Evaluation of Home Respiratory Therapy Delivered to Patients in the Ministry of Health's Home Medical Program (HMP) and Administered through the Madinah HMP Center, Kingdom of Saudi Arabia, 2013 Público

Abstract

Objective:

To evaluate home respiratory therapy (HRT) administered through the Madinah Home Medical Program (MHMP) Center in the Ministry of Health's (MoH) Home Medical Program (HMP), Kingdom of Saudi Arabia (KSA)

Methods:

Using a retrospective design and descriptive analyses, we evaluated HRT delivered through the MHMP Center. We analyzed the characteristics of patients enrolled (N = 83), including clinical care received and outcomes. From an economic perspective, we also assessed a 30-patient subset for cost.

Results:

Population: Among the 83 patient-records evaluated, 72% were > 60 years of age. Most were female (80%) and of Saudi nationality (90%), and 56% percent were not married.

Clinical diagnosis: Asthma accounted for 34% of diagnosed respiratory disease; other diagnoses included chronic obstructive pulmonary disease (COPD) (11%), respiratory failure (10%), and lung fibrosis (8%).

HMP: Eighty-three of 574 (14%) MHMP Center patients received HRT. Among them, 59 of 83 (71%) required two or three respiratory modalities, and seven of 83 (8%) required four. Most HRT patients (78 of 83, 94%) used respiratory treatment modalities like oxygen therapy; while only 12 of 83 (14%) were on mechanical ventilation.

Outcomes: Patients (or their caregivers) had a high level of satisfaction regarding HRT services provided through the MHMP Center (37 of 41,90%). Almost half (36 of 83, 43%) of patients enrolled receiving HRT through the MHMP Center saw an improvement in their condition; 48% remained clinically static (i.e., neither improvement nor deterioration), and 8% (7 of 83) deteriorated or died. Costs savings were achieved in delivery of HRT through the MHMP Center as measured by reduced emergency room and outpatient department visits after HRT enrollment compared to before HRT enrollment.

Conclusion:

HRT administered through the MHMP Center improved clinical outcomes and increased patient satisfaction while reducing hospital utilization and associated costs. While this evaluation was just descriptive, prospective studies (i.e., a randomized trial, cost-effective study) seem well-justified to carefully assess MHMP services in comparison to hospitalization.

Table of Contents

Chapter 1.Introduction...1 Chapter 2.Review of Literature...7 Chapter 3.Manuscript...12

Chapter 4. Conclusion and Recommendations...38

References...39

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Palavra-chave	Effectiveness Evaluation Saudi Arabia Home health care Respiratory therapy
Committee Chair / Thesis Advisor	McNabb, Scott JN, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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