Abstract
Background: Integrated care (IC) aims at addressing the fragmentation of healthcare services and providing coherent patient-centred care. The Saudi Healthcare Sector Transformation Program (HSTP) introduced the new model of care (MoC) in 2018, identifying IC as a key pillar. The ultimate goal was to deliver IC across governmental and private healthcare organisations.
Understanding the Saudi healthcare leaders' perspectives around IC is integral for assessing the readiness for IC implementation, nationally. This abstract reports results from an ongoing study that aims to assess the readiness of Saudi healthcare organisations for IC delivery and the prevalence of IC practice. Additionally, we assessed the correlates of IC maturity.
Methods: In this cross-sectional study, we approached executives and leaders at 39 healthcare organisations, aiming to sample 10 participants from each. The calculated sample size was 408. Participants were contacted via email and encouraged to forward the electronic surveys to their organisational executive colleagues and leaders, using snowballing. The study tool was adapted from the 'Scaling Integrated Care into Context' (SCIROCCO), a validated instrument for assessing IC maturity across 12 dimensions. The survey also assessed awareness about the Saudi HSTP, MoC, and IC. Data collection was planned from July 2023 to June 2024.
Results: As of this abstract’s preparation, 25 healthcare leaders from 14 healthcare organisations have participated. Participants were mostly executives involved in IC activities, with an average age of 44 years (± 9.4) and 18 years of experience. Only 50% of respondents have IC units at their organisations. Stakeholders’ awareness levels about IC, Saudi HSTP, and MoC averaged 6.5 (±2.5), 7 (±2.2), and 7.4 (±2.1) on a 0-10 scale, respectively.
In the SCIROCCO domains (rated 0-5), the highest means were observed in ‘Readiness to Change’ (2.24 ±1.4), ‘Breadth of Ambition’ (2.24 ±1.6), and ‘Standardisation and Simplification’ (2.12 ±1.5). In contrast, the lowest scores were in ‘Innovation Management’ (1.56 ±1.3), ‘Removal of Inhibitors’ (1.64 ±1.4), and ‘Population Health Approach’ (1.64 ±1.6). The overall mean for the SCIROCCO survey was 1.9 (±1.0), indicating a low readiness for IC implementation. Having an IC unit at the organisation was associated with a 0.91-point increase in the average score across all dimensions (95% CI: 0.05 to 1.77).
Lessons learnt: This pilot study provides a preliminary insight into the current state of IC readiness and practice in Saudi Arabia (SA). Findings from the SCIROCCO survey revealed that the maturity levels across most IC dimensions in the surveyed organisations fall behind compared to global practices. The presence of IC units within organisations significantly influenced their readiness, emphasising the importance of dedicated structures for effective IC implementation. Additionally, leadership's attitude and commitment to IC emerged as key factors, necessitating enhanced awareness for successful IC adoption.
Next steps: As part of an Explanatory Sequential Mixed Methods design, the ultimate findings will be complemented by a subsequent qualitative phase, aiming to provide in-depth insights into the barriers and facilitators impacting a mature IC system in SA. Additionally, a future follow-up study is required to track the progress of MoC implementation across healthcare organisations.