The supply and demand for rehabilitation health workforce in Saudi Arabia.

Background: Adequate supply of rehabilitation health workforce is a prerequisite for enhancing access to rehabilitation care. However, there is a lack of comprehensive data regarding the supply of rehabilitation health workers in Saudi Arabia. Aims: To determine the need for, and supply of, rehabilitation workforce, and investigate the relationship between rehabilitation workforce supply and rehabilitation needs in Saudi Arabia. Methodology: This cross-sectional study measured the ratio of physiotherapists and occupational therapists per 10 000 population. Data were obtained from the Ministry of Health, family health survey and census data of the General Authority for Statistics and published literature. To assess the need for rehabilitation services, we computed a composite disability index based on 3 variables: count of individuals with physical disabilities, those with chronic diseases, and those aged > 65 years. Determinants of the supply potential were population size, rural population percentage, and physician supply. Data were analysed using descriptive statistics and simple linear regression. Results: The ratios of physiotherapists and occupational therapists working at the Ministry of Health facilities were 0.69 and 0.03 per 10 000 population, respectively. Overall rehabilitation health workforce ratio was 0.73 per 10 000. Supply varied across regions, from 0.4 for Riyadh to 2.5 for Al Jouf. Nine regions exceeded the overall ratio. Rehabilitation need index ranged from 0.144 in Najran to 0.212 in Aseer. No significant associations were found between rehabilitation workforce supply on one hand, and need and other potential determinants on the other hand. Conclusion: The rehabilitation workforce supply in Saudi Arabia surpassed the regional and global averages, but was lower than the average for high-income countries. Workforce distribution varied by region across the country and was not related to need. It is important to consider the need for rehabilitation services and context-specific factors when determining the optimal size and distribution of the rehabilitation health workforce in Saudi Arabia.

Budget impact analysis for three glucagon-like peptide-1 receptor agonist-based therapies for type 2 diabetes mellitus management in Saudi Arabia.

BACKGROUND AND OBJECTIVES: This study presents a budget impact analysis (BIA) conducted in Saudi Arabia, evaluating the cost implications of adopting semaglutide, tirzepatide, or dulaglutide in the management of type 2 diabetes mellitus (T2DM) patients. The analysis aims to assess the individual budgetary impact of these treatment options on healthcare budgets and provide insights for decision-makers. METHODS: A prevalence-based BIA was developed using real-world and clinical trials data. The model considered disease epidemiology, medication prices, diabetes management expenses, cardiovascular (CV) complications costs, and weight reduction savings over a 5-year time horizon. One-way and probabilistic sensitivity analyses (OWSA, PSA) were performed to assess the robustness of the results. RESULTS: Over a 5-year period, the cumulative budget impact for semaglutide, tirzepatide, and dulaglutide were 85,923,089 USD, 169,790,195 USD, and 94,558,356 USD, respectively. Hypothetical scenarios considering price parity between semaglutide and tirzepatide are associated with financial impacts of 85,923,091 USD and 86,475,335 USD, respectively. In the public sector, semaglutide showed the lowest incidence of 3-point major adverse CV events (3P-MACE), with tirzepatide leading in weight loss and HbA1c reduction, and dulaglutide presenting the highest 3P-MACE rates and least improvements in HbA1c and weight. A breakeven analysis suggested that tirzepatide's list price would need to be $199.91 lower than its current list price to achieve budget impact parity with semaglutide based on currently available evidence. Results from the OWSA suggested that risk reductions for CV events were key drivers of budget impact. PSA results were confirmatory of base-case analyses. CONCLUSIONS: CV cost-offsets and drug acquisition considerations may make semaglutide a favorable use of resources for Saudi budget planners and decision-makers. These results were robust to assumptions regarding the list price of tirzepatide.

The Role of the Temporary Contracting and Visiting Doctor Program in Supporting the Health System during and after COVID-19 Pandemic in Saudi Arabia.

Background: Adequate supply of health workforce with proper skills is essential to deliver appropriate health services in normal times and during disasters. Objective: To describe the role of the Saudi Temporary Contracting and Visiting Doctors Program in the provision of critical care during COVID-19 pandemic, and in the clearance of the surgical backlog thereafter. Methods: We reviewed reports of General Directorate of Health Services and Saudi Ministry of Health annual statistical books to obtain the following data: number of temporary healthcare professionals contracted from 2019 to 2022; number of intensive care unit beds before and during COVID-19 pandemic; volume of elective surgeries before, during and after COVID-19 pandemic. Results: In 2020, intensive care unit beds increased from 6341 to 9306 in governmental hospitals in response to COVID-19 pandemic. A total of 3539 temporary healthcare professionals were recruited from April to August 2020 to contribute towards staffing the added beds. During the recovery period from COVID-19 pandemic, 4322 and 4917 temporary health care professionals were recruited in 2021and 2022 respectively. Elective surgeries volume increased from 5074 in September 2020 to 17533 in September 2021 to 26242 in September 2022, surpassing the volume of surgeries in pre-COVID-19 period. Conclusions: In response to COVID-19 pandemic, and through the existing temporary contracting program, the Saudi Ministry of Health was able to recruit temporary staff of verified credentials in a timely manner, to supplement the existing staff, for activation of the newly added intensive care unit beds, and for clearing the resulting surgical backlog.

The Temporary Contracting and Visiting Doctors Program in the Saudi Ministry of Health: Development, Reform and Outputs.

Background: Temporary Contracting and Visiting Doctors' Program was initiated by the Saudi Ministry of Health to address issues of sustainable supply of healthcare professionals in the whole country and in remote areas in particular. Objective: This study aimed to describe the experience of the Saudi Temporary Contracting and Visiting Doctors' Program, the undertaken reform steps and the program outputs. Methods: We conducted a case study and reviewed documents of the Temporary Contracting and Visiting Doctors' Program to obtain data about the program's development and steps of reform. We also extracted data about the number of different types of temporary contracts, the program budget and the healthcare professionals registered on the "VISITORs" platform. Results: Scope of the Temporary Contracting and Visiting Doctors' Program had widened from contracting physicians from outside Saudi Arabia to include healthcare professionals from inside the country. The program's reform efforts included: formation of a governing central committee, development of guidelines, adoption of decentralized implementation system and modified budget release system, development of electronic staff bank and e-recruitment system and the introduction of virtual healthcare under the scope of the program. During the program evolution the number of temporary contracts has increased steadily, specifically the more efficient part-time contract variety, the contracts with physicians with rare sub-specialties, and contracts with Saudi healthcare professionals. Conclusion: Reform undertaken in the Saudi Temporary Contracting and Visiting Doctors' Program ensures needs-based recruitment, efficient use of resources, and supply of staff of verified quality.