Each year during Hajj, the Saudi Ministry of Health places additional staff and medicines to the selected existing primary health care centers (PHCC) in Makkah, to provide free health care to millions of hajjis. However, these resources are feared to be misdistributed among these facilities, leading to wastage of precious resources. Under the circumstances we conducted this study, to review the distribution of the human and medicinal resources in relation to their workload as a component of a quality health care delivery system.
Methodology
A descriptive cross-sectional design was used to evaluate 23 PHCC with additional resources and 7 PHCC without additional resources, using structured data collection instruments for an interview and data extraction tool from health centers records. Data was collected in two visits; in first the team collected information about last year and the allocation of additional resources during Hajj. During the second visit after Hajj season, the statistical data for patient's load and drugs consumption during the Hajj was collected.
Results
Mean of total physicians in the centers with additional supplies was 7.57 (SD=2.29) as compared to 5.3 (SD 3.4) physicians in health centers without additional supplies (p-value=0.048). The mean of total nurses in the centers with additional supplies was 12.0 (SD=3.7). The mean of number of regular nurses in centers without additional supplies was 13.4 (SD=6.5) (p-value=0.56). During year 1425H and 1426H, the means of total patients in centers with additional supplies reached maximum during Hajj period of year 1425H and 1426H, while there was no difference in means of total patients in centers without additional supplies throughout the year including the Hajj period. Some of the facilities with additional resources showed daily patient to physician ratio and patient to nurse ratio reaching or exceeding one hundred. On an average 23.97 (SD 16.89) drug items were dispensed to each patient. However, two of the facilities with additional resources and four of the facilities without additional resources dispensed more than forty items per patients.
Conclusion
Patient load during Hajj among the facilities with additional resource allocation was significantly higher than facilities without such allocation, and they also exhibited higher patient load during Hajj than the rest of the year, which justifies the provision of additional staff and medicines. However, 3 facilities have unrealistically high patient-staff ratio, and 6 facilities have shown very high ratio of number of medicinal items prescribed per patient, requiring further exploration.