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. 2024 Jul 17:12:1337138.
doi: 10.3389/fpubh.2024.1337138. eCollection 2024.

Acceptance of electronic referrals across the Kingdom of Saudi Arabia: results from a national e-health database

Abdullah A Alharbi  1 , Nawfal A Aljerian  2   3   4 , Meshary S Binhotan  4   5 , Hani A Alghamdi  6 , Reem S AlOmar  7 , Ali K Alsultan  2 , Mohammed S Arafat  2 , Abdulrahman Aldhabib  2 , Ahmed I Aloqayli  2 , Eid B Alwahbi  2 , Mohammed K Alabdulaali  8
Affiliations

Acceptance of electronic referrals across the Kingdom of Saudi Arabia: results from a national e-health database

Abdullah A Alharbi et al. Front Public Health. .

Abstract

Introduction: An effective referral system is necessary to ensure quality and an optimum continuum of care. In the Kingdom of Saudi Arabia, an e-referral system known as the Saudi Medical Appointments and Referrals Centre (SMARC), has been fully functioning since 2019. This study aims to explore the rate of medical e-referral request acceptance in the KSA, and to study the factors associated with acceptance.

Methods: This period cross-sectional study utilised secondary collected data from the SMARC e-referral system. The data spans both 2020 and 2021 and covers the entirety of the KSA. Bivariate analyses and binary logistic regression analyses were performed to compute adjusted Odds Ratios (aORs) and 95% confidence intervals.

Results: Of the total 632,763 referral requests across the 2 years, 469,073 requests (74.13%) were accepted. Absence of available machinery was a significant predictor for referral acceptance compared to other reasons. Acceptance was highest for children under 14 with 28,956 (75.48%) and 63,979 (75.48%) accepted referrals, respectively. Patients requiring critical care from all age groups also had the highest acceptance including 6,237 referrals for paediatric intensive care unit (83.54%) and 34,126 referrals for intensive care unit (79.65%). All lifesaving referrals, 42,087 referrals, were accepted (100.00%). Psychiatric patients were observed to have the highest proportion for accepted referrals with 8,170 requests (82.50%) followed by organ transplantations with 1,005 requests (80.92%). Sex was seen to be a significant predictor for referrals, where the odds of acceptances for females increased by 2% compared to their male counterparts (95% CI = 1.01-1.04). Also, proportion of acceptance was highest for the Eastern business unit compared to all other units. External referrals were 32% less likely to be accepted than internal referrals (95% CI = 0.67-0.69).

Conclusion: The current findings indicate that the e-referral system is mostly able to cater to the health services of the most vulnerable of patients. However, there remains areas for health policy improvement, especially in terms of resource allocation.

Keywords: digital health transformation; e-referrals; public health policy; tele-health; the Kingdom of Saudi Arabia; the Saudi Medical Appointments and Referrals Centre.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Distribution of medical specialities according to referral status.
Figure 2
Figure 2
Referral status across the five business units of the Kingdom of Saudi Arabia.
Figure 3
Figure 3
Referral status across 13 administrative regions of the Kingdom of Saudi Arabia.
See this image and copyright information in PMC

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References

    1. Akbari A, Mayhew A, Al-Alawi MA, Grimshaw J, Winkens R, Glidewell E, et al. . Interventions to improve outpatient referrals from primary care to secondary care. Cochrane Database Syst Rev. (1996) 20:CD005471. - PMC - PubMed
    1. Naseriasl M, Adham D, Janati A. E-referral solutions: successful experiences, key features and challenges-a systematic review. Materia sociomed. (2015) 27:195–9. doi: 10.5455/msm.2015.27.195-199, PMID: - DOI - PMC - PubMed
    1. Bashar MA, Bhattacharya S, Tripathi S, Sharma N, Singh A. Strengthening primary health care through e-referral system. J Family Med Prim Care. (2019) 8:1511–3. doi: 10.4103/jfmpc.jfmpc_184_19, PMID: - DOI - PMC - PubMed
    1. Pittalis C, Brugha R, Gajewski J. Surgical referral systems in low-and middle-income countries: a review of the evidence. PLoS One. (2019) 14:e0223328. doi: 10.1371/journal.pone.0223328, PMID: - DOI - PMC - PubMed
    1. Alnassar A, Aljerian N, Alhosaini A, Alsultan A, Ashry L, Alharthi S, et al. . Trends of referrals throughout the kingdom, a retrospective analysis of the Saudi medical appointments and referrals Centre registry, Saudi Arabia. Int J Innov Res Med Sci. (2022) 7:563–78. doi: 10.23958/ijirms/vol07-i11/1517 - DOI

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