Study of the relation between quality of inpatient care and early readmission for diabetic patients at a hospital in the Eastern province of Saudi Arabia

Readmission of diabetic patients after discharge from hospital has potential value as a quality of care indicator. This retrospective cohort and case-control study aimed to determine the readmission rate for diabetic patients within 28 days after discharge and the association between quality of inpatient care and unplanned readmission. An audit of records was conducted in a hospital in the Eastern province of Saudi Arabia during 2000-2008. The rate of unplanned readmission of patients originally admitted with diabetes mellitus [n = 1125] was 5.2%. Comparison of data from readmitted patients [n = 62] and a sample of non re admitted patients [n = 62] showed that adherence by health care providers to American Diabetes Association guidelines for admission work-up [OR 0.91, 95% Cl: 0.85-0.99] and readiness for discharge criteria [OR 0.89, 95% Cl: 0.84-0.95] were significantly more likely to decrease the risk of readmission within 28 days

WHO/INRUD patient care and facility-specific drug use indicators at primary health care centres in Eastern province, Saudi Arabia

This study aimed to measure the performance of primary health care centres in Eastern province, Saudi Arabia, using the WHO/International Network of Rational Use of Drugs patient care and facility-specific drug use indicators. In a cross-sectional study, 10 health centres were selected using systematic random sampling. A total of 300 patients were interviewed while visiting the centre from January to March 2011 and 10 pharmacists from the same centres were interviewed. Average consultation time was 7.3 min [optimal >/-30 min], percentage of drugs adequately labelled was 10% [optimal 100%] and patient's knowledge of correct dosage was 79.3% [optimal 100%]. The percentage of key drugs in stock was only 59.2% [optimal 100%]. An overall index of rational facility-specific drug use was calculated and applied to rank the health centres for benchmarking

WHO/INRUD drug prescribing indicators at primary health care centres in Eastern province, Saudi Arabia

Appropriate use of drugs is an essential element in achieving quality of health and medical care for patients and the community as a whole. This study aimed to measure the drug prescribing performance of primary health care centres in Eastern province, Saudi Arabia, using the WHO/International Network of Rational Use of Drugs core drug prescribing indicators. In a retrospective cohort study 10 health centres were selected using systematic random sampling. A total of 1000 prescribing encounters were investigated from January to December 2010. Mean values were: number of drugs per encounter 2.4 [optimal

Appointment delay among patients attending endocrinology outpatient clinic of Al-Qatif central hospital, Kingdom of Saudi Arabia

Patient's appointment is a fixed mutual agreement between patient and any health care giver to obtain the required medical services that suit his/her health needs. Appointment delays in outpatient clinics are the most important cause for patients' dissatisfaction due to the complications that might develop during the wait time and consequently affecting their health status. The present study aimed to measure the appointment time from referral from primary health care centers to get the first appointment for patients cared for the most common diseases in the endocrinology outpatient clinic of Al-Qatif Central Hospital, and study reasons and effect of delayed appointment on patients. It is a cross- sectional descriptive study. The target population was medical records and database of 200 patients, all the working staff, and patients attended the study clinic during the year 2008. Results revealed that 60.5% of the patients had delayed appointment, while 39.5% had no delayed appointment. The acceptable appointment time delay for diabetes meilitus, hypothyroidism and hyperthyroidism were [chi= 55 +/- 8.66, 95 +/- 5.00 and 19 +/- 4.35 days respectively] in comparison to the current appointment time dalay [chi=118.3 +/- 81.0, 113.6 +/- 70.4 and 87.9 +/- 49.7 days respectively]. Most of the patients with delayed appointment were dissatisfied [74.4%] compared to only 67% of those with no delayed appointment. Also, 22.3% of, the patients with delayed appointment perceived that their health status was affected to a great extent in comparison to only 10.1% of those with no delayed appointment. Among the reasons mentioned by the working staff for delayed appointment were increased number of "no show" patients, population served by the study hospital, and follow up visits [83.3% each]. Accordingly, the present study recommended availability of a center for diagnosis and treatment of diabetes mellitus in addition to the outpatient clinic of the study hospital; developing a system for reminding patients with the date of appointment e.g. SMS, telephone call,... etc; and establishing a prioritizing system for appointments based on emergency of the conditions

Patients' rights at different health facilities in Alexandria

Patients' rights are universal values that we have to adopt. However, it is not so easy to put such values and principles into effect. This study aims at determining the extent of implementation of patients' rights at different health facilities and the degree of patients' preferences for these rights. A household interview survey was conducted and 205 participants were willing to participate. The survey was chosen to be carried out at Toson region, Montaza District, in Alexandria due to the availability of diverse health facilities. Results revealed that explanation of illness, procedures, and benefits and side effects of medication were implemented to a higher extent in the family health unit and center than in the other facilities [97.7%, 86.4% and 97.7%, respectively]. The possibility of choosing a named physician and of taking a second opinion were nil [0.0%] in the Health Insurance facilities, the Maternal and Child Health center, and the Ministry of Health and Population general hospital. Participation in decision making was implemented for only 22.0% of cases. However, it had a high degree of preference especially among secondary and university educated persons [90.8%]. Getting a summary report on discharge was preferred by 89.8% of participants, although it was exercised by only 3.9% of them. It was recommended that explanation of illness and procedures must be implemented in Health Insurance facilities, Maternal and Child Health center and Ministry of Health and Population hospital. Physicians should learn to involve patients in decision making, and health care planners have to investigate the applicability of choosing a named physician and of taking a second opinion as they were associated with high levels of patients' preferences

Access to conventional and complementary medicine in a squatter area in Alexandria

WHO [1996] stated that access to health is everybody's right and the ethical basis of any country's health policy should be "Health for All". Meanwhile, there is a shift towards use of complementary and alternative medicine [CAM]. The reasons that people give for using CAM are diverse: some perceive that conventional health care is ineffective, while others consider CAM to be more consistent with their own values and beliefs about health. This study aims at determining utilization of conventional and complementary medicine of a population sample in Ancient Abou Qir region. A household survey was conducted during the period of March till May 2004, covering a number of 337 houses. The total population sample amounted to 1480. Results revealed that 33.9% of the sample was not covered by health insurance. Majority of the sample [80.4%] had no governmental hospital admissions during the last 5 years, which was attributed to lack of confidence of services offered [47.6%], lack of resources [specialists, investigations and medication] [37.9%], and bad art of care [17.5%]. On the other hand, one-fourth of the sample [24.9%] utilized complementary medicine. Herbal therapy was the most commonly practiced method [88.1%], followed by cupping therapy [Hegama] [14.3%]. Based on the aforementioned findings, it is recommended to improve the quality of governmental hospital inpatient services, increase health insurance coverage as much as possible, and including CAM in medical and nursing curricula