Healthcare Transformation in Saudi Arabia: An Overview Since the Launch of Vision 2030

Exploring the utilization and perceptions of pre-travel health consultations in primary care settings in Saudi Arabia: a cross-sectional study

BACKGROUND

International travel exposes individuals to diverse health risks, necessitating proactive pre-travel health preparations. Saudi Arabia has witnessed increased outbound travel. This study addresses a critical gap in knowledge by investigating the utilization and perceptions of pre-travel health consultations among adults in the Eastern Province of Saudi Arabia.

METHODS

This cross-sectional study surveyed patients at the Family and Community Medicine Center of Imam Abdulrahman Bin Faisal University during January 2024 to explore perceptions of pre-travel health consultations among the Saudi Arabian population. Adults aged 18 years or older in the waiting area were invited to complete a self-administered questionnaire.

RESULTS

Of the 772 participants, 624 (80.8%) engaged in international travel within the last year. However, 593 (76.8%) had never sought pre-travel health consultations. Age, gender, and education level significantly influenced the pursuit of pre-travel health advice, with older individuals, females, and those with higher educational attainment more likely to seek consultations. Participants perceived vaccination recommendations (597, 77.4%) and disease prevention information (678, 87.8%) as crucial parts of pre-travel health consultations. However, barriers to seeking advice included perceived low risk (445, 74.8%), lack of awareness (215, 36.3%), time constraints (128, 21.6%), and cost concerns (92, 15.5%).

CONCLUSION

The low prevalence of pre-travel health consultations among travelers highlights the need for targeted educational campaigns and the integration of travel health services into primary healthcare. Addressing the identified barriers and leveraging preferred information sources are crucial steps towards enhancing the uptake of pre-travel health consultations, ultimately improving the health and safety of international travelers from the region.

Saudi Cerebral Palsy Register (SCPR): Protocol on the Methods and Technical Details

This protocol presents a comprehensive proposal for the establishment of the Saudi Cerebral Palsy Register (SCPR), a crucial project for investigating and addressing the prevalence, etiology, and management of cerebral palsy (CP) in Saudi Arabia. The SCPR will not only provide a robust database for ongoing research and analysis but will also serve as a platform for investigating the causes of CP, implementing preventative strategies, and improving the quality of care and outcomes for people with CP and their families in Saudi Arabia. Detailed case definitions, inclusion/exclusion criteria, and data collection protocols are discussed to ensure the integrity and comparability of the data. The plan also outlines strategic funding, institutional and government endorsement, sustainability considerations, potential challenges and proposed solutions, and expected outcomes and impact. These include creating research and educational opportunities, fostering regional and international collaborations, and significantly contributing to CP prevention strategies. Overcoming anticipated obstacles, such as stigma, institutional policies, and collaborations, and securing both necessary funding and endorsements are highlighted as critical for the success of the SCPR. The project is not only aligned with promote prevention of health risks, a target of Vision 2030 in Saudi Arabia, but is also expected to have a substantial impact on the health and quality of life of people with CP and their families in Saudi Arabia, serving as inspiration for similar efforts worldwide.

Knowledge of Antibiotic Use and Resistance Among Medical Students in Saudi Arabia

Introduction

The World Health Organization (WHO) has placed great importance on providing thorough, hands-on training to medical students regarding responsible and appropriate antibiotic prescription. Accordingly, this study aims to gain a better perspective on the knowledge of antibiotic use and resistance among medical students in Jeddah, Saudi Arabia.

Methods

A questionnaire-based cross-sectional study was conducted among medical students in Jeddah, Saudi Arabia, from 1 September to 30 November 2023. The categorical variables are presented as frequencies and percentages. Mann-Whitney and Kruskal-Wallis tests were used to compare the outcomes, and generalised linear regression models were constructed to predict the students' knowledge of antibiotics and antibiotic resistance. A p-value of < 0.05 was taken to indicate statistical significance.

Results

The study included a total of 353 medical students. First-year medical students represented 28.60% of the participants, while females represented 76.80%. Most participants (92.40%) agreed that antibiotics are effective against bacteria, whereas only 25.20% agreed about antibiotics' effectiveness against viruses. More than half of the participants (53.80%) believed that bacterial infections can be resolved without antibiotics. A significant majority (78.20%) agreed that the unnecessary use of antibiotics makes them less effective. More than half of the participants (56.90%) acknowledged that infections caused by resistant bacteria are increasing in Saudi Arabia, and two-thirds (75.10%) believed that healthcare workers could effectively reduce antibiotic resistance in Saudi Arabia. Male students had low knowledge about antibiotics [Beta = -1.429, 95% CI (-2.618, -0.241), P value = 0.019].

Conclusion

Improving the curriculum by incorporating topics like resistance mechanisms and responsible antibiotic usage can address the knowledge gap among male students. This comprehensive training, utilizing various educational methods, is essential for fostering responsible antibiotic practices among future healthcare professionals.

Navigating Challenges in Teleradiology Implementation: A Case Study from Saudi Arabia's Healthcare System

Background and Aims

Teleradiology is the practice of interpreting medical images acquired in an off-site location. Teleradiology has been utilized widely around the world to address the needs for subspecialty coverage, workload balancing, and as a solution for understaffing. This study aims to assess the perceptions of teleradiology among radiologists in Saudi Arabia, investigate any challenges they might face, and explore strategies that would help mitigate those challenges.

Methods

A cross-sectional study using a self-administered electronic questionnaire was conducted to collect responses from radiologists practicing or having practiced teleradiology in Saudi Arabia. The questionnaire was conducted from January to June 2023, and 105 responses were included in the analysis. The responses were analyzed using chi-squared testing to investigate factors affecting the radiologists' perceptions.

Results

The most common challenges for teleradiology were access to patients' health records, access to prior imaging exams, and concerns about image quality assurance. Around 74% of participants perceived teleradiology to be beneficial for geographic, after-hour, and subspecialties coverage. Teleradiology was also perceived to help reduce the turn-around time of radiology interpretations. Better communication with referring physicians and technologists was seen as a way to help improve teleradiology services.

Conclusion

The findings suggest that the perception of teleradiology's challenges and benefits may not be influenced by experience, workplace, or subspecialty. Emphasis should be placed on the importance of quality assurance of images acquired remotely. Addressing the concerns and challenges related to access to patients' health records is also crucial to ensuring the successful implementation of teleradiology in the country.

Hypertension clinical pathway: Experience of Aseer region, Saudi Arabia

BACKGROUND

Hypertension (HTN) is a common chronic health problem with many complications and high morbidity rates. This study aimed to describe the HTN pathway, to assess the performance of screening and registration programs, to explore the challenges and suggest solutions for those challenges.

MATERIALS AND METHODS

This study was conducted in primary care centers in the Aseer region, Saudi Arabia, at the end of 2022. The study consisted of three parts namely: Screening for HTN, registration of known hypertensive patients and opinions of representatives of Primary Healthcare Centers (PHCs) on challenges to the implementation of HTN pathway and suggestions for overcoming these challenges. Three Google forms were developed by the investigators to achieve the objectives of this study. The first two forms were completed by doctors and nurses at each PHC and reviewed by the leader of HTN pathway, and the third form completed by a representative of each PHC. SPSS version 26 was used for data management and analysis. Chi-square test was used to determine association between categorical variables; binary logistic regression analysis was performed to determine the correlates of being hypertensive and having good control of HTN.

RESULTS

A total of 159,243 individuals were screened for HTN, 55% of whom were females and 94% were Saudis. The prevalence of HTN was 13%; 70% were overweight or obese and 14% had diabetes. The total registered number of patients was 55,628; 50% had good HTN control. Major challenges were inadequate health coaches, care coordinators, laboratory and radiology facilities, lack of coordination with hospitals, and ineffective appointment system.

CONCLUSION

This study revealed that the current HTN pathway was successful with regard to screening and registration of patients with HTN. Many challenges need an executive plan with SMART objectives to optimize the care for HTN patients in the region.

Obstetrics and gynecology patients' perceptions about bedside teaching at a Saudi teaching hospital

BACKGROUND

Bedside teaching (BST) is a crucial component of medical education. It entails the interaction of students with patients in outpatient clinics and inpatient wards under the supervision of their tutors in order to improve the clinical skills of the students and, ultimately, patient outcomes. This teaching relies heavily on patients' willingness and cooperation. The aim of this study was to assess the perception of Obstetrics and Gynecology (OB/GYN) patients regarding the presence and participation of medical students in BST.

MATERIALS AND METHODS

A cross-sectional survey was conducted among OB/GYN patients at the outpatient clinics and inpatient wards at King Fahd Hospital of the University (KFHU) in Al-Khobar from January 1 to April 30, 2023. Data were collected online through the Google Drive survey tool using a validated and pilot tested questionnaire. Data were analyzed utilizing SPSS version 26.0. Chi-squared test was employed to test for association between two categorical variables. Multiple logistic regression model was used to determine variables associated with positive attitudes.

RESULTS

A total of 507 patients completed online questionnaire. A highly positive patients' attitude was observed toward the presence and participation of medical students during BST with a mean score of 81.8 ± 10.4. The acceptance rates were higher for female students compared to male students (91.9% vs 61.7%) and for senior doctors compared to junior doctors (89.9% vs 58.9%). Patients who came to the outpatient clinics were also more likely to accept students' presence than those who went to hospital wards. Age, marital status, and previous clinic visits were positively associated with the acceptance level of the presence and involvement of medical students in BST without a significant difference.

CONCLUSION

In general, patients had a good perception of medical students' engagement in their care and that the gender of the medical students/doctors and clinical setting could affect this perception. Raising patients' awareness of their valuable role in male medical students' and doctors' education should be raised, as this will increase their acceptance during BST.

Evaluating the Effectiveness of a Self-Management Program on Patients Living with Chronic Diseases

Background

Chronic diseases are a major public health concern globally, and the position in Saudi Arabia is no exception. The Chronic Disease Self-Management Program (CDSMP) is a widely used intervention process to address care of chronic conditions. However, its effectiveness in a Saudi context has not been extensively studied. Therefore, this study aimed at evaluating the post-intervention outcomes of the CDSMP in Saudi Arabia.

Materials and Methods

The study utilized a qualitative design on patients with chronic conditions. Data were collected through two focus group sessions with 15 participants who had completed the CDSMP. A thematic analysis technique was used for data analysis.

Results

Three key themes emerged from analysis of the qualitative data obtained through the focus groups: the perceived benefits from participation in the CDSMP workshop; the impact of the CDSMP workshop on improving health status and quality of life; and, the cultural acceptability of the CDSMP. The study also found that the CDSMP was effective in improving participants' self-management skills and quality of life. Additional benefits included increased motivation for behavioral change, enhanced confidence regarding self-care of chronic conditions, improved communication with healthcare providers, and better coping strategies.

Conclusion

This study provides valuable insights into the effectiveness of the CDSMP in addressing chronic conditions in Saudi Arabia. The program's emphasis on self-management skills and peer support aligns with the cultural values of Saudi Arabia. However, applying the CDSMP across various chronic conditions should be addressed in future interventions.

Nurses' ethical responsibilities: Whistleblowing and advocacy in patient safety

BACKGROUND

In the dynamic landscape of healthcare, nurses play a crucial role as ethical stewards, responsible for whistleblowing, nurse advocacy, and patient safety. Their duties involve ensuring patient well-being through ethical practices and advocacy initiatives.

AIM

This study investigates the ethical responsibilities of nurses regarding whistleblowing and advocacy in reporting concerns about patient safety.

RESEARCH DESIGN

A cross-sectional study utilized cluster and simple random sampling to gather a representative sample of actively practicing registered nurses. Data collection involved a demographic form, Nurse Whistleblowing Intentions Scale, Nursing Advocacy Scale, and Clinical Decision-Making Scale.

PARTICIPANTS AND RESEARCH CONTEXT

The study utilizing a robust sample size determination formula for reliable findings included 96 diverse nurses, predominantly females. Engaged actively in direct patient care across various outpatients clinics. The recruitment process specifically sought individuals with expertise in safety protocols and reporting, contributing to a nuanced understanding of the study's focus.

ETHICAL CONSIDERATIONS

Ethical approval was obtained from the ethics committee of the university and the hospitals involved. Written consent was obtained from the participants. A thorough ethical review was conducted to guarantee participant protection and adherence to ethical principles.

RESULTS

Surveyed nurses demonstrated positive whistleblowing (Overall Mean Score: 3.58), high advocacy (Overall Mean Score: 12.2), and nuanced ethical decision-making for patient safety (Overall Mean Score: 15.78). Demographic factors, such as nationality and ethical training, significantly impacted whistleblowing intentions, while age, gender, and ethical training correlated with nursing advocacy behavior. Associations with experience and qualification emerged in ethical decision-making.

CONCLUSION

The gained insights foster targeted interventions, improving ethical practices, advocacy, and informed decision-making in nursing. This study explores the intricate link between demographics and ethical considerations among surveyed nurses, acting as a catalyst for ongoing initiatives to strengthen the ethical foundation in healthcare sector.

Effects of a team Quality Improvement method in a national clinical audit programme of four clinical specialties in Ministry of Health hospitals in Saudi Arabia

In 2018, the Ministry of Health (MoH) in Saudi Arabia developed a clinical excellence strategy. An objective was to reduce variation in clinical practices in MoH hospitals, particularly for conditions with high mortality in Saudi Arabia, by applying best practice clinical standards and using the clinical audit process to measure clinical practice. The strategy included working with multiprofessional teams in hospitals to implement improvements needed in clinical practice. To test the feasibility of carrying out national clinical audits in MoH hospitals, audits were carried out in 16 MoH hospitals on four clinical subjects-acute myocardial infarction, major trauma, sepsis, and stroke. Clinical expert groups, including Saudi clinicians and an international clinical expert, developed clinical care standards for the four conditions from analyses of international and Saudi clinical guidelines. The audits were designed with the expert groups. Multiprofessional teams were appointed to carry out the audits in designated MoH hospitals. Data collectors in each hospital were trained to collect data. Workshops were held with the teams on the clinical care standards and how data would be collected for the audits, and later, on the findings of data collection and how to use the improvement process to implement changes to improve compliance with the standards. After 4 months, data collection was repeated to determine if compliance with the clinical care standards had improved. Data collected from each hospital for both cycles of data collection were independently reliably tested. All designated hospitals participated in the audits, collecting and submitting data for two rounds of data collection and implementing improvement plans after the first round of data collection. All hospitals made substantial improvements in clinical practices. Of a total of 84 measures used to assess compliance with a total of 52 clinical care standards for the four clinical conditions, improvements were made by hospital teams in 58 (69.1%) measures. Improvements were statistically significant for 34 (40.5%) measures. The project demonstrated that well-designed and executed audits using evidence-based clinical care standards can result in substantial improvements in clinical practices in MoH hospitals in Saudi Arabia. Keys to success were the improvement methodology built into the audit process and the requirement for hospitals to appoint multiprofessional teams to carry out the audits. The approach adds to evidence on the effectiveness of clinical audits in achieving improvements in clinical quality and can be replicated in national audit programmes.

Assessing Medical Emergency E-referral Request Acceptance Patterns and Trends: A Comprehensive Analysis of Secondary Data From the Kingdom of Saudi Arabia

Introduction Patient transfers in emergencies have been linked to reduced mortality rates and enhanced quality of care. The Saudi Medical Appointments and Referrals Centre (SMARC), an e-referral system in the Kingdom of Saudi Arabia (KSA) since 2019, plays a crucial role in ensuring quality and continuity of care. The findings of this study can provide valuable insights into the effectiveness of the e-referral system and identify potential areas for improvement in the management of emergency cases. Objective This study aims to examine e-referral patterns for emergency medical cases throughout all 13 administrative regions of KSA. Concurrently, it estimates the acceptance rate of medical emergency referrals and investigates associated factors among KSA hospitals. Methods This retrospective study utilized secondary data from the SMARC e-referral system, specifically focusing on medical emergency e-referral requests in the entire KSA during 2021. Descriptive univariate analyses were conducted to characterize the referral requests, followed by bivariate analyses to explore associations between factors and referral acceptance. Adjusted multiple logistic regression analyses were then performed to calculate adjusted odds ratios (ORs) and corresponding 95% confidence intervals, controlling for potential confounding variables. Results A total of 29,660 medical emergency referral requests were initiated across all regions of KSA during the study time frame, and, of these, 20,523 (69.19%) were accepted. The average age of patients with a medical emergency referral was 52 years old, and referral requests were higher among Saudis (13,781; 54.18%), males (13,781; 54.18%), and those from the Western region (10,560; 35.60%). Nearly 20,854 (70%) were due to the unavailability of specialized doctors or specialties in facilities. Based on multi-logistic regression, referral request acceptance was high in some factors as follows: compared to the Central region, requests from the Northern, Southern, Eastern, and Western regions had higher acceptance rates at 123%, 64%, 54%, and 46%, respectively. In addition, referral requests that were due to the unavailability of a specialized doctor or medical equipment had higher acceptance rates (19% and 16%), respectively, than those due to the unavailability of a specific specialty. Conclusion This study provides valuable insights into regional variations, sociodemographic factors, and referral reasons within the medical emergency e-referral system in the KSA. By estimating the acceptance rate of medical emergency referrals and investigating associated factors, this analysis confirms the effectiveness of the e-referral system in facilitating access to quality care, particularly for marginalized patients. The study highlights the need for health policy improvements to ensure equitable resource allocation and reduce disparities in healthcare access.

Factors Influencing the Choice of Glucose-Lowering Medications Among Physicians Treating Patients With Type 2 Diabetes

Background The factors considered by physicians when prescribing a glucose-lowering agent to patients with type 2 diabetes (T2D) in real-world settings are not necessarily consistent with those recommended by clinical practice guidelines. Here, we identify the major factors that drive physicians' selection of glucose-lowering agents in the real world and how these factors may differ by physician's specialty.  Methods A web-based survey was conducted among 135 physicians who manage patients with T2D in Saudi Arabia. Physicians were categorized according to their specialty into "specialists" (endocrinologists and/or diabetologists) and "generalists" (internists, family physicians, and primary care physicians). Physicians were asked about the type of glucose-lowering medication that they would typically prescribe in certain clinical scenarios and what factors drive such a selection. Results Sulfonylurea remains the most frequently prescribed second-line agent, as an add-on to metformin, according to 50% of the physicians surveyed. Most physicians (89%) reported prescribing glucagon-like peptide 1 receptor agonists (GLP-1RA) to less than half of their patients with T2D and ischemic heart disease; over two-thirds reported prescribing sodium-glucose cotransporter 2 inhibitors (SGLT-2i) to less than half of their patients with T2D and heart failure. When prescribing GLP-1RAs, the cost was a "major consideration" by 75% and 65% of the specialists and generalists, respectively. Likewise, when prescribing SGLT-2i, the cost was a major consideration by 57% and 71% of the specialists and generalists, respectively. Several other factors differed between the generalists and specialists when prescribing thiazolidinedione (TZD), sulfonylurea, dipeptidyl peptidase 4 (DPP-4) inhibitors, GLP-1RAs, and SLGT-2i, but not insulin.  Conclusion Our findings highlight several challenges faced by physicians in the real world that may prevent them from adopting the latest evidence-based guidelines when managing patients with T2D. Health policies to increase accessibility to novel glucose-lowering agents, particularly for patients with T2D and cardiovascular/renal diseases, are needed.

Factors influencing the likelihood of dental service checkup: results from a survey in Saudi Arabia

Background

The funding and delivery of healthcare including dental care in the Kingdom of Saudi Arabia (KSA, or Saudi Arabia) is undergoing a process of reform. To inform this process, it is important that policymakers are aware of the relationships between service use, specific types of use, and the factors that influence this. Currently, there is a paucity of research in this area in KSA that examines dental service use for checkups at a national level and none that examines differences in this use across regions or that examines explicitly the role of income.

Aims

This study uses the most recent version of the Saudi Health Interview Survey (SHIS) to examine the relationships between the use of dental services for a checkup and socio-demographic characteristics of respondents. Particular focus is given to the differences between regions in service use and the role of socio-demographics within regions.

Methods

Data were taken from SHIS 2013. Descriptive statistics (means and standard errors) were used to characterize the sample. Logistic regression analyses were used to examine the relationship between checkups in the past 12 months and a range of covariates including income and region. The analysis was repeated for sub-samples based on specific regions. No attempt was made to impute missing values.

Results

A sample of 7603 respondents provided complete data for analysis. Fifty-one per cent of the respondents were male, 29% were educated at least to degree level, 25% reported that they floss at least once per day, 69% reported that they brushed their teeth at least once per day, and 11% reported that they had visited the dentist for a checkup in the preceding 12 months. Logistic regression analyses revealed income, region, and oral hygiene habits to be among the significant determinants of the likelihood of dental checkup in the preceding 12 months. In logistic regression analyses at the regional level, different relationships were evident between checkups and socio-demographic characteristics across regions.

Conclusion

Region and income are significant determinants of dental service use for checkups. Differences exist between regions in the relationship between socio-demographic characteristics and the likelihood of getting checkups. Policy changes should reflect the potential differences they might have across regions for which the role of socio-demographic characteristics varies.

The State of Cardiac Rehabilitation in Saudi Arabia: Barriers, Facilitators, and Policy Implications

Cardiovascular disease (CVD) is a critical public health issue in Saudi Arabia, where it is the leading cause of death. The economic burden of CVD in the country is expected to triple by 2035, reaching $9.8 billion. This paper provides an overview of CVD in Saudi Arabia and its risk factors, impact on healthcare, and effects on patients' quality of life. The review emphasizes the potential of cardiac rehabilitation (CR) programs in addressing the CVD epidemic. CR programs have been shown to reduce morbidity, mortality, and hospital readmissions while improving patients' cardiovascular health and overall well-being. However, these programs are underutilized and inaccessible in Saudi Arabia. The paper highlights the urgent need for CR programs in the country and suggests key strategies for implementation. These include increasing patient referrals, tailoring programs to individual needs, enhancing patient education, and making CR accessible through home-based options. Fostering multidisciplinary collaboration and developing tailored guidelines for Arab countries can further enhance the impact of CR programs. In conclusion, this review underscores the vital importance of comprehensive CR programs in Saudi Arabia to combat the rising CVD burden, improve patient quality of life, and align with the goals of the Saudi 2030 Vision for a healthier society.

Colorectal cancer-related resource utilization and healthcare costs in Saudi Arabia

Background

Recently, there has been an increase in the incidence of colorectal cancer in Saudi Arabia. Although numerous studies worldwide have investigated the economic burden of colorectal cancer the information specific to Saudi Arabia remains limited. While advanced cancer treatments offer substantial benefits, they they also come with substantial financial challenges.

Objective

This study aimed to estimate the economic burden of colorectal cancer and identify the primary cost drivers.

Method

This retrospective, single-center cost of illness study examined all patients with colorectal cancer from January 2017 to December 2020. This study used a micro-costing, bottom-up approach to estimate healthcare resource utilization and direct medical costs associated with colorectal cancer.

Result

The study included 326 patients with colorectal cancer. The total direct medical cost for all patients were $19 million, with an annual cost per patient of $58,384. Medication costs were the primary driver of healthcare spending (45%) of the total cost, followed by surgical costs (27%). This study explained cost associated with colorectal cancer, which represents a significant cost to the Saudi healthcare budget. The expected growth and aging of the population and availability of costly treatments may lead to an increase in costs. These findings are valuable for healthcare policymakers seeking to comprehend the economic challenges posed by colorectal cancer.

Evaluating Gaps in Otolaryngology Training: An In-Depth Needs Assessment in Saudi Arabia

BACKGROUND

The landscape of otolaryngology training in Saudi Arabia is undergoing transformation due to the expansion of medical colleges and increased overseas medical scholarships. However, concerns persist regarding the satisfaction and adequacy of surgical education. This study aims to assess gaps in otolaryngology training through an in-depth needs assessment.

METHODS

A cross-sectional study was conducted among 85 otolaryngology-head and neck surgery residency graduates in Saudi Arabia between 2019 and 2021. Participants completed a validated questionnaire assessing deficiencies, importance, and competence in different subspecialty areas. Data were analyzed using descriptive statistics, median comparisons, and Kruskal-Wallis tests.

RESULTS

Participants identified deficiencies in training across domains, with significant variations in specific subspecialties among different regions. Dissatisfaction with clinical discussions, research training, access to simulation labs, and training in emerging subspecialties was evident.

CONCLUSION

The study highlights challenges within otolaryngology training, emphasizing the need for continuous evaluation and adaptation to ensure high-quality and comprehensive training. Addressing these gaps is essential to produce well-rounded otolaryngologists capable of meeting the evolving demands of modern healthcare.

Health care overbooking cost minimization model

Challenges in the health care industry have confounded the provision of quality services for patients. Among many relevant concerns, the drive for cost-effectiveness and efficient care have placed considerable pressure on public health care systems and insurance coverage, amid existing barriers to restructuring entrenched systems. This study closely examines the factors impacting disruptions in health care scheduling systems using a structured case study in the health care industry. The study introduces a novel model to identify optimal overbooking capacity and minimize no-show costs. To address the complexity of this issue on a smaller scale, the model is implemented using a private hospital clinical platform in Jeddah, Saudi Arabia, instituting an overbooking reservation and queuing system in 14 departments to investigate the factors that influence disruptions and inefficacy of service provision, while also introducing a strategy for covering costs. The results identify the maximum amount of overbooking that can be made for each clinic. The cost-saving plan developed is expected to save each clinic a considerable sum, as opposed to randomly overbooking without any cost assumptions. Overall, if the clinics studied implemented this strategy, a total loss of no more than SAR. 2, 408 would be incurred from overbooking, in contrast to the exponentially growing amount of SAR. 10,000 that is currently lost on scheduling errors per year. The loss model developed has practical application as a tool for decision-making that includes no-show cost minimization variables.

Weighing Successes and Challenges in the Establishment of Additional Epilepsy Monitoring Units at the Saudi Arabian Kingdom's Capital City

Epilepsy has a prevalence rate of 6.54 per 1,000 people in Saudi Arabia, making it a prevalent chronic condition. Drug-resistant epilepsy (DRE) is thought to affect one-third of patients; in these circumstances, a complete presurgical examination in the epilepsy monitoring unit (EMU) is necessary. Unfortunately, to accommodate the growing number of referrals, the units' availability and number must be reviewed.

Breast Cancer Awareness Among Medical Students, University of Bisha, Saudi Arabia

Objective

Breast cancer (BC) is a major public health problem in Saudi Arabia and worldwide and significantly affects the health of Saudi women. This study investigates the awareness and predictors of breast cancer among medical students at the University of Bisha, Saudi Arabia.

Methods

This cross-sectional study involved 391 medical students from the University of Bisha (Medicine and Applied Medical sciences) conducted from June to December 2022. Data were collected using a questionnaire with 27 questions. Data were analyzed using Stata/ BE 17.0 for Mac (Intel 64-bit) 1985-2021 Stata Corp LLC. All ethical issues were addressed honestly, including IRB and student consent.

Results

In our study, almost half of the participants (49.36%) had suboptimal knowledge of general BC awareness, which was statistically significantly related to gender and previous participation in BC education (p-value < 0.05). Of the students (57%) showed a positive intention to participate in BC activities. Logistic regression models were used to identify factors that positively predicted student participation and engagement in BC activities. These factors showed a statistically significant relationship (p-value < 0.05), including previous participation (OR =1.557143), female (OR =1.412844), living in rural areas (OR =1.7075471), and medical applied sciences students (OR =1.439252).

Conclusion

Despite half of the participants having suboptimal awareness of BC, there was a significant willingness to engage in BC prevention activities. Therefore, we recommend further analysis to identify gaps in the medical curriculum and update it accordingly, as well as to plan an extracurricular activity to increase student awareness of breast cancer as part of the University of Bisha's social accountability.