Pub Date : 2026-03-01Epub Date: 2025-11-13DOI: 10.1016/j.vhri.2025.101544
Bayan A. Hariri MSc , Faisal M. Albagmi PhD , Afnan A. Aljaffary PhD
Objectives
This article examines the implementation of value-based healthcare (VBHC) in Saudi Arabia, focusing on policy makers’ and health system leaders’ perceptions of the challenges and facilitators to its adoption. The study aims to identify key factors that can inform policy and resource allocation in the context of the country’s healthcare transformation and Vision 2030 initiative.
Methods
A qualitative approach was used through interviews with system leaders, followed by an inductive thematic analysis to identify the challenges and facilitators of VBHC implementation.
Results
Four major themes were identified: (1) Health System Structure, (2) Health Financing Structures, (3) Data Governance, and (4) Knowledge Translation in the Health Workforce. Subthemes were categorized according to the challenges and facilitators described by the experts.
Conclusions
This study emphasizes that the success of VBHC in Saudi Arabia depends on a comprehensive transformation, not just isolated technical fixes. Addressing interconnected challenges through aligned incentives, data systems, and governance is essential for sustainable healthcare value.
{"title":"Navigating the Transition to Value-Based Healthcare in Saudi Arabia: A Qualitative Study of Policy-Maker Perspectives","authors":"Bayan A. Hariri MSc , Faisal M. Albagmi PhD , Afnan A. Aljaffary PhD","doi":"10.1016/j.vhri.2025.101544","DOIUrl":"10.1016/j.vhri.2025.101544","url":null,"abstract":"<div><h3>Objectives</h3><div>This article examines the implementation of value-based healthcare (VBHC) in Saudi Arabia, focusing on policy makers’ and health system leaders’ perceptions of the challenges and facilitators to its adoption. The study aims to identify key factors that can inform policy and resource allocation in the context of the country’s healthcare transformation and Vision 2030 initiative.</div></div><div><h3>Methods</h3><div>A qualitative approach was used through interviews with system leaders, followed by an inductive thematic analysis to identify the challenges and facilitators of VBHC implementation.</div></div><div><h3>Results</h3><div>Four major themes were identified: (1) Health System Structure, (2) Health Financing Structures, (3) Data Governance, and (4) Knowledge Translation in the Health Workforce. Subthemes were categorized according to the challenges and facilitators described by the experts.</div></div><div><h3>Conclusions</h3><div>This study emphasizes that the success of VBHC in Saudi Arabia depends on a comprehensive transformation, not just isolated technical fixes. Addressing interconnected challenges through aligned incentives, data systems, and governance is essential for sustainable healthcare value.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"52 ","pages":"Article 101544"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145516902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To determine the economic burden and level of social support among individuals with schizophrenia in Saudi Arabia by quantifying direct and indirect costs and identifying key determinants of perceived social support.
Methods
This study conducted in Saudi Arabia used a cost-of-illness methodology to evaluate schizophrenia among 250 participants aged 18 and older. Data were collected using the Treatment Inventory Cost in Psychiatric Patients for cost analysis, along with the Multidimensional Scale of Perceived Social Support. The direct and indirect costs data were analyzed using SPSS and Excel.
Results
The social support scale demonstrated high reliability (Cronbach’s alpha = 0.973). Most patients (52.8%) reported moderate support, primarily from others. The average annual direct cost of schizophrenia was SAR 14 471.21 (US$3858) per patient, whereas the indirect cost was SAR 519.80 (USD 139) per 4 weeks. Costs varied based on age categories (P = .006). Education level, marital status, and working status were significantly associated with social support (P = .027, P = .027, P = .003, respectively). Retired patients demonstrated significantly higher costs, whereas an increase in social support was associated with a decrease in costs. The overall model exhibited statistical significance (F = 7.040, P < .001) and accounted for 5.4% of the variance in costs. Additionally, work and marital status influenced social support by 9.3%.
Conclusions
Schizophrenia presents a considerable economic burden in Saudi Arabia, with an average annual direct cost of SAR 14 471.21 (US$3858) per patient. The level of social support encountered by individuals with schizophrenia was predominantly moderate and demonstrated a significant correlation with marital status, educational attainment, and employment status.
{"title":"Exploring the Dual Dimensions: Economic Burden and Social Support Among Patients With Schizophrenia in Saudi Arabia","authors":"Emad Shdaifat PhD , Amira Alshowkan PhD , Ohoud Alonazi MSN","doi":"10.1016/j.vhri.2025.101552","DOIUrl":"10.1016/j.vhri.2025.101552","url":null,"abstract":"<div><h3>Objectives</h3><div>To determine the economic burden and level of social support among individuals with schizophrenia in Saudi Arabia by quantifying direct and indirect costs and identifying key determinants of perceived social support.</div></div><div><h3>Methods</h3><div>This study conducted in Saudi Arabia used a cost-of-illness methodology to evaluate schizophrenia among 250 participants aged 18 and older. Data were collected using the Treatment Inventory Cost in Psychiatric Patients for cost analysis, along with the Multidimensional Scale of Perceived Social Support. The direct and indirect costs data were analyzed using SPSS and Excel.</div></div><div><h3>Results</h3><div>The social support scale demonstrated high reliability (Cronbach’s alpha = 0.973). Most patients (52.8%) reported moderate support, primarily from others. The average annual direct cost of schizophrenia was SAR 14 471.21 (US$3858) per patient, whereas the indirect cost was SAR 519.80 (USD 139) per 4 weeks. Costs varied based on age categories (<em>P</em> = .006). Education level, marital status, and working status were significantly associated with social support (<em>P</em> = .027, <em>P</em> = .027, <em>P</em> = .003, respectively). Retired patients demonstrated significantly higher costs, whereas an increase in social support was associated with a decrease in costs. The overall model exhibited statistical significance (F = 7.040, <em>P</em> < .001) and accounted for 5.4% of the variance in costs. Additionally, work and marital status influenced social support by 9.3%.</div></div><div><h3>Conclusions</h3><div>Schizophrenia presents a considerable economic burden in Saudi Arabia, with an average annual direct cost of SAR 14 471.21 (US$3858) per patient. The level of social support encountered by individuals with schizophrenia was predominantly moderate and demonstrated a significant correlation with marital status, educational attainment, and employment status.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"52 ","pages":"Article 101552"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-10-16DOI: 10.1016/j.vhri.2025.101509
Sami Khedhiri PhD
Objectives
This study aims to cluster the MENA countries in terms of the shape of their trajectory patterns of mortality related to the leading causes, including communicable diseases, noncommunicable diseases, and injuries. This allows us to distinguish which diseases are the deadliest in what cluster of countries.
Methods
A longitudinal cluster analysis is performed on the annual death counts, which are collected between 2007 and 2023 for the MENA countries. The method enables finding the optimal number of clusters of countries with similar trajectory patterns of mortality related to each category of diseases.
Results
Distinct trajectory patterns of death are identified, and diseases that are the leading causes of fatality in each country are described. Our results point to a concerning health burden expected to be related essentially to neurological conditions, neoplasms, and cardiovascular diseases in specific clusters of MENA countries.
Conclusions
It is argued that rapid increases in death patterns sparked by these causes in the MENA countries require targeted health intervention that deals specifically with how to manage these priority diseases effectively to reverse their expected trend of higher fatalities over time.
{"title":"Analysis of Mortality Trajectory Patterns in the Middle East and North Africa: Which Diseases Are the Deadliest?","authors":"Sami Khedhiri PhD","doi":"10.1016/j.vhri.2025.101509","DOIUrl":"10.1016/j.vhri.2025.101509","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to cluster the MENA countries in terms of the shape of their trajectory patterns of mortality related to the leading causes, including communicable diseases, noncommunicable diseases, and injuries. This allows us to distinguish which diseases are the deadliest in what cluster of countries.</div></div><div><h3>Methods</h3><div>A longitudinal cluster analysis is performed on the annual death counts, which are collected between 2007 and 2023 for the MENA countries. The method enables finding the optimal number of clusters of countries with similar trajectory patterns of mortality related to each category of diseases.</div></div><div><h3>Results</h3><div>Distinct trajectory patterns of death are identified, and diseases that are the leading causes of fatality in each country are described. Our results point to a concerning health burden expected to be related essentially to neurological conditions, neoplasms, and cardiovascular diseases in specific clusters of MENA countries.</div></div><div><h3>Conclusions</h3><div>It is argued that rapid increases in death patterns sparked by these causes in the MENA countries require targeted health intervention that deals specifically with how to manage these priority diseases effectively to reverse their expected trend of higher fatalities over time.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"52 ","pages":"Article 101509"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To estimate the direct and indirect costs of ischemic heart disease (IHD) in Morocco and identify its main determinants.
Methods
A retrospective prevalence-based cost-of-illness study was carried out in patients with IHD admitted to a university hospital in 2019. Collected data included sociodemographic data, clinical profiles, and healthcare utilization. Direct medical costs were estimated using national insurance rates. Indirect costs, due to productivity loss, were calculated using the human capital approach and limited to working-age individuals based on Morocco’s retirement age. A bottom-up approach from a societal perspective was used over a 12-month period. The mean total cost was compared according to sociodemographic and clinical characteristics.
Results
The study included 180 patients; 58.3% were male, mean age was 62.1 years, and 46.1% were current or former smokers. Mean direct medical cost per patient was $3519.9 (95% CI $3141.8-$3898.0), with revascularization and medications as the main cost components. The mean indirect cost was $336.4 (95% CI $313.7-$359.0), with a mean productivity loss of 41.8 days. The mean total cost was $3856.3 (95% CI $3349.1-$4129.2), significantly higher for males (P = .015) and smokers (P < .001). The national economic burden of IHD was approximately $1.23 billion annually.
Conclusions
IHD imposes a substantial economic burden in Morocco, particularly among high-risk populations. Beyond tobacco control, integrated prevention strategies, including early detection and risk factor management, are urgently needed. In addition, healthcare resource planning and equitable access to medications are essential to reduce the burden of IHD.
{"title":"Economic Burden of Ischemic Heart Disease in Morocco: Evidence From a Teaching Hospital, a Cost-of-Illness Study","authors":"Moncef Maiouak MD , Mohammed Cherti MD, PhD , Mohamed Youbi MD , Latifa Belakhel MD , Loubna Abouselham MD , Samira El Fakir MD, PhD , Mohamed Berraho MD, PhD , Imane El Menchawy MD , Fatima Zahra Benmessaoud MD , Nabil Tachfouti MD, MPH, PhD","doi":"10.1016/j.vhri.2025.101504","DOIUrl":"10.1016/j.vhri.2025.101504","url":null,"abstract":"<div><h3>Objectives</h3><div>To estimate the direct and indirect costs of ischemic heart disease (IHD) in Morocco and identify its main determinants.</div></div><div><h3>Methods</h3><div>A retrospective prevalence-based cost-of-illness study was carried out in patients with IHD admitted to a university hospital in 2019. Collected data included sociodemographic data, clinical profiles, and healthcare utilization. Direct medical costs were estimated using national insurance rates. Indirect costs, due to productivity loss, were calculated using the human capital approach and limited to working-age individuals based on Morocco’s retirement age. A bottom-up approach from a societal perspective was used over a 12-month period. The mean total cost was compared according to sociodemographic and clinical characteristics.</div></div><div><h3>Results</h3><div>The study included 180 patients; 58.3% were male, mean age was 62.1 years, and 46.1% were current or former smokers. Mean direct medical cost per patient was $3519.9 (95% CI $3141.8-$3898.0), with revascularization and medications as the main cost components. The mean indirect cost was $336.4 (95% CI $313.7-$359.0), with a mean productivity loss of 41.8 days. The mean total cost was $3856.3 (95% CI $3349.1-$4129.2), significantly higher for males (<em>P</em> = .015) and smokers (<em>P</em> < .001). The national economic burden of IHD was approximately $1.23 billion annually.</div></div><div><h3>Conclusions</h3><div>IHD imposes a substantial economic burden in Morocco, particularly among high-risk populations. Beyond tobacco control, integrated prevention strategies, including early detection and risk factor management, are urgently needed. In addition, healthcare resource planning and equitable access to medications are essential to reduce the burden of IHD.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"52 ","pages":"Article 101504"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer care in Ethiopia imposes a significant financial burden, with high direct costs (eg, treatment and hospital stays) and indirect costs (eg, lost productivity). Despite the growing cancer burden, comprehensive data on its economic impact and cost-effectiveness remain limited. This systematic review assesses the economic burden of cancer care and the cost-effectiveness of interventions in Ethiopia, focusing on both adult and pediatric cancers.
Methods
A systematic search was conducted in PubMed, Embase, Scopus, and the Cochrane Library following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting Ethiopian-specific cost data, including direct and indirect costs, catastrophic health expenditure, and cost-effectiveness, were included. Economic evaluations and observational studies covering prevention to palliative care were considered. Cost data were standardized to 2019 values using the Campbell and Cochrane Economics Methods Group and the Evidence for Policy and Practice Information and Coordinating-Centre cost converter. Two independent reviewers’ extracted data, with quality assessment using the Consolidated Health Economic Evaluation Reporting Standards checklist.
Results
Of 656 identified records, 11 studies met the inclusion criteria. Cancer care costs were substantial, with medications, treatment, and hospital stays being the primary cost drivers. Lost productivity further exacerbated the burden. Pediatric oncology care and human papillomavirus vaccination were consistently cost-effective. Methodological approaches included decision trees, Markov models, and cost-effectiveness analyses. Gaps in uncertainty analysis, discount rates, and sensitivity analysis were noted.
Conclusions
Cancer care in Ethiopia remains a financial challenge, but cost-effective interventions, such as pediatric oncology programs and human papillomavirus vaccination, can mitigate costs. Strengthening financial protection mechanisms and conducting more detailed economic evaluations are crucial to informing policy and improving cancer care affordability.
{"title":"Economic Burden and Cost-Effectiveness of Cancer Care in Ethiopia: A Systematic Review","authors":"Tenaw Baye Tarekegn MSc, Getachew Ashagrie MSc, Abebe Tarekegn Kassaw MSc, Desye Gebrie MSc, Fentaw Girmaw MSc","doi":"10.1016/j.vhri.2025.101515","DOIUrl":"10.1016/j.vhri.2025.101515","url":null,"abstract":"<div><h3>Objectives</h3><div>Cancer care in Ethiopia imposes a significant financial burden, with high direct costs (eg, treatment and hospital stays) and indirect costs (eg, lost productivity). Despite the growing cancer burden, comprehensive data on its economic impact and cost-effectiveness remain limited. This systematic review assesses the economic burden of cancer care and the cost-effectiveness of interventions in Ethiopia, focusing on both adult and pediatric cancers.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in PubMed, Embase, Scopus, and the Cochrane Library following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting Ethiopian-specific cost data, including direct and indirect costs, catastrophic health expenditure, and cost-effectiveness, were included. Economic evaluations and observational studies covering prevention to palliative care were considered. Cost data were standardized to 2019 values using the Campbell and Cochrane Economics Methods Group and the Evidence for Policy and Practice Information and Coordinating-Centre cost converter. Two independent reviewers’ extracted data, with quality assessment using the Consolidated Health Economic Evaluation Reporting Standards checklist.</div></div><div><h3>Results</h3><div>Of 656 identified records, 11 studies met the inclusion criteria. Cancer care costs were substantial, with medications, treatment, and hospital stays being the primary cost drivers. Lost productivity further exacerbated the burden. Pediatric oncology care and human papillomavirus vaccination were consistently cost-effective. Methodological approaches included decision trees, Markov models, and cost-effectiveness analyses. Gaps in uncertainty analysis, discount rates, and sensitivity analysis were noted.</div></div><div><h3>Conclusions</h3><div>Cancer care in Ethiopia remains a financial challenge, but cost-effective interventions, such as pediatric oncology programs and human papillomavirus vaccination, can mitigate costs. Strengthening financial protection mechanisms and conducting more detailed economic evaluations are crucial to informing policy and improving cancer care affordability.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"52 ","pages":"Article 101515"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-10-22DOI: 10.1016/j.vhri.2025.101507
Susan E. Francis PGDipPopHlth , Luling Lin PhD , Richard P. Edlin PhD , Greg Gamble MSc , Caroline A. Crowther MD
Objectives
This study compared the costs of tight with less tight glycemic targets in the management of gestational diabetes using data from the TARGET trial.
Methods
The TARGET trial included women with gestational diabetes from 10 District Health Boards in New Zealand. This economic evaluation assessed 2 glycemic control strategies: tight versus less tight targets. Data on healthcare resource use, including antenatal care, birth outcomes, and hospital stay, were collected and analyzed to identify cost differences. The analysis was conducted from the perspective of New Zealand’s public healthcare system. The primary analysis adjusted for gestational age at the time of oral glucose tolerance test; additional analyses accounted for additional maternal and clinical factors.
Results
There were no significant differences in total healthcare costs between the 2 glycemic target groups. After adjusting for gestational age at the time of oral glucose tolerance test, the mean difference in combined maternal and infant costs was $203 (95% CI 1074 to 1479, P = .76). Further adjustment for additional confounders showed a cost difference of −$59 (95% CI: −1318 to 1200; P = .93). Although total combined costs were slightly lower in the tight glycemic group, patterns of resource use varied, particularly in antenatal care and birth outcomes.
Conclusions
Tight glycemic control in gestational diabetes care does not result in higher healthcare costs. However, variations in resource use and birth outcomes warrant further investigation to optimize glycemic control strategies. Future research should explore the long-term impact of different glycemic targets and consider patient-centered outcomes to guide cost-effective policy decisions.
目的：本研究使用TARGET试验的数据比较了严格和不严格血糖目标治疗妊娠糖尿病的成本。方法：TARGET试验包括来自新西兰10个地区卫生局的妊娠糖尿病妇女。这项经济评估评估了两种血糖控制策略：严格控制目标和不严格控制目标。收集并分析了有关医疗资源使用的数据，包括产前护理、分娩结果和住院时间，以确定成本差异。分析是从新西兰公共医疗体系的角度进行的。初步分析调整了口服糖耐量试验时的胎龄；额外的分析解释了额外的产妇和临床因素。结果：2个血糖目标组的总医疗费用无显著差异。在口服葡萄糖耐量试验时调整胎龄后，母婴联合成本的平均差异为203美元（95% CI 1074 ~ 1479, P = 0.76）。进一步调整其他混杂因素显示成本差异为- 59美元（95% CI: -1318至1200；P = 0.93）。虽然血糖控制严密组的总综合费用略低，但资源使用模式各不相同，特别是在产前护理和分娩结果方面。结论：在妊娠期糖尿病护理中严格控制血糖不会导致更高的医疗费用。然而，资源利用和出生结果的差异需要进一步研究以优化血糖控制策略。未来的研究应探索不同血糖目标的长期影响，并考虑以患者为中心的结果，以指导具有成本效益的政策决策。
{"title":"Cost Comparison of 2 Different Targets for Glycemic Control in Women With Gestational Diabetes: Evaluation From the TARGET Stepped-Wedge Randomized Trial","authors":"Susan E. Francis PGDipPopHlth , Luling Lin PhD , Richard P. Edlin PhD , Greg Gamble MSc , Caroline A. Crowther MD","doi":"10.1016/j.vhri.2025.101507","DOIUrl":"10.1016/j.vhri.2025.101507","url":null,"abstract":"<div><h3>Objectives</h3><div>This study compared the costs of tight with less tight glycemic targets in the management of gestational diabetes using data from the TARGET trial.</div></div><div><h3>Methods</h3><div>The TARGET trial included women with gestational diabetes from 10 District Health Boards in New Zealand. This economic evaluation assessed 2 glycemic control strategies: tight versus less tight targets. Data on healthcare resource use, including antenatal care, birth outcomes, and hospital stay, were collected and analyzed to identify cost differences. The analysis was conducted from the perspective of New Zealand’s public healthcare system. The primary analysis adjusted for gestational age at the time of oral glucose tolerance test; additional analyses accounted for additional maternal and clinical factors.</div></div><div><h3>Results</h3><div>There were no significant differences in total healthcare costs between the 2 glycemic target groups. After adjusting for gestational age at the time of oral glucose tolerance test, the mean difference in combined maternal and infant costs was $203 (95% CI 1074 to 1479, <em>P</em> = .76). Further adjustment for additional confounders showed a cost difference of −$59 (95% CI: −1318 to 1200; <em>P</em> = .93). Although total combined costs were slightly lower in the tight glycemic group, patterns of resource use varied, particularly in antenatal care and birth outcomes.</div></div><div><h3>Conclusions</h3><div>Tight glycemic control in gestational diabetes care does not result in higher healthcare costs. However, variations in resource use and birth outcomes warrant further investigation to optimize glycemic control strategies. Future research should explore the long-term impact of different glycemic targets and consider patient-centered outcomes to guide cost-effective policy decisions.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"52 ","pages":"Article 101507"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-12-09DOI: 10.1016/j.vhri.2025.101516
Soye Shin PhD , Ada Mohammad Alqunaibet PhD , Reem Alsukait PhD , Amaal Alruwaily MPH , Volkan Cetinkaya PhD , Christopher H. Herbst PhD , Eric A. Finkelstein PhD
Objectives
Taxes on sugar-sweetened beverages in Saudi Arabia (SA) and other countries have reduced purchases of these beverages and their associated calories and sugar. However, expanding such taxes to cover a broader range of foods and nutrients may be more effective at improving overall diet quality.
Methods
We tested the effectiveness of a comprehensive, salient, tiered, nutrient-based food and beverage (F&B) tax using a fully functional online grocery store. A total of 644 SA shoppers were randomized into 1 of 3 conditions: no-tax (control); the current beverage tax (current tax); or the comprehensive, salient tiered F&B tax (comprehensive tax) targeting all products.
Results
The nutritional quality of the shopping baskets, measured by average Nutri-Score points (ie, base scores used to determine the Nutri-Score grades from A [healthiest] to E [least healthy]), weighted by serving size, did not differ statistically between the control and current beverage tax arms. However, the comprehensive tax led to healthier baskets, improving Nutri-Score points by 0.88 (95% CI −0.07 to 1.83) relative to the control arm and 1.16 points (95% CI 0.21 to 2.11) relative to the current tax arm, which is equivalent to a 3.04% and 4.05% increase, respectively.
Conclusions
These findings suggest that a comprehensive, salient tiered F&B tax has the potential to improve diet quality among SA shoppers.
目标：沙特阿拉伯（SA）和其他国家对含糖饮料征税，减少了这些饮料及其相关卡路里和糖的购买量。然而，将此类税收扩大到更广泛的食物和营养素范围，可能更有效地改善整体饮食质量。方法：我们使用功能齐全的在线杂货店测试了全面，突出，分层，营养为基础的食品和饮料（F&B）税的有效性。共有644名SA购物者被随机分为三种情况：无税（对照组）；现行饮料税（当期税）；或针对所有产品的全面、突出的分层餐饮税（综合税）。结果：购物篮的营养质量，以营养评分平均值（即用于确定营养评分从A[最健康]到E[最不健康]等级的基本分数）衡量，按份量加权，在对照组和现行饮料税组之间没有统计学差异。然而，综合税收带来了更健康的篮子，相对于对照组提高了0.88点（95% CI -0.07至1.83），相对于当前税收组提高了1.16点（95% CI 0.21至2.11），分别相当于提高了3.04%和4.05%。结论：这些发现表明，一个全面的、显著的分层餐饮税有可能改善SA购物者的饮食质量。
{"title":"A Randomized Online Grocery Store Trial to Test a Salient Tiered Food and Beverage Tax in Saudi Arabia","authors":"Soye Shin PhD , Ada Mohammad Alqunaibet PhD , Reem Alsukait PhD , Amaal Alruwaily MPH , Volkan Cetinkaya PhD , Christopher H. Herbst PhD , Eric A. Finkelstein PhD","doi":"10.1016/j.vhri.2025.101516","DOIUrl":"10.1016/j.vhri.2025.101516","url":null,"abstract":"<div><h3>Objectives</h3><div>Taxes on sugar-sweetened beverages in Saudi Arabia (SA) and other countries have reduced purchases of these beverages and their associated calories and sugar. However, expanding such taxes to cover a broader range of foods and nutrients may be more effective at improving overall diet quality.</div></div><div><h3>Methods</h3><div>We tested the effectiveness of a comprehensive, salient, tiered, nutrient-based food and beverage (F&B) tax using a fully functional online grocery store. A total of 644 SA shoppers were randomized into 1 of 3 conditions: no-tax (control); the current beverage tax (current tax); or the comprehensive, salient tiered F&B tax (comprehensive tax) targeting all products.</div></div><div><h3>Results</h3><div>The nutritional quality of the shopping baskets, measured by average Nutri-Score points (ie, base scores used to determine the Nutri-Score grades from A [healthiest] to E [least healthy]), weighted by serving size, did not differ statistically between the control and current beverage tax arms. However, the comprehensive tax led to healthier baskets, improving Nutri-Score points by 0.88 (95% CI −0.07 to 1.83) relative to the control arm and 1.16 points (95% CI 0.21 to 2.11) relative to the current tax arm, which is equivalent to a 3.04% and 4.05% increase, respectively.</div></div><div><h3>Conclusions</h3><div>These findings suggest that a comprehensive, salient tiered F&B tax has the potential to improve diet quality among SA shoppers.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"52 ","pages":"Article 101516"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-10-07DOI: 10.1016/j.vhri.2025.101503
Carsten Bauer PhD , Oliver Unger PhD , Martin Holderried MD Habil, PhD
Objectives
Healthcare systems around the world face significant cost pressure and need to find ways to deal with this challenge without compromising treatment quality. Investigating and using learning effects might be an approach to achieve this goal. This study investigates surgeons’ learning effects of a standard surgical procedure in otorhinolaryngology, the tonsillectomy. It focuses on short-, medium-, and long-term effects using incision-suture times and complications as cost indicators. Surgeons’ experience, measured by qualification level, was also assessed.
Methods
Using process, quality, and economic data from a German tertiary care hospital, the economic effects of team learning processes and medical experience were compared using statistical methods to assess teamwork’s impact on outcomes.
Results
Team learning and increased surgeon experience yielded cost savings and quality improvements across short-, medium-, and long-term periods. Teamwork accelerated learning, reducing operation times compared with individual settings. Resident physicians benefitted from engaging in team surgeries for accelerated knowledge acquisition.
Conclusions
Team learning in tonsillectomies as a very common surgical procedure in the field of otorhinolaryngology offers insights into improving surgical outcomes from an economic and quality management perspective. The importance of teamwork in enhancing learning curves and reducing costs in head and neck surgery is underscored. Recommendations advocate for integrating quality management principles into surgical practices to optimize outcomes and resource utilization.
{"title":"Team Learning in Head and Neck Surgery: An Economic and Quality Management Perspective","authors":"Carsten Bauer PhD , Oliver Unger PhD , Martin Holderried MD Habil, PhD","doi":"10.1016/j.vhri.2025.101503","DOIUrl":"10.1016/j.vhri.2025.101503","url":null,"abstract":"<div><h3>Objectives</h3><div>Healthcare systems around the world face significant cost pressure and need to find ways to deal with this challenge without compromising treatment quality. Investigating and using learning effects might be an approach to achieve this goal. This study investigates surgeons’ learning effects of a standard surgical procedure in otorhinolaryngology, the tonsillectomy. It focuses on short-, medium-, and long-term effects using incision-suture times and complications as cost indicators. Surgeons’ experience, measured by qualification level, was also assessed.</div></div><div><h3>Methods</h3><div>Using process, quality, and economic data from a German tertiary care hospital, the economic effects of team learning processes and medical experience were compared using statistical methods to assess teamwork’s impact on outcomes.</div></div><div><h3>Results</h3><div>Team learning and increased surgeon experience yielded cost savings and quality improvements across short-, medium-, and long-term periods. Teamwork accelerated learning, reducing operation times compared with individual settings. Resident physicians benefitted from engaging in team surgeries for accelerated knowledge acquisition.</div></div><div><h3>Conclusions</h3><div>Team learning in tonsillectomies as a very common surgical procedure in the field of otorhinolaryngology offers insights into improving surgical outcomes from an economic and quality management perspective. The importance of teamwork in enhancing learning curves and reducing costs in head and neck surgery is underscored. Recommendations advocate for integrating quality management principles into surgical practices to optimize outcomes and resource utilization.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"52 ","pages":"Article 101503"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-07-07DOI: 10.1016/j.vhri.2025.101149
Nizar Alsubahi MHA , Milena Pavlova PhD , Ahmed Ali Alzahrani MHA , Ala’eddin Ahmad PhD , Wim Groot PhD
Objectives
This study investigated the association between patient-reported experience measures (PREMs) and patient-reported outcome measures (PROMs) among patients with diabetes in the Kingdom of Saudi Arabia.
Methods
This quantitative cross-sectional study was conducted on 594 patients with diabetes from July to August 2023 at all primary healthcare centers affiliated with general hospitals operated by the Ministry of Health in Jeddah, Saudi Arabia. Data were collected through face-to-face interviewer-administered questionnaires on PREMs, and PROMs used the random sampling technique. Data were analyzed using SPSS version 28 and the lavaan package within the R statistical environment (version 4.3.2).
Results
The results indicated that respondents hold positive perceptions of PREMs and PROMs. The study revealed that the correlation between PREMs and PROMs was significant (0.198, P < .01) when considering PROMs at an aggregated level; PREMs showed positive correlations with “How You Feel” (0.219, P < .01), “Support from Others” (0.451, P < .01), and “Capabilities to Manage Diabetes” (0.315, P < .01). However, no significant correlations were found between PREMs and “Worries about Diabetes” (r = −0.021, P > .05) or “Barriers to Living as Desired” (r = −0.01, P > .05).
Conclusions
The findings suggest that PREMs and PROMs are associated and provide valuable insight into enhancing patient experiences and improving the quality and patient centeredness of diabetic care. Integrating PREMs and PROMs into routine diabetes care can help enable more value-based healthcare delivery. Providers and policy makers should consider these measures when developing more effective, patient-centered diabetes management strategies.
目的：本研究调查了沙特阿拉伯王国糖尿病患者中患者报告体验测量（PREMs）和患者报告结果测量（PROMs）之间的关系。方法：本定量横断面研究于2023年7月至8月在沙特阿拉伯吉达卫生部运营的综合医院附属的所有初级卫生保健中心对594例糖尿病患者进行了研究。数据的收集采用面对面的访谈问卷，并采用随机抽样技术。数据分析使用SPSS 28和R统计环境（4.3.2版）中的lavaan软件包。结果：调查结果显示，被调查者对企业绩效管理和企业绩效管理持积极态度。研究发现，在综合水平上，PREMs与PROMs的相关性显著（0.198,P < 0.01）；PREMs与“自我感受”（0.219,P < 0.01）、“他人支持”（0.451,P < 0.01）、“糖尿病管理能力”（0.315,P < 0.01）呈正相关。然而，PREMs与“对糖尿病的担忧”（r = -0.021, P < 0.05）或“生活障碍”（r = -0.01, P < 0.05）之间没有显著相关。结论：研究结果表明PREMs和PROMs是相关的，为改善患者体验、提高糖尿病护理质量和以患者为中心提供了有价值的见解。将prem和prom集成到常规糖尿病护理中可以帮助实现更多基于价值的医疗保健服务。提供者和决策者在制定更有效的、以患者为中心的糖尿病管理策略时应考虑这些措施。
{"title":"The Association Between Patient-Reported Experience Measures and Patient-Reported Outcome Measures Among Patients With Diabetes in the Kingdom of Saudi Arabia","authors":"Nizar Alsubahi MHA , Milena Pavlova PhD , Ahmed Ali Alzahrani MHA , Ala’eddin Ahmad PhD , Wim Groot PhD","doi":"10.1016/j.vhri.2025.101149","DOIUrl":"10.1016/j.vhri.2025.101149","url":null,"abstract":"<div><h3>Objectives</h3><div>This study investigated the association between patient-reported experience measures (PREMs) and patient-reported outcome measures (PROMs) among patients with diabetes in the Kingdom of Saudi Arabia.</div></div><div><h3>Methods</h3><div>This quantitative cross-sectional study was conducted on 594 patients with diabetes from July to August 2023 at all primary healthcare centers affiliated with general hospitals operated by the Ministry of Health in Jeddah, Saudi Arabia. Data were collected through face-to-face interviewer-administered questionnaires on PREMs, and PROMs used the random sampling technique. Data were analyzed using SPSS version 28 and the lavaan package within the R statistical environment (version 4.3.2).</div></div><div><h3>Results</h3><div>The results indicated that respondents hold positive perceptions of PREMs and PROMs. The study revealed that the correlation between PREMs and PROMs was significant (0.198, <em>P</em> < .01) when considering PROMs at an aggregated level; PREMs showed positive correlations with “How You Feel” (0.219, <em>P</em> < .01), “Support from Others” (0.451, <em>P</em> < .01), and “Capabilities to Manage Diabetes” (0.315, <em>P</em> < .01). However, no significant correlations were found between PREMs and “Worries about Diabetes” (r = −0.021, <em>P</em> > .05) or “Barriers to Living as Desired” (r = −0.01, <em>P</em> > .05).</div></div><div><h3>Conclusions</h3><div>The findings suggest that PREMs and PROMs are associated and provide valuable insight into enhancing patient experiences and improving the quality and patient centeredness of diabetic care. Integrating PREMs and PROMs into routine diabetes care can help enable more value-based healthcare delivery. Providers and policy makers should consider these measures when developing more effective, patient-centered diabetes management strategies.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"52 ","pages":"Article 101149"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-07-07DOI: 10.1016/j.vhri.2025.101155
Wu Zeng MD, PHD , Tianjiao Gao MPP , Eva Jarawan PHD, MBA , Heba Abu Shindi MS , Anas Almohtaseb MD, MS , Raja Khater MD , Sawsan A. Majali PHD , Nagham Abu Shaqra MD
Objectives
Maternal mortality has been one of the most profound challenges affecting countries worldwide. To monitor maternal death, Jordan has established a surveillance system named Jordan Maternal Mortality Surveillance and Response System (JMMSR). This study aims to estimate the economic burden of maternal deaths in Jordan and examine its social and geographic variations.
Methods
This study used data from JMMSR and applied a cost-of-illness approach to estimate the economic burden of maternal death in Jordan. The length of stay and characteristics of the deceased pregnant women and survival of fetuses were obtained from JMMSR, whereas the unit cost data were obtained from the literature. The indirect cost due to productivity loss was estimated using the value of statistical life.
Results
The non-COVID-19 maternal mortality rate was 29.8, 32.4, 30.0, and 29.8 per 100 000 live births in 2018, 2019, 2020, and 2021, respectively. The overall burden was between JOD 43.74 (US dollars $61.60) and JOD 51.03 (US dollars $71.87) million per year, accounting for an average of 1.95% of annual current health expenditure and 4.89% of public health expenditure. However, there was a wide variation of economic burden across different age groups, governorates, education status, and nationality of deceased pregnant women.
Conclusions
Despite a relatively low maternal mortality rate in Jordan, the economic burden triggered by maternal death remains high. Developing targeted approaches to address specific health needs for identified vulnerable populations is needed to further reduce the economic burden due to maternal death.
{"title":"The Economic Burden of Maternal Death in Jordan From 2018 to 2021: Social and Geographic Variations","authors":"Wu Zeng MD, PHD , Tianjiao Gao MPP , Eva Jarawan PHD, MBA , Heba Abu Shindi MS , Anas Almohtaseb MD, MS , Raja Khater MD , Sawsan A. Majali PHD , Nagham Abu Shaqra MD","doi":"10.1016/j.vhri.2025.101155","DOIUrl":"10.1016/j.vhri.2025.101155","url":null,"abstract":"<div><h3>Objectives</h3><div>Maternal mortality has been one of the most profound challenges affecting countries worldwide. To monitor maternal death, Jordan has established a surveillance system named Jordan Maternal Mortality Surveillance and Response System (JMMSR). This study aims to estimate the economic burden of maternal deaths in Jordan and examine its social and geographic variations.</div></div><div><h3>Methods</h3><div>This study used data from JMMSR and applied a cost-of-illness approach to estimate the economic burden of maternal death in Jordan. The length of stay and characteristics of the deceased pregnant women and survival of fetuses were obtained from JMMSR, whereas the unit cost data were obtained from the literature. The indirect cost due to productivity loss was estimated using the value of statistical life.</div></div><div><h3>Results</h3><div>The non-COVID-19 maternal mortality rate was 29.8, 32.4, 30.0, and 29.8 per 100 000 live births in 2018, 2019, 2020, and 2021, respectively. The overall burden was between JOD 43.74 (US dollars $61.60) and JOD 51.03 (US dollars $71.87) million per year, accounting for an average of 1.95% of annual current health expenditure and 4.89% of public health expenditure. However, there was a wide variation of economic burden across different age groups, governorates, education status, and nationality of deceased pregnant women.</div></div><div><h3>Conclusions</h3><div>Despite a relatively low maternal mortality rate in Jordan, the economic burden triggered by maternal death remains high. Developing targeted approaches to address specific health needs for identified vulnerable populations is needed to further reduce the economic burden due to maternal death.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"52 ","pages":"Article 101155"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号