Public's perception and satisfaction on the role and services provided by family physicians in Saudi Arabia: A cross-sectional study

Factors influencing contracting of residents with family doctors in China: a national cross-sectional survey

BACKGROUND

Family doctor contract services (FDCS) have been introduced in China in 2009 [1] and rapidly expanded recently. This study sought to investigate factors that influenced the willingness of Chinese residents to use FDCS.

METHODS

We employed multistage stratified and convenience sampling to administer questionnaires to 1455 Beijing, Qinghai, and Fujian residents. The willingness of residents in each province to contract family doctors was analyzed using the chi-square test and binary logistic regression.

RESULTS

The analysis in this study found that the signing rate of family doctors in China was about 27.77%, with differences in the signing up levels in Beijing (13.68%), Fujian (64.49%) and Qinghai (11.22%). In addition, the binary logistic regression results emphasized the relative importance of age, education, medical preference and policy knowledge on the willingness to sign up. Distrust of family doctors' medical skills (65.7%), not knowing how to contract (47.8%), and not knowing what medical problems can be solved (41.1%) were the top three reasons accounting for the reluctance of residents to contract with family doctors.

CONCLUSION

Residents from different backgrounds have different willingness to sign up, so the specific circumstances and needs of different groups should be taken into account. In order to increase the signing-up rate, consideration can be given to promoting the family doctor model in Fujian throughout the country. Individual hesitation can be eliminated by increasing the reimbursement rate of health insurance, reducing the out-of-pocket expenses of contracted patients, and providing incentives of certain discounts for consecutive contracted patients.

Patient satisfaction of primary care services in Gulf Cooperation Council Countries: A scoping review

Patient satisfaction (PS) is an essential element in evaluating and improving healthcare systems. Few studies have gathered evidence about patient satisfaction with primary care (PC) services in the Gulf Cooperation Council (GCC) countries. Therefore, it is important to review the existing literature examining PS with PC services in the GCC countries. This scoping review was conducted for primary data studies published between 2000 to March 2022. Out of 4461 screened articles, 37 met the inclusion criteria. Most studies were conducted in Saudi Arabia and were of cross sectional methodology. PS with primary care in the GCC is affected by multiple provider-related and patient-related factors and users are generally satisfied with the service provided. Future research should focus on the effects of the factors that were not explored and validate the existing results.

Knowledge, attitude, and practice of patients, visiting a private primary level health care facility towards family physicians

Aim and Objective

To study the knowledge, perception, attitude, and practice of patients visiting a private primary health centre towards family physicians.

Methodology

A cross-sectional questionnaire-based study was planned.

Results

A total of 272 patients visiting the health centre were included in the study.

Knowledge

Above 90% of the patients felt confident in the capabilities of family physicians in managing all kinds of health problems and the time/cost-effectiveness of this speciality. Timely referral and holistic care were other areas that boosted their confidence on family physicians. 96.7% knew that family physicians are trained specialists.

Attitude

Although only 50% of the study participants were already seeking the services of a family physician, 88% of them felt that a family physician would be their primary point of contact in their health care needs.

Practice

The positive attitude, knowledge, and perception towards family medicine were not reflected on their treatment seeking practice in areas of care, such as childcare (66.2%) and pregnancy (81.6%), where they preferred the services of a specialist. Also, for diabetes (52%) and chest pain (66%) related issues, the patients favoured a specialist's care over that of a family physician.

Conclusion

Patients visiting our primary health centre had good knowledge and positive perception about the family physicians. Preference for specialists over family physicians was seen for conditions such as chest pain, diabetes care, child care, and obstetrics issues.

Analysis of Emergency Department Use by Non-Urgent Patients and Their Visit Characteristics at an Academic Center

Objective

We studied the extent and reasons for non-urgent emergency department (ED) visits in a single university hospital, their predictors, and patient outcomes to propose solutions suitable for Middle Eastern healthcare systems.

Design

We conducted a retrospective review of electronic medical records, including all non- and less-urgent ED visits with complete triage records (levels 4 and 5 triage based on the Canadian Triage and Acuity Scale (CTAS) over one year. The data on patient demographics, visit characteristics, and patient disposition were analyzed using SPSS software.

Setting

The study was conducted in the ED at King Abdullah Bin Abdul-Aziz University Hospital (KAAUH), a Saudi university hospital located within the campus of Princess Nourah Bint Abdulrahman University.

Participants

A chart review was carried out for 18,880 patients with CTAS 4 or 5 visiting the KAAUH ED between July 2020 and July 2021. Additionally, a total of "11,857" patients with missing triage acuity or CTAS levels 1, 2, or 3 were excluded from the study.

Results

The majority (61.4%) of the 30,737 ED visits were less-urgent or non-urgent. The most common reasons for non-urgent visits were routine examination/investigation (40.9%), medication refilling (14.6%), and upper respiratory tract infection/symptoms (9.9%). Most visits (73.4%) were during weekdays and resulted in the prescription of medication (94.2%), laboratory tests (62.8%), sick leaves (4.7%), radiology examinations (3.6%), and a visit to primary healthcare clinics (family medicine) within a week of the emergency visit (3.6%).

Conclusion

Less- and non-urgent ED visits often did not need any further follow-ups or admission and represented a burden better managed by a primary healthcare center. Policymakers should mitigate unnecessary ED visits through public awareness, establish clear regulations for ED visits, improve the quality of care in primary healthcare centers, facilitate booking for outpatient department appointments, and regulate the systems of payment coverage/insurance and referral by other organizations.

Chronic Illness Patients' Perceptions of Quality of Care During Hospitalization: A Qualitative Study

Introduction

The rising prevalence of patients living with chronic illnesses and frequent hospitalizations represent many challenges in delivering high-quality care. Assessing patients' perceptions and needs regarding the quality of health care services is a critical step in improving quality of care.

Objective

This study sought to explore the perception of quality of care from the perspectives and experiences of chronically ill patients during hospitalization.

Methods

This study was conducted using a qualitative descriptive design. Face-to-face semi-structured individual interviews were conducted with 15 chronically ill patients at their bedside during their current hospital admission. Analysis followed Braun and Clarke's thematic analysis approach.

Results

Overall patients were pleased with their hospitalization experience; however, they highlighted many aspects of care that can be addressed to improve the quality of care provided. Five themes were identified from the analysis as follows: defining quality of care; aspects related to the healthcare providers; unmet care needs; patient's involvement in healthcare decisions and care expectations and outcomes.

Conclusion

A key finding of this study was the association between quality of care and healthcare providers' skills, clinical competence, and attitudes. Poor communication and discoordination of care were the most significant impediment expressed. Actively involving patients in care may be effective when combined with meeting expectations. The findings of this study helped to identify the strength points and areas of improvement that are the cornerstone for developing tailored and patient-centered strategies to improve the quality of care during hospitalizations among chronically ill Saudis.

Current state of ethical challenges reported in Saudi Arabia: a systematic review & bibliometric analysis from 2010 to 2021

Background

Over the past few years, five domains of importance about the current state of bioethics in Saudi Arabia have shaped the perspective of most research: doctor-patient relationship, informed consent, do-not-resuscitate, organ donation, and transplantation, medical students’ knowledge and attitudes about medical ethics curriculum. This systematic review aimed to systematically identify, compile, describe and discuss ethical arguments and concepts in the best-studied domains of bioethics in Saudi Arabia and to present cultural, social, educational, and humane perspectives.

Methods

Six databases were searched using Boolean operators (PubMed, Embase, Web of Science, Scopus, CINAHL, Google Scholar) from December 2020–June 2021. The search and report process followed the statement and flowchart of preferred reporting items for systematic reviews and meta-analyses (PRISMA).

Resutls

The search resulted in 1651 articles, of which 82 studies were selected for a final review and assessment. There is a gradual increase in research, whereby a substantial increase was observed from 2017. Most of the published articles focused on ‘Organ Donation & Transplantation’ with 33 articles, followed by ‘Doctor-Patient Relations’ with 18 publications. Most of the published articles were from Central Province (33), followed by Western Province (16). The authorship pattern showed a collaborative approach among researchers. The thematic analysis of keywords analysis showed that ‘Saudi Arabia,’ ‘attitude PHC,’ ‘organ donation,’ ‘knowledge and education,’ and ‘donation’ have been used the most commonly.

Conclusion

This systematic quantitative synthesis is expected to guide researchers, stakeholders, and policymakers about the strengths and gaps in knowledge and attitudes regarding medical ethics in Saudi Arabia, both among the general public and health professionals.

Public Awareness and Perception of Family Medicine in Jeddah, Saudi Arabia

Background

Family medicine is a specialty that provides care for family members' physical, social, and psychological aspects regardless of age, gender, and health conditions. A family physician can manage a wide range of health conditions and prevent various diseases. However, there are scarce data on the awareness and perceptions of the Saudi population regarding family medicine; therefore, we aim to determine the awareness and perception of family medicine and family physicians in the population of Jeddah, Saudi Arabia.

Methodology

This cross-sectional study was conducted in Jeddah and randomly enrolled 519 participants aged 18 years and older through an online self-administered survey. Microsoft Excel and SPSS were employed for the data entry and analysis.

Result

The analysis indicated that 86.7% of the participants had heard about family physicians, 55.1% recognized the family physician's role, 61.7% had never visited one, and 57.2% were unfamiliar with the locations of family medicine clinics.

Conclusion

The results of this study demonstrated that the general population of Jeddah has moderate positive responses toward the role of a family physician as a vital element in the healthcare system. However, the majority of the participants had never previously visited a family physician and were unfamiliar with the locations of family medicine clinics.

Community perspective on family medicine and family physician in Saudi Arabia 2020

BACKGROUND

Despite the importance and advantages of family medicine, it has poorly developed in Arab communities when compared to other medical specialties. Therefore, in this study, we aim to investigate the perception of the Saudi population about family medicine and physicians.

MATERIALS AND METHODS

A cross-sectional study was carried out using a self-administered structured online survey tool through the Google Forms platform. The online questionnaire was distributed to all Saudi Arabia's residents aged more than 15 years. A predesigned questionnaire was used and included items collecting data about participants' sociodemographic characteristics, awareness/knowledge, and experience/attitudes.

RESULTS

A total of 6974 valid participants were included in the current study, where the age group 25-35 years (37.1%) and 51.7% of them were females. Out of the included participants, 81.3% (n = 5671) did not report any chronic illnesses, while the other 18.7% (n = 1303) did. The mean awareness and knowledge score for all participants was 9.57 ± 3.39 (out of 20 possible points), while the mean experience and attitude score for all participants was 10.15 ± 2.58 (out of 16 possible points). Patients' perceptions, whether awareness and knowledge or experience and attitude scores, were significantly correlated (P-value < 0.001) to chronic illness status, being a healthcare worker, job, marital status, and gender factors. Moreover, experience and attitude score was additionally correlated to residence region (P-value = 0.034) and participants' nationality (P-value< 0.001).

CONCLUSION

General population in Saudi Arabia were aware about the importance of family physicians and they trust them. The identified predictors should be considered when trying to increase public awareness and enhance the experience with family physicians.

Qualitative Focus Group Study Examining Perceptions of the Community's Important Health Issues, Health Care Needs and Perceived Barriers to Access Among Arabic Speaking Primary Care Clients in the State of Qatar

Objective

This study is a part of the Primary Health Care Corporation’s (PHCC) Health Needs Assessment (HNA) Initiative. It focuses on identifying perceptions of Arabic speaking primary care clients regarding community’s major health issues, their experiences in utilizing health services, and the barriers that limit their access to health care in the State of Qatar.

Study Setting and Design

A total of 10 focus groups sessions were conducted at different PHCC’s health centers between October of 2019 and March of 2020. Sessions were distributed to cover all PHCC’s three geographical regions. Data were analyzed using thematic analysis.

Participants

A total of 89 adult Arabic speaking individuals were recruited. Participants included were in the age groups (18–69), native Arabic speaker, and registered at one of the PHCC’s health centers with a valid health card at time of recruitment.

Results

Areas investigated included perceptions of the community’s health issues, needed health services, and perceived barriers to health care. Priority health issues identified were chronic non-communicable diseases, mental health, timely access to care, cultural competency of delivered services, and integration and coordination across health care settings and sectors. Participants were able to identify socioeconomic and environmental factors such as the need for health and wellness interventions at schools that affects the health of the individual and the community. The importance of raising the community’s awareness about health-related issues and availability of health services was highlighted by study participants.

Conclusion

Collecting qualitative data provides an opportunity to examine people’s perceptions, and motivations and engage the whole community. This process is very important for strategic planning of health services. The study attempts to fill the knowledge gap and should be linked to health policy and the development of socially and culturally appropriate health programs.

Perception toward the family medicine services among the Physicians of Prince Sultan Military Medical City, Riyadh City, 2018: Cross-sectional study

Background:

Family medicine is the medical specialty that continuously provides comprehensive type of health care for individuals and families. Although the family physician role is essential, this specialty faces underestimation by other physicians of other specialties, thus resulting in a considerable gap in their cooperation and coordination, as some studies around the world had shown. The present study aimed to estimate the perception of other physicians toward the practice of family medicine physicians to improve the relationship between family physicians and other physicians, which in turn may lead to enhance healthcare system by high quality of work and higher efficiency.

Objective of the Study:

To estimate the perception among the physicians of Prince Sultan Military Medical City, Riyadh City by measuring the satisfaction toward the family medicine medical practices.

Subjects and Methods:

Through a cross-sectional design, the study had recruited 289 physicians who were actively practicing and working at Prince Sultan Military Medical City and fulfill the inclusion and exclusion criteria during the period from October 2018 until June 2019. Data collection carried out by questionnaire designed and revised by an expert panel of health professionals. An appropriate statistical test, such as the Chi-square test, was used to record the statistical significance between participants' answers and their demographic characteristics.

Results:

According to the study design, 289 patients were included in the study; the mean age was 42 years that ranged between 25 and 74 years. Two-Third of them (66%) were male and had Saudi nationality. Half of the participants are medical consultant, and a third of all participants worked under the department of internal medicine. The majority expressed their good perception with the family physician practice (91%). Most of the medical departments satisfied with statistically significant (P value <0.05) with the need for family medicine services. There was less satisfaction from physicians in different departments with effective communication between family medicine services and other departments but didn't reach up to significant statistical level. Higher qualified physicians with high-rank job categories were less satisfied with the performance of family medicine services.

Conclusion:

Among other physicians in different departments, family medicine physicians have a good perception, and most of the physicians agreed that family medicine physicians should work more in their referral letters to improve their communication between them and other departments.