Conceptualization and establishment of value-based healthcare in Saudi Arabia: A scoping review.

Objectives: Value-based healthcare (VBHC) represents a paradigm shift in healthcare delivery through optimizing patient outcomes relative to the costs of achieving those outcomes. This scoping review is aimed at revealing critical insights into the conceptualization and establishment of VBHC in the context of Saudi Arabia, a nation in a critical stage of healthcare transformation. Methods: A scoping review was conducted by using online databases and official websites with a timeframe of 2017-2023. This review included 14 pieces of literature, comprising six research articles, six government documents, and two reports. Results: The findings highlight increasing alignment with the definition of global VBHC principles, notably the emphasis on patient outcomes as a primary metric of healthcare value. Furthermore, financial reform has signaled a real move toward VBHC in the Kingdom, through a gradual shift from volume-based payments to value-based payments. However, the diverse interpretations and applications of VBHC across the examined literature indicate a promising stage of implementation characterized by evolving definitions and practices tailored to local needs and constraints. Conclusion: This scoping review describes the current landscape of VBHC conceptualization and establishment, highlighting the substantial progress achieved and the future challenges.

Patient Safety Culture in Primary Healthcare Centers in the Eastern Province of Saudi Arabia.

PURPOSE: This study aimed to explore health-care workers' perceptions of patient safety culture (PSC) at primary health-care centers (PHCs) in the Eastern Province of Saudi Arabia and the factors that influence them. An additional aim was to identify the challenges of adopting PSCs in the PHCs of this region. METHODS: This is a cross-sectional study that adopted a PSC questionnaire from the Agency for Healthcare Research and Quality (AHRQ). The questionnaire was administered online and onsite targeted health-care workers at private, governmental, and quasi-governmental PHCs in the Eastern Province of Saudi Arabia, with 310 participants completing the survey. RESULTS: The overall positive response rate of participants to the survey areas was 43.5% which is lower than the average for the AHRQ data in general. Teamwork scored the highest positive response (68.8%) while Number of Events and non-punitive Response to Error scored the lowest at 10.6% and 30.7%, respectively. In addition, ANOVA and t-tests were used to determine the bivariate associations for the parametric variables. The study reveals statistically significant differences between all demographic variables and overall PSC score, except by age. CONCLUSION: The findings highlight a number of areas for improvement, particularly in relation to event reporting, non-punitive responses, and openness in communication. Consequently, establishing a safety culture in health-care organizations necessitates the elimination of three crucial elements regarding errors: blame, fear, and silence. Error reporting should not just be considered a means of learning from mistakes; it should also be considered the first step towards preventing injury and improving patient safety.

Digital health transformation in Saudi Arabia: A cross-sectional analysis using Healthcare Information and Management Systems Society' digital health indicators.

Background: The digital revolution has had a huge impact on healthcare around the world. Digital technology could dramatically improve the accuracy of diagnosis, treatment, health outcomes, efficiency of care, and workflow of healthcare operations. Using health information technology will bring major improvements in patient outcomes. Purpose: This study aims to measure the readiness for digital health transformation at different hospitals in the Eastern Province, Saudi Arabia in relation to Saudi Vision 2030 based on the four dimensions adopted by the Healthcare Information and Management Systems Society: person-enabled health, predictive analytics, governance and workforce, and interoperability. Methods: The study was conducted with a cross-sectional design using data collected through an online questionnaire from 10 healthcare settings, the questionnaire consists of the four digital health indicators. The survey was developed by Healthcare Information and Management Systems Society for the purpose of assessing the level of digital maturity in healthcare settings. Results: Ten healthcare facilities in the Eastern Province, both private and governmental, were included in the study. The highest total scores for digital health transformation were reported in private healthcare facilities (median score for private facilities = 77, public facilities = 71). The 'governance and workforce' was the most implemented dimension among the healthcare facilities in the study (median = 80), while the dimension that was least frequently implemented was predictive analytics (median score = 70). In addition, tertiary hospitals scored the least in digital transformation readiness (median = 74) compared to primary and secondary healthcare facilities in the study. Conclusion: The results of the study show that private healthcare facilities scored higher in digital health transformation indicators. These results will be useful for promoting policymakers' understanding of the level of digital health transformation in the Eastern Province and for the creation of a strategic action plan.

Shared Decision-Making: A Cross-Sectional Study Assessing Patients Awareness and Preferences in Saudi Arabia.

Background and Aim: Shared decision-making (SDM) has become broadly accepted during the consultation, especially when there are many options of treatment. This study aims to assess patients' levels of awareness and preferences of SDM in Saudi Arabia. Methods: This is a cross-sectional study targeting patients in Saudi Arabia. Two validated questionnaires were used, the first validated questionnaire focuses on measuring knowledge, attitude and experiences of shared-decision making. The second questionnaire is the the Autonomy-Preference-Index focusing on patients' preferences for being involved in SDM. Relevant items to the study aim were chosen and translated into Arabic. Psychometric testing was conducted for Arabic and English versions and tested for content and face validity. The questionnaire administered online via social media channels, between February 2021 and May 2021. A total of 411 respondents completed the questionnaire. Results: The findings showed a positive association between awareness and preferences of SDM among patients in Saudi Arabia. In the awareness of the SDM domain, females reported higher scores than male participants (t = -4.504, P < 0.001). Saudis reported higher scores in their awareness of SDM than non-Saudis (t = 2.569, P = 0.011). Participants without health insurance reported higher scores in their awareness of SDM than those insured (t = -2.130, P = 0.034). Participants with degree have higher knowledge levels than participants with no degree (f = 10.034, P < 0.001). Females reported higher scores in their preferences of SDM than the male (t = -2.099, P = 0.036). Participants who visited private health-care settings in their last clinical encounter reported higher preferences of SDM than participants who received care in other settings (f = 2.653, P = 0.048). Conclusion: The study concludes that the more aware a patient is, the more likely they prefer SDM practice. This finding can support health-care policymakers in developing SDM policies that enhance patient-centered care.

The OPTION Scale: Measuring Patients' Perceptions of Shared Decision-Making in the Kingdom of Saudi Arabia.

BACKGROUND: Involving patients in the decision-making process is now widely accepted as appropriate and ethical during consultations, particularly when several options are available. The aim of this study is to measure the patients' perceptions of shared decision-making practices during clinical encounters in Saudi Arabia. METHODS: This study employs a quantitative cross-sectional design. The OPTION scale was translated to Arabic. The questionnaire's content validity was assessed using an expert panel review. The questionnaire was then administered to 291 participants through online recruitment. RESULTS: Participants reported positive perceptions of shared decision-making practices in Saudi Arabia. The lowest perceived shared decision-making scores were from patients who visited the internal medicine department (f = 2.163, P = 0.009). Participants who received care from female physicians reported significantly higher levels of involvement in the shared decision-making process compared to male physicians (t = -2.732, P = 0.007). Although the majority of the participants in the study were from Eastern Province, this province documented the lowest mean perceived decision-making score by the patients compared to other provinces within Saudi Arabia (f = 3.613, P = 0.007). Female participants in the study had a higher shared decision-making score than the male participants (t = -3.644, P < 0.0001). CONCLUSION: Generally, the study results confirmed that shared decision-making in the Saudi health system includes significant patient involvement. Interventions that enhance the culture of shared decision-making in Saudi Arabia are necessary to ensure better adherence to treatment plans and thus better health outcomes.