تعزيز الصحة القائم على القيمة من خلال الممارسات المبنية على الأدلة البحثية، والبيانات الواقعية، وتقنيات الذكاء الاصطناعي: تجسير الفجوة بين البحث العلمي والواقع
الملخص
تواجه أنظمة الرعاية الصحية في منطقة الشرق الأوسط تحديات بالغة، من أبرزها تزايد أعباء الأمراض غير السارية، والقصور الهيكلي في تقديم الخدمات، إضافة إلى ضعف توظيف الابتكارات التحويلية مثل الأدلة الواقعية (RWE)، والبحث العلمي، والتحليلات التنبؤية المعززة بتقنيات الذكاء الاصطناعي. ويطرح هذا البحث نموذج معدل "الصحة القائمة على القيمة" كإطار تحويلي لمعالجة هذه التحديات الجوهرية. فمن خلال دمج الأدلة الواقعية مع البحث العلمي، والاستفادة من قدرات البحث العلمي في الذكاء الاصطناعي والطب النانومتري، يعزز هذا النموذج من دقة اتخاذ القرارات السريرية، ويرفع من كفاءة استخدام الموارد، ويُحسّن مخرجات الرعاية الصحية للمرضى.
يعرض البحث حلولًا مبتكرة مدعومة باستراتيجيات قابلة للتنفيذ، تهدف إلى تقوية منظومة البحث العلمي، وإصلاح السياسات الصحية، وتعزيز الشراكات بين القطاعين العام والخاص، وإنشاء بنى تحتية صحية مستدامة تتماشى مع الهدف الثالث من أهداف التنمية المستدامة (الصحة الجيدة والرفاه). كما يتناول البحث بالتحليل نماذج بديلة مثل نموذج الدفع مقابل الخدمة (FFS) مع تعزيز التنظيم، ونموذج التغطية الصحية الشاملة (UHC) في إطار أنظمة مركزية. ومن خلال تحليل مقارن، يُبرز البحث الأسباب التي تجعل من نموذج الطب القائم على القيمة الخيار الأكثر فاعلية واستدامة لإصلاح وتطوير أنظمة الرعاية الصحية في منطقة الشرق الأوسط وشمال أفريقيا.
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Boussetta, O., Aissaoui, N., & Sellaouti, F. (2022). MENA countries face the challenge of the knowledge-based economy. In Cases on applying knowledge economy principles for economic growth in developing nations (pp. 150–202). IGI Global Scientific Publishing. https://doi.org/10.4018/978-1-7998-8417-0.ch010
Burns, L., Le Roux, N., Kalesnik-Orszulak, R., Christian, J., Hukkelhoven, M., Rockhold, F., & O’Donnell, J. (2022). Real-world evidence for regulatory decision-making: Guidance from around the world. Clinical Therapeutics, 44(3), 420–437.https://doi.org/10.1016/j.clinthera.2022.01.012
Carter, A. K. (2022). Primary care transformation from fee-for-service care delivery to value-based care delivery (Master’s thesis, The College of St. Scholastica).
Cattell, D., & Eijkenaar, F. (2020). Value-based provider payment initiatives combining global payments with explicit quality incentives: A systematic review. Medical Care Research and Review, 77(6), 511–537. https://doi.org/10.1177/1077558719856775
Diabetes Atlas 11th edition. (2025). IDF Diabetes Atlas 2025, Global diabetes data & insights. https://diabetesatlas.org/resources/idf-diabetes-atlas-2025
Dowd, B. E., & Laugesen, M. J. (2020). Fee-for-service payment is not the (main) problem. Health Services Research, 55(4), 491–495. https://doi.org/10.1111/1475-6773.13316
El Ojeil, R. (2024). Pioneering value-based healthcare in MENA. Health Policy. https://marketaccesstoday.com/pioneering-value-based-healthcare-in-mena/
Esposti, F., & Banfi, G. (2020). Fighting healthcare rocketing costs with value-based medicine: The case of stroke management. BMC Health Services Research, 20(1), 75. https://doi.org/10.1186/s12913-020-4925-0
Ganju, A., Goulart, A. C., Ray, A., Majumdar, A., Jeffers, B. W., Llamosa, G., Cañizares, H., Ramos-Cañizares, I. J., Fadhil, I., Subramaniam, K., Lim, L.-L., El Bizri, L., Ramesh, M., Guilford, M., Ali, R., Duddi Devi, R., Malik, R. A., Potkar, S., & Wang, Y. P. (2020). Systemic solutions for addressing non-communicable diseases in low- and middle-income countries. Journal of Multidisciplinary Healthcare, 13, 693–707. https://doi.org/10.2147/JMDH.S256437
García-Lorenzo, B., Gorostiza, A., Alayo, I., Castelo Zas, S., Cobos Baena, P., Gallego Camiña, I., Izaguirre Narbaiza, B., Mallabiabarrena, G., Ustarroz-Aguirre, I., Rigabert, A., & Balzi, W. (2024). European value-based healthcare benchmarking: Moving from theory to practice. European Journal of Public Health, 34(1), 44–51. https://doi.org/10.1093/eurpub/ckad181
Jain, P., Jain, B., Hammond, A., Sabet, C. J., Rahim, F. O., Patel, T. A., & Lewis, S. (2025). Value-based care: Lessons for the United Kingdom’s National Health Service. Value in Health, 28(9), 1309–1316. https://doi.org/10.1016/j.jval.2025.06.003
Johnson, K. B., Wei, W. Q., Weeraratne, D., Frisse, M. E., Misulis, K., Rhee, K., Zhao, J., & Snowdon, J. L. (2021). Precision medicine, AI, and the future of personalized health care. Clinical and Translational Science, 14(1), 86–93. https://doi.org/10.1111/cts.12884
Kamel, A. M., Moaness, M., Salama, A., Ahmed, M. M., Beherei, H. H., & Mabrouk, M. (2025). Smart hydrogels for rapid wound repair: Chitosan-PVP matrices empowered by bimetallic MOF nanocages. International Journal of Biological Macromolecules, 288, 138672. https://doi.org/10.1016/j.ijbiomac.2024.138672
Karimi, M., Tsiachristas, A., Looman, W., Stokes, J., van Galen, M., & Rutten-van Mölken, M. (2021). Bundled payments for chronic diseases increased health care expenditure in the Netherlands, especially for multimorbid patients. Health Policy, 125(6), 751–759. https://doi.org/10.1016/j.healthpol.2021.04.004
Katoue, M. G., Cerda, A. A., García, L. Y., & Jakovljevic, M. (2022). Healthcare system development in the Middle East and North Africa region: Challenges, endeavors and prospective opportunities. Frontiers in Public Health, 10, 1045739. https://doi.org/10.3389/fpubh.2022.1045739
Larsson, S., Clawson, J., & Howard, R. (2023). Value-based health care at an inflection point: A global agenda for the next decade. NEJM Catalyst Innovations in Care Delivery, 4(1). https://doi.org/10.1056/CAT.22.0332
Leao, D. L. L., Cremers, H., van Veghel, D., Pavlova, M., & Groot, W. (2023). The impact of value-based payment models for networks of care and transmural care: A systematic literature review. Applied Health Economics and Health Policy, 21(3), 441–466. https://doi.org/10.1007/s40258-023-00790-z
Lemaire, X. (2011). Off-grid electrification with solar home systems: The experience of a fee-for-service concession in South Africa. Energy for Sustainable Development, 15(3), 277–283. https://doi.org/10.1016/j.esd.2011.07.005
Lozano, R., Fullman, N., Mumford, J. E., Knight, M., & Banach, M. (2020). Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet, 396(10258), 1250–1284. https://doi.org/10.1016/S0140-6736(20)30750-9
MacLean, C., Titmuss, M., Lee, J., Russell, L., & Padgett, D. (2021). The clinical, operational, and financial components of a successful bundled payment program for lower extremity total joint replacement. NEJM Catalyst, 2(10). https://doi.org/10.1056/cat.21.0240
Maha, N. C. C., Kolawole, N. T. O., & Abdul, N. S. (2024). Harnessing data analytics: A new frontier in predicting and preventing non-communicable diseases in the US and Africa. Computer Science & IT Research Journal, 5(6), 1247–1264. https://doi.org/10.51594/csitrj.v5i6.1196
Meskó, B., & Görög, M. (2020). A short guide for medical professionals in the era of artificial intelligence. NPJ Digital Medicine, 3(1), 126. https://doi.org/10.1038/s41746-020-00333-z
Mjåset, C., Ikram, U., Nagra, N. S., & Feeley, T. W. (2020). Value-based health care in four different health care systems. NEJM Catalyst. https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0530
NCDs. (n.d.). NCD progress monitor. World Health Organization, Regional Office for the Eastern Mediterranean. https://www.emro.who.int/noncommunicable-diseases/publications/ncd-progress-monitor.html
Obermeyer, Z., & Emanuel, E. J. (2016). Predicting the future, Big data, machine learning, and clinical medicine. The New England Journal of Medicine, 375(13), 1216–1219. https://doi.org/10.1056/NEJMp1606181
O’Donnell, M. T., Lewis, S., Davies, S., & Dinneen, S. F. (2023). Delivering value-based healthcare for people with diabetes in a national publicly funded health service: Lessons from Ireland and Wales. Journal of Diabetes Investigation, 14(8), 925–929. https://doi.org/10.1111/jdi.14023
Olawade, D. B., Ige, A. O., Olaremu, A. G., Ijiwade, J., & Adeola, A. O. (2024). The synergy of artificial intelligence and nanotechnology towards advancing innovation and sustainability: A mini-review. Nano Trends, 8, 100052. https://doi.org/10.1016/j.nwnano.2024.100052
Porter, M. E., & Kaplan, R. S. (2016). How to pay for health care. Harvard Business Review, 94(7–8), 88–100, 134. https://pubmed.ncbi.nlm.nih.gov/27526565
Porter, M. E., & Lee, T. H. (2013). The strategy that will fix health care. Harvard Business Review, 91(10), 50–70. Retrieved from https://www.hbs.edu/faculty/Pages/item.aspx?num=45614
Rudrapatna, V. A., & Butte, A. J. (2020). Opportunities and challenges in using real-world data for health care. The Journal of Clinical Investigation, 130(2), 565–574. https://doi.org/10.1172/JCI129197
Salhab, N., Yartey, J., Akala, F. A., Claeson, M., Downing, A., Jenkins, C. F., & Robalino, D. A. (n.d.). Public health in the Middle East and North Africa: Meeting the challenges of the twenty-first century. World Bank Group. https://documents.worldbank.org/en/publication/documents-reports/documentdetail/390071468756934950
Sarkar, M., Dey, R., & Mia, M. T. (2025). Artificial intelligence in telemedicine and remote patient monitoring: Enhancing virtual healthcare through AI-driven diagnostic and predictive technologies. International Journal of Science and Research Archive, 15(2), 1046–1055. https://doi.org/10.30574/ijsra.2025.15.2.1402
Seedat, F., Evangelidou, S., Abdellatifi, M., et al. (2024). Defining indicators for disease burden, health outcomes, policies and barriers and facilitators to health services for migrant populations in the Middle East and North African region: A protocol for a suite of systematic reviews. BMJ Open, 14(7), e083813. https://doi.org/10.1136/bmjopen-2023-083813
Shrestha, B., Tang, L., & Hood, R. L. (2023). Nanotechnology for personalized medicine. In Micro/nano technologies (pp. 555–603). https://doi.org/10.1007/978-981-16-8984-0_18
Smith, P. C., Sagan, A., Siciliani, L., & Figueras, J. (2023). Building on value-based health care: Towards a health system perspective. Health Policy, 138, 104918. https://doi.org/10.1016/j.healthpol.2023.104918
Tariq, A., Gill, A. Y., & Hussain, H. K. (2023). Evaluating the potential of artificial intelligence in orthopedic surgery for value-based healthcare. International Journal of Multidisciplinary Sciences and Arts, 2(1), 27–35. https://doi.org/10.47709/ijmdsa.v2i1.2394
Tsiachristas, A., Vrangbæk, K., Gongora-Salazar, P., & Kristensen, S. R. (2023). Integrated care in a Beveridge system: Experiences from England and Denmark. Health Economics, Policy and Law, 18(4), 345–361. https://doi.org/10.1017/S1744133123000166
Udegbe, F. C., Ebulue, O. R., Ebulue, C. C., & Ekesiobi, C. S. (2024). AI’s impact on personalized medicine: Tailoring treatments for improved health outcomes. Engineering Science & Technology Journal, 5(4), 1386–1394. https://doi.org/10.51594/estj.v5i4.1040
Van Staalduinen, D. J., Van Den Bekerom, P., Groeneveld, S., Kidanemariam, M., Stiggelbout, A. M., & Van Den Akker-Van Marle, M. E. (2022). The implementation of value-based healthcare: A scoping review. BMC Health Services Research, 22(1), 270. https://doi.org/10.1186/s12913-022-07489-2
Varela-Rodríguez, C., Rosillo-Ramirez, N., Rubio-Valladolid, G., & Ruiz-López, P. (2023). Editorial: Real world evidence, outcome research and healthcare management improvement through real world data (RWD). Frontiers in Public Health, 10, 1064580. https://doi.org/10.3389/fpubh.2022.1064580
Wolfe, J. D., Epstein, A. M., Zheng, J., Orav, E. J., & Joynt Maddox, K. E. (2022). Predictors of success in the Bundled Payments for Care Improvement program. Journal of General Internal Medicine, 37(3), 513–520. https://doi.org/10.1007/s11606-021-06820-7
World Health Organization, Regional Office for the Eastern Mediterranean. (2022). Building resilient health systems to advance universal health coverage and ensure health security in the Eastern Mediterranean Region (EM/RC69/4). https://applications.emro.who.int/docs/EM_RC69_4_en.pdf
Yanful, B., Kirubarajan, A., Bhatia, D., Mishra, S., Allin, S., & Di Ruggiero, E. (2023). Quality of care in the context of universal health coverage: A scoping review. Health Research Policy and Systems, 21(1), 21. https://doi.org/10.1186/s12961-022-00957-5

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