Healthcare Development Strategies in the Kingdom of Saudi Arabia PDF
Preview Healthcare Development Strategies in the Kingdom of Saudi Arabia
Healthcare Development Strategies in the Kingdom of Saudi Arabia Healthcare Development Strategies in the Kingdom of Saudi Arabia Mohammed Hassan S. Mufti M.D., F.R.C.S., M.S., A.B.M.M. Consultant in Health Administration Saudi Arabia KLUWERACADEMIC PUBLISHERS New York, Boston, Dordrecht,London, Moscow eBookISBN: 0-306-47183-3 Print ISBN: 0-306-46314-8 ©2002 Kluwer Academic Publishers New York, Boston, Dordrecht, London, Moscow Print ©2000 Kluwer Academic / Plenum Publishers New York All rights reserved No part of this eBook may be reproduced or transmitted in any form or by any means, electronic, mechanical, recording, or otherwise, without written consent from the Publisher Created in the United States of America Visit Kluwer Online at: http://kluweronline.com and Kluwer's eBookstore at: http://ebooks.kluweronline.com To my wife Afaf A. Aldakhil, and to my children Maram, Mishal, Majed, and Mansour with the greatest love and affection and with appreciation for their support, encouragement, and patience Foreword This book is very timely at the present stage of development of the health care system in the Kingdom of Saudi Arabia. Dr. Mufti has demonstrated, in a convincing manner, his thorough knowledge and mastery of the health care delivery system and current issues faced by it. The book essentially asks and answers the question; now that we have all the human, technical and physical resources in place, thanks to the strong and wise commitment of the government, what roles do we have to play as planners, managers, and health care providers, in sustaining the future viability and efficiency of the health care system. I sincerely hope that health care provider agencies will read this book and reflect seriously on the strategic issues raised and the policy actions recommended in it. Issues discussed, such as the problem of coordination and integration ofactivities among health care providers, are very timely and extremely pertinent in light of the fast evolving economic and social environment in the Kingdom. Inefficiency, wasteful use of resources, and needless redundancy of services should never be an excuse for promoting the status quo. At long last we have a health care system that we can justifiably be proud of. We must continue to improve the quality of this system in an efficient manner. The problems we face in doing this are not insurmountable. Overall, this book raises some major strategic issues faced by our health care system and contributes significantly to the literature on the provision of health care in the Kingdom. These policy issues and the recommended policy actions will hopefully increase awareness, stimulate thinking, promote discussions, and inspire necessary action. Abdul-Wahab Bin Abdul-Salam Attar Minister of Planning Foreword Healthcareisone of the main priorities inSaudi Arabia and the government has provided several organizations for this purpose. The Ministry of Health is the main governmental agency with overall responsibility for health policies and planning for the Kingdom. The private sector receives substantial support from the government and, therefore, it is steadily growing. The support and guidance the health sector has received from His Majesty the Custodian of the Two Holy Mosques King Fahd bin Abdulaziz, HRH Prince Abdullah Bin Abdul Aziz, the Crown Prince and the Chief of the National Guard, and HRH Prince Sultan Bin Abdul Aziz, the Second Premier and Minister of Defense and Aviation and General Inspector, is unlimited. This support and guidance motivates us to provide high quality preventive, curative and rehabilitative services. Dr. Mohammed Mufti has written an interesting book: he has illustrated the healthcare delivery system in the Kingdom and put forward strategic issues, which need to be considered in the future. An appropriate prospective to assist healthcare planners and executives is now available inone volume. This book emphasizes the best utilization of resources, the financing of the health sector and suggests contemporary solutions such as National Health Insurance, patient charges, certificate of need and the important topic of Saudization. Professor Ossama Shobokshi, MBBS, M.D., CCST, PhD,FRCS (Hon) Minister of Health ix Preface The Saudi health system has made unprecedented progress within a short period of time. The commitment to providing high quality health care to residents, and the huge investment in health care by government and the private sector, have created a level of health care infrastructures and other resources comparable with the highly developed countries. This, and the general improvement in economic and social conditions, have, in turn, led to some very dramatic improvements in the health status of the population. As in the case with most health systems, a number of problems have arisen. While some of the problems result from a worldwide phenomenon of escalating cost, population explosion and technological innovations, a few of them stem from factors peculiar to our health system--funding,organization, delivery, utilization, etc. This book discusses what I consider the main strategic issues of the Saudi health system, and suggests I hope, some ways of tackling the problems. Our health system has done very well so far. There is, however, a growing awareness that, unless some drastic steps are taken in areas of our delivery system where changes are indicated, the long-term sustainability of the system may be in jeopardy. Some of the strategic issues I have discussed in this book are already being addressed in various quarters, while others are either largely ignored or are not taken seriously. My personal belief, is that the 8 percent of Gross Domestic Product (GDP) spent on health care in the Kingdom is more than adequate. The problem, as I see it, is one of efficiency in delivery and use of services. I have, therefore, devoted a good portion of the book to the discussion of cost-containment. Other strategic issues--contract management of public facilities, coordination of activities of health sector agencies, long-term care, etc., are discussed from the point of view of containing costs and increasing efficiency. The status of health informatics in the Kingdom is discussed in depth. Advancement in medical technology is seriously changing the way health care is delivered. Thanks to the government’s readiness to support all efforts at improving quality, a good number of health facilities have the latest medical equipment and are engaging in telemedicine and other high-tech techniques for delivering care. Close cooperation among health facilities in this area of high-tech medicine will be beneficial to all and significantly increase the quality of care provided in the Kingdom. The Author Acknowledgements I am deeply grateful to God for the energy and support bestowed on me during my life and in the writing of this book. I am indebted to their excellencies Dr. Abdulwahab Attar, Saudi Minister of Planning, and Professor Osama Shobokshi, Saudi Minister of Health for their kindness in accepting to write a foreword. I thank Dr. Willy De Geyndt for his wise feedback and advice. I also thank my administrative assistant, Ms. Kathleen Banks, for her help as well as Ms. Suzanne McLeesand Ms. Julie-Anne Graitge for their assistance in editing the book. Numerous people in Saudi Arabia have supported this effort and have provided me with data, such as the staff of the ministries of Health, Finance and Economy, Planning, Higher Education, and of the medical departments of the National Guard, the Ministry of Defense and Aviation, and the Ministry of Interior. I am very grateful for their assistance. I also wish to acknowledge the assistance from staff of the World Bank and the World Health Organization. xiii Contents Page Mapofthe Kingdom ofSaudi Arabia xix Acronyms and Abbreviations xxi Chapter1 Introduction The Country andIts People 1 Government 2 Population 2 HistoryofHealth Care inthe Kingdom 3 OriginofMajor Health Providers 4 MinistryofHealth 4 SaudiRedCrescent Society 4 NationalGuard 4 Medical ServicesoftheArmedForces 4 Medical Services ofthe Ministry of Interior 5 The Five-Year Development Plans 5 Introduction to Subsequent Chapters 8 Chapter2 The Health Sector inSaudi Arabia HealthPolicyEnvironment 9 Organization and Deliveryof Health Services 9 MinistryofHealth 9 Regionalization 10 MOHPrimary Health Centers 10 NationalGuardHealth Services 11 Medical Services Department ofthe Ministry of Defense 12 and Aviation Medical Services Department ofthe Ministry of Interior 12 King Faisal Specialist Hospital andResearch Center 13 King Khalid Eye Specialist Hospital 13 University Hospitals 14 The General Organization for Social Insurance 14 SaudiRedCrescent Society 15 Other Government Health Providers 15 Private Sector 16 Contract Management ofPublic Hospitals 18 Evolution of Hospital Management 18 Chapter3 Achievements over the Last Twenty Years Health Status ofSaudi Population 21 Human Resources 23 Physical Infrastructure 24 xv Chapter4 Resources Facilities 27 GrowthinHospitals and Hospital Beds bySector 27 Major Diagnostic Equipment by Sector 29 Health Centers and Polyclinics 30 Health Information System: Current Situation 31 Security Forces Hospital 33 Manpower 34 GrowthinManpowerbyNationality 34 Future Supply and Demand 36 SaudizationofManpower 37 ProgressinHealth Manpower Development 41 Closing the Resource Gap 42 Physician Assistants and Other Auxiliary Professionals 42 Saudi Council for Health Specialties 43 Chapter5 ExpendituresandFinancing Trends in Healthcare Expenditures 44 Whythe Rising Expenditures? 45 Financing 48 Public Financing 49 Occupational Hazard Insurance 49 Private Sector Funding 49 Voluntary Insurance 51 Health Maintenance 51 Future Financing: National Health Insurance (NHI) 52 Brief Background onNHI 52 The Proposed NHIProgram 54 FirstPhase:NHIfor Non-Saudis 55 WhattoExpect 55 Future Financing: UserChargesinPublic Hospitals 57 Chapter6 StrategicIssuesandRecommendations Contract Management of Public Facilities 61 Cost Effectiveness 61 Quality of Service 63 FutureofContract Management in Public Hospitals 64 Recommendations 65 Coordination of Activities byHealth Sector Agencies 66 Needfor Integration andCooperation 71 Recommendations 72 Cost Containment 73 Cost-Consciousness amongst Physicians 77 NHIand Cost Containment 78 Deductibles and Co-Payments 79 xvi
The list of books you might like
