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-020-05692-7"},{"key":"bibr87-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-019-4849-8"},{"key":"bibr88-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-09107-4"},{"key":"bibr89-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2017.03.053"},{"key":"bibr90-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-018-5431-8"},{"key":"bibr91-27551938241230761","unstructured":"Sabharwal NS, Mishra VK, Naik AK, Holmes R, Hagen-Zanker J. How does social protection contribute to social inclusion in India. Evidence from the National health insurance programme (RSBY) in Maharashtra and Uttar Pradesh: overseas development Institute. 2014."},{"key":"bibr92-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1016\/j.cegh.2017.04.002"},{"key":"bibr93-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1186\/1478-4505-11-29"},{"key":"bibr94-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1080\/13648470.2015.1135787"},{"key":"bibr95-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1177\/2158244015614607"},{"key":"bibr96-27551938241230761","first-page":"46(20):56","author":"Rajasekhar D","year":"2011","journal-title":"Econ Polit Wkly."},{"key":"bibr97-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1016\/j.glmedi.2023.100009"},{"key":"bibr98-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1177\/0256090918804390"},{"key":"bibr99-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1136\/postgradmedj-2020-137760"},{"key":"bibr100-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1080\/17441692.2019.1651369"},{"key":"bibr101-27551938241230761","unstructured":"Comptroller and Auditor General of India. Report No. 11 of 2023- Performance Audit of Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana \u2013 Union Government (Civil) National Health Authority Ministry of Health and Family Welfare. Available: https:\/\/cag.gov.in\/en\/audit-report\/details\/119060. Date Accessed: September 01, 2023."},{"key":"bibr102-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1007\/s40258-023-00838-0"},{"key":"bibr103-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1177\/0972820116653335"},{"key":"bibr104-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1017\/S1744133118000257"},{"key":"bibr105-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1007\/s41775-020-00093-3"},{"key":"bibr106-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1002\/hpm.3272"},{"key":"bibr107-27551938241230761","doi-asserted-by":"publisher","DOI":"10.25133\/JPSSv28n1.006"},{"key":"bibr108-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1177\/0972063419868561"},{"key":"bibr109-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1177\/0019556118780093"},{"key":"bibr110-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06777-7"},{"key":"bibr111-27551938241230761","first-page":"3","volume":"5","author":"Haelle T","year":"2013","journal-title":"Sci Am."},{"key":"bibr112-27551938241230761","unstructured":"Nagarajan R.\n                      AIIMS doctors lead the way, wage war on unnecessary medical tests\n                      . The Times of India. 2014. Available: https:\/\/timesofindia.indiatimes.com\/india\/aiims-doctors-lead-the-way-wage-war-on-unnecessary-medical tests\/articleshow\/37425725.cms."},{"key":"bibr113-27551938241230761","author":"Bang A","year":"2012","journal-title":"Public Health Foundation of India"},{"key":"bibr114-27551938241230761","author":"Kumar R","journal-title":"Int Trans Oper Res."},{"key":"bibr115-27551938241230761","unstructured":"Government of India.\n                      Department of Pharmaceuticals. 2019-2020 Annual report.\n                      Available: http:\/\/janaushadhi.gov.in\/Data\/Annual%20Report%202019-20_21052020.pdf. Date Accessed: July 15, 2022."},{"key":"bibr116-27551938241230761","doi-asserted-by":"crossref","DOI":"10.1017\/S1463423619000537","volume":"20","author":"Jain R","year":"2019","journal-title":"Prim Health Care Res Dev."},{"key":"bibr117-27551938241230761","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0135112"},{"key":"bibr118-27551938241230761","unstructured":"Kumar A, Sarwal R. \u201c\n                      Health Insurance for India\u2019s Missing Middle\n                      \u201d. Niti Aayog. 2021. Available: https:\/\/www.niti.gov.in\/sites\/default\/files\/2021-10\/HealthInsurance-forIndiasMissingMiddle_28-10-2021.pdf. Date Accessed: September 04, 2022."},{"key":"bibr119-27551938241230761","unstructured":"World Health Organization (WHO).\n                      Primary Health Care on the Road to Universal Health Coverage: 2019 Global Monitoring Report\n                      . 2020. Available: https:\/\/www.who.int\/publications\/i\/item\/9789240029040. Date Accessed: December 25, 2022."},{"key":"bibr120-27551938241230761","unstructured":"National Health Policy 2017.\n                      Ministry of health and Family Welfare Government of India\n                      . Available: https:\/\/www.nhp.gov.in\/\/NHPfiles\/national_health_policy_2017.pdf. Date Accessed: Jan 02, 2023."}],"container-title":["International Journal of Social Determinants of Health and Health Services"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/27551938241230761","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/27551938241230761","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/27551938241230761","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:04:51Z","timestamp":1777507491000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/27551938241230761"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,11]]},"references-count":120,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1177\/27551938241230761"],"URL":"https:\/\/doi.org\/10.1177\/27551938241230761","relation":{},"ISSN":["2755-1938","2755-1946"],"issn-type":[{"value":"2755-1938","type":"print"},{"value":"2755-1946","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,11]]}}}