Equality, Accessibility and
Affordability – Planning for
the Future of Rehabilitation
in Saudi Arabia & GCC
Abdullah Bin Zarah
Executive Director of Clinical Affairs
Director of Business Development
Sultan Bin Abdulaziz Humanitarian City
www.humanitariancity.org.sa
Health-Care
A physician is obligated to consider more than a diseased organ,
more even than the whole man - he must view the man in his
world - Harvey Cushing
A Short History of Medicine
2000 B.C. - "Here, eat this root."
1000 B.C. - "That root is heathen, say this prayer."
1850 A.D. - "That prayer is superstition, drink this potion."
1940 A.D. - "That potion is snake oil, swallow this pill."
1985 A.D. - "That pill is ineffective, take this antibiotic."
2000 A.D. - "That antibiotic is artificial. Here, eat this root."
~Author Unknown
Health is a state of complete
physical, mental and social wellbeing and not merely the absence of
disease or infirmity.
WHO
Rehabilitation
Is the right to equitable and
affordable healthcare and
rehabilitation services a right or a
benefit?
I believe it to be a fundamental right
for a citizen to be able to access
equitable and affordable healthcare.
Countries needs to put their
strategic plans and implementation
actions and executing programs to
fulfill that goal.
HealthCare - Principles
CONSIDER THOSE THREE PRINCIPLES
WHEN YOU STRATEGIZE/PLAN
Equality – That everyone is able to access a base level
of healthcare services regardless of any other criteria.
Accessibility – Regardless of location, each resident
has access to comparable healthcare services.
Affordability – A mechanism is in place that ensures
affordability for all residents. Whether it is through a
public or private options or a combination of both.
Health Care Trends
• Gradually rising share of aging population. Currently it is
estimated that 994,512 or 4.2% of population are classified at
60+. By 2015, it is estimated this group will compromise 4.5% of
population which translates to a growth of 327,506 to 1,322,017.
This age group require more frequent and expensive intensive
interventions.
• 95% of strokes occur in people age 45 and
older, and two-thirds of strokes occur in those
over the age of 65.
• The risk of stroke is two-and-a-half times
in people with diabetes. Research shows that
around 66% of those who experience a stroke
can benefit from receiving intensive
rehabilitation.
Health Care Trends
•
•
•
Cardiovascular diseases and Obesity are alarmingly increasing. Due
to lifestyle we are now seeing strokes and MI in people as young as
30.
According to WHO Saudi Arabia has one of the highest
obesity rates with 35.6% population classified as
over-weight. Prevalence of diabetes is at 22-25%
according to WHO.
Trauma and RTA. Highest rate of RTA accidents
and mortality in the GCC.
Rehabilitation Coverage
1. Acknowledged Deficiency
2. Fragmented services
spread between multiple
organizations.
3. No national strategy
implemented.
4. No comprehensive
interdisciplinary
approach.
5. Majority of organizations
are either charitable or
not-for-profit.
Interdisciplinary Vs.
Multidisciplinary
Sultan Bin Abdulaziz Humanitarian
City a Role Model
• Multidisciplinary
• Program and Outcomes Specific
• Focus on discharge Plan
• Combination of acute and rehab
services under one umbrella
• Planning for life-after rehab
• Disability Advocacy, Public Policy
and Community Awareness
Campaigns.
Sultan Bin Abdulaziz Humanitarian
City.
• Stroke, Amputee, TBI, SCI, Pediatrics, WHU
programs.
• With specialized programs such as
Hippotherapy and Vital Stim.
• Combined with a fully equipped acute
hospital with O.Rs, Hemodialysis etc…
• Working with national, regional and
international organizations to further
rehabilitation within Saudi Arabia and the
GCC.
Centralized Vs. Decentralized
All has to be patient centered
Pressing Issues
• Inefficient scattered initiatives and programs.
•lack of national registries, reliable and accurate data, statistics and
specialized studies and weak research on disability, types, causes and
available services, Efficacy of care provided, Continuum of care.
• No national or even regional institution that collects reliable
healthcare information on disease incidence and treatment
effectiveness let alone rehabilitation.
• Such an institute will provide decision makers with better information
for planning and disease management and badly needed tool for
forecasting futuristic trends and most efficient utilization of limited
resources.
• Currently rehabilitation is a neglected segment with no clear
guidelines on health care provision.
Pressing Issues
•Provision of a comprehensive rehab coverage as part of the national
health insurance scheme.
•A effective national body to coordinate strategies and plans and
their timely execution with all stakeholders/providers to ensure
quality rehabilitation for the entire population.
• Privatization initiatives, A heavy focus on Private Health Care
provisioning means that less attention is paid to prevention.
• The government must focus on prevention, education and primary
health care.
•Funding health care services is an ever increasing burden on
governments and is a political struggle in most nations.
Health Care Funding
• Due to the global recession and even before, governments around
the word are struggling to maintain health care levels as Health Care
expenditure as a percentage of GDP continues to grow.
• Normally charity organizations suffers most during financial
hardships.
• Cost effective approaches are sought by governments but at
unsatisfactory outcomes.
•More efficient economical options remains to be explored.
Strategies…The Way Forward
•Establish nationwide strategies and programs to tackle the
disability from a global scientific approach.
•Prevention is the fundamental aspect to tackle the future trends.
•Develop a sustainable financial scheme to fund and provide
rehabilitation coverage for all without any discrimination.
•Clarify funding guidelines – so as to incentivize the private
sector.
•Rehabilitation care may be administered by both private and nonfor profit organizations.
• Drug and equipment prices are negotiated by a single national
authority.
• All medical services and conditions are covered until the patient
achieves optimal functional ability.
Strategies…The Way Forward
• With a greater focus on CBR and brining rehabilitation services
to people in their area, rather then having to travel long distances.
•Establishment of national or even regional database that collects
relevant data so that it may be disseminated to interested stakeholders.
•Provision of PPP insurance programs to include rehabilitation as
a component of the insurance scheme.
• Build own capacity by all stakeholders to offer the needed
services at the right quality and magnitude.
• An alternative to the fee for service model, instead health care
providers reimbursed on the over all health outcomes of their
patients.
• Focus on prevention and education by governments.
Strategies…The Way Forward
• Invest in people, Numerous studies have shown the economic
rationale for rehabilitation services. Governments and nations
will save huge budgets over the long run.
• There are savings of millions of dollars and riyals if
comprehensive rehabilitation is provided at right time to the
right people.
• Multiple social benefits as these people can rejoin society as
productive members.
• Family members can be assured that their loved ones are taken
care of and don’t have to devote time to take care of them.
• More productive people means stronger and stable nations.
Thank You
A win-win situation for every-one!