Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Jul 12, 2024
Open Peer Review Period: Jul 12, 2024 - Sep 6, 2024
Date Accepted: Oct 29, 2024
(closed for review but you can still tweet)
Digital Surveillance of Mental Health Care Services in Saudi Arabia: Retrospective Analysis of National e-Referral System
ABSTRACT
Background:
Mental illness remains a serious public health concern worldwide, yet significant gaps in access to mental healthcare persist globally. Electronic referral (eReferral) systems have emerged as an innovative digital health solution to improve coordination and continuity of mental healthcare. The Kingdom of Saudi Arabia (KSA) pioneered one of the first nationwide eReferral systems, the Saudi Medical Appointments and Referrals Centre (SMARC), launched in 2019. Leveraging this advanced digital platform provides an unprecedented opportunity to conduct large-scale analysis of mental health referral patterns and unmet needs across the KSA.
Objective:
The objective of this study was to analyze national eReferral data in Saudi Arabia to examine mental health referral patterns, identify care disparities, and prioritize areas for health system improvements.
Methods:
This retrospective, cross-sectional study utilized secondary data from SMARC on 10,033 psychiatric eReferrals in the KSA during 2020-2021. Referrals were assessed by patient sociodemographics, clinical characteristics, geographic region, and temporal trends. Descriptive statistical analyses identified referral patterns, while regression modeling determined predictors of external referrals to other regions.
Results:
Most mental health referrals were for Saudi nationals (87.10%), males (63.93%), and adults aged 18-44 years (58.99%). Referrals increased significantly in 2021 compared to 2020 (58.35% vs 41.65%). Substantial regional variability was observed, with the Western business unit demonstrating the highest referral rate (45.17%, P<.001). Emergency referrals predominated (40.27%), frequently for general ward beds (68.06%), mainly due to lack of mental health specialty services (68.70%).
Conclusions:
Analysis of the KSA's national eReferral data revealed unequal distribution and strain on mental health system capacity, especially impacting youth. Targeted investments, expanded community-based services, virtual care capabilities, and advanced eReferral functionalities could help address disparities as part of the KSA's digital health transformation under Vision 2030. This study demonstrates the value of leveraging digital platforms like SMARC to generate data-driven insights and guide mental healthcare planning at scale.
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Copyright
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