Population Health: Addressing Community Need

This essay discusses the evolution of healthcare in Saudi Arabia, focusing on the advancements made since 1949. It addresses the challenges faced by the population, particularly those with limited financial resources, and how the government has worked to improve healthcare access. The essay also delves into the impact of changes on healthcare delivery, including the implementation of Diagnosis Related Groups (DRG) and the Case Mix Index (CMI). Furthermore, it explores methods for determining community healthcare needs, strategies used by other nations, and the benefits of database management systems and enterprise information portals in healthcare. The essay concludes by highlighting the importance of data management and technology in enhancing healthcare services.

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Introduction: In the year 1949, the medical facilities of Saudi Arabia were not very convincing
and there were countable hospitals and doctors. But since then a huge advancement has taken
place in the field of healthcare services. The Saudi Ministry of Health gives around 60% of these
health services while the remaining is provided by other agencies which are connected by
government as well as private service providers. A major plan of development in relation to
healthcare services in Saudi Arabia has built a mega-infrastructure domain for the advancement
of healthcare for the people of the nation. Quick changes in medical facilities and many training
programs have been started to train the people of Saudi Arabia. Health development plans have
been started by the government to address the people of Saudi Arabia and bring changes in
positive terms in their health. The changes health of the population is addressed by improving the
skills attained by various medical personnel and providing financial services to various sectors
providing medical facilities. The poor people belonging to very low class have been facing
enormous problems related to health because they do not have enough funds to improve their
health and their lifestyle is very unhygienic which pushes them towards health problems. In
Saudi Arabia, 53% of the population has faced health issues due to lack of funds in 2015. Major
developments have brought health services to every corner of the vast kingdom. Compared to
1949, the number of doctors and nurses has multiplied 25 times and 20 times in 2015. There are
many factors leading to bad health for example bad eating habits, drinking and smoking,
unhygienic environment etc. Such factors need to be eradicated for living beings to live healthy
and live longer. People need to change their living styles to improve their health. Government in
many countries has started opening healthcare centers at easily reachable points where cheap and
economical but best healthcare services will be provided and all is done especially for the benefit
of poor people. Healthy mind can do wonders and people need to stay healthy to bring about
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change. Many people cannot afford to improve their health as they cannot afford the high fees so
the government has been making efforts to provide best services in fewer prices.
Effect of changes on delivery of healthcare: The expenses related to healthcare are increasing
day by day and the patients are growing enormously in number and therefore, it has become
imperative to figure out new and cost effective ways to manage the records and costs related
areas. This helps in the improvement of problems which are being faced by hospitals, which are
related to costs. There is a dire need of various processes to lower down costs as it helps to
analyze that whether the information given by healthcare industries correspond to the
information which is given in the records which are maintained regarding the patients. The main
purpose is to figure out what are the errors related to sequencing and coding which has an
influence over the assignments in Saudi Arabia (Sebai, Milaat, & Al-Zulaibani, 2001).
As the number of audit cases has been escalated in Saudi Arabia exponentially with time and
also the hospitals have been scrutinized by the auditors very closely to ensure that they are
following the right practices and are not over charging or under charging. There is always a great
possibility that coders often under code in the system with the fear that auditor while scrutinizing
might curtail down the diagnosis-related group or refuse the claim in its entirety. The auditors
make the reports and documentation properly & accurately and report all the factors affecting the
assignment and the reimbursements related to the medical records (Mokdad, 2016).
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Developments related to changes
Diagnosis related group: Saudi Arabia has come up with DRG. The provider has to give a full
and accurate medical record which comprises of documents that helps to support all ICD codes
and the DRG. A written report is submitted to the provider after the audit is complete. The
auditing is done, which should correspond coding guidelines, coding manual, coding clinic etc.
The parties involved in the auditing process should work in compliance with all the laws and the
information of the patients should be kept confidential (Ahmed & Damrah, 2012). The auditing
documents are based on the records which are present and available at the time when notification
comes regarding the audit. This will be the base for initiating the auditing program and helps to
achieve better standards of auditing. Diagnosis-related group helps to divide cases of the
hospitals into one of the 467 groups and the last group is considered as "Ungroup able". This
process of division was discovered in collaboration by Robert B Fetter, a student of the Yale
School of Management and John D. Thompson, MPH, of the Yale School of Public Health.
Case mix index: CMI used by the nation is a value which is assigned to a diagnosis related
group of patients in a health care environment. The CMI value is utilized in figuring out the
allocation of resources for care for and treatment of the patients in the group. The finance
department keeps a check on the case-mix index (CMI) and on the good side the hospital’s CMI
can go as higher as possible. A high CMI implies that the performance of the hospital is going in
the right direction and the hospital is getting a high amount of money from a single patient. At
the time of calculation of CMI, a specific time period is chosen for example a month, two
months or a year (Almalki, Fitzgerald, & Clark, 2011). During that time period, all the DRGs
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that have been billed by the hospital are taken into account plus the relative weights add to it.
The total number is then divided by the total number of DRGs available. The final number which
comes up is the CMI of the hospital for that specific period.
Finance departments take into consideration the CMI in order to determine the budget of the
hospital. The finance department predicts the CMI of the hospital and if it goes below the
predicted CMI that means that is not in favor of the hospital and it may suffer loss and earn less
revenue. A slight change in CMI of the hospital impacts the hospital to a great extent. The CMI
helps to determine the costs of hospital based on various factors such as geographical factors and
other costs also come in purview such as graduation in medical courses cost and the patients who
cannot serve themselves and have less money is also included in this. If the CMI of the hospital
comes down, it is a sign that surgical and medical requirements changing. Similarly, if the CMI
of one hospital is comparatively less than the other hospitals in the same area, it can be an omen
that the hospital is not able to overcome the complications that the hospital has to deal while
working. It must be noted that the hospital cannot indulge itself in the activities which are not
required and are only performed to improve the CMI (Albejaidi, 2010). The different ways can
be adopted to improve the CMI of hospital for example efficient physicians can be appointed so
that proper documentation can be done. If people who come to take the services of hospitals have
MCCs and CCs that exhibits an increased level of complications, the hospital can bill for DRGs
which are high weighted. But the personnel who are involved in coding only reports that
documents which are used by the physician while making patients’ records. It is to be
remembered that CMI only relates to the patients in the hospital. The CMI of the hospital should
be properly calculated as it helps to determine the efficiency of the hospital.
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Methods to determine healthcare needs of the community: There are various methods to
determine the healthcare needs of the community and once such method is collecting the data
through questionnaires and surveys and recording them. Recording is an important function for
all the organizations and it is very significant for any organization as it necessary to keep the
records of information of its human resources. Analyzing the needs of the community and
recording them is very significant. In addition to that now a day’s recording is an elementary
thing at the individual level also. Everyone stores their documents, work related files, other work
related information, music, images, videos and the list is endless. With the advent of technology
and with the evolution of various digital techniques, the art of recording has taken a paradigm
shift. The documents that were just wasting the time, efforts and space to store as heavy paper
files are now stored as word documents and PDF and are now placed in pen drives, laptops,
computers, hard disks, mobile phones etc. The digital recording has made the people’s lives
simpler and easier making it more convenient saving their time and space (Perspectives, 2014).
Due to the dynamic nature of business processes these days, it has become challenging to capture
the ongoing activities and records of the organizations. Because of this manipulative aspect of
organizations, the business is exposed to risk, unnecessary expenditure and inefficiency while
they keep the record of the whole of the processes. Business archives are archival departments
within an organization that maintains the records. These archives provide exposure to the public
to have access to the processes of business varying from company to company depending on the
policies and procedures of the respective company.
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Strategies used by other nations
Storage technology: As we have studied above that a back - up plan is very important for the
hospital as important information of the patients and employees is stored in the system. Hence,
the hospitals in other nations use a storage technology called data mirroring or data replication,
which automatically creates a replica of the content stored. This is being used by the hospital as
the hospital gives a great amount of significance to storage of data. The hospital deals with
infinite number of patients and when the data is lost, it causes loss to the hospital. Many patients
have registered cases of fraud, negligence, sexual harassment on the authorities and there are sets
of information which are not in the records of the hospital due to the poor storage system. Due to
these bad experiences, the hospital has added to its features, the feature of data replication. This
database system is considered to be very strong and effective and can be used to replicate the
amendments and sync them in order to avoid loss of data. As compared to other database system,
it requires no special hardware, thereby recuing the cost of infrastructure. This contains an
automatic system in which the message pops up when data is lost and is then restored by the
click of a single button. Hence, the important data of the hospital is not lost by the introduction
of this system (Aljuaid, Mannan, Chaudhry, Rawaf, & Majeed, 2016).
Database management system: The Middle Eastern nations are using a database management
system. This system makes the information properly stored and organized so that it can be easily
accessed by the people who want the information. The end users have the power to create, edit,
modify, delete and update the data. The DBMS takes care of three important elements: the data,
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the database engine that helps the people to access the data, secure it and edit it and the third is
database schema, which explains what the logical structure of the database is (WHO, 2016).
Benefits of the system: Various benefits of the system are these three significant elements help
to enhance the security, concurrency, integrity of data and uniformity. All the information is
stored at one place, so it avoids the generation of duplicate data. This is a primary data, unlike
the paper data which requires copes and editing. This enhances the accuracy of data and loss of
data is not possible because data is stored in multiple computers so loss of data is impossible and
this storage of data ensures high benchmarks. This is one of the most significant features of
database management system that is confined only to those people who have the permission to
manipulate it, therefore the people who have no access cannot breach the information. The data
management using computer systems is considered to be more responsive and the information
stored is well organized in this system rather than in other information systems (Group, 2016).
Application: For instance, applications such as calculation like addition, subtraction,
multiplication can be easily done through this system. A Database management system is a
compute based record-keeping system. It stores the important information about the organization
and keeps it organized in a proper manner so that it can be used as and when required. The data
is stored, defined, retrieved, updated, modified and can be used on demand.
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The DBMS is used in many fields, for example, universities, schools, colleges, banking, aviation,
wholesale, retails etc. and the use has been increasing year by year and now every organization
stores the information through this system as it is considered to be a secure system and
modification can be easily done when it is required (Elaraby, Almasoud, & Abdukhalilov, 2016).
This is one of the most efficient systems and this storage promotes lifelong storage of data. The
organizations whether small or large use this system to keep the information safe in the long run
and can be accessed easily by everyone. This has reduced the paper based information which is
generally spoiled by book worms.
Enterprise information portal: The hospital is suing this portal to provide search facilities to
people. It is basically a system which can be accessed by any person who wants to obtain the
information about the enterprise. It can be accessed by the employees of the organization, the
customers, the partners, the shareholders, the stakeholders and even the general public. The
information exhibited is useful for the one who accesses it and the confidential information is not
a part of this portal. The information which is against the interests of the general public is not
displayed through this portal (Competitive Government, 2015).
It consists of five elements which are this portal makes sure that the person who requires the
information gets the information in the same context in which he wants it. The next step is
categorization of the information to make it in a deliverable state. This portal enables the people
to meet and share their ideas irrespective of the long distance. It takes care of the security, only
that information can be accessed which is important to be accessed (Burton, 2009).
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Benefits of EIP: It enhances the better communication in the organization, among the employees
as all the employees get to know the same information without any filtration. It reduces the
miscommunication which helps in taking better decisions useful for achieving long term goals. It
helps the employers to know what the return on investment is and what the estimated profits of
the year are. It helps to compare the present data with the previous data and analyze what are the
shortcomings.
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