Cancer care Abroad National look Ahmed I Al-Sagheir Hematologist and medical oncologist KFSH-Dammam King Saud University Saudi Arabia.

Cancer care AbroadNational look

Ahmed I Al-SagheirHematologist and medical oncologist

KFSH-DammamKing Saud University

Saudi Arabia

Fatimah A

• 55 yrs old, new seisures, and breast mass– Mammogram: suspecious, FNA: cancer– CT: confirms metastases, to CNS, bone and liver.– Family meeting

• Need to start palliative radiotherapy and chemotherapy, both are available

• Poor prognosis

• A week later the family wants a medical report, pathology slides and want advise about going to US, Germany or UK and may be Thiland.

Introduction

• Cancer care…definition• What do patients want?

• What does the society want?

• What does the health of the society need?

No good Data

What is the magnitude of the problem?

Introduction

• Cancer care…definition• What do patients want?

• What does the society want?

• What does the health of the society need?

Cancer care– Not only therapeutic

intervention– Screening programs– Early detection– Palliative care

Patients need

• Best possible care

• Access to health care

• Support– Education– Communication– Family support– Financial support

Why do patients choose to go

abroad ?

Patients need

• Best possible care

• Access to health care

• Support– Education– Communication– Family support– Financial support

• Pros– Confidence in health

care– Lack of confidence in

local services– Assumption that

medical errors are less frequent

– Availability of the option– Culture and expectation

Patients need

• Second opinion• Tourism

– Summer vs winter

• Political gains

• Pros– Confidence in health

care– Lack of confidence in

local services– Assumption that

medical errors are less frequent

– Availability of the option– Culture and expectation

Patients need

• Cons– Illness and homesickness– Unnecessary delays– Un-necessary diagnostic

procedures– Lack of familiarity with local

diseases• G6PD

– Lack of support• Societal

• religious

– Financial costs

• Pros– Confidence in health

care– Lack of confidence in

local services– Assumption that

medical errors are less frequent

– Availability of the option– Culture and expectation

Society prospective

• History – Generations of

patients going to Iraq, lebanon and Egypt

• Culture• Inferiority complex• Value system

– Guilt feelings

• Health sector is a major financial drive

• Jobs• Opportunity to

support loved ones during illness

• Companions– Vacation– Family disturbance

• Charity

Public health prespective

• Establishing national registry

• Building on experience– Training

• Long-term care– Cancer survivors

• Costs

Cost of lost opportunities

• Building on experience– Developing training for doctors, nurses, pharmacists,

etc

• National registry– Which ultimately will help identifying pattern of

disease– Help in prevention and planning

• Jobs• Social impacts

No good Data

What is the magnitude of the problem?

Health system in SA

• Ministry of Health (MOH)– KFMC– KFSH-D

• King Faisal Hospital and Research system (KFSH&RC)

• Security forces health system• National Guard Hospitals (NGH)• Military hospitals (MH)• University hospitals• Private sector

New cancer casesSaudi Arabia experience

Population 26 MKFSH&RC NGH KFMC KFSH-D Abroad

2005 ~3000 -- -- -- --

2007 2500 950 800 660 --

2008 ~2300 1000 1000 900 100

Budget

2008

3.2 Billion

SAR

--- 1.6 Billion SAR

1 Billion

SAR

1 Billion

SAR

1 SAR = 0.266 US $

Contributing Factors

• Way the media deals with the medical errors– Exaggeration of medical errors

• How do health care providers act?– Public awareness– Sharing experience

SolutionsTargetting Patient satisfaction

• Satisfied patients are more likely to accept therapy compliance outcomes

• High impact easy gains– Nursing quality and courtesy– Cleanliness of the hospital

Some suggestions

• How would we act as role models?

• What massage does our own actions give..– Story of AbdulRahman Al-Sagheir…my son..

Case AbdulRahman Al-Sagheir

Some suggestions

• Starting research on identifying predictors of good health care at national level

• Monitoring referrals abroad– Indications– Monitor outcomes

• Quality intiatives– Private– Government sectors

• Involving media in talking about achievements• Providing second opinion thought telemedicine

Conclusion

• Cancer care…definition• What do patients want?

• What does the society want?

• What does the health of the society need?

Cancer care– Not only therapeutic

intervention– Screening programs– Early detection– Palliative care

Case AbdulRahman Al-Sagheir

Thank

You