A Case for Community and Hospital-Based Long-Term Care Facilities in Saudi Arabia

Abstract

MH Mufti. A Case for Community and Hospital-Based Long-Term Care Facilities in Saudi Arabia. 2002; 22(5-6): 336-338 In countries like Saudi Arabia, where improvement in health and social status of the population has risen sharply in a short period of time, growth in the number of elderly persons is even more remarkable. Life expectancy at birth is currently 70 years, up almost 60% from 44 years in 1960. It is estimated that about 3% of the population of 18.3 million are over 65 years. 1The increasing demand for elderly care services in acute care hospitals, and the pressures on inpatient average length of stay, is a serious problem. The cost of services provided in less specialized long-term care (LTC) facilities is usually a small fraction of the cost of such services in acute hospitals, and therefore a strong economic incentive for timely discharge of chronically ill elderly persons into an appropriate level facility should prevail. Yet, because less specialized LTC facilities are not available, and given the complexity of some elderly patients' illnesses, it is often difficult to discharge such patients directly from hospital to home.2 One other factor contributing to the problem of long-stay in acute hospitals, in the case of Saudi Arabia, is the lack of economic pressures on all the parties involved because of the system of free health care. Studies on issues and problems of long-term care in the Kingdom reveal that Saudis generally prefer care in hospitals rather than in the home or long-term care facilities, such as nursing homes. Al-Shammari, in his study of the determinants of length of stay in hospitals in Saudi Arabia, also found that a high percentage of elderly patients did not require inpatient care and could have been cared for at home. Even though 70% of patients' homes were suitable for care of patients, about 60% of relatives and 50% of patients preferred inpatient care. 4 Although respondents in the survey by Umeh were aware of the cost implications of providing services to such elderly people in acute care facilities, the majority preferred the more costly alternative of inpatient care. Respondents believed that residential facilities such as nursing homes are needs of the industrialized Western societies, and that it is religiously/culturally unacceptable. 3 The result is that elderly persons needing only skilled level nursing care occupy a significant number of acute hospital beds in the Kingdom. Acute hospital beds occupied by long-stay patients in Riyadh range from 4.3% in University hospitals, to over 14%) in the Armed Forces hospitals. In his study of the problem of long-stay patients in acute facilities (seven hospitals in Riyadh), Abbahussein found that the over 65s (3% of the population) occupied 22% of the beds; some of the patients had been in the facilities for over six months; and some were not receiving any kind of medical treatment, and had officially been discharged. In some cases, families resisted attempts by hospitals to discharge patients. 5 The studies concluded that ...

Assessment of physical health status and quality of life among Saudi older adults

“…There is also a limited response to older people’s care in acute care hospitals in Saudi Arabia. Similarly, one study claims that hospitals are not ideal for older persons with long-term conditions who have high accident rates (62.5%) that primarily occur in patients aged 60 years or older 6 ) . It is suggested that may be the result, in part, to nursing staff lacking the time and skills necessary to provide longer-term hospital care for older patients 7 ) .…”

Conducting Qualitative Fieldwork with Ageing Saudis

“…We were particularly interested in participants who were literate, because the probes used in this fieldwork involve some reading and writing. Likewise, we recruited individuals living at home because generally, older Saudis live with their families in the same household and prefer informal home care [12,13].…”