https://journal.achsm.org.au/index.php/achsm <p>The Asia Pacific Journal of Health Management (APJHM) is a peer-reviewed journal for managers of organisations offering healthcare and aged care services. The APJHM aims to promote the discipline of health management throughout the region by facilitating the transfer of knowledge among readers by widening the evidence base for management practices.<br /><br />*Print 1(1);2006 - 5(1);2010 Online 4(2);2009 - current<br />*ISSN 2204-3136 (online); ISSN 1833-3818 (print)</p> Australasian College of Health Service Management en-US Asia Pacific Journal of Health Management 1833-3818 https://journal.achsm.org.au/index.php/achsm/article/view/6580 <p>The objective of this applied, quantitative, non-experimental, cross-sectional correlational study conducted in a specialized radiodiagnostic center in Piura, Peru, in 2026 was to determine the association between administrative management and the user care process, establishing how each management dimension (planning, organization, direction, and control) relates to that process. Two 24-item questionnaires with a five-point Likert scale were administered to 300 participants—comprising 12 staff members via census and 288 users via convenience sampling—to evaluate the scores and levels (low, medium, and high) of both variables and their dimensions, alongside instrument reliability estimated through a pilot of 30 participants. Hypotheses were tested using Spearman's rho at a significance level of 0.05, revealing good internal consistency for the instruments and demonstrating a positive and high association between the two variables (<span class="math-inline" data-math="\rho = 0.779" data-index-in-node="212">$\rho = 0.779$</span>; <span class="math-inline" data-math="p &lt; 0.001" data-index-in-node="226">$p &lt; 0.001$</span>). By dimension, the coefficients were 0.679 for direction, 0.665 for control, 0.648 for planning, and 0.534 for organization (<span class="math-inline" data-math="p &lt; 0.001" data-index-in-node="126">$p &lt; 0.001$</span> in all cases), with half of the participants rating administrative management (50.3%) and user care (49.3%) as high. The conclusions indicate that better-rated administrative management goes together with better-rated user care, with all four dimensions contributing to the association (organization being the weakest), while noting that the cross-sectional correlational design does not allow causal inference and single-center convenience sampling limits generalizability. Consequently, the findings suggest prioritizing the formal definition of roles and procedures and systematic monitoring through indicators, addressing keywords such as administrative management, user care, radiodiagnosis, service quality, user satisfaction, and operational efficiency.</p> Jimena Natalie Bruno Reto Richard Pedro Fernando Chuquillanqui Ruiz Copyright (c) 21 2 https://journal.achsm.org.au/index.php/achsm/article/view/6579 <p><strong>Objective: </strong>To appraise the evidence for angiotensin-converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB), finerenone and sodium–glucose cotransporter-2 inhibitors (SGLT2i), alone and combined, in diabetic and non-diabetic chronic kidney disease (CKD), and to identify implications for health service managers and policy makers.</p> <p><strong>Approach: </strong>Comprehensive review informed by a structured search of PubMed/MEDLINE, Embase, the Cochrane Library, ClinicalTrials.gov and congress proceedings (January 1990 to October 2026). Phase 3 randomised trials, individual-participant meta-analyses and current guidelines in adults with CKD were prioritised and synthesised narratively.</p> <p><strong>Context: </strong>CKD affects about one in ten adults worldwide, including up to 434 million adults in Asia, and residual risk of kidney failure and cardiovascular death remains high despite renin–angiotensin system inhibition (RASi).</p> <p><strong>Main findings: </strong>ACEi/ARB remain foundational; dual RAS blockade is harmful, and withdrawal in advanced CKD gives no kidney benefit. SGLT2i reduced kidney progression by 28–39% irrespective of diabetes, down to an eGFR of 20 mL/min/1.73 m². Finerenone reduced kidney and cardiovascular events in type 2 diabetes, slowed eGFR decline in non-diabetic CKD and reduced albuminuria in type 1 diabetes; across 14,574 participants it lowered kidney composite risk by 24%. Simultaneous finerenone and empagliflozin reduced albuminuria by about 52%, 29–32% more than either alone, without excess hyperkalaemia. Hyperkalaemia, the early eGFR dip and volume depletion are predictable and manageable.</p> <p><strong>Conclusions: </strong>Layered therapy, with maximally tolerated ACEi/ARB, an SGLT2i where indicated and finerenone for persistent albuminuria, should be standard care. Underuse is now the main barrier. Health services can narrow the gap through systematic albuminuria testing, protocol-driven potassium-guided titration led by nurses or pharmacists, formulary access and audit. Hard-outcome combination trials and implementation research are needed.</p> Antoine Zgheib Copyright (c) 21 2