Critical care service in Saudi Arabia

T Kingdom of Saudi Arabia (KSA), is one of the largest Middle Eastern countries with a landmass of 2.5 million square kilometers, and has transformed over 50 years to the most urbanized country in the region. With an estimated population of almost 30 million residents with an annual growth rate of 2.7%,1 the Saudi Arabian healthcare sector caters to a rapidly growing population and the concurrent increasing demand on the healthcare sector. Healthcare services in the KSA receive much attention from its leadership. Such services are considered top priority. It has undergone considerable development brought about by means of the successive development plans, where the Ministry of Health (MOH) has a crucial role to play. According to the World Health Organization, the Saudi health care system is ranked 26th among 190 of the world’s health care systems.2 The purpose of this brief report is to provide some insights into the current status of critical care practice in Saudi Arabia, including major challenges like, intensive care unit (ICU) standard level, cost, education, training, research activities, and Saudi critical care experience during Hajj. In the year 2012, the cumulative budget allocation for the MOH was around 54 billion (6.6% from the total government budget) Saudi Riyals (SAR) compared to around 25 billion (5.6%) SAR in year 2008.1 This was reflected on the total number of hospitals throughout the kingdom. The Ministry’s strategy has placed particular emphasis on expanding the critical care services and promoted the accessibility and feasibility of the critical care services. In order to improve the health care and to invest in citizens, the MOH has embraced several projects and redirected the necessary funds for these programs, such as establishing and developing of a new general hospitals, medical cities, and specialist hospitals. These projects aim to cover the whole land of KSA, and to deliver health care, including critical care services to all Saudi citizens and expatriates working in public sectors, free of charge to all.3 There is an increasing demand for critical care services in KSA and globally, this demand is attributable to the increasing population age, longer survival of previously incurable diseases, and advanced surgical procedure that makes post-operative intensive care admission mandatory. Many patients who required such treatment in the past, had to go abroad, while it becomes possible now to provide such advanced medical treatments locally. The improvement in critical care medicine itself has made it possible to improve or prolong survival of certain diseases leading to longer ICU stay and increasing demand for critical care services and support. The return of highly qualified physicians and surgeons after completion of their postgraduate training in an international academic medical centers lead to the introduction of new treatment modalities, such as bone marrow and liver transplantation and radical cancer surgeries. Such therapies and surgeries typically require intensive care. Factors like worldwide growth in the critical care specialty and the national introduction of advanced medical therapies were other reasons behind the recently witnessed major developments in critical care medicine in KSA. The MOH provides health services at primary, secondary, and tertiary hospitals. Three different levels of critical care are provided by these hospitals (Tables 1 & 2). Cases that need more complex levels of care are transferred to specialized hospitals (the tertiary level of health care).4 The Saudi Critical Care Society (SCCS) is a premier critical care society in the Middle East with its largest and most expansive education programs focused on serving the critical care community Brief Report