COST-MINIMIZATION AND EPIDEMIOLOGICAL STUDY OF HOME HEALTH CARE SERVICES IN ASEER REGION, SAUDI ARABIA: A RETROSPECTIVE COHORT STUDY

Abstract

Background: Home health care (HHC) services were in line with Saudi Arabia Vision 2030 and the Health Sector Transformation Program and were introduced to serve patients with complex chronic multimorbidity outside of hospital settings. However, the cost efficacy and epi-benefit should be evaluated in a broad HHC population.

Methods: This Retrospective Cohort Study was developed in line with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) protocol and included 677 HHC patients in the Aseer region up to 2025. HHC-related HHC features were as follows from the EMRs: demographics, ICD-10 based clinical codes, results of the Braden Scale and mobility functional assessments, use of devices, and service utilization. The cost was calculated using the Ministry of Health Service Coding Manual (IOS) and the SFDA pharmaceutical price list. The assumed equality in clinical outcomes was implicit in the cost-minimization study comparing monthly HHC costs with modelled inpatient extended-care costs. One-way sensitivity analyses were performed relative to the key costs.

Results: The mean age of the 126 patients was 53.8 years, 65.3% were female, and 69.9% resided in urban areas. Multimorbidity was common, with 69.1% having hypertension, 52.9% diabetes, and 21.9% a prior stroke. Polypharmacy was reported in > 80% of patients, and 85% were severely disabled. The total monthly cost of HHC was 3,900 SAR per person compared to 56,500 SAR for an inpatient LTC, representing a cost saving of 93%. The  annual savings for 677 patients was projected to be SAR 427.2 million. Sensitivity analyses confirmed that HHC remained >90% less expensive under these assumptions.

Conclusions: The findings from this HHC study for highly dependent, multimorbid patients in Saudi Arabia suggest" that a 93% cost saving is achievable, although the comparison of resources used was even more unflattering than other alternatives found in the healthcare system. Scaling up and strengthening HHC service provision is aligned with Saudi Vision 2030.