Hospitals In Makkah Research Articles

Response of the intravenous versus oral antibiotic regimen in brucellosis bacteremia.

BACKGROUND AND OBJECTIVE: More than 500,000 new cases are reported globally annually. The World Health Organization recommends doxycycline with rifampicin or an aminoglycoside for brucellosis bacteremia. Some experts prefer to use doxycycline and rifampicin. We aimed to observe the response rate of intravenous versus oral anti-brucella therapy regimens in brucellosis bacteremia patients and compare the frequency of side effects and complications in both groups. METHODOLOGY: This observational study included adult brucellosis bacteremia patients treated in a hospital in Makkah, KSA for four years. According to the method of treatment (oral versus IV antibiotics), patients were grouped into two categories. Following the treatment, all these patients’ records were evaluated. The negative blood culture was the primary endpoint whereas complications and all-cause mortality were secondary endpoints. The chi-square test, Fisher's exact test, and Mann-Whitney U test were applied accordingly to analyze the two groups’ characteristics. RESULTS: A total of 93 cases were enrolled, the majority were males i.e., 64 (68.8%); with a mean age group (44.33 ±19.22 years). In total, 37 (39.8%) of patients were given IV regimens and the remaining 56 (60.2%) of patients were given oral regimens. Follow-up negative blood culture after 4 weeks was 90.3% (n = 84). The recovery rate was 93.5% (n = 87). No death was reported over this period. No difference was observed (P-value 0.309) between the oral and IV treatment regimens regarding the blood culture negativity. CONCLUSION: Oral doxycycline-rifampicin (DR) and IV gentamicin-doxycycline-rifampicin (GDR) regimens have similar response rates in bacteremia brucellosis.

Identifying Work-Related Injuries Among Healthcare Workers in Makkah Hospitals, Saudi Arabia: A Cross-Sectional Study in 2024.

Background Work-related injuries (WRIs) are a major occupational health issue among healthcare workers (HCWs) worldwide. HCWs face numerous daily hazards including needlestick injuries, chemical exposures, ergonomic strains, and psychological stressors crucial for their health and healthcare system functionality.In Makkah, Saudi Arabia, healthcare infrastructure advances raise concerns about work-related injuries among HCWs. This study in Makkah hospitals aims to identify, understand, and manage WRIs for improved occupational health guidelines and strategies. Methods This descriptive cross-sectional study on HCWs was conducted at Makkah hospitals using an electronic questionnaire that investigated the demographics, work-related injuries, and occupational hazards. The data collected from the retrieved questionnaires were analyzed using the IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States). Results Among 379 enrolled HCWs, 172 (49.3%) were physicians and 89 (19.8%) were nurses; 304 (80.2%) of the total participants knew about occupational safety. The total incidence of WRIs was 67.8%. WRIs were significantly associated with age (P˂0.001), gender (P=0.02), educational level (P˂0.001), profession (P˂0.001), working hours (P˂0.001), and shift time (P˂0.001). Conclusion WRIs were highly prevalent among HCWs with varying rates based on the type of injury and the frequency of injury. WRIs were associated with various factors including age, gender, education, profession, working house, and shift time of the participants.

Patient safety culture in a tertiary care hospital in Makkah, Saudi Arabia, a cross-sectional study

BackgroundPatient safety remains an area of global concern, and patient safety culture among healthcare staff is one of its most important determinants. Saudi Arabia is investing much effort in enhancing patient safety. Assessment of patient safety culture is enlightening about the impact of such efforts and invaluable in informing policy makers about future directions. This study aimed to assess patient safety culture in King Abdullah Medical City (KAMC), a tertiary referral center in Makkah, Saudi Arabia.MethodsIn this cross-sectional study the Hospital Survey on Patient Safety Culture (HSOPSC) version 2.0 was distributed electronically to all staff of KAMC. The HSOPSC version 2.0 Data Entry and Analysis Tool was used to compare results obtained from KAMC to those obtained from global data. Additional analyses were performed on SPSS to explore the presence of associations between responses and participant characteristics.ResultsA total of 350 participants completed the questionnaire, 58.6% of whom were nurses. A comparison of the composite measure of all 10 domains of the HSOPSC showed 62% positive responses at KAMC versus 70% in the global database. This difference was statistically significant, with a chi-square of 10.64 and a p value of 0.001. The percentages of positive responses from the KAMC data exceeded those from the global data in the “Organizational learning and continuous improvement” and the “Communication about error” domains (p = 0.002 and 0.003, respectively).ConclusionAlthough safety culture seems to score lower at KAMC than globally, accelerated improvement in the future is expected based on improvement trends in the literature and the national efforts focused on patient safety.

Prevalence of Varicose Veins Among Surgeons: A Cross-Sectional Study.

Background Extended periods of standing, obesity, female sex, and older age are risk factors associated with a higher probability of developing varicose veins (VV). This study aimed to determine the prevalence of VV among surgeons in public hospitals inMakkah, Saudi Arabia, and to identify the risk factors associated with this condition. Methodology This is a descriptive cross-sectional study based on a validated online questionnaire distributed via hospital WhatsApp(Meta Platforms Inc., Menlo Park, CA) groups conducted between January and June 2024. The inclusion criteria of this study were surgeons of both sexes and any age group working in the selected hospitals in Makkah City, who agreed to participate in the study. The exclusion criteria were any other healthcare workers from outside the surgical field. We included 192 participants, and Epi Info software (Centers for Disease Control and Prevention, Atlanta, GA) was used to calculate the sample size. The data were collected, reviewed, and then fed into IBM SPSS Statistics software for Windows version 21 (IBM Corp., Armonk, NY). Every participant filled out a consent form. The university ethics committee of Umm Al-Qura University, Makkah, granted ethical permission. Result This study comprised 192 surgeons in Makkah hospitals. Twenty-eight surgeons were either diagnosed with VV or had signs of VV. Varicose veins were detected among 50% of thoracic surgeons, 42.9% of pediatric surgeons, and 26.3% of orthopedic surgeons. The most reported risk factors were a family history of VV (17%), hypertension (16%), and diabetes mellitus (14%). Surgeons aged 40 years or older had a higher prevalence of VV than younger ones. Also, 55.6% of obese surgeons had VV compared to 7.8% of others with average weight. Conclusion We found that VV is a common problem, particularly among individuals with predisposing factors, such as long standing hours, smoking, pregnancy, and obesity. We found that surgeons specializing in thoracic and pediatric specialties and female surgeons were more likely to be affected by VV. Preventive measures, such as avoiding prolonged standing, wearing compression stockings, and maintaining a healthy lifestyle, are recommended.

Seroprevalence of transfusion-transmitted infections among blood donors in Makkah, Saudi Arabia.

Blood donation is vital for healthcare; however, transfusion-transmitted infections (TTIs) pose a serious risk. This study investigated the seroprevalence of TTIs among Saudi blood donors. This retrospective study included male blood donors aged ≥ 18 years who donated blood at Al-Noor Specialist Hospital in Makkah from January 2017 to December 2022. The blood units were screened for hepatitis B surface antigen (HBsAg) and core antibodies (HBc-IgG), hepatitis C antibodies (HCV-Abs), syphilis, HIV-1 antigen/antibody (HIV-1 Ag/Ab), human T-lymphotropic virus 1, 2 (HTLV-1/2), and malaria. There were 40,287 donors with an average age of 44.33 ± 18.12 years, and 62.3% (n = 25103) were Saudis. The overall rate of TTIs seropositivity was 7.4% (n = 2953); HBc-IgG (6.1%; n = 2473) was the most common, followed by HCV-Abs (0.4%; n = 177), and syphilis (0.34%; n = 136). All cases were negative for malaria, whilst HIV and HTLV positive donors were 0.06% (n = 24) and 0.13% (n = 52), respectively. Syphilis was more prevalent among non-Saudis (0.24%; n = 83) than among Saudis (0.1%; n = 53), whereas anti-HBc antibodies seropositivity was significantly higher among Saudi (3.4%; n = 1373) than non-Saudi donors (2.7%; n = 1100). Hepatitis B virus was the most frequently detected bloodborne pathogen, followed by hepatitis C virus and syphilis. Hepatitis B virus was also more prevalent among Saudi donors, whilst expatriates had higher rates of syphilis. Additional prospective multicenter studies are needed to accurately determine the prevalence of TTIs in Saudi Arabia.

Outcomes of central nervous system tuberculosis in Saudi Arabia: a multi-center study

ABSTRACT Objectives Central nervous system tuberculosis (TB) (CNS-TB) can occur in several forms, including intracranial tuberculoma, tuberculous brain abscess, TB meningitis (TBM), and spinal TB. Early treatment can save lives and prevent severe neurological complications. This study aimed to describe the characteristics and post-treatment outcomes of patients with CNS-TB and identify factors associated with poor outcomes. To the best of our knowledge, this is the largest CNS-TB study till date published in Saudi Arabia. Methods This retrospective cohort study included all patients diagnosed with CNS-TB in three tertiary centers in Saudi Arabia (King Abdulaziz Medical City in Jeddah, King Abdulaziz Medical City in Riyadh, and Al-Noor Specialist Hospital in Makkah) between 2009 and 2019. Data of patients’ demographics, co-morbidities, presenting symptoms, type of CNS-TB, medical and surgical treatments, and outcome after completion of treatment were obtained from medical records. Treatment outcomes were categorized using the modified Rankin Scale for neurological disability. Results A total of 140 participants were included in this study from 2009 to 2019. Good outcomes were achieved in approximately 65% of cases, whereas 35% had poor outcomes based on the modified Rankin Scale. Glasgow Coma Scale score ≤10 at presentation and TBM/tuberculoma were significantly associated with poor outcomes. Moreover, the use of corticosteroids, more than three anti-TB medications, and surgical interventions were not significantly associated with good or poor outcomes. Discussion CNS-TB is associated with a high burden of long-term neurological morbidity. Early detection and treatment are crucial to prevent serious complications and decrease morbidity and mortality.

Overuse and waste of blood units in Makkah hospitals: A call for action

Overuse and waste of blood units in Makkah hospitals: A call for action

Factors Influencing Exclusive Breastfeeding in Saudi Arabia.

Exclusive breastfeeding is defined as the practice of providing infants with breast milk as their sole source of nourishment for the first six months of life. This study investigated the factors influencing exclusive breastfeeding practices in Makkah, Saudi Arabia. The study employed a descriptive cross-sectional study design. Data gathered from 340 mothers attending the Maternity and Childhood Hospital in Makkah provided insights into the demographic profiles and postpartum practices of participants. The study revealed the significance of early breastfeeding initiation and the provision of pre-birth breastfeeding information in extending the duration of exclusive breastfeeding. There was a statistically significant difference between mothers who had Cesarean section deliveries and those who had natural deliveries in terms of exclusive breastfeeding duration. These findings have essential implications for healthcare professionals, policymakers, and future research endeavors, emphasizing the importance of healthcare education and timely support in promoting extended exclusive breastfeeding practices.

Evaluating Adherence to Therapeutic Drug Monitoring Guidelines for Gentamicin in Neonatal Care: A Retrospective Study at the Maternity and Children's Hospital in Makkah.

In this study, we assess healthcare providers' adherence to therapeutic drug monitoring (TDM) guidelines for gentamicin in neonates. Conducted at the Maternity and Children's Hospital in Makkah, Saudi Arabia, from July 2020 to July 2022, it retrospectively analyzed the compliance of healthcare workers in managing neonates treated with gentamicin. Covering 410 neonates, primarily diagnosed with respiratory distress (56%) and sepsis (32%), the study revealed that while a majority of trough and peak levels conformed to guidelines, substantial deviations were noted in cases of respiratory distress. This underlines the necessity for targeted TDM strategies, particularly in managing respiratory distress in neonates, to ensure optimal treatment efficacy and safety. The findings urge stringent compliance with TDM guidelines, emphasizing personalized approaches in neonatal gentamicin therapy for improved healthcare outcomes.

Adherence of Hemodialysis Patients to Fluid, Diet, Medications, and Hemodialysis Sessions, Makkah, Saudi Arabia.

The adherence of hemodialysis (HD) patients to medical instructions is considered crucial for a longer life expectancy and better quality of life. Despite its importance, there is a remarkable paucity in research dealing with the adherence of patients under HD in Saudi Arabia. The objective of this study was to identify the prevalence of adherence to fluid, diet, medications, and HD sessions among HD patients in Makkah. This was a cross-sectional study in which 361 HD patients were randomly selected from HD centers in three governmental hospitals in Makkah. Individuals were assessed for adherence using the End-Stage Renal Disease Adherence Questionnaire in addition to a clinical examination and laboratory investigations. These methods were used to identify the level of adherence to fluid, diet, medications, and HD sessions. The frequency of adherence of patients was found to be high for dietary guidelines (88.4%), fluid restriction (87.8%), and medications (88.0%), but it was relatively low for adherence to HD sessions (56.0%). The overall adherence rates in the current study population were thought to be within the range of most published international studies.

Prevalence and Severity of Ectopic Eruption of First Permanent Molars in Pediatric Patients in Makkah, Saudi Arabia.

Background Early detection and management of ectopic eruption (EE) of first permanent molars (FPMs) are crucial to avoid complicated treatments later. Aim This study aimed to assess the prevalence and severity of EE of FPMs among children in Makkah, Saudi Arabia. Methods This retrospective study was based on a radiographic evaluation of 1,008 dental panoramic radiographs performed for children attending the Dental Educational Hospital at Umm Al-Qura University and the Security Forces Hospital in Makkah. Patients' age, sex, tooth location, and severity of EE were assessed. The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline for cross-sectional studies. Results Of the 1,008 reviewed cases, 18 (1.79%) were diagnosed with EE of FPMs. Among the 11 male patients, 81.82% showed severe EE, while 57.14% exhibited moderately severe EE among the seven female patients. The prevalences of EE in the maxilla and mandible were 1.59% and 0.20%, respectively. In contrast, the occurrence of EE of FPMs was similar between the right and left sides. Conclusion In this study, the prevalence of EE of FPMs among children in Makkah was 1.79%. The frequency and severity were both greater in male patients compared to female patients. While significantly more EE of FPMs was observed in the maxilla than in the mandible, there was no significant difference between the right and left sides.

A Multi-Objective Facility Coverage Location Problem for Emergency Medical Service Decisions in Hajj

This paper proposes a multi-objective facility model of coverage location problem to determine the number, locations, and redeployments of Emergency Medical Services (EMS) system. The EMS runs with two types of ambulances, Basic Life Support (BLS) and Advance Life Support (ALS). The suggested Multi-objective Coverage Location model (MO-CL) considers a bi-objective function, which is minimizing the EMS costs and the fatigue of EMS crew members. This can be managed by reducing the number of redeployments for both types of ambulances while still providing the required coverage levels. The MO-CL model is based on the approximation hypercube model that eliminates the assumptions of autonomous ambulance operation and system-wide busy probability. It can be solved by applying a modified MO-CL search algorithm. The model and solution method have been applied for a case study based on real data collected from the Al Noor Specialist Hospital in Makkah, Saudi Arabia during the period of fifteen days of Hajj pilgrimage. The results showed that, to achieve the 95% coverage threshold of critical and non-critical demand, the MO-CL model needs at least 64 ambulances (29 ALS, 12 for BLS backups, and 23 for BLS) and 19 redeployments for every day (9 for ALS, 2 for BLS backup, and 8 for BLS).

Point Prevalence Survey of Antimicrobial Use and Resistance during the COVID-19 Era among Hospitals in Saudi Arabia and the Implications.

The inappropriate prescribing of antimicrobials increases antimicrobial resistance (AMR), which poses an appreciable threat to public health, increasing morbidity and mortality. Inappropriate antimicrobial prescribing includes their prescribing in patients hospitalized with COVID-19, despite limited evidence of bacterial infections or coinfections. Knowledge of current antimicrobial utilization in Saudi Arabia is currently limited. Consequently, the objective of this study was to document current antimicrobial prescribing patterns among Saudi hospitals during the COVID-19 pandemic. This study included patients with or without COVID-19 who were admitted to five hospitals in Makkah, Saudi Arabia. Data were gathered using the Global PPS methodology and analyzed using descriptive statistics. Out of 897 hospitalized patients, 518 were treated with antibiotics (57.7%), with an average of 1.9 antibiotics per patient. There were 174 culture reports collected, representing 36.5% of all cases. The most common indication for antibiotics use was community-acquired infections, accounting for 61.4% of all cases. 'Watch' antibiotics were the most commonly prescribed antibiotics, with the cephalosporins and carbapenems representing 38.7% of all antibiotics prescribed, followed by the penicillins (23.2%). Notably, Piperacillin/Tazobactam and Azithromycin were prescribed at relatively higher rates for COVID-19 patients. These findings highlight the need for continuous efforts to optimize the rational use of antibiotics through instigating appropriate antimicrobial stewardship programs in hospitals and, as a result, reduce AMR in the country.

Parental Knowledge of Appendicitis and Its Management Options Among Children of Makkah Region, Saudi Arabia.

Despite decades of studies, appendicitis in children still presents several uncertainties regarding optimal treatment. To assess parental understanding of appendicitis, along with its risks and treatment, and to determine attitudes to operative and non-operative treatment of uncomplicated appendicitis. This is a cross-sectional study. The current study has targeted all parents who visited the pediatric outpatient departments or clinics at three different hospitals in Makkah and Jeddah City, including Maternity and Children Hospital (MCH) in Makkah, King Fahad Armed Force Hospital (KFAFH), and Saudi German Private Hospital (SGH) in Jeddah. Data was collected via an online Google form and was analyzed by using SPSS. A total of 408 subjects were involved in this study. The majority of them were females (74.5%); 25.5% weremales. Most of the study participants aged between 25 and 34 years. Our results found that the average knowledge score of the study population was 4.1±1.81 out of 11. Only 23.5%of them had good knowledge about appendicitis. More than half of the respondents identified the appendix as a part of the digestive system and most of the study population were aware of the currenttreatment for appendicitis, which is surgery (80.9%). Female participants and respondents who knew someone that has been treated for appendicitis were significantly associated with a better level of knowledge about appendicitis (P-values: 0.011 and 0.033, respectively). Moreover, we found that educational level significantly influenced preference for treatment with antibiotics and surgeryif appendicitis happened again (P-value: 0.049). The study population had poor knowledge of appendicitis and its management options. The highlighted criteria of self-reported relevance to parents should be addressed in all appendicitis counseling and consent. We advocate for the establishment of national public awareness campaigns, as well as increased research and clinical trials. Understanding lay views of treatment alternatives and efficacy will influence future approaches to appendicitis therapy by analyzing the community's preference for emerging treatment modalities and identifying future directions for patient-centered clinical trials.

Prevalence of Stigma among medical care providers towards patients with Schizophrenia and Obsessive Compulsive Disorders

OBJECTIVE: This study aimed to identify the stigma among medical care providers towards people with Schizophrenia and Obsessive-Compulsive Disorder and the factors associated with increased stigma among them. METHODOLOGY: A cross-sectional study design was used to determine the prevalence of stigma among medical professionals toward patients with Schizophrenia and obsessive-compulsive disorders (OCD). Participants were from one of the best hospitals in Makkah, Saudi Arabia, King Abdullah Medical City (KAMC), in which 283 of their medical care providers were randomly selected using the RAOSOFT calculator technique. All medical care providers at King Abdullah Medical City were included. Medical care providers who refused to participate were excluded. Data entered, cleaned, and analyzed using the Statistical Package for Social Sciences (SPSS) Version 22. RESULTS: The study clarified that medical care providers have less stigmatization towards patients suffering from OCD (53%) than their stigma towards patients with Schizophrenia (54.4%). The study found that (26.4%), and (1.4%) of physicians felt comfortable dealing with OCD and schizophrenic patients, respectively, while (28.2%) and (11.2%) of nurses felt comfortable dealing with OCD and schizophrenic patients, respectively. CONCLUSION: The study concluded that the stigma towards patients with Schizophrenia is higher than it is towards patients with OCD; this stigma is higher among physicians than nursing staff. KEYWORDS: Cross-sectional, Stigma, Schizophrenia, Obsessive-compulsive disorder (OCD), Medical care providers, Medical City.

Prevalence of Intestinal Infections with Entamoeba histolytica Among Patients of Makkah Hospitals, Saudi Arabia: A 5-Year Retrospective Study

Prevalence of Intestinal Infections with Entamoeba histolytica Among Patients of Makkah Hospitals, Saudi Arabia: A 5-Year Retrospective Study

Characterization of aminoglycoside resistance genes in multidrug-resistant Klebsiella pneumoniae collected from tertiary hospitals during the COVID-19 pandemic.

Since the peak of the coronavirus disease 2019 (COVID-19) pandemic, concerns around multidrug-resistant (MDR) bacterial pathogens have increased. This study aimed to characterize aminoglycoside resistance genes in MDR Klebsiella pneumoniae (K. pneumoniae) collected during the COVID-19 pandemic. A total of 220 clinical isolates of gram-negative bacteria were collected from tertiary hospitals in Makkah, Saudi Arabia, between April 2020 and January 2021. The prevalence of K. pneumoniae was 40.5%; of the 89 K. pneumoniae isolates, MDR patterns were found among 51 (57.3%) strains. The MDR isolates showed elevated resistance rates to aminoglycoside agents, including amikacin (100%), gentamicin (98%), and tobramycin (98%). PCR assays detected one or more aminoglycoside genes in 42 (82.3%) MDR K. pneumoniae strains. The rmtD gene was the most predominant gene (66.7%; 34/51), followed by aac(6')-Ib and aph(3')-Ia (45.1%; 23/51). The aac(3)-II gene was the least frequent gene (7.8%; 4/51) produced by our isolates. The rmtC gene was not detected in the studied isolates. Our findings indicated a high risk of MDR bacterial infections through the COVID-19 outbreak. Therefore, there is a need for continuous implementation of effective infection prevention control (IPC) measures to monitor the occurrence of MDR pathogens and the emergence of MDR bacterial infections through the COVID-19 outbreak.

Risk of Polypharmacy and Its Outcome in Terms of Drug Interaction in an Elderly Population: A Retrospective Cross-Sectional Study.

The simultaneous use of multiple drugs-termed 'polypharmacy'-is often required to manage multiple physiological and biological changes and the interplay between chronic disorders that are expected to increase in association with ageing. However, by increasing the number of medications consumed, the risk of undesirable medication reactions and drug interactions also increases exponentially. Hence, knowledge of the prevalence of polypharmacy and the risk of potentially serious drug-drug interactions (DDIs) in elderly patients should be considered a key topic of interest for public health and health care professionals. Methods: Prescription and demographic data were collected from the electronic files of patients who were aged ≥ 65 years and attended Al-Noor Hospital in Makkah, Saudi Arabia, between 2015 and 2022. The Lexicomp® electronic DDI-checking platform was used to evaluate the patients' medication regimens for any potential drug interactions. Results: A total of 259 patients were included in the study. The prevalence of polypharmacy among the cohort was 97.2%: 16 (6.2%) had minor polypharmacy, 35 (13.5%) had moderate polypharmacy, and 201 (77.6%) had major polypharmacy. Of the 259 patients who were taking two or more medications simultaneously, 221 (85.3%) had at least one potential DDI (pDDI). The most frequently reported pDDI under category X that should be avoided was the interaction between clopidogrel and esomeprazole and was found in 23 patients (18%). The most frequently reported pDDI under category D that required therapeutic modification was the interaction between enoxaparin and aspirin, which was found in 28 patients (12%). Conclusions: It is often necessary for elderly patients to take several medications simultaneously to manage chronic diseases. Clinicians should distinguish between suitable, appropriate and unsuitable, inappropriate polypharmacy, and this criterion should be closely examined when establishing a therapeutic plan.

Epidemiology of Hajj pilgrimage mortality: Analysis for potential intervention

BackgroundThe Saudi Vision 2030 predicts the attendance of 30 million pilgrims each year by 2030. Cost-effective healthcare services during the Hajj are important to manage this increase in the number of pilgrims. Little is known about the impact of the existing chronic diseases on morbidity and mortality during the Hajj. Furthermore, the quality of services provided by Hajj hospitals warrants further study. This study aims to describe patterns of inpatient, all-cause mortality during the Hajj and the relationship between mortality and preexisting chronic diseases as well as the services provided in Hajj hospitals. MethodsThe population included pilgrims who were admitted to Hajj hospitals in Makkah and sacred sites between 2012 and 2017, excluding 2015. A retrospective, matched, case-control study design was utilized. 2237 cases of mortality were matched to 4474 control cases based on age and gender. The data were extracted from hospital admissions offices and medical records. Hierarchical, logistic regression models were used to examine the medical services. The effect measure modification of the copresence of more than one chronic disease was also examined. ResultsThe rate of inpatient all-cause mortality was higher in Makkah hospitals compared to sacred site hospitals. Inpatient, all-cause mortality was significantly associated with diabetes, hypertension, and cardiovascular diseases. Effect measure modification was present between diabetes and cardiovascular diseases, hypertension, and cardiovascular diseases, but not between diabetes and hypertension. Patients who received medical services were more likely to die during their hospital stay compared to patients not receiving services. ConclusionThe current focus on public health issues during the Hajj should be equally distributed between communicable and non-communicable diseases. Although advanced services are provided by Hajj hospitals, interventions to address the increased risks, including mortality, faced by pilgrims with preexisting, chronic diseases should be further investigated and considered.

Opportunities and Barriers in the Planning of Hospital Bed Capacity in a Tertiary Care Hospital in Makkah, Saudi Arabia

Introduction: In alignment with Saudi Arabia’s 2030 Vision to improve healthcare services, Saudi hospital policymakers must have a clear understanding of the needs of their hospitals to make strategic decisions regarding hospital bed capacity planning. King Abdullah Medical City (KAMC) is a tertiary and quaternary healthcare facility that has four state-of-the-art excellence centers, of which the Cardiac and Oncology Centers are among the largest and the most advanced in the west of Saudi Arabia. Methods: This study used a mixed-methods approach. The study’s quantitative component included a revision of retrospective data of KAMC’s operational parameters, such as bed capacity, bed occupancy rate (BOR), and length of stay (LOS). For the study’s qualitative component, researchers used semi-structured interviews. Personnel at different management levels were interviewed to explore factors that might influence an increase in the BOR and patients’ LOS. Results: KAMC’s key performance indicators showed an overall LOS of 9.9 days and an overall BOR of 88%. Analysis broken down by the department shows the General and the Neuroscience Intensive Care Units and the Hematology/Oncology departments to have the highest BOR, ranging between 95% and 97%. Qualitative analysis of semi-structured interviews suggested that the delays in the provision of consultation services among the hospital’s inpatients were among the factors that have the biggest influence on bed occupancy; the presence of dedicated case managers in every department was among the top suggested solutions. Conclusion: A battery of interventions might help to reduce the LOS by supporting timely patient discharge. The presence of a dedicated case manager with a medical background in each department is one of the most practical interventions. Other vital opportunities include reinforcement of back-referral policies, revising policies, and having cluster-level referral policies and bed management strategies. Although such efforts are likely to have a positive effect, they are expected to only partially meet the existing gap, which probably requires increasing the number of available active beds.