Cancer care Abroad National look

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Cancer care AbroadNational look

• Ahmed I Al-Sagheir
• Hematologist and medical oncologist
• KFSH-Dammam
• King Saud University
• Saudi Arabia

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Fatimah A

• 55 yrs old, new seisures, and breast mass
• Mammogram suspecious, FNA cancer
• CT confirms metastases, to CNS, bone and liver.
• Family meeting
• Need to start palliative radiotherapy and
  chemotherapy, both are available
• Poor prognosis
• A week later the family wants a medical report,
  pathology slides and want advise about going to
  US, Germany or UK and may be Thiland.

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Introduction

• Cancer caredefinition
• What do patients want?
• What does the society want?
• What does the health of the society need?

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What is the magnitude of the problem?
No good Data
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Introduction

• Cancer caredefinition
• What do patients want?
• What does the society want?
• What does the health of the society need?

• Cancer care
• Not only therapeutic intervention
• Screening programs
• Early detection
• Palliative care

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Patients need

• Best possible care
• Access to health care
• Support
• Education
• Communication
• Family support
• Financial support

• Why do patients choose to go abroad ?

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Patients need

• Best possible care
• Access to health care
• Support
• Education
• Communication
• Family support
• Financial support

• Pros
• Confidence in health care
• Lack of confidence in local services
• Assumption that medical errors are less frequent
• Availability of the option
• Culture and expectation

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Patients need

• Second opinion
• Tourism
• Summer vs winter
• Political gains

• Pros
• Confidence in health care
• Lack of confidence in local services
• Assumption that medical errors are less frequent
• Availability of the option
• Culture and expectation

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Patients need

• Cons
• Illness and homesickness
• Unnecessary delays
• Un-necessary diagnostic procedures
• Lack of familiarity with local diseases
• G6PD
• Lack of support
• Societal
• religious
• Financial costs

• Pros
• Confidence in health care
• Lack of confidence in local services
• Assumption that medical errors are less frequent
• Availability of the option
• Culture and expectation

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Society prospective

• History
• Generations of patients going to Iraq, lebanon
  and Egypt
• Culture
• Inferiority complex
• Value system
• Guilt feelings

• Health sector is a major financial drive
• Jobs
• Opportunity to support loved ones during illness
• Companions
• Vacation
• Family disturbance
• Charity

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Public health prespective

• Establishing national registry
• Building on experience
• Training
• Long-term care
• Cancer survivors
• Costs

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Cost of lost opportunities

• Building on experience
• Developing training for doctors, nurses,
  pharmacists, etc
• National registry
• Which ultimately will help identifying pattern of
  disease
• Help in prevention and planning
• Jobs
• Social impacts

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What is the magnitude of the problem?
No good Data
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Health system in SA

• Ministry of Health (MOH)
• KFMC
• KFSH-D
• King Faisal Hospital and Research system
  (KFSHRC)
• Security forces health system
• National Guard Hospitals (NGH)
• Military hospitals (MH)
• University hospitals
• Private sector

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New cancer casesSaudi Arabia experiencePopulatio
n 26 M
1 SAR 0.266 US
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Contributing Factors

• Way the media deals with the medical errors
• Exaggeration of medical errors
• How do health care providers act?
• Public awareness
• Sharing experience

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SolutionsTargetting Patient satisfaction

• Satisfied patients are more likely to accept
  therapy? compliance? outcomes
• High impact easy gains
• Nursing quality and courtesy
• Cleanliness of the hospital

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Some suggestions

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

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Case AbdulRahman Al-Sagheir
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Some suggestions

• Starting research on identifying predictors of
  good health care at national level
• Monitoring referrals abroad
• Indications
• Monitor outcomes
• Quality intiatives
• Private
• Government sectors
• Involving media in talking about achievements
• Providing second opinion thought telemedicine

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Conclusion

• Cancer caredefinition
• What do patients want?
• What does the society want?
• What does the health of the society need?

• Cancer care
• Not only therapeutic intervention
• Screening programs
• Early detection
• Palliative care

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Case AbdulRahman Al-Sagheir

• Thank
• You