Healthcare in the Kingdom of Saudi Arabia

Healthcare in the Kingdom of Saudi Arabia Eng. Faris Albugami, MBA Programs Manager Planning & Training Assistant Deputyship Saudi Ministry of Health

HISTORICAL FACTS Hospitals Hospital Beds Primary Care Centers 1970 1990 2010 74 9,030 (1.3 / 1000) 257 41,123 (3.4 / 1000) 415 58,126 (2.14 / 1000) 591 3,028 4,594 Physicians 1,172 22,136 66,014 Nurses 3,261 48,477 129,792 Paramedical 1,741 22,410 68,705

HISTORICAL FACTS

Article 27: The government guarantees the right to healthcare for citizens and their families in cases of emergency, sickness, disability and old age. Article 31: The government is responsible for public health in the Kingdom and provides healthcare services to every citizen.

Guarantee provision of primary healthcare services to all citizens Provide secondary and tertiary healthcare services Develop strategies and implementation of plans to ensure provision of healthcare services

1983 2010 Average life expectancy at birth (years) 66 73.7 Vaccination Coverage 85% (cities) 27% (villages) 98.8% Infant mortality (per 1000 live births) 52 16.9 Mortality of children under 5 (per 1000 live births) 63 19.5 Maternal Mortality per 10.000 live births 32 14.0

100 80 60 40 81.2 53.7-6.5% CAGR 62.0 54.1 39.5 20 0 2003 2005 2007 2009 2010 Source: MoH Statistical Yearbook (2003-201)

1983 2010 Polio Measles 1.0 304.4 zero 1.29 Tuberculosis 52.2 15.82

1 9 17 25 33 41 49 57 65 73 81 89 97 105 113 121 129 137 145 153 161 169 177 185 193 100 90 80 70 60 50 40 30 20 10 0 Country Ranking* * KSA is within the first ten

MoH 60% Other Government Sectors 20% Private Sectors 20%

1423 1427 1431 1423 1427 1431 1423 1427 1431 KSA Japan Europe 1423 1427 USA 1431 Sources: OECD, EIU, IMS Flashlight

45 40 35 30 25 20 15 10 5 0 2.20 1.57 37.2 1.19 31.8 0.97 1.02 1.07 31.8 23.2 23.7 24.2 2005 2006 2007 2010 2015E 2020E Saudis aged 60 years above Population Growth

1. Nauru (1) 2. Tonga (2) 71.1% 57.6% 3. Kuwait 42.0% 4. KSA 33.0% 5. USA 33.0% 6. UAE 32.7% 7. Bahrain 28.9% 8. UK 9. Seychelles 26.9% 23.9% 1. Nauru (1) 31.0% 2. UAE 19.0% 3. KSA 17.0% 4. Bahrain 5. Kuwait 15.0% 15.0% 6. Oman 13.0% 7. Tonga 13.0% 8. Mauritius 9. Malaysia 16.0% 12.0% Note: 1) Nauru 2) Tonga - Oceanic islands near Australia with an estimated population between 9K and 100K respectively Source: WHO (2010)

Roadside accidents 2009 484,000 accidents (6,142 deaths and 33,000 injuries and disabilities) Lack of physical activity 34% of the population due to climatic conditions Smoking Male population (35-45% = Adults and 24% = Teenagers) Ranked 23 rd in the world s highest tobacco consumption Source: 2009 Annual Report to the General Administration of Traffic / 1 st Saudi and GCC Health Promotion Council (2010) 2009 WHO Statistics Report / MoH Anti-smoking Program (2010)

13*.7 8.2 7.1 Organization of Economic Cooperation and Development (OECD) = 5.8 3.8* 3.3* 3.3* 3.1* 2.2 1.9 Japan Germany France Australia UK Canada USA KSA GCC Source: OECD Health Data 2011 (* 2008 * 2009) / MoH

3.53 3.5 3.0 2.7 2.7 OECD = 3.06 2.4 2.1 2.0 1.8 Germany France Australia UK USA KSA Japan Canada GCC Source: WHO (2011 report) N.B. The rate for KSA is based on MOH Statistics, WHO figures where 0.94

11.0* 10.8* 10.2* 9.5* 9.5* 9.4* 8.8.5*4 OECD = 9.66 4.8 4.0 Germany USA Australia UK Japan Canada France KSA GCC Source: OECD Health Data 2011 (* 2008 * 2009 *2010) / MoH

17.4%* 11.8%* 11.6%* 9.8%* 8.7%* 8.5%* 3.8% 3.7% 3.4% USA France Germany UK Australia Japan Qatar Bahrain KSA Source: OECD Health Data 2011 (* 2008 * 2009) / MoH

7,690* 4,478* 4,218* 3,487* 3,445* 2,878* 2,403 1,253 901 531 USA Canada Germany UK Australia Japan Qatar UAE Kuwait KSA Source: OECD Health Data 2011 (* 2008 * 2009 *2010) / MoH Note: In USD, PPP (Purchasing Power Parity)

Country UK USA Australia Canada France Germany Japan KSA Government healthcare expenditure As % of Total Healthcare Expenditure 81.7 45.5 67.5 70.0 79.0 76.9 81.3 79.5 As % of Total Government Budget 15.6 19.5 17.6 18.1 16.6 18.2 17.9 8.4

High % Participation of private sector Low 75% 71% 52% 51% 32% 31% 30% 25% 24% 17% 15% 11% 9% Private sector Government funding Source: 2011 WHO Statistics Report

120 100 80 60 40 20 71% 29% 7% 93% 0 Small Hospitals Large Hospitals (50 beds) (400 beds and above)

Australia Canada Ireland Jordan Malaysia Morocco Singapore South Africa Spain Tunisia UAE UK USA

Referrals Healthcare Center Hospitals Referrals Referrals Healthcare Center Healthcare Center Referrals Referrals Referrals Referrals

Local Hospital Patient Central Hospital General Hospital Healthcare Center Local Hospital Healthcare Center Healthcare Center Local Hospital General Hospital Central Hospital General Hospital Central Hospital

TODAY FUTURE Central Hospital General Hospital Local Hospital A/B Primary Care Center

National Roll-out

1 8 Implement accreditation of MoH facilities Develop and restructure hospitals 2 Improve primary healthcare services 7 Ensure adequate supply of pharmaceuticals Improve patient referral system 3 Develop Human Resources 6 Develop medical information systems and E-health 5 Develop ambulance transportation system 4

Current Future 30 Main Hospitals 5 Medical Cities 62 249 MoH Hospitals 100 General Hospitals Central Hospitals 120 305 Hospitals General Hospitals 114 Small Hospitals 118 Local Hospital 2,086 Healthcare Centers 2,736 Healthcare Centers

5 Medical Cities Medical Specializations Tertiary/Quaternary Care Services Central Hospitals Advance Care Services General Hospitals Intermediate and Critical Care Services Local Hospital A/B Basic Medical Services Healthcare Centers Primary Healthcare Services

5 national zones Medical City Central Hospital General Hospital Local Hospital Primary Healthcare Centers

Newborn Protection Solution Saudi PACS Patient Satisfaction Home Care Support Strategy and Change Management e-health Cloud Computing Patient Satisfaction National e-health Standards Hospital Information Systems Referral Management System Business Process Standards

Tele-Medicine Support Services E-Learning Services Public Health (HESN) Data Center Services e-health Marketing And Communications National Healthcare Laboratory Hospital Information Systems (RFP Phase) Toxicology Management Services

MoH Heads of Directorate MoH and Health Officials Health Committee Shoura Council

Operation Cost Per Bed Quaternary Referral Hospital SR1.8 m Central Hospital SR 750,000 General Hospital SR 500,000

Workforce Hospital (Physician per bed) PHC (Physical per healthcare center) 0.7 4.32 Medication Saudi population x 60% x SR500 SR 5.4 bn

Training Employees x SR3000 per year SR 529 m Less than 100-bed Hospital 2 Ambulance 150 to 300-bed Hospital 3 More than 400-bed Hospital 5

Healthcare Finance Solutions Public-Private-Partnership Health Insurance Performance Measures Health Industry and Technology Transfer Strategic Alignment Investment in IP Localization: Economic Self-sufficiency National Security Access Quality of Care Quality of Life Research EBM Health Technology Assessment Knowledge Translation Clinical Practice Guidance

5 Medical Cities 190 Hospitals Medical Devices Pharmaceuticals E-Health Mobile Clinics 1400 PHC

King Fahad Medical City (Central Region) King Abdullah Medical City (Western Region) King Faisal Medical City (Southern) and Prince Mohammad bin Abdulaziz Medical City (Northern Region) King Khalid Medical City (Dammam)

Opportunities

Summary

Presentation of the Project to the Custodian of the Two Holy Mosques (September 2009) Nothing is more precious than the health of citizens -The Custodian of the Two Holy Mosques

THANK YOU...