Lower respiratory tract infections (LRIs) are the fourth leading cause of death globally, affecting all age groups and leading to over 2 million deaths annually. Saudi Arabia faces a significant burden from LRIs, affecting more than 15% of the population each year. This study aims to provide an overview of LRI mortality, etiologies, and risk factors in Saudi Arabia from 1990 to 2021.

Data on LRI mortality in Saudi Arabia from 1990 to 2021 were extracted from the 2021 edition of the Global Burden of Disease (GBD) Result Tool. The analysis encompassed mortality rates across all age groups, with particular emphasis on children under five and adults over 70. Four primary etiologies influenza, respiratory syncytial virus (RSV), Streptococcus pneumoniae, and Haemophilus influenzae type b (Hib) were examined, alongside 14 associated risk factors.

The total LRI deaths in Saudi Arabia decreased by 6% from 1990 to 2021, with a significant reduction observed among children under five years old (96%). In contrast, LRI mortality among adults over 70 increased by 16% during the same period. The age-standardized mortality rate decreased by 47%, with significant reductions in deaths associated with pneumococcus and RSV. However, risk factors, such as smoking and ambient particulate matter pollution, showed minimal declines or even increased mortality rates in older adults.

Over the past three decades, Saudi Arabia has made significant progress in reducing LRI mortality, particularly among children under five. However, the increasing mortality rates among the elderly highlight the need for targeted interventions to address their unique vulnerabilities. Continued investment in public health infrastructure, vaccination coverage, and environmental health initiatives is essential for further reducing the burden of LRIs in Saudi Arabia.

Cardiac rehabilitation (CR) is an effective secondary prevention intervention, yet it is globally underutilized. Physicians play a key role in CR uptake by eligible patients through encouragement and referral to the program. This study assessed the knowledge, attitudes, and practices concerning CR among cardiologists in the Kingdom of Saudi Arabia (KSA), identified barriers to patient referrals to CR programs, and proposed strategies to increase service adoption.

We conducted an observational cross-sectional study in which an online questionnaire was distributed via email to cardiologists and cardiology fellows during the Saudi Heart Association's annual conference in October 2023 and through social media platforms. Participants were required to have at least six months of clinical practice in managing patients, including those with coronary heart disease (CHD) following percutaneous coronary intervention (PCI).

Of the 140 cardiologists surveyed, 106 completed more than 95% of the questionnaires. The cohort, which was primarily male (88.7%), included 67% consulting cardiologists, 15.1% fellows, and 17.9% specialists in areas such as general cardiology (29.2%), interventional cardiology (21.7%), and echocardiography (20.8%). Major barriers included a lack of local CR services (72.6%) and inadequate referral systems (41.5%). Despite the challenges and mixed views on the effectiveness of CR in KSA, attitudes toward CR were largely positive. The knowledge scores averaged 7.97, indicating a moderate to high understanding of CR services and benefits. Referral practices vary widely and are influenced by demographic and workplace factors, mainly geographic location.

While cardiologists in KSA generally have reasonable knowledge of CR and its benefits, substantial barriers hinder its broader implementation. There is enthusiasm for adopting diverse CR models; thus, further research is necessary to explore and evaluate alternative CR approaches, including home-based CR and telerehabilitation, to enhance patient care.

Access to healthcare is a critical determinant of individual and population health outcomes. However, few validated tools exist to evaluate healthcare access among Arabic-speaking populations.

This study aimed to validate the Arabic version of the Perception of Access to Health Care Services Questionnaire (PAHSQ) and assess its psychometric properties, including reliability and construct validity, using factor and Rasch analyses.

A cross-sectional study was conducted with 485 participants (53.4% female) recruited from hospitals and pharmacies in Jordan.

Confirmatory factor analysis (CFA) and Rasch analysis were employed to evaluate the construct validity and item performance of the 30-item, six-factor model. Internal consistency was assessed using Cronbach's alpha.

The Arabic PAHSQ exhibited strong psychometric properties. CFA confirmed the suitability of the six-factor model (χ²/df = 3.2, RMSEA = 0.07, CFI = 0.93, TLI = 0.92). Cronbach's alpha values for the six dimensions ranged from 0.82 to 0.93. Rasch analysis demonstrated acceptable infit and outfit values for all items, with item thresholds correctly oriented. Key findings highlighted significant disparities in healthcare access, particularly among participants with low income and no insurance coverage.

The Arabic PAHSQ is a reliable and valid tool for assessing healthcare access among Arabic-speaking populations. Its use can inform targeted interventions, guide resource allocation, and support health equity initiatives. Further research should explore its applicability across diverse Arabic-speaking regions and incorporate qualitative methodologies to capture more subtle access barriers.

The Saudi health transformation program entails a comprehensive reform of all health system functions. One of the pillars of this reform is the health care financing transformation. The Council of Health Insurance (CHI) aims to bring more transparency and understanding of case-mix through the introduction of patient classification and data standardization. Until recently, the private health insurance sector was using a variety of in-house non-standardized billing codes that impeded transparency and a value-based health care (VBHC) financing model. This study enabled the introduction of standardized billing codes known as the Saudi Billing System (SBS).

We reviewed and assessed several patient classification and billing systems as part of the assessment phase, followed by data collection from the three largest health insurance companies relating to eighty health care providers. A representative sample of 36,299 patient records were re-coded. Coding was undertaken using the Australian Classification of Health Interventions (ACHI) 10th Edition. Codes were assigned based on assessment by clinical coders using an established methodology and followed by an audit to confirm the assigned code or assign an alternative code where the coding could not be adequately completed by the initial coder.

Seventy-five percent of records were mapped to an existing ACHI code, leaving 25% being a partial match, an approximate match or other (1%, 22% and 2% respectively). As part of this process, the original ACHI codes were modified, and additional codes were added, ensuring full compatibility with billing practices. We named the new code set the Saudi Billing System (SBS). As a result of this work, we created an additional 1,774 codes, bringing the total SBS code set to 7,947 codes (30% increase from ACHI 10th Edition).

Patient classification and standardized billing systems are critical for transparency in providing health care and financing. Working within the existing national patient classification mandate and clinical coding standards required innovative ways to adapt these systems to a private health insurance market (specificity, familiarity, existing license with modification rights and ability to build fee schedule), to address the requirements of a reformed and more value-based insurance market. Current mandated patient classification systems are a good basis for adaptation to serve the needs of the overall health care transformation in the country and a building block towards more transparency and VBHC.

Teledentistry offers an effective, cost-efficient solution for caries detection in school children, improving access to early diagnosis and preventive care in underserved areas. Through remote imaging, it enables timely assessments without in-person visits, helping bridge healthcare gaps and enhance children's oral health outcomes.

Three examiners participated in this study, examiner 1 (E1) clinically examined the children then examined the clinical photos, examiner 2 (E2) examined the photos only, and examiner 3 (E3) took the clinical photos at school without participating in clinical examination. Sample size consisted of 141 school-going children from primary one to primary six grades. They were examined clinically by E1 using deft/DMFT indices, then clinical photos were taken for both arches from occlusal view. Occlusal surface photos were only included in the analysis. These photos were examined by E1 and E2 after a 48-h wash-out period and the same indices were measured and calibrated.

There was a strong agreement between clinical and photo diagnosis for E1 (kw = 0.899, p < 0.001), clinical and photo diagnosis for E2 (kw = 0.834, p < 0.001), and image diagnoses (E1) and (E2) (kw = 0.898, p < 0.001). The internal consistency between clinical and photo diagnoses (E2) was acceptable 0.790 (0.706:0.85). For other scores, the internal consistency between all variables was excellent (α > 0.9).

Teledentistry provides accurate and reliable results. It is a valuable tool for school-screening programs without dental radiographs.

It was retrospectively registered on clinical trial.gov on 25/10/2024 with an identifier NCT06661837.

Chronic respiratory diseases (CRDs) are a significantly major cause of mortality in Saudi Arabia, with their progression frequently involving comorbidities and exacerbations that extend beyond the lungs. This review considers the current state of pulmonary rehabilitation (PR) in Saudi Arabia, this being a well-known non-pharmacological intervention to help control and reduce the burden of CRDs, highlighting the intervention's availability, multidisciplinary approach, and integration within the healthcare system, as well as examining the diseases' contribution to overall symptom severity, impairing daily activities and significantly worsening the patient's quality of life. Although PR is strongly recommended for managing CRDs, its utilization in Saudi Arabia remains limited or unavailable in many regions. Key barriers to PR access include inadequate awareness among healthcare providers and patients, logistical challenges, and an insufficient number of specialized facilities and trained professionals. Expanding PR programs in Saudi Arabia requires addressing geographical barriers, ensuring adequate space, resources, and trained personnel, and raising awareness among healthcare providers through education and training. Integrating PR principles into medical education and offering incentives for specialization can help overcome personnel shortages. Additionally, promoting telerehabilitation can enhance patient compliance and ensure the long-term success of PR programs. These initiatives aim to optimize PR services and improve patient outcomes across the nation.

Drug safety is crucial in healthcare, ensuring the secure and effective administration of medications to protect patient welfare. Drug and medication safety is a major concern among Saudi healthcare providers, with numerous studies outlining the incidence of medication errors and the need for enhanced safety standards. This review will examine the existing level of drug-related safety in Saudi Arabia, categorizing the areas for improvement and highlighting concepts to improve safety practices. The overview discusses the history and evolution of pharmaceutical safety procedures, the present regulatory framework, major stakeholders, and the types and origins of prescription errors. It also examines the role of healthcare personnel and the use of technology and patient education in promoting pharmaceutical safety. The data reveal that the rate of pharmaceutical errors in Saudi hospitals is shockingly high, ranging from 13 to 56 per 100 medication orders, highlighting the urgent need for effective medication safety standards. Despite the formation of the Saudi Food and Drug Authority (SFDA) and the National Pharmacovigilance and Drug Safety Centre, issues such as poor understanding among healthcare providers and the need for more effective reporting methods remain a challenge. The evaluation highlights the deficiencies in ongoing education, such as real-world case scenarios and related trainings, inadequate incorporation of skills in assessment methods, and deficiency in standardized protocols for error reporting. To address these gaps, it is proposed to implement structured competency-based training, simulation exercises must be preferred for periodic skill assessments, and a safe reporting culture should be encouraged for the sake of transparency and learning from errors. We recognize the use of technology, such as electronic health records and computerized physician order input systems, as an important technique for improving medication safety. Future directions include creating national guidelines, establishing a centralized pharmaceutical error reporting system, and fostering a safety culture inside healthcare organizations. By addressing these obstacles and capitalizing on the opportunities indicated, we may improve pharmaceutical safety and, ultimately, patient care and outcomes in Saudi Arabia.

The significant rise in bariatric procedures (BPs) reflects the global increase in obesity. In Saudi Arabia, obesity prevalence is notably high at 35.6%, surpassing the global average. This retrospective cohort study primarily aims to identify demographic and clinical predictors influencing BP uptake among individuals at a single healthcare centre in Jeddah, Saudi Arabia. Secondarily, it evaluates the effectiveness of BPs, particularly laparoscopic sleeve gastrectomy (LSG), in reducing body mass index (BMI) and obesity-related comorbidities.

Data were extracted from the hospital's registry between October 2023 and June 2024. The study population included obese adults of varying ages, genders and comorbidities who underwent bariatric surgery. However, the single-centre design limited generalisability, long-term outcome data were unavailable and contextual factors, such as socioeconomic status and health literacy, were not captured.

A cohort of 208 patients was analysed, 64.9% females and 34.2% males, with a mean age of 36 ± 11.2 years. The pre-operative BMI was 44.10 ± 6.2 kg/m² (P = 0.462), which decreased to 35.1 ± 6.5 kg/m² (P = 0.577) postoperatively, reflecting a mean reduction of 9.03 ± 4.9 kg/m² (20.5%) (P = 0.255). LSG was the most performed BP at 93.3%. The most prevalent obesity-related comorbidities identified were hypertension, diabetes and GIT disease including gall bladder disorders (15.9%, 13.9% and 13.5%, respectively).

This study highlights the increasing prevalence of BP, particularly among young, predominantly female patients. LSG demonstrated substantial effectiveness, achieving a 20.5% reduction in BMI and improvement in obesity-related comorbidities. Future research could explore more patient demographics that could not be analysed in this study.

Many researchers have attempted to investigate the relationship between individuals and healthcare utilization; however, there is a lack of adequate studies examining the factors influencing healthcare-seeking behavior among Saudi Arabian women. Therefore, this study aimed to explore the barriers that influence healthcare-seeking behavior among Saudi women in Riyadh city, Saudi Arabia. This cross-sectional study was conducted with 511 Saudi women during October and November of 2022. Ethical approval was obtained from the Research Ethics Committee of King Saud University, Saudi Arabia. Participants completed self-administered online surveys regarding their demographic characteristics, healthcare-seeking behavior, and barriers to seeking healthcare. To analyze the relationship between healthcare-seeking behavior, barriers to healthcare, and independent variables, data were analyzed using SPSS version 23 with descriptive statistics and correlation. The majority of participants were aged 31-40 years. Analysis of the responses to the Barriers to Seeking Healthcare Scale revealed an overall mean score of 14.37 out of 20 (SD = 2.3), indicating that barriers to seeking healthcare significantly impacted the participants. Key findings revealed a statistically significant relationship between occupation (specifically full-time workers) and barriers to seeking healthcare (p = 0.003), suggesting that full-time female workers perceive more barriers to healthcare access. Most participants identified the lack of available appointments and difficulty obtaining required healthcare as significant barriers. Understanding Saudi women's healthcare-seeking behavior and its determinants is crucial for identifying these barriers and improving women's health outcomes. This study confirms the various challenges Saudi women face in seeking healthcare. The conclusion proposes new research directions and strategies to address these challenges. It is important to emphasize that further research is needed to capture the broader cultural and social factors at play. A comprehensive policy intervention is recommended, focusing on recognizing and addressing women's healthcare needs in light of current efforts to reduce these barriers.

This review's primary objective is to explore factors causing turnover and turnover intention in nurses working in KSA and to identify ways to prevent turnover and reduce turnover intention in the KSA nursing workforce.

Qualitative evidence synthesis (QES).

MEDLINE/Ovid/PubMed, Web of Science, PsychINFO, CINAHL, and Google Scholar (GS) underwent a structured search for articles. Articles were selected for inclusion if they reported primary studies with qualitative or mixed methods study designs published in English or Arabic in the peer-reviewed literature or as a thesis or dissertation.

In order to determine which type of synthesis to choose, we applied the RETREAT framework recommended in the Cochrane handbook and used by other researchers. Thematic synthesis was the most applicable choice, so this approach was selected.

Seven studies published in nine reports in the years 2016 through 2022 were included. The final coding framework included five predominant themes related to 19 subthemes. Three main findings were that there are leadership challenges at all levels in the KSA healthcare system leading to nurse turnover, a complex web of discrimination discourages nurses from remaining in the Saudi healthcare workforce, and societal pressure experienced by both Saudi and non-Saudi nurses leads to turnover and turnover intention.

KSA leaders should focus on intervening in the leadership challenges found at all levels of the KSA healthcare system. Addressing this issue could also positively impact the related issues of discrimination and societal pressure in the workplace and could begin to take steps toward improving occupational conditions and reducing nurse turnover and turnover intention.

Addressing the serious problem of the leadership challenges in healthcare would likely have a strong positive impact on the other two findings that relate to discrimination and societal pressure.

Not applicable.

Background/Objectives: Poisoning represents a significant global public health challenge, particularly with its complex manifestations in adult populations. Understanding regional epidemiology through digital health systems is crucial for developing evidence-based prevention and management strategies. This nationwide study analyzes hospital-based toxicology teleconsultation data from the Toxicology Consultation Service-Saudi Medical Appointments and Referrals Center (TCS-SMARC) platform to characterize the epidemiological patterns, clinical features, and outcomes of adult poisoning cases across Saudi regions. Methods: We conducted a retrospective cross-sectional analysis of 6427 adult poisoning cases where hospitals sought teleconsultation from the Saudi Toxicology Consultation Service (TCS) from January to December 2023. Descriptive statistics were used to analyze poisoning rates by demographic characteristics, agents responsible for the poisoning, clinical presentations, and management decisions. Population-adjusted rates were calculated using the national census data. Associations between variables were analyzed using cross-tabulations and chi-square tests. Results: Young adults aged 18-35 years constituted most cases (58.67%), with the highest population-adjusted rates observed among those aged 18-24 (5.15 per 10,000). Medicine-related poisonings were the most common across all regions (50.04%), followed by bites and stings (15.31%). Regional analysis indicated relatively uniform poisoning rates across Business Units (BUs) (2.02-2.74 per 10,000). Most cases (87.44%) were asymptomatic, with 91.71% exhibiting normal Glasgow Coma Scale scores, although substance abuse cases had higher rate of severe manifestations (24.34%). Significant seasonal variations were observed (p < 0.001), with peak incidents occurring in the summer (29.25%). Management decisions primarily involved hospital observation (40.27%) and admission (30.34%), with agent-specific variations in care requirements (p < 0.001). Conclusions: This comprehensive analysis demonstrates the effectiveness of Saudi Arabia's digital health infrastructure in capturing and managing nationwide poisoning data. The integrated digital platform enables real-time surveillance, standardized triage, enhanced access to specialized toxicology services, and coordinated management across diverse geographical contexts. Our findings inform evidence-based recommendations for targeted prevention strategies, particularly for young adults and medicine-related poisonings, while establishing a scalable model for digital health-enabled poisoning management.

Empowering women in Saudi Arabia has become a critical agenda, reflecting the nation's shifting societal and economic dynamics. This review highlighted recent policy initiatives, societal changes, and institutional reforms aimed at enhancing the role of women in the Saudi health sector.

This scoping review explored academic literature and government reports related to gender equality and women's empowerment in the Saudi health sector to provide an overview of the advancements made and the challenges that remain.

The review found substantial progress in empowering female healthcare workers (HCWs), evidenced by increased participation in leadership roles, higher enrollment in medical education, and the implementation of workplace policies promoting gender equity. These efforts are aligned with Saudi Arabia's Vision 2030, which emphasizes inclusivity and diversity as central pillars for sustainable development. However, persistent challenges such as traditional gender norms, workplace biases, and limited access to mentorship and leadership opportunities were identified as barriers to further progress.

While significant strides have been made, achieving gender equality in the Saudi healthcare sector requires sustained efforts to address societal and institutional challenges. The transformative potential of education, leadership development, and mentorship programs should be harnessed to empower female HCWs. Continued policy reforms and cultural shifts are crucial for fostering a gender-diverse healthcare system.

Burnout is a significant issue among healthcare professionals, particularly nurses, due to high workloads and emotional demands. However, limited research has explored burnout among primary healthcare nurses in Saudi Arabia, who play a vital role in healthcare delivery. This study aims to address this gap by investigating burnout levels and their association with anxiety, depression and self-efficacy among primary healthcare nurses. A cross-sectional survey design was employed, with 161 primary healthcare nurses from the Qassim region, Saudi Arabia. Data were collected using the Maslach Burnout Inventory, the Patient Health Questionnaire-4 and the General Self-Efficacy Scale. Pearson correlation and logistic regression were used to analyse the associations between study variables. A high prevalence of burnout risk (78.9%) was observed. Emotional exhaustion was detected in 35.4%, depersonalisation in 44.7% and low personal accomplishment in 57.8%. Anxiety (r = 0.707, p < 0.01) and depression (r = 0.564, p < 0.01) were positively correlated with emotional exhaustion, while self-efficacy was negatively correlated (r = -0.260, p < 0.05). Logistic regression analysis revealed that anxiety (OR = 5.784, 95% CI: 2.056-16.269) and low self-efficacy (OR = 6.625, 95% CI: 2.979-14.737) were significant predictors of burnout. Targeted interventions are essential to mitigate burnout among primary healthcare nurses. Specific measures could include mindfulness-based stress reduction programmes to address emotional exhaustion, peer support sessions to reduce depersonalisation and skill-building workshops to enhance self-efficacy. These interventions can improve nurse well-being and ensure sustainable healthcare delivery in primary care settings.

Background/Objectives: Patients on chronic anticoagulation undergoing metabolic surgery represent an increased risk of complications, including both bleeding and thrombotic events, such as deep vein thrombosis (DVT) and pulmonary embolism (PE). The optimal perioperative management of patients who are receiving chronic anticoagulation therapy (CAT) is complex. In the colorectal surgery literature, patients on CAT have a 10% rate of peri-procedural bleeding and a 3% rate of thromboembolism. The aim of this study was to evaluate and compare the safety and postoperative outcomes between patients with and without CAT undergoing Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) at a tertiary referral center in the United Arab Emirates (UAE). Methods: All patients who underwent primary bariatric surgery between September 2015 and July 2019 were retrospectively reviewed. The first group included patients with CAT, and the second group included patients without CAT. Demographics, perioperative outcomes, and postoperative results were examined. Results: Our study included 542 patients, 22 (4%) with CAT and 520 (96%) without CAT. Mean age was 46.3 ± 10.5 years in the CAT group and 36.0 ± 11.7 years in the non-CAT group (p < 0.001); median BMI was 41.8 (range 33.1-61.3) and 42.7 (range 30.1-78.4) kg/m2, respectively (p = 0.52). The CAT group had significantly higher rates of hypertension (77.2% vs. 32.5%, p < 0.001), obstructive sleep apnea (81.8% vs. 31.5%, p < 0.001), and coronary artery disease (31.8% vs. 2.8%, p < 0.001). In the CAT group, 8/22 (36.4%) patients underwent Roux-en-Y gastric bypass and 14/22 (63.6%) sleeve gastrectomy, compared to 228/520 (43.8%) and 292/520 (56.2%), respectively, in the non-CAT group (p = 0.51). There were no statistically significant differences in postoperative emergency department (ED) visits (18.1% vs. 24.2%, p = 0.51), early major complications (4.5% vs. 3.4%, p = 0.54), readmission rates within 30 days (4.5% vs. 3.6%, p = 0.56), or late complications (4.5% vs. 4.2%, p = 0.60). Mean length of stay was significantly longer in the CAT group (4.6 vs. 2.6 days, p < 0.001). The mean follow-up was 10 ± 7.3 months for the CAT cohort and 11 ± 9.7 months for the non-CAT cohort (p = 0.22). Weight loss outcomes at 12 months were comparable, with a percent total body weight loss (TBWL) of 27.0 ± 7.3% in the CAT group and 28.9 ± 8.3% in the non-CAT group (p = 0.29). There were no deaths in either group. Conclusions: In this series, at a tertiary referral center in the UAE, metabolic surgery is safe for CAT patients. Multidisciplinary preoperative preparation might be warranted to avert potential complications.

This systematic review assesses the role of the Cooperative Health Insurance System (CHIS) in achieving Universal Health Coverage (UHC) in Saudi Arabia's evolving healthcare system by consolidating and analyzing findings from diverse studies to provide a comprehensive overview of CHIS's impact and also identifies contextual challenges and practical insights that can inform similar reforms globally.

We report results following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following six databases were searched for relevant studies: PubMed, Scopus, CINAHL, Business Source Complete, APA PsycINFO, and SocIndex. The review protocol was registered with PROSPERO. Inclusion criteria focused on studies examining the impact of CHIS on the UHC dimensions based on the following themes: population covered, affordability, quality, efficiency, access, services covered, and financial coverage. The initial search identified 1316 publications.

A total of 30 studies met the inclusion criteria. Our synthesis indicates that CHIS has significantly improved healthcare access and quality, particularly in the private sector. CHIS was also associated with increased healthcare efficiency through standardized benefit packages and reduced out-of-pocket expenditures. However, these studies noted challenges such as rising insurance premiums, infrastructural deficiencies, and cultural barriers.

CHIS is integral to Saudi Arabia's healthcare reform, substantially contributing to UHC's objectives. Despite notable advances, continuous efforts are needed to address existing challenges and expand coverage. The findings suggest that enhanced government support and public awareness are crucial for advancing UHC goals in Saudi Arabia.

Telehealth has emerged as a pivotal tool in bridging the gap between consultants and primary healthcare physicians, particularly in remote, mountainous, and island regions. This paper discusses the innovative NARAKOM project, which leverages available technology to facilitate this connection. The project aims to enhance healthcare service delivery, ensure general practitioners' continuous education, and improve patient outcomes in underserved areas. The project provides the confidentiality and effectiveness of medical consultations by employing mobile phones, phone calls, and the WhatsApp social networking program. Initial implementation in the Jazan region has shown promising results, and the project is poised for expansion across Saudi Arabia.

This study aimed to determine the direct and indirect costs of sickle cell disease (SCD) in Saudi Arabia.

Data were collected from 217 participants aged ≥18 years in the eastern region of Saudi Arabia, using a prevalence-based cost-of-illness approach. The Institute for Medical Technology Assessment Medical Consumption Questionnaire and Institute for Medical Technology Assessment Productivity Cost Questionnaire were used to assess costs. A multistage process was used, encompassing patient data collection over 3 months, cost calculation from clinic visits and drug prices, and extrapolation for annual estimates.

The study revealed substantial societal costs of SCD, with an average per-patient cost of SAR181 899 (US$48 506), covering healthcare and productivity losses. Healthcare costs, including hospitalization, informal care, and medication, averaged SAR80 306 (US$21 415). In addition, productivity costs, including unpaid work and presenteeism, averaged SAR101 594 (US$27 092). Obtaining higher levels of education, such as a diploma and BSc degree or higher, has been found to significantly decrease the costs associated with SCD (P = .016, P = .001). Furthermore, when comparing different employment statuses, students (B = -0.301, P = .058) were found to have marginally lower SCD costs, suggesting that their expenses were lower than those of individuals in other employment categories. The predictive model used in this study explained 11.2% of the variation in costs.

Our study highlights a significant economic burden of SCD in Saudi Arabia and highlights the need for targeted strategies to alleviate financial challenges and improve patient well-being.

To provide evidence-based clinical practice recommendations for managing Systemic Lupus Erythematosus (SLE) in Saudi Arabia.

This EULAR-adapted national guideline in which a multidisciplinary task force utilized the modified Delphi method to develop 31 clinical key questions. A systematic literature review was conducted to update the evidence since the EULAR publication. After reaching a consensus agreement, two rounds of voting and group discussion were conducted to generate consolidated recommendations/ statements.

A significant number of patients in Saudi Arabia experience delays in accessing rheumatologists, highlighting the significance of timely referral to SLE specialists or rheumatologists to ensure accurate diagnosis and prompt treatment. The primary goal of Glucocorticoid (GC) therapy in SLE patients is to establish disease control with a minimum dose and duration. Steroid-sparing agent utilization facilitates steroid-sparing goals. Hydroxychloroquine is recommended for all SLE patients, though physicians must carefully monitor toxicity and prioritize regular medication adherence assessment. SLE management during pregnancy starts from preconception time by assessing disease activity, major organ involvement, hypercoagulability status, and concomitant diseases that may negatively impact maternal and fetal outcomes. Multidisciplinary care with close monitoring may optimize both maternal and fetal outcomes. For patients with antiphospholipid antibodies, low-dose aspirin prophylaxis is recommended. Also, Long-term anticoagulant medications are fundamental to prevent secondary antiphospholipid syndrome due to high thrombosis recurrence.

This Saudi National Clinical Practice guidelines for SLE management provide evidence- based recommendations and guidance for healthcare providers in Saudi Arabia who are managing patients with SLE. These guidelines will help to standardize healthcare service, improve provider education, and perhaps lead to better treatment outcomes for SLE patients.

Saudi Vision 2030 is a game-changer for all aspects of the economy, including healthcare. This article provides a comprehensive overview of healthcare financing in the Kingdom of Saudi Arabia (KSA). It identifies key healthcare financing challenges that must be addressed to achieve the initiative's envisioned health system goals. The review also examines and demonstrates how healthcare funds in the KSA are allocated among different healthcare services, to offer a perspective on resource use efficiency at various healthcare levels. This research used a mixed-method design which includes a literature review and secondary data analysis. A literature review was conducted aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. The secondary data were gathered from the reports and websites of government agencies, international organizations, and non-governmental organizations. Despite implementing significant reforms in its healthcare system, the share of private healthcare expenditure in total healthcare spending has seen only marginal growth. The current healthcare financing system appears insufficient to adequately support the chronically ill and the poor. There is a significant imbalance in the allocation of government budgets between hospitals and primary care, with four-fifths of financial resources directed towards hospital services. The Ministry of Health's budget allocation prioritizes personnel compensation, potentially reducing the available budget for medicines and other essential healthcare supplies. Ongoing reforms in the health sector, including privatization, public-private partnership initiatives, and the government's commitment to developing a robust primary healthcare network, are expected to play a significant role in controlling rapidly increasing public healthcare expenditures in Saudi Arabia.

This narrative review focuses on the role of mobile MRI and CT units in addressing the challenges of healthcare accessibility and patient wait times in Saudi Arabia. It underscores the growing demand for diagnostic imaging amid infrastructural and geographical barriers, emphasizing mobile units as innovative solutions for enhancing radiological services across diverse Saudi landscapes. The purpose of this study is to assess how these mobile technologies can mitigate service delays, improve patient outcomes, and support healthcare delivery in remote or underserved areas, reflecting on global trends towards more dynamic, patient-centered healthcare models.

This review utilizes an expanded database search and refined keywords to ensure comprehensive literature coverage. The study focused on peer-review articles and grey literatures that directly examined the impact of these mobile units on healthcare accessibility, wait times, and service delivery. A thematic analysis identified significant contributions to accessibility improvements, emergency responses, and rural healthcare, highlighting areas for further research and policy development.

Mobile units have advanced technical specifications with high-field magnets and multi-slice CT scanners on par with fixed facilities. They prioritize patient comfort and safety with examination areas, control rooms, and waiting areas. Telemedicine capabilities allow real-time image transmission to specialists. Strategic deployment can address workforce shortages by distributing services equitably. Mobile units represent cost-effective solutions to expand healthcare access without fixed infrastructure.

Integration of mobile MRI and CT units in Saudi Arabia can transform access to diagnostic imaging by decentralizing services and directly reaching patients, including rural areas. Evidence shows mobile units reduce diagnostic delays and optimize resource use. Despite challenges, strategic investments and collaborations can overcome obstacles to make radiological services more equitable, flexible and patient-focused in Saudi Arabia.

This cross-sectional study addresses scarcity of evidence on oral health issues among Saudi children and their impact on quality of life (OHRQL). We aimed to investigate parental reports of oral health problems in children and their effect on their OHQRL.

Parents of children aged 2-11-years from Five-Saudi regions participated from February 2021 to July 2021 by completing an electronic, self-administered questionnaire structured according to World Health Organization-Oral Health Questionnaire for children. It comprises questions on children experiencing oral pain/discomfort, oral lesions/manifestations and reduction in their OHRQL.

Among 1,516 responders, 1,107 (73.0%) reported that their children experienced toothache/discomfort. The possibility of parents reporting toothache/discomfort or oral manifestations decreased with younger children. For children aged 2-5 years, the odds ratio (AOR) was 0.18 (95% CI [0.13-0.24], P < 0.001) for toothache and 0.58 (95% CI [0.45-0.74], P < 0.001) for oral manifestations. For children aged 6-8 years, the AOR was 0.57 (95% CI [0.4-0.81], P = 0.002) for toothache. Additionally, parents of younger children less frequently reported reduced OHRQL with AORs of 0.58 (95% CI [0.45-0.73], P < 0.001) for children aged 2-5 years and 0.64 (95% CI [0.49-0.83], P < 0.001) for those aged 6-8 years. Lower parental education increased AORs, with values of 1.575 (95% CI [1.196-2.074], P = 0.001) and 1.505 (95% CI [1.208-1.876], P < 0.001) for younger and 6-8-year-old children, respectively.

Results revealed notable prevalence of toothache/discomfort and oral manifestations in children reported by parents, which was related to age and parental education; ultimately leading to reduction in their OHRQL.

To achieve universal health coverage consistent with World Health Organization recommendations, monitoring financial protection is vital, even in the context of free medical care. Toward this end, this study investigated out-of-pocket (OOP) expenditure on medicines and their determinants among adults in Saudi Arabia.

This analysis was based on cross-sectional data derived from the Family Health Survey conducted by the General Authority for Statistics in 2018. Data analyses for this study were based on the total sample of 10,785 respondents. Descriptive statistics were used to identify the sample distribution for all variables included in the study. Tobit regression analysis was used to examine the determinants of OOP expenditure on medicines.

The average OOP expenditure on medicines was estimated to be 279.69 Saudi Riyal in the sampled population. Tobit regression analysis showed that age, average household monthly income, education level, and suffering a chronic condition were the main determinants of OOP expenditure on medicines. Conversely, being married and employed were associated with a lower probability of OOP expenditure on medicines.

This study could assist policy makers to provide additional insurance funding and benefits to reduce the possibility of catastrophic OOP expenditure on medicines, especially for the most vulnerable demographic.

Continuous assessment of community health needs is essential to predict, recognize, and act on healthcare issues. Conducting community health needs assessments (CHNAs) in Saudi Arabia has become a priority to overcome the current healthcare challenges and keep pace with the Saudi Arabia 2030 vision. Studies reporting community health needs in Saudi Arabia regions are limited despite the high incidence of chronic diseases. This study aims to understand the community's health problems and the range of healthy behaviors and determine the priority health problems.

We conducted a cross-sectional study based on the adults in Primary Health Care Centers in Hail, Northern Saudi Arabia, by using the CHNA standard questionnaire. In addition to the demographic information, the questionnaire collects data on personal health status, the health status of adults and children, health facilities access information, receiving of healthcare procedures, traveling for healthcare, source of medical information, safety measures and behaviors, health problems, childcare (special needs), and perceived community problems.

In all, 336 individuals were approached to participate in this study; 303 agreed to participate (response rate: 90%). The analysis comprised 276 individuals after eliminating 27 who did not fulfill the age inclusion criteria or had missing gender data. Of these, 107 (38.8%) were men and 169 (61.2%) were women. Our data revealed that almost half of the participants, 135 (52.9%) constantly or 107 (42%) occasionally, were able to visit the doctors when needed.

Our findings reported positive health behaviors and good accessibility to healthcare services when needed. However, the study findings also revealed healthcare challenges that required urgent action from Hail healthcare leaders. Developing healthcare strategies, screening/prevention programs, and changing healthcare policies in the Hail region are needed to control and prevent health problems and improve the population's health.

At the beginning of the COVID-19 pandemic, it was recommended to provide emergency dental care and avoid aerosol-generating procedures (AGPs) when possible. This study aimed to determine how Saudi Arabian pediatric patients utilized emergency dental services at the national level at the beginning of the COVID-19 pandemic and what situations required an AGP.

Data was collected from all Ministry of Health dental facilities in Saudi Arabia between March and May 2020. All pediatric dental patients who received emergency dental care during the COVID-19 lockdown were included in this study.

The majority of the 1,544 pediatric dental patients who received emergency dental care during this period received treatment for caries (77.9 %). AGPs were predominant in the treatment of urgent dental conditions (51.5 %). About 64 % of cases with pulpal inflammation and 52.4 % with abscesses underwent an AGP.

Emergency and urgent dental conditions were the main reason for seeking dental care during the pandemic (75.8 %), while only 24.2 % of cases were considered non-urgent. Despite the recommendations, AGPs were required for some urgent conditions to relieve the associated pain, and this comprised 46.8 % of dental treatment provided.

This study examines the 2022 distribution of primary healthcare centers across Saudi Arabia's 20 regions, focusing on disparities and healthcare accessibility.

A quantitative analysis of the Ministry of Health's data was conducted. Primary healthcare centers distribution was evaluated by calculating the number of primary healthcare centers per 100,000 population across different administrative regions.

The study uncovered regional disparities, with the PHCs-per-100,000-people ratio showing significant variance. Regions like Riyadh had an above-average ratio with 7.5 PHCs-per-100,000-people, while Jeddah lagged behind with a concerning 3.2 PHCs-per-100,000-people despite being a populous city. The PHC-per-capita ratio declined to 6.6 in 2022 from 8.0 in 2017. The data also revealed that the Eastern Province showed an increase in the number of primary healthcare centers.

Disparities in the distribution of primary healthcare centers in 2022 highlight a critical need for equitable healthcare access across Saudi Arabia. Many regions require increased primary healthcare center allocation to match population needs. The findings underscore the urgency of integrating these insights into policy frameworks to achieve the goals of Vision 2030, emphasizing the development of a sustainable and equitable healthcare system.

Policymakers need to consider these disparities to guide the strategic placement of primary healthcare centers and ensure an equitable healthcare system. This study provides a basis for targeted policy interventions to improve healthcare equity and prepare the health system for future demographic and epidemiological transitions.

Fostering market entry of novel antibiotics and enhanced use of diagnostics to improve the quality of antibiotic prescribing are avenues to tackle antimicrobial resistance (AMR), which is a major public health threat. Pricing, procurement and reimbursement policies may work as AMR 'pull incentives' to support these objectives. This paper studies pull incentives in pricing, procurement and reimbursement policies (e.g., additions to, modifications of, and exemptions from standard policies) for novel antibiotics, diagnostics and health products with a similar profile in 10 study countries. It also explores whether incentives for non-AMR health products could be transferred to AMR health products.

This research included a review of policies in 10 G20 countries based on literature and unpublished documents, and the production of country fact sheets that were validated by country experts. Initial research was conducted in 2020 and updated in 2023.

Identified pull incentives in pricing policies include free pricing, higher prices at launch and price increases over time, managed-entry agreements, and waiving or reducing mandatory discounts. Incentives in procurement comprise value-based procurement, pooled procurement and models that delink prices from volumes (subscription-based schemes), whereas incentives in reimbursement include lower evidence requirements for inclusion in the reimbursement scheme, accelerated reimbursement processes, separate budgets that offer add-on funding, and adapted prescribing conditions.

While a few pull incentives have been piloted or implemented for antibiotics in recent years, these mechanisms have been mainly used to incentivize launch of certain non-AMR health products, such as orphan medicines. Given similarities in their product characteristics, transferability of some of these pull incentives appears to be possible; however, it would be essential to conduct impact assessments of these incentives. Trade-offs between incentives to foster market entry and thus potentially improve access and the financial sustainability for payers need to be addressed.

In the Kingdom of Saudi Arabia (KSA), little is known about the adoption of virtual consultations (VCs), with most studies being survey-based leading to varying results. This study aims to utilise secondary collected data on the use of both kinds of VCs currently available, and to epidemiologically describe the adoption of these consultations.

This retrospective study analysed data provided by the Ministry of Health between January 1st 2021 and June 30th 2022. For both the home-based and the hospital-based consultations, variables included the age and sex of patients, date of consultation, duration in minutes, closure status for the appointment and the governorate in which the patient is residing. A heat map was drawn to present patterns of utilisation across the country.

The total number of VCs for both types were 1,008,228. For both types, females were higher adopters (54.73%). Of the total number of consultations, 751,156 were hospital-based. Of these consultations, family medicine consultations were the most common (20.42%), followed by internal medicine. Maternity follow-up clinics were higher in home-based clinics. The proportion of patient no-shows was high overall (48.30%). Utilisation was high in urban governorates, and low in rural ones.

Findings have several implications on health policy. It provides further evidence of the importance of family medicine, where it was the most common speciality even in hospital-based settings. The high variability in the adoption of consultations across rural and urban areas as well as the extremely high number of patient-no-shows warrants further investigation.

There are many known risk factors for the development of deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE). However, a recently observed risk factor is prolonged sitting (or immobility) for occupational dispensation. Some occupations, especially electronic information technology (IT) professionals, computer gamers, programmers, etc., are amenable to prolonged sitting periods for their work. Such a trend significantly increased in the corporate world during the covid pandemic restrictions and work-from-home policy of the IT companies. We have reported a case of the sudden death of an IT professional due to DVT and PTE. There is a conspicuous indication of the association between prolonged sitting hours and the development of DVT and PTE. This is also known as e-thrombosis. The prolonged seated immobility thromboembolic syndrome is a recently observed phenomenon in professionals having prolonged seated working styles. This paper is a case-based review of all tenets, i.e., clinical presentation, autopsy pathology, and preventive measures of the prolonged seated immobility thromboembolism associated with a sedentary working style.

Digitization shall improve the secondary use of health care data. The Government of the Kingdom of Saudi Arabia ordered a project to compile the National Master Plan for Health Data Analytics, while the Government of Estonia ordered a project to compile the Person-Centered Integrated Hospital Master Plan.

This study aims to map these 2 distinct projects' problems, approaches, and outcomes to find the matching elements for reuse in similar cases.

We assessed both health care systems' abilities for secondary use of health data by exploratory case studies with purposive sampling and data collection via semistructured interviews and documentation review. The collected content was analyzed qualitatively and coded according to a predefined framework. The analytical framework consisted of data purpose, flow, and sharing. The Estonian project used the Health Information Sharing Maturity Model from the Mitre Corporation as an additional analytical framework. The data collection and analysis in the Kingdom of Saudi Arabia took place in 2019 and covered health care facilities, public health institutions, and health care policy. The project in Estonia collected its inputs in 2020 and covered health care facilities, patient engagement, public health institutions, health care financing, health care policy, and health technology innovations.

In both cases, the assessments resulted in a set of recommendations focusing on the governance of health care data. In the Kingdom of Saudi Arabia, the health care system consists of multiple isolated sectors, and there is a need for an overarching body coordinating data sets, indicators, and reports at the national level. The National Master Plan of Health Data Analytics proposed a set of organizational agreements for proper stewardship. Despite Estonia's national Digital Health Platform, the requirements remain uncoordinated between various data consumers. We recommended reconfiguring the stewardship of the national health data to include multipurpose data use into the scope of interoperability standardization.

Proper data governance is the key to improving the secondary use of health data at the national level. The data flows from data providers to data consumers shall be coordinated by overarching stewardship structures and supported by interoperable data custodians.

The healthcare system in KSA has been substantially transformed as part of Vision 2030, including implementation of an electronic prescribing system, called Wasfaty, to enable patients to receive their prescriptions from community pharmacies (CPs). This study assessed patient satisfaction with CPs and the Wasfaty system.

This cross-sectional observational study used existing data from the Saudi Ministry of Health's patient experience program. Data were collected from patients (≥15 years of age) visiting governmental primary care clinics in 2022. Summary statistics were determined and multivariable logistic regression analyses were conducted.

The sample included 66,541 patients. More than 70% of patients were satisfied with the services of the CPs and the Wasfaty system. Being older and being female consistently showed a positive association with satisfaction across several services. Whereas patients in preventive clinics had higher odds of satisfaction with medication availability (OR: 1.19, 95% CI: 1.03-1.37) and waiting time (OR: 1.23; 95% CI: 1.03-1.47), patients in chronic disease clinics had lower satisfaction with medication availability (OR: 0.92, 95% CI: 0.85-0.99). Saudi patients had lower odds of being satisfied with multiple services.

The overall high satisfaction among patients suggested the success of the Wasfaty system in meeting patient needs and expectations. However, areas for improvement exist to increase patient satisfaction, such as addressing medication shortages and ensuring clear patient-pharmacist communication. The results highlight the importance of continued monitoring and evaluation to support the patient experience with pharmacy services, and to improve patients' journeys, medication adherence, and overall healthcare outcomes.

Dental treatments and oral health promotion are now more mobile and versatile thanks to the Internet of Things (IoT)-based healthcare services. This scoping review aims to compile the available data and outline the aims, design, assessment procedures, efficacy, advantages, and disadvantages of the implementation of IoT to improve children's oral health. Articles for this review were gathered from PubMed, Scopus, and Ebscohost databases to identify and construct the keywords and primary research topic. The selected studies were published between 2000 and 2022 and focused on children aged 1 to 18 and/or parents/caregivers of children who received oral health promotion and/or dental disease preventive treatments utilizing the IoT. Each study topic required data extraction. A total of nine papers were included in this review. Two of the nine publications were quasi-experimental, while the remaining six papers were randomized control trials. The nine papers considered in this appraisal have a range of interventions and follow-up periods. Mobile-Health (m-Health), home healthcare, hospital/clinical management, and electronic-Health applications (e-Health) are the most common IoT architecture used as interventions. Three studies assessed oral health knowledge and behavior scores, whereas the bulk of studies (6/7) used m-Health treatments focusing on dental plaque buildup as well as gingival health evaluation to assess oral hygiene. IoT is one of the mediums or instruments that might be used to encourage children's dental health. The studies suggest that the use of IoT could help in improving oral hygiene and oral health, which can further improve children's oral health.

Referrals are an integral part of any healthcare system. In the Kingdom of Saudi Arabia (KSA) an electronic referral (e-referral) system known as the Saudi Medical Appointments and Referrals Centre (SMARC) began formally functioning in 2019. This study aims to showcase the Saudi experience of the e-referral system and explore the epidemiology of referrals nationally.

This retrospective descriptive study utilised secondary collected data between 2020 and 2021 from the SMARC system. Cross tabulations with significance testing and colour-coded maps were used to highlight the patterns across all regions.

The study analysed over 600,000 referral requests. The mean age of patients was 40.70 ± 24.66 years. Males had a higher number of referrals (55.43%). Referrals in 2021 were higher than those in 2020 (56.21%). Both the Autumn and Winter seasons had the highest number of referrals (27.09% and 27.43%, respectively). The Surgical specialty followed by Medicine had the highest referrals (26.07% and 22.27%, respectively). Life-saving referrals in the Central region were more than double those in other regions (14.56%). Emergency referrals were also highest in the Southern regions (44.06%). The Central and Eastern regions had higher referrals due to unavailable sub-speciality (68.86% and 67.93%, respectively). The Southern regions had higher referrals due to both unavailable machine and unavailable beds (18.44% and 6.24%, respectively).

This study shows a unique system in which referrals are between secondary, tertiary, and specialised care. It also highlights areas of improvement for equitable resource allocation and specialised care in slightly problematic areas as well as the use of population density in future planning.

Background: There is limited evidence on the association between psychological distress, academic stress, and burnout among Saudi nursing students. Clarifying such an association is crucial to understanding the factors associated with psychological distress and developing interventions to prevent it. Aim: To explore the prevalence and association of psychological distress with academic stress and burnout among Saudi nursing students. Methods: A cross-sectional design was used, and 237 students participated from a nursing college in Riyadh, Saudi Arabia. Students' demographics; the Depression, Anxiety, and Stress Scale; the Academic Stress Inventory; and the Maslach Burnout Inventory were used for data collection. Results: Most of the participants reported no-to-mild depression, anxiety, and stress. Stress related to studying in groups, time management, emotional exhaustion, depersonalization, and personal accomplishment were the significant predictors of psychological distress, explaining 52.1% of the variance. Conclusions: This study suggest implementing tailored mental health screenings and support services for nursing students, embedding mental health professionals in the program, and using telehealth or mobile apps for remote monitoring to ensure comprehensive care for nursing students. Future research should consider these predictors while designing strategies to decrease psychological distress among students.

Saudi Arabia has begun reforming its government-run health care system to increase efficiency and reduce costs. One effort is the adoption of an electronic prescribing system (Wasfaty) and outsourcing pharmaceutical services from government-run clinics to community pharmacies (CP). This study aims to compare satisfaction with pharmaceutical services offered in the two systems.

This cross-sectional observational study used existing survey data collected from patients (≥15 years of age) visiting government primary health care centers from January 2022 to June 2022. Satisfaction with three pharmaceutical services (availability of medications, pharmacist's explanation of the prescription, and waiting time to get medications) were the main outcomes.

The study comprised 91,317 participants, 74.06 % of them were CP/Wasfaty users. CP/Wasfaty patients had lower odds of satisfaction with the three pharmaceutical services: availability of medications (OR = 0.49, 95 % CI = 0.47-0.51), pharmacists' explanation of prescription (OR = 0.55, 95 % CI = 0.53-0.58), and waiting time to get medications (OR = 0.81, 95 % CI = 0.75-0.88). Additional findings showed variations in satisfaction levels based on demographic factors and clinic types.

The significant differences observed in satisfaction levels based on demographic characteristics and type of clinics visited emphasize the importance of tailoring pharmaceutical services to meet the specific needs and expectations of different patient populations.

Posterior circulation stroke (PCS) may be less prevalent than its anterior counterpart but contributes to substantial morbidity and mortality. The aim was to characterize PCS's demographics, clinical presentation, management, and outcomes between younger and older adults in Saudi Arabia.

This retrospective cohort study was conducted at two tertiary medical centers in Saudi Arabia between March 2016 and December 2020. All patients who presented with symptoms of posterior circulation stroke and had positive brain imaging were included.

The study involved 160 posterior circulation stroke patients, stratified into two age groups: 71 patients aged 18-59 years and 89 patients aged 60 years and above. The mean age of the entire cohort was 60.9 years, and 77 % were males. Hypertension was more prevalent in the older age group (88 % vs. 69 %, p=0.005), and smoking was significantly higher among younger patients (38 % vs. 15 %; p=0.0009). Only 22.4 % received thrombolysis and/or thrombectomy. Most strokes involved the posterior cerebral artery (45.6 %). Large artery atherosclerosis was the most common subtype. At discharge, younger patients had higher NIHSS compared to older patients.

Our investigation of 160 PCS patients in Saudi Arabia uncovers notable trends: a mere 22.4 % received thrombolysis and/or thrombectomy and a significant prevalence of posterior cerebral artery involvement due to large artery atherosclerosis. The study further reveals younger patients disproportionately had severe outcomes. Highlighting the need for improved stroke care and heightened awareness, this research contributes vital data to an underexplored domain, urging further study to optimize care and understand PCS dynamics in Saudi Arabia.

In this study, we investigated the motivations of paramedic staff serving in rural and remote communities, given the consistent shortage of healthcare workers in these areas. Using a modified Global Motivation Scale (GMS) questionnaire, we surveyed 450 paramedics in Saudi Arabia, analyzing data from 379 respondents (response rate: 84.2%) with SPSS 29. Chi-square tests explored demographic links to motivation, and ANOVA compared mean scores across groups (p < 0.05). The results showed a moderate overall motivation (M = 3.37, SD = 0.82), with high intrinsic motivation (M = 3.67, SD = 0.96) and relatively high extrinsic motivation, notably in integration (M = 3.48) and identification (M = 3.41). Age and gender significantly influenced motivation (p < 0.05), with individuals aged 24-30 years exhibiting markedly lower motivation. ANOVA confirmed the age, gender, marital status (unmarried), and EMS experience (5-10 years) as significant factors, while the education, job title, and employment site had no significant impact. Scheffe's post hoc test revealed age-related differences and emphasized the importance of EMS experience. This study suggests that both intrinsic factors and external pressures contribute to the lower motivation in adults in their mid-twenties in rural areas. Experience, particularly in EMS, significantly impacts motivation levels. We recommend tailored interventions that focus on intrinsic motivation and address external pressures to improve retention and care quality.

Background and objective Saudi Arabia's rapid medical education expansion has posed unique challenges for its students, particularly concerning specialty selection. Having broad exposure to medical specialties is crucial for making informed decisions. This study explores how the size of students' hometowns influences their exposure to their preferred specialty, thereby affecting their choice. Methods Our cross-sectional study collected data from medical students in their 4th and 5th years, interns, and graduates across Saudi Arabia. An electronic survey gathered information about medical specialty choice, interest levels, students' self-ranking compared to their peers, and level of exposure to the chosen specialty. Overall exposure to specialties was quantified by tallying participants' experiences in preclinical observerships, didactic lectures, research projects, core and elective rotations, and attended conferences. We divided the students into three city sizes: primary urban centers, intermediate urban cities, and small townships and compared the outcomes between these three groups. Results Responses were obtained from 1,072 participants, with 424 (39.6%) from primary urban centers, 367 (34.2%) from intermediate urban cities, and 281 (26.2%) from small townships. Student hometown size was an independent predictor of specialty exposure, with students from smaller cities reporting lower exposure scores (OR = 0.73, (0.63-0.84), p<0.01). The study also identified gender disparities in exposure, with female students found to be correlated with a lower exposure score (OR = 0.72, (0.58-0.89), p<0.01). Conclusion City size is a significant determinant of specialty exposure for Saudi medical students. These findings highlight the need for initiatives that promote equal educational experiences, ensuring comprehensive specialty exposure to all students.

People with vision impairment encounter many difficulties when it comes to medicines use. However, evidence indicates that there are major gaps in pharmaceutical care service provision worldwide and limited research on interventions to optimise medication use for this patient population. The Theoretical Domains Framework (TDF) provides a method for theoretically understanding individuals' behaviour and informing development of interventions. The aim of this research was to (a) identify the barriers and facilitators to the provision of medication dispensing and counselling services by pharmacists to patients with vision impairment, and (b) identify key TDF domains to be targeted in a future intervention.

Semi-structured interviews were conducted with pharmacists from different pharmacy practice settings/areas in Saudi Arabia. The 14-domain TDF was utilised as the theoretical lens through which pharmacists' behaviours were examined. Interviews were conducted in Arabic or English, either face-to-face or over the telephone based on the participant's preference. Following transcription, interviews conducted in Arabic were translated into English before analysis. Data analysis involved using the framework method and content analysis to identify important barriers and facilitators to the provision of dispensing and counselling services to those with vision impairment. Key TDF domains that could be targeted in a future intervention were then identified using a consensus-based approach.

Twenty-six pharmacists were interviewed. Pharmacists' experience in pharmacy practice ranged from two to 28 years. A range of barriers and facilitators were highlighted as important in providing services to those with vision impairment. Eight domains were identified as 'key domains' including: 'Knowledge', 'Skills', 'Beliefs about capabilities', 'Goals', 'Memory, attention, and decision processes', 'Environmental context and resources', 'Social influences', and 'Behavioural regulation'.

Barriers and facilitators identified by pharmacists will inform the development of an intervention to ensure its applicability to everyday practice. Future research will focus on the process of developing the proposed intervention through targeting key TDF domains to improve medication dispensing and counselling by pharmacists to patients with vision impairment.

Perception of illness (PI) and self-medication (SM) have been thoroughly explored in the existing literature. However, there is a lack of understanding about the mediating effect of health literacy on PI and SM in a non-homogenous population like Saudi Arabia. As such, primary healthcare nurses who have constant interaction with the outpatients have difficulty addressing self-medication. This study aimed to investigate health literacy as mediator between PI and SM among outpatients in the Kingdom of Saudi Arabia (KSA).

This study employed a cross-sectional approach and was conducted at 10 major primary healthcare (PHC) clinics serving 30 million individuals in 13 different regions of KSA. The 424 outpatients who participated in this study were selected through convenience sampling. Data collection started in November 2022 and concluded in February 2023.

The mean of the Brief Health Literacy Screening Tool, self-medication scale (SMS), and PI scores were 13.01 ± 3.32, 27.46 ± 7.01, and 45.56 ± 7.69, respectively. There was a significant relationship between the age and BRIEF scores (p = 0.039), and the level of education was significantly related to all variables, as were nationality and BRIEF scores (p = 0.001). Finally, occupation was significantly related to BRIEF and SMS scores (p = 0.001 and 0.003, respectively). Completing college and being non-Saudi had positively significant effects on health literacy (p < 0.01). The structural equation model (SEM) found no effect of PI on health literacy or SM behaviour (p = 0.263 and 0.84, respectively), but health literacy did have an effect on SM behaviour (p<0.001).

Health literacy is an important factor in self-medication behavior and that PI is not directly related to health literacy or self-medication behavior, but that health literacy does influence self-medication behavior. Therefore, primary healthcare givers should promote public health literacy alongside the control of other conditions as one of the most effective ways to decrease the prevalence of self-medication and the risks associated with it.

While telemedicine offers significant benefits, there remain substantial knowledge gaps in the literature, particularly regarding its use in Saudi Arabia. This study aims to explore health consumers' behavioral intention to use telemedicine examining the associated factors such as eHealth literacy and attitudes toward telemedicine services.

A cross-sectional observational study was conducted to collect data on demographics, health status, internet skills, attitudes toward telemedicine, and eHealth literacy. An online survey was administered at two large public gatherings in Riyadh. The eHEALS-Pl scale was used to measure perceived eHealth literacy levels, and data analysis was performed using SPSS (IBM Corp. United States).

There were 385 participants, with an equal distribution of genders. The largest age group was 18-20 years old (57%). Nearly half of the participants were neither employed nor students, while 43% had access to governmental hospitals through employment. 71% reported proficiency in using the internet. Health-wise, 47% rated their health as excellent, and 56% did not have medical insurance. 87% expressed a high likelihood of using telemedicine if offered by a provider. Participants were categorized based on their eHealth Literacy scores, with 54% scoring low and 46% scoring high. Overall, participants showed positive attitudes toward telemedicine, with 82% agreeing that it saves time, money, and provides access to specialized care. About half of the participants perceived the process of seeing a doctor through telemedicine video as complex. Both eHealth Literacy and attitudes toward telemedicine showed a statistically significant association with the intention to use telemedicine (p < 0.001). There was a positive and significant correlation between eHealth Literacy and attitudes (ρ =0.460; p < 0.001). Multivariate ordinal regression analysis revealed that the odds for a high likelihood of intention to use telemedicine significantly increased with positive attitudes (p < 0.001). Mediation analysis confirmed the significant mediating role of attitudes toward telemedicine in the relationship between eHealth Literacy and the intention to use telemedicine.

The findings underline the importance of enhancing health literacy and consumer attitudes toward telemedicine, particularly during the healthcare digital transformation we are experiencing globally. This is crucial for promoting increased acceptance and utilization of telemedicine services beyond the COVID-19 pandemic.

Introduction Being the first in-line care providers, primary healthcare (PHC) physicians may encounter all forms of medical emergencies, ranging from minor complaints to major life-threatening events; therefore, this study aims to assess the PHC physicians' knowledge and attitude related to the diagnosis and management of emergency cases as well as their preferences for emergency medicine training courses and their preferred methods of training. Methods A descriptive cross-sectional study was conducted among physicians working at PHC in Al-Ahsa, Saudi Arabia, between November and December 2023, excluding those who do not work at PHC. The minimum required sample size was 192. A self-administered online questionnaire was developed using Google Forms and distributed conveniently through social media platforms. It consists of 22 items categorized into four sections: The first section focused on demographic information; the second section assessed knowledge related to the diagnosis and management of emergency cases commonly encountered in PHC, along with actual management experiences; the third section gauged physicians' attitudes, and the fourth section explored participants' preferences for emergency medicine courses and their preferred methods of training in this field. The Kruskal-Wallis rank sum and Wilcoxon rank sum tests were employed to identify predictors of knowledge and attitude. Results The study involved 193 participants, with 96 (50%) females and a median age of 30 years. The participants included 43 (22%) consultants, 69 (36%) family residents, 30 (16%) general practitioners, and 50 (26%) specialists. Participants reported a median of 4.0 years of experience in PHC in Saudi Arabia. The majority, 69 (36%), reported working in the hospital emergency department, with a reported median duration of three months. Roughly 84% of PHC physicians had a positive attitude toward emergency cases diagnosis and management, while 92% showed fair diagnostic knowledge of emergency cases, and 73% showed fair management knowledge. Higher knowledge in the diagnosis and management of PHC was linked to increasing age, being consultants, being employed in the emergency department, and having higher years of experience in PHC (p < 0.05). A positive attitude toward PHC was found to be associated with working as a consultant and being employed in the emergency department (p < 0.05). Approximately 133 (68.9%) expressed a preference for a course in wound care trauma, followed by central nervous system emergencies (n = 124, 64.2%), coronary artery disease emergencies (n = 116, 60.1%), and obstetrics/gynecologic emergencies (n = 114, 59.1%) with 160 (82.9%) favored training through practice in PHC under supervision of qualified staff. Conclusion While many PHC centers are well equipped and prepared for early stabilization and management of emergency cases, PHC physicians showed low competency in dealing with emergency cases. This indicates a great need for enhancing physician's knowledge and skills regarding emergency situations. Nevertheless, courses like basic life support (BLS) and advanced trauma life support (ATLS) should be the bare minimum requirements for PHC physicians. Mote advance training and lectures should be organized to enhance PHC physician competencies to deal with different emergencies.

This comprehensive review examines the dental healthcare system in Saudi Arabia, tracing its evolution, current status, and persisting challenges. The system has evolved significantly due to government initiatives and technological integration, yet it grapples with issues like professional shortages, financial constraints, and disparities in access. Despite improvements in accessibility, geographic and socio-economic disparities persist, and oral health promotion remains limited. The integration of technology faces resistance, and specialized care for people with disabilities requires targeted strategies. Cultural and social factors influence oral health, and the system's response to the COVID-19 pandemic showcases adaptability and patient-centered approaches. Addressing these challenges is crucial for ensuring equitable and effective oral health service delivery in Saudi Arabia.

Delivering high-quality care is a cornerstone of achieving satisfying health outcomes, and evidence-based medicine is the basis for doing so. For that, some governments mandate accreditation programs for the healthcare sector. One of these programs is CBAHI in KSA (SA), and many studies have shown positive healthcare outcomes associated with CBAHI accreditation in SA. While these achievements indicate progress, challenges remain. Variability in the quality of healthcare services across different regions of SA is a concern. Furthermore, the fact that healthcare is a complex industry that is rapidly evolving poses many challenges. CBAHI tries to overcome these challenges by continuously developing standards, obtaining international accreditation, and training surveyors to assess healthcare facilities across SA. The success of these efforts will help enhance the SA healthcare system's credibility and attract international patients who are seeking high-quality care.

Hospitals employ many social workers, whose tasks are complicated and arduous. Quality of life assessments by healthcare professionals (HCWs) are essential for better healthcare and skillful health service delivery. HCWs have been under tremendous mental and psychological strain and at high risk of virus acquisition since the COVID-19 pandemic outbreak.

This study evaluated public hospital efficiency issues and remedies in the Kingdom of Saudi Arabia.

The study examined leadership styles and job satisfaction among Saudi Arabian healthcare workers (HCWs). Between September 1 and December 31, 2021, a descriptive cross-sectional investigation was conducted. During the COVID-19 pandemic, a verified web-based survey reached the appropriate sample and data was collected. A web-based self-administered survey collected demographic data, leadership style using Multifactor Leadership Questionnaire Form 6-S (MLQ-6S), and health care employee satisfaction (SEHC) from HCWs.

Leadership styles affected HCW job satisfaction, according to this study. Individual concern, idealized influence, contingent compensation, and inspiring motivation were negatively correlated with work satisfaction ratings.

Creating a special training programme for new leaders should cover leadership styles and approaches, the skills needed to foster a productive workplace with high-quality care, and the creation of motivated work opportunities that can boost worker engagement and satisfaction.