Abstract
The population of the Kingdom of Saudi Arabia (KSA) exceeding 35 million people and in the presence of a non-structured increase in the number of pediatric cardiac centers, we expect to face some concerns like dilution of the service where the volume will be less than the acceptable standards, the increase in mortality and morbidity, and failure to obtain personalized medicine at a reasonable cost. Therefore, we built up this survey questionnaire about those concerns and collected the opinion of expert medical staff in Saudi Arabia who are working in the field of pediatric cardiology. Seventy percent of the responders vs. 25% recommend the centralization of the PCS as the solution for the above concerns, and 94% recommend sticking to the globally accepted criteria when issuing the license of the centers providing PCS including the volume of patients in each center, and minimum multidisciplinary facilities in terms of resources, services, and personnel.
Highlights
The population of the Kingdom of Saudi Arabia (KSA) exceeds 35 million people (1); the birth rate continues to show a decreasing pattern in the recent report of the World Bank (2).The recently reported prevalence of congenital heart disease in KSA looks to be higher than reported in other populations in the Middle East and Europe (3)
In the presence of a non-structured increase in these centers, we expect to face the same global issues that emerged in comparable situations (4), those issues including the concern of dilution of the service where the volume will be less than the acceptable standards (5), the increase in mortality and morbidity (6), and failure to maintain quality medicine at a reasonable cost (7)
The majority (70%) of responders expect that the centralization of pediatric cardiology services (PCS) in the centers of each province will improve the outcome of these services and decrease morbidity and mortality as it was proved in many registries and reports in Europe (6) and the United States (4)
Summary
The recently reported prevalence of congenital heart disease in KSA looks to be higher than reported in other populations in the Middle East and Europe (3) We explain that this relative prevalence increase, when compared to neighboring countries, is due to an increase in PCS in a well-structured system, while when compared with European countries it might be related to higher inbreeding and fertility in KSA compared to European countries. The institution of more centers mandates the presence of all comprehensive hospital practices that must run 24/7/365 These include all levels of urgency as well as all other specialties of the hospital system (including radiology, laboratory medicine, pharmacy, and blood bank) (4), which could represent an unreasonable load to the health system. These concerns are studied in many developed countries and they consider the centralization of the PCS to a few centers a practical solution for these concerns (6–8)
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