Alshowair Abdulmajeed, Altamimi Saleh, Alruhaimi Faisal, Tolba Ali, Almeshari Alhanouf, Almubrick Rehab, Abdel-Azeem Amro
Community Health Excellence, Riyadh First Health Cluster Ministry of Health, Riyadh, Saudi Arabia.
Public Health Administration, Riyadh First Health Cluster Ministry of Health, Riyadh, Saudi Arabia.
Clinicoecon Outcomes Res. 2022 May 5;14:371-381. doi: 10.2147/CEOR.S355507. eCollection 2022.
The objectives of the study are to assess the outcome and cost-effectiveness of specialized reference clinics (SRCs) in primary health care centers (PHCCs) of Riyadh First Health Cluster (RFHC), then to estimate the patient satisfaction among clients utilizing such SRCs.
This facility-based study was conducted in Riyadh city, Saudi Arabia among six PHCCs in RFHC that contain SRCs. Records of all patients utilizing SRCs and their referral information were studied along two years. An in-depth interview was conducted with health care providers in SRCs. Cost analysis was calculated by the financial support group within RFHC. Also, a randomly selected 400 subjects utilizing SRCs were asked to fill patient satisfaction questionnaire.
Over two years, a total number of 55,084 patients utilized SRCs among different specialties. Most of these patients (86.7%) had full medical service within PHC-SRCs with no need for referral to hospitals. SRCs are significantly effective in decreasing the burden on hospitals in most specialties (p < 0.001). This effectiveness is significantly increased during the 2nd year of service. The time spent until appointment is significantly reduced from an average of six weeks in hospitals to an average of one week in SRCs. SRCs are very cost-effective as they reduced referrals to hospitals by 86.7% among 55,084 patients who utilized SRCs over two years, saving total costs of about 14.08 million Saudi Riyals (3.75 million US dollars). Most of the specialties are cost-effective except for urology and general surgery clinics, which are not cost-effective. Patient satisfaction is high regarding all service domains. The overall patient satisfaction score increased from 71.4% in the 1st year up to 73.2% in the second year.
PHC-SRCs are cost-effective health services and their creation is reasonable and beneficial in terms of reducing costs of health care delivery, reducing the burden on hospitals, and improving patient satisfaction.
本研究的目的是评估利雅得第一健康集群（RFHC）初级卫生保健中心（PHCC）中专科参考诊所（SRC）的成效和成本效益，然后估算使用此类SRC的患者的满意度。
这项基于机构的研究在沙特阿拉伯利雅得市RFHC的六个设有SRC的PHCC中进行。研究了所有使用SRC的患者的记录及其转诊信息，为期两年。对SRC的医疗服务提供者进行了深入访谈。成本分析由RFHC内的财务支持小组进行。此外，随机选取400名使用SRC的受试者填写患者满意度问卷。
在两年时间里，共有55084名患者在不同专科使用了SRC。这些患者中的大多数（86.7%）在初级卫生保健 - SRC中获得了全面医疗服务，无需转诊至医院。SRC在减轻大多数专科的医院负担方面具有显著效果（p < 0.001）。这种效果在服务的第二年显著增强。预约前等待时间从医院的平均六周显著减少至SRC的平均一周。SRC具有很高的成本效益，因为在两年内使用SRC的55084名患者中，转诊至医院的比例降低了&86.7%，节省了约1408万沙特里亚尔（375万美元）的总成本。除泌尿外科和普通外科诊所不具有成本效益外，大多数专科都具有成本效益。患者对所有服务领域的满意度都很高。患者总体满意度得分从第一年的71.4%提高到了第二年的73.2%。
初级卫生保健 - SRC是具有成本效益的卫生服务，其设立在降低医疗服务成本、减轻医院负担以及提高患者满意度方面是合理且有益的。
