Cancer care AbroadNational lookAhmed I Al-SagheirHematologist and medical oncologistKFSH-DammamKing Saud UniversitySaudi Arabia

Fatimah A55 yrs old, new seisures, and breast massMammogram: suspecious, FNA: cancerCT: confirms metastases, to CNS, bone and liver.Family meetingNeed to start palliative radiotherapy and chemotherapy, both are availablePoor prognosisA week later the family wants a medical report, pathology slides and want advise about going to US, Germany or UK and may be Thiland.

IntroductionCancer caredefinitionWhat do patients want?

What does the society want?

What does the health of the society need?

What is the magnitude of the problem?No good Data

IntroductionCancer caredefinitionWhat do patients want?

What does the society want?

What does the health of the society need?Cancer careNot only therapeutic interventionScreening programsEarly detectionPalliative care

Patients needBest possible care

Access to health care

SupportEducationCommunicationFamily supportFinancial support

Why do patients choose to go abroad ?

Patients needBest possible care

Access to health care

SupportEducationCommunicationFamily supportFinancial supportProsConfidence in health careLack of confidence in local servicesAssumption that medical errors are less frequentAvailability of the optionCulture and expectation

Patients needSecond opinionTourismSummer vs winterPolitical gainsProsConfidence in health careLack of confidence in local servicesAssumption that medical errors are less frequentAvailability of the optionCulture and expectation

Patients needConsIllness and homesicknessUnnecessary delaysUn-necessary diagnostic proceduresLack of familiarity with local diseasesG6PDLack of supportSocietalreligiousFinancial costsProsConfidence in health careLack of confidence in local servicesAssumption that medical errors are less frequentAvailability of the optionCulture and expectation

Society prospective

History Generations of patients going to Iraq, lebanon and EgyptCultureInferiority complexValue systemGuilt feelingsHealth sector is a major financial driveJobsOpportunity to support loved ones during illnessCompanionsVacationFamily disturbanceCharity

Public health prespectiveEstablishing national registryBuilding on experienceTrainingLong-term careCancer survivorsCosts

Cost of lost opportunities

Building on experienceDeveloping training for doctors, nurses, pharmacists, etcNational registryWhich ultimately will help identifying pattern of diseaseHelp in prevention and planningJobsSocial impacts

What is the magnitude of the problem?No good Data

Health system in SAMinistry of Health (MOH)KFMCKFSH-DKing Faisal Hospital and Research system (KFSH&RC)Security forces health systemNational Guard Hospitals (NGH)Military hospitals (MH)University hospitalsPrivate sector

New cancer casesSaudi Arabia experiencePopulation 26 M1 SAR = 0.266 US $

Contributing Factors Way the media deals with the medical errorsExaggeration of medical errorsHow do health care providers act?Public awarenessSharing experience

SolutionsTargetting Patient satisfactionSatisfied patients are more likely to accept therapy compliance outcomesHigh impact easy gainsNursing quality and courtesyCleanliness of the hospital

Some suggestionsHow would we act as role models?What massage does our own actions give..Story of AbdulRahman Al-Sagheirmy son..

Case AbdulRahman Al-Sagheir

Some suggestionsStarting research on identifying predictors of good health care at national levelMonitoring referrals abroadIndicationsMonitor outcomesQuality intiativesPrivateGovernment sectorsInvolving media in talking about achievementsProviding second opinion thought telemedicine

ConclusionCancer caredefinitionWhat do patients want?

What does the society want?

What does the health of the society need?Cancer careNot only therapeutic interventionScreening programsEarly detectionPalliative care

Case AbdulRahman Al-Sagheir

Thank

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