© 1995 Faculty of Public Health Medicine of the Royal Colleges of Physicians of the United Kingdom
research-article |
Clinical and epidemiological pattern of long-stay in-patients: an opportunity for the provision of out-reach community services in Saudi Arabia
Sulaiman Al-Shammari, Associate Professor and Coordinator of Residency Program in Primary Health Care
Jamal Jarallah, Associate Professor and Chairman
Ferial Felimban, Assistant Professor
Mohammad El-Shabrawy Ali, Professor
Suleiman Al-Bilali, Ex-Director General of Hospitals Hospitals, Ministry of Health, Riyadh
Jaafer Hamad, Consultant, General Directorate of Hospitals
Department of Family and Community Medicine, College of Medicine P.O. Box 2925, Riyadh 11461, Saudi Arabia
Address correspondence to Dr. Sulaiman Al-Shammari
BACKGROUND: The aim of the present study was to find out the clinical and epidemiological pattern of long-stay in patients.
METHODS: A cross-sectional survey of long-stay patients in Ministry of Health general hospitals was conducted during the period January–June 1993. A trained research team which consisted of a physician, a nurse, social workers and medical record officers completed a pre-designed data form and interviewed treating teams, patients and their relatives. The data form consisted of sociodemographic data of patients, their duration of stay, and their clinical, social and psychological characteristics. The doctors', patients', their relatives' perceptions and their preferences about the place of care (hospital or home) plus the geographical location of the hospitals involved were also recorded.
RESULTS: Of the 1194 patients, 55 per cent came from either the central or southern regions. Male patients represent 65·2 per cent and the elderly (> 60 years of age) 41·6 per cent. Multiple pathologies were found in 50·9 per cent and special signs and symptoms, e.g. incontinence, were found in 59 per cent. The medical team felt that 54·1 per cent of all patients did not need nursing or required only routine nursing care. Treating doctors thought that 16·2 per cent of patients did not need admission and that a further 54·8 per cent could be cared for in the patient's home. However, 47·5 per cent of patients preferred to stay in hospital, and 60·6 per cent of their relatives preferred them to remain in hospital.
CONCLUSIONS:: There is a need to plan for more cost-effective facilities for these patients. Any proposed health services will have to be culturally acceptable so as to encourage patients and relatives to utilize them.