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According to the Ministry of Health in Saudi Arabia, patients may consult the services of private healthcare institutions when there are no adequate beds in public facilities especially during emergency situations (Ahmad, 2012). It is crucial to mention that the government foots the medical bill for a patient who has sought help in a private hospital owing to lack of similar services, equipment or drugs in a government institution.
Critical cases that demand emergency admissions are also permissible under this clause. For instance, admissions at the intensive care unit for newborns, pediatric care and adults are supposed to be taken care by the government when a public healthcare facility is not available at the same time. In addition, the ambulatory emergency cases are covered by the system if the services are executed by non-government hospitals. However, the nearest hospital should offer the services through the Saudi Red Crescent. In addition, the provision covers patients who have been admitted in government hospitals for extremely long period of time.
Long-term admissions in government healthcare facilities can be categorized in different levels (Hassanain, Assaf, Al-Ofi & Al-Abdullah, 2013). Nonetheless, it is the responsibility of the ministry of health to provide care services to such patients regardless of their levels of their admission. As a matter of fact, some patients may be admitted in government hospitals for some years leading into a hefty financial burden for the affected families.
When patients are admitted in government facilities for several months or even a couple of years, it obviously results into shortage of beds. Since this has been a persistent problem in the healthcare sector, the Saudi government opted to collaborate with the private healthcare sector to address the challenge. Hence, patients who fall in the above three categories can be treated free of charge in private hospitals courtesy of the Saudi government (Yang, Shih, Chang, Huang & Chien, 2011).
The neurology department and intensive care units are the worst affected divisions in both private and public hospitals when it comes to long-term admissions. For example, between 50 and 60 ICU bed spaces in Riyadh are occupied by patients admitted for long periods. On the other hand, about 25 to 30 percent of patients in other hospitals are mainly comprised of patients who have stayed for long in healthcare facilities (Hassanain, Assaf, Al-Ofi & Al-Abdullah, 2013).
Owing to financial constraints for meeting medical expenses, some families are often compelled to abandon their patients in healthcare facilities. As a result, the managements of such hospitals are obliged to admit the affected patients. Worse still, some powerful and influential individuals also fight to prolong the stay of their patients in hospitals even if they have fully recuperated. The latter overburdens facilities (including bed shortage) in a hospital. Most of these patients are mainly comprised of men and women from the Armed Forces Hospital who may sometimes stay in hospitals for up to nine years (Al-Omar & Al-Ghanim, 2010).
The global ratio of patients who stay for long in hospitals is roughly 25% of the total number of admissions. Healthcare statistics in Saudi Arabia also prove the same figures. The latter explains why the post-acute care services have been improved by the western nations. As it stands now, post-acute care facilities in the western world has been increased to almost 33 percent per year in order to address medical challenges that cannot be adequately addressed with home settings (Hassanain, Assaf, Al-Ofi & Al-Abdullah, 2013).
Categories of patients who are usually admitted for long stay in hospitals include those suffering from stroke, road accidents, patients with special needs “Ventilator, dialysis, bed sores, feeding through tubes,” patients without families as well as poor patients who definitely require financial assistance (Al-Omar & Al-Ghanim, 2010).
Patients with long stays in hospitals are a major healthcare challenge in Saudi Arabia due to the high costs involved. Estimates reveal that a single patient who has been admitted for a long time in a Saudi healthcare facility requires between $400 and $500 on a daily basis. Specialists estimate that the total cost of staying for one day in a post-acute care hospital ranges between $250 and $350 (Yang, Shih, Chang, Huang & Chien, 2011).
Redistribution of health service budgets in Saudi Arabia assists in offering balanced and fair healthcare services to the population. King Fahad hospital in Riyadh has already managed to set up special units for patients with long-stays. However, the unit has become fully occupied thereby compelling the hospital to contract private hospitals to accept some of these patients whenever the need arises (Al-Omar & Al-Ghanim, 2010).
Psychiatric patients are among those who usually stay for too long in public healthcare institutions. There are diverse factors that contribute towards the long stay of psychiatric patients. For instance, there are psychiatric patients who stay for long in healthcare facilities because they are supposed to continue with their treatment plans within the hospital even though they have sensibly recovered. Such patients cannot be discharged in a hurry. Consequently, they end up staying for long in hospital facilities.
The current number of available beds is not compatible with the growing size of psychiatric patients in psychiatric hospitals. A total of 1792 beds are available while psychiatric patients with long stays occupy 1120 beds. This leads to massive congestion or a complete lack of bedding space for other patients (Al-Omar & Al-Ghanim, 2010).
There are a number of impacts associated with long stays in healthcare facilities. First, there are several patients who eventually lack beds in hospitals and therefore, cannot receive the much needed and urgent medical care. Some emergency departments tend to extend the length if stays for patients before they can access crucial facilities for treatment. On a daily basis, between 20 and 30 patients are served in the emergency department and in most cases, they have to line up and wait for hospital beds top be available. Some emergency patients even wait for more than six hours before they can be formally admitted (Yang, Shih, Chang, Huang & Chien, 2011).
The kingdom of Saudi Arabia urgently requires additional post-acute care healthcare facilities and rehabilitation centers so as to alleviate the challenge of costly long stays in hospitals. Such hospitals do exist currently and unless some pragmatic steps are put in place, Saudi citizens will continue to bear the brunt of expensive medical bills for long stays in hospitals. The high rate of occupancy in both the neurological department and Intensive Care Units is unbearable. Apart from the public-private partnership in the provision of healthcare services for post-acute care, the government of Saudi Arabia should invest in additional bedding spaces in public hospitals in order to reduce congestion and length of stay in hospitals.
References
Ahmad, A. M. K. (2012). Macro-environment influences on health service strategy in saudi private sector hospitals: An empirical investigation. International Business Research, 5(5), 49-64.
Al-Omar, B., & Al-Ghanim, S. (2010). Utilization of hospital resources: A survey- based study of saudi hospitals in riyadh city. Clinical Governance, 15(2), 134-141.
Hassanain, M. A., Assaf, S., Al-Ofi, K., & Al-Abdullah, A. (2013). Factors affecting maintenance cost of hospital facilities in saudi arabia. Property Management, 31(4), 297-310.
Yang, C., Shih, N., Chang, W., Huang, S., & Chien, C. (2011). Long-term medical utilization following ventilator-associated pneumonia in acute stroke and traumatic brain injury patients: A case-control study. BMC Health Services Research, 11, 289.
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