Evidence map›Paper›PMID 41975831›Full record

ReviewHealthcare (Basel, Switzerland)2026

Enhancing Healthcare Services for Vulnerable Aging Populations: A Comparative Analysis of Puerto Rico and International Case Studies.

Varun Nannuri, Sara Belligoni, Darya Sulkouskaya, Rutwa Shah, Om Pathak, Fernando I Rivera

Abstract readReview
In one paragraph

Review in Healthcare (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Varun NannuriBurnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32827, USA.ORCID 0009-0002-2945-2126
Sara BelligoniJohn Jay College of Criminal Justice, The City University of New York, New York, NY 10019, USA.
Darya SulkouskayaBurnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32827, USA.
Rutwa ShahPuerto Rico Research Hub, University of Central Florida, Orlando, FL 32816, USA.ORCID 0009-0005-1964-8012
Om PathakBurnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32827, USA.ORCID 0009-0009-0163-9133
Fernando I RiveraPuerto Rico Research Hub, University of Central Florida, Orlando, FL 32816, USA.ORCID 0000-0003-0523-8248

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study examines healthcare system strains in rapidly aging societies through a comparative analysis of Puerto Rico, Cuba, Japan, the Philippines, and South Korea. While existing research documents global aging and physician migration trends, few studies explore how these challenges manifest in conjunction with each other. Puerto Rico presents a critical case, with 24% of its population aged 65+, severe physician migration, and systemic underfunding under U.S. Medicaid structures. Using a structured comparative case methodology, we analyze policy responses across four nations with divergent approaches: Cuba, Japan, the Philippines, and South Korea. Data from government reports, academic literature, and World Health Organization (WHO) datasets show that (1) proactive medical education investments outperform reactive measures, (2) dedicated long-term care financing is essential but structurally unavailable in Puerto Rico, and (3) territorial status in the case of Puerto Rico, constrains policy innovation. Conventional aging frameworks are challenged by revealing how high-income territories can exhibit low systemic adaptability. Proposed are targeted reforms for Puerto Rico, including Medicaid restructuring and workforce incentives, with broader implications for aging societies under constrained sovereignty. This study fills a critical space in understanding how geopolitical contexts shape healthcare system vulnerabilities.

Indexed as

aging populationCubahealthcare systemsJapanphysician migrationPuerto RicoSouth Koreathe Philippines

Identifiers

PMID41975831
PMCPMC13072849

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.