2.2 Health system in KSA
The financial appropriations of the government budget allocated for the Ministry of Health (MOH) is considered the main financing source for health resources. The Saudi government exerts effort to ensure continuous support to the MOH through the five year developmental plan, in which the allocated MOH budget undergoes continuous increase.
Budget Allocations
Between 2005 and 2008 Saudi Arabia allocated approximately SAR 23.5 billion per annum with a cumulative amount of SAR 94 billion investment in the healthcare sector. However, in 2010 and 2011 there was a substantial increase in the healthcare budget which increased from SAR 30 billion (6.3% of total Government Budget) in 2008 to SAR 52 billion in 2009 (11% of total Government Budget) and to SAR 61.2 billion in 2010 (11.3% of total Government Budget). The budget allocation was further increased to SAR 68.7 billion (11.8% of total Government Budget) in 2011, a cumulative allocation of SAR 113 billion in last two years compared to SAR 94 billion in the previous four years.
However, in terms of percentage spent on healthcare as a percentage of GDP, Saudi Arabia still is behind many developed nations in the world.
Healthcare Overview
With an estimated population of 26 million residents with an annual growth rate of 2.2%, the Saudi Arabian healthcare sector caters to a rapidly growing population and the concurrent increasing demand on the healthcare sector.
Overall the supply of healthcare facilities struggles to keep pace with the burgeoning population, a situation recognised by the Government who have recently introduced initiatives to encourage the private sector to match the shortfall and benefit from this potentially lucrative sector.
The Healthcare sector in the Kingdom of Saudi Arabia is primarily managed by the Government through the Ministry of Health (MOH) and number of semi-public organisation who specifically operate hospitals and medical services for their employees. In addition, private sector operators are also playing a key role in providing quality healthcare services in the Kingdom.
Life expectancy in KSA for year 2013 (75 years) exceeds the regional average by 7 years and exceeds the global average by 5 years. Crude death rate (per 1,000 population) in KSA for year 2013 (3.8) is lower than the regional rate (6.3) and is almost half the global rate (7.9).
The financial appropriations of the government budget allocated for the Ministry of Health (MOH) is considered the main financing source for health resources. The Saudi government exerts effort to ensure continuous support to the MOH through the five year developmental plan, in which the allocated MOH budget undergoes continuous increase.
Inappropriate utilization (overutilization or underutilization) of hospital resources is not a new phenomenon and has been an issue of concern to medical staff, administrators and policy makers worldwide. Hospital services are the most expensive components of modern health care systems (Panis, Gooskens et al., 2003). The utilization of hospital resources which does not result in any significant benefit for the patient, or which results in benefit which could have been obtained at a lower care level is considered ‘inappropriate’ (Eriksen, Kristiansen et al., 1999).
Hospital resources’ utilization is increasing in most countries and the Kingdom of Saudi Arabia (KSA) is no exception. The Saudi Ministry of Health (MOH) annual statistics, for example, show that there were 2,346,186 admissions to all health care facilities in the Kingdom in 2004, of which 55.3% were in the MOH hospitals, 18.5% in other governmental hospitals and 26.2% were in the private sector’s hospitals (MOH, 2004). The number of hospitalized patients rose from 2,088,006 in 2000 to 2,346,186 in 2004 (an increase of approximately 12%). Decision-makers indicate that health resources are limited and the expenditure on health care is high and still escalating.
Ministry of Health (“MOH”): Approximately 60% of all hospitals within the Kingdom are owned and operated by the MOH. These hospitals provide basic healthcare services, as well as, in certain cases, specialised facility centres. MOH facilities are increasingly being made available mostly to Saudi Nationals only with accessibility to expatriates in majority of cases restricted to specialised treatments except in rural areas where private sector facilities are not present. With MOH facilities slowly being restricted to only Saudi Nationals, the 5.5 million of expatiates (half of which are concentrated in Riyadh and Jeddah) within the Kingdom are being forced towards the private healthcare sector.
The total number of MOH hospitals operating in year 2013 is 268, with a total number of 38,970 beds.
Other Governmental Organizations: Health treatment in other government and quasi organizations is effectively free for employees, typical organizations would include The National Guard, Ministries of Defence and Aviation and the Royal Commission.
Facilities in other governmental sectors include the following:
University hospitals and medical centres in the Kingdom; Armed Forces Hospitals; National Guards Medical Services; Ministry of Interior Medical Services; King Faisal Specialist Hospital & Research centre, Riyadh; King Faisal Specialist Hospital & Research Centre, Jeddah; Royal Commission Hospitals in Jubail and Yunbu; School Health Units, Ministry of Education; Youth Welfare; Sports medicine services in the general authority for youth welfare; Saudi Red Crescent Society; Water Desalination Corporation; and Institute of Public Administration, Riyadh.
The total number of hospital beds in facilities of other governmental sectors is 11,497 in 2013. While the total number of hospitals in facilities of other governmental sectors is 39 in 2013.
Private Sector: Historically most of the outpatient treatments were provided by the private sector. However, increasingly inpatient treatments are also being provided by the private sector due to the high demand and the restrictions placed on entry to MOH facilities.
The total number of private hospitals operating in year 2013 is 136, with a total number of 14,310 beds.
With access increasingly limited to MOH hospitals, most of the expatriates seek treatments at the growing number of private hospitals.
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Concept of unnecessary hospital admission (general)
