CULTURALLY ACCEPTABLE HEALTH-CARE SERVICES FOR SAUDIS ELDERLY POPULATION - THE DECISION-MAKERS PERCEPTION

This article reports on a study carried out in 1993 to elicit the opin ions of decision makers (medical and non-medical) as to the types of f acilities, locations and culturally acceptable levels of health care a ppropriate for the elderly in Saudi Arabia. In addition, the study sou ght to find out the procedures and likely constraints in the developme nt of future health care services for the elderly. An opinion survey w as carried out on a randomly selected sample of decision makers, drawn from: hospitals of 100-bed capacity or more; and, from directorates o f education, agriculture, police, municipalities, commerce, transport and media, in each of the regions of Saudi Arabia. A predesigned Arabi c questionnaire was completed by the respondents during February-April , 1993. Of the 244 respondents, the most important categories of elder ly to be cared for were considered to be those with handicaps, the chr onically ill, and those without family support. The non-medical decisi on makers gave higher scores to these alternatives than did the medica l decision makers (P < 0.05). Use of the family home for elderly healt h care was rated as the most appropriate, followed by medical rehabili tation centres, and only then by hospitals. Non-medical respondents ga ve more emphasis on rehabilitation centres (P < 0.02). Medical respond ents thought that primary care doctors (87.2%), physiotherapists (87.2 %) and general nurses (78.2%) can adequately fulfil the needs of most elderly patients. In contrast, non-medical respondents demanded the pr esence of specialist doctors (72.3%), specialist nurses (78.9%), labor atory and X-ray facilities to run such services (P<0.05). Medical deci sion makers were also more concerned than the non-medical respondents that the availability of such medical facilities might encourage some people to neglect their elderly parents (P<0.04). Equally, medical res pondents were seemingly more aware of the high cost of hospital beds t han their non-medical counterparts (P<0.0001). The conclusion to be dr awn is that there is a need to provide both acceptable and suitable he alth care facilities tailored to the needs of the elderly in Saudi Ara bia. Any proposed setting should be both cost-effective and avoid soci ally adverse outcomes. Above all, the community should be encouraged t o participate positively in the development, running and periodic eval uation of such facilities.