Dr. Hanan E. Badr, MD, MPH, DrPH Faculty of Medicine, Kuwait University

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Transcription:

Dr. Hanan E. Badr, MD, MPH, DrPH Faculty of Medicine, Kuwait University hanan@hsc.edu.kw

Outline Background Kuwait: Main Highlights Current Healthcare System in Kuwait Challenges to Healthcare System in Kuwait Opportunities for Better Healthcare System in Kuwait 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 2

Background Dr.Ph Research Teaching PH HP 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 3

Background 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 4

Moving to Kuwait! 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 5

07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 6

Kuwait: Main Highlights 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 7

Facts about Kuwait Area: 6,879 square miles (17,818 sq km) Main income: Oil production Population: 4.2 M (June, 2015). Population growth rate: 1.7% Total expenditure on health as % of GDP (2013): 2.89% 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 8

Vital Health Indicators in Kuwait! Life expectancy at birth (2013): M/F 78/79 Healthy life expectancy at birth (both sexes): 68 Total fertility rate: 2.6 Under-five mortality rate (per 1000 live births): 10 Maternal mortality ratio (per 100,000 live births): 14 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 9

Population of Kuwait (June, 2015) Total 4.2 M Kuwaitis 31% Expatriates 69% Asians 54% Arabs 39% Others 7% 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 10

Population Pyramid of Kuwait, 2014 52.3% 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 11 CIA World Factbook, 2014

Current Healthcare System In Kuwait 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 12

Healthcare System in Kuwait Kuwait s Ministry of Health is the owner, operator, regulator, and financier of the vast majority of healthcare services rendered, pharmaceuticals purchased, and medical equipment acquired in Kuwait. Kuwait is building well-equipped hospitals, specialized centers, and new laboratory and surgical facilities. 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 13

Healthcare Structure in Kuwait Ministry of Health (MOH) Public 80% 15 hospitals Private 20% 12 hospitals Overseas Medical Treatment In 2013, 2580 Kuwaitis. About 7000 beds About 1000 beds Cost: >$ 700 M (2013/2014) 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 14

Manpower in Healthcare Sector in Kuwait, 2013 100 Governmental 92.5 Private Sector 99.5 80 60 60.2 67.4 84.8 40 39.8 32.6 20 0 7.5 11.4 8.6 15.2 0.5 Physicians Dentists Nurses Physicians Dentists Nurses Kuwaiti Non-Kuwaiti 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 15

Healthcare structure in Kuwait: Regulatory structure Regulates Current the Situation operations Healthcare facilities (public & private) Healthcare professionals Ministry of Health (MOH) Provider of Healthcare Services Provider of primary, secondary and tertiary healthcare services Public Healthcare Insurer Role Insurer of public healthcare services needs underwriter of nationals healthcare service needs in and out of Kuwait 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 16

Target of Health Insurance System in Kuwait! High quality of medical services (acute & chronic): High quality doctors New evidenced efficient medications Sensitive advanced equipments for early diagnosis and treatment Hospital care facilities Number and quality of beds Quality of service Level of service 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 17

Population Pyramid of Expatriates, Kuwait 2013 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 18

Hierarchy of Receiving Healthcare in Kuwait Primary Health Care Incomplete medical service Complete medical service (referral) Outpatient Governmental hospitals Inpatient Laboratory Investigations Radiological (x-ray, MRI, CT,..) Medical (medication) Intervention Surgical procedures 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 19

Health care load of Expatriates in MOH hospitals in Kuwait, 2013 % 50.0 45.0 40.0 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0 36.0 Outpatient visits 42.0 Emergency visits 4.9 1.5 46.7 Inpatient Surgeries PHC Visits 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 20

Ministry of Health Budget! 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 21

MOH Budget of Total Government Budget 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 22

Per Capita Health Expenditure! 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 23

Total Health Expenditure as % of GDP in Kuwait 12 Canada 10 11.1 10.9 10.9 10.9 8 6 4 2 0 4.8 4.9 4.9 5.1 2.8 2.6 2.6 Egypt Kuwait 2010 2011 2012 2013 2.9 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 24

Challenges To Healthcare System In Kuwait!!! 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 25

Burden of NCDs WHO predicts that NCDs will constitute more than 60% of burden of disease in the Gulf Region by 2020. Current data show that Kuwait is already showing steady increases in coronary health disease, cancers, diabetes, Accidents NCDs = 60% in 2020 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 26

Proportional mortality (% of all deaths) in Kuwait, 2014 CVD 12% Cancers 11% 41% Diabetes 12% 2% 4% 14% Chronic respiratory diseases Other NCDs NCDs are estimated to account for 73% of total deaths 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 27

Overweight & Obesity among Kuwaiti Adults (2013) 45 40 35 30 25 20 15 10 5 0 23.2 23.1 41.7 35.7 30.4 34.4 4.7 Normal Overweight Obese Morbid obese 6.8 Male Female 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 28

Overweight and obesity among boys & girls (13-15 years) in Kuwait, 2013 Boys 3% Girls 2% 26% 19% 42% 27% 52% 29% Underweight Normal Underweight Normal Overweight Obese Overweight Obese 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 29

Kuwait ranks the 5 th in Diabetes

Badr, H. Healthcare System in Kuwait 31 07/07/2015- Toronto

Physical Inactivity Among Students (13-15), 2013 in Kuwait % 90 80 70 60 50 40 30 20 10 0 70 90 80 Males Females Total Physically active a total of at least 60 minutes per day on five or more days during the past seven days. 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 32

07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 33

Tobacco Use in Kuwait 100% 80% 60% 40% 20% 0% 65 35 Adults Smokers 73 27 Adolescents (13-15 years) Non-smokers 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 34

Estimated Prevalence of Kuwaiti Seniors (60+) % 25 20 25.0 15 10 5 5.0 8.0 0 2010 2030 2050 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 35

Opportunities For Better Healthcare System In Kuwait!!! 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 36

Opportunities A small country with a small number of population Available finance for improving infrastructure and international exchange of experiences In 2012, MOH announced a nine public hospital project ($4.42 B) within the next 10 years to add: 5400 beds. 150 operating rooms 500 outpatient clinics 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 37

Opportunities Plan for Public Health Agency Healthcare policy should not focus only on finance: universal sustainable equal health coverage insurance for nationals community awareness & participation 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 38

Examples of the Expansion Project 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 39

How to change?? High incidence and Decreased hospitalization prevalence of NCDs and health care costs High Rate of Hospitalization Decreased incidence and prevalence of NCDs and Health Care Health Health Promotion & & Prevention Prevention 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 40

Preventive vs. Curative The priority should be focused on reducing ill health and the burden of diseases through programs that secure the health of the whole population. This cannot be achieved without shifting resources from curative to preventive public health activities, including prevention of NCDs and reduction of risk factors. 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 41

Early Detection Clinics!!! Aim of the clinic Health Promotion Preventive Services Early Detection 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 42

We can turn the tide. But we have a long way to go Dr Margaret Chan Director-General, WHO 07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 43

07/07/2015- Toronto Badr, H. Healthcare System in Kuwait 44