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This was a cross-sectional national survey of the elderly population of Saudi Arabia conducted between January 1994 and December 1995. The participants' physical, mental, social, and environmental health status were assessed in a personal interview during which a structured data form was completed by a trained research team. Data on 6,139 elderly participants have been analyzed: 64.2 percent were males mean age: 69.2 +/- 7.8 years which was higher than females 68.0 +/- 7.6 years (P < 0.0001). The widowhood (46.7%) status was also higher than the widowerhood (4.1%) and 9.3 percent of the participants were never married. The proportion of female illiterates (95.8%) was higher than the males (71.4%). The proportion of participants with definite psychopathology was 33.8 percent and this increased with age and higher among females than males. Overall, 18.8 percent were dependent on others for ADL. Other clinical findings included visual impairment (46.1%) and difficulty in hearing (19.9%). However, a sizeable majority (72.2%) enjoyed good health. Only 3.7 percent lived alone. The proportion of the elderly taking part in any recreational exercise was 14.7 percent and only 4.3 percent had any experience of physical therapy. There were no special hospital wards for the elderly patients, and they were treated by general internists. There is a need for a national cost-effective program for the care of the elderly. The present widespread primary health care centers can be upgraded to coordinate the proposed services.

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BACKGROUND: The aim of the present study was to find out the clinical and epidemiological pattern of long-stay in-patients. METHODS: A cross-sectional survey of long-stay patients in Ministry of Health general hospitals was conducted during the period January-June 1993. A trained research team which consisted of a physician, a nurse, social workers and medical record officers completed a pre-designed data form and interviewed treating teams, patients and their relatives. The data form consisted of sociodemographic data of patients, their duration of stay, and their clinical, social and psychological characteristics. The doctors', patients', their relatives' perceptions and their preferences about the place of care (hospital or home) plus the geographical location of the hospitals involved were also recorded. RESULTS: Of the 1194 patients, 55 per cent came from either the central or southern regions. Male patients represent 65.2 per cent and the elderly (> 60 years of age) 41.6 per cent. Multiple pathologies were found in 50.9 per cent and special signs and symptoms, e.g. incontinence, were found in 59 per cent. The medical team felt that 54.1 per cent of all patients did not need nursing or required only routine nursing care. Treating doctors thought that 16.2 per cent of patients did not need admission and that a further 54.8 per cent could be cared for in the patient's home. However, 47.5 per cent of patients preferred to stay in hospital, and 60.6 per cent of their relatives preferred them to remain in hospital. CONCLUSIONS: There is a need to plan for more cost-effective facilities for these patients. Any proposed health services will have to be culturally acceptable so as to encourage patients and relatives to utilize them.

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Assessment of the progress of residency training in graduate education after 9 years shows that the original goals established for various specialties are being effectively met. There are now 7 approved residency programmes for diplomas and 10 approved residency programmes for fellowships with 324 residents trained and in training, out of whom (32%) were females, and 222 (68%) were male residents. Student interest in these programmes has remained at a high level. Only 15 candidates (4.64%) had withdrawn from the residency training programmes. Heavy emphasis has been placed upon curriculum design, selection criteria of students and quality control mechanisms through residency committees in specialty departments and the residency board embracing residency coordinators. This paper outlines some concerns regarding the present status of various residencies and suggests some recommendations for future development of these programmes.

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Consumption of Arabic coffee is commonly practised by Saudi citizens. The present study was conducted to explore the possible relationship between the serum total cholesterol levels and the intake of Arabic coffee. A total of 252 adult Saudi individuals were recruited, of whom 143 were coffee drinkers and 109 did not drink coffee. The study showed that in comparison to the non-coffee drinkers the serum total cholesterol concentration was significantly higher among the coffee drinkers. Furthermore, the level was higher among females than males who were coffee drinkers. The effect of the duration of coffee consumption on the serum total was significant for both sexes (P < 0.001). It is suggested that further studies should be generated in order to address questions related to the issues discussed. At the present time a reduction in coffee consumption by those groups found to be more liable to adverse influence on their serum total cholesterol levels to have a positive influence should be considered.

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Patient satisfaction is of value to primary health care authorities. The main objective of this study was to estimate patient satisfaction with respect to primary health care services in Riyadh City. 14 primary health care centres were chosen randomly to represent geographic areas of Riyadh. Information was collected through a pre-tested questionnaire conducted by 30 well-trained final year medical students. Systematic sampling of family files was conducted and the household head was interviewed. 900 respondents were interviewed concerning their satisfaction with the services delivered. 40% were dissatisfied. One third of the dissatisfied said that the centre was too far away: 19.4% complained that the working hours of the centre were not suitable: 38.9% complained about the absence of specialty clinics: 19.4% had language barriers with the physicians: 63.9% complained about the delay in the centre: 16.7% of the satisfied and 38.9% of the dissatisfied complained that the physicians do not explain to them their health problems and their treatment. In 22.7% of the non-satisfied category, physician's explanations were neither clear nor understandable. The Primary Health Care Centre will be the first choice if they feel sick for 74.6% of the satisfied category and 61.1% for the non-satisfied category. Implications of the findings are discussed and recommendations are given to rectify certain situations.

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