The status of emergency medicine in the state of Kuwait | International Journal of Emergency Medicine

The state of Kuwait is a constitutional monarchy, and it claimed independence from the British protectorate on June 19, 1961 [1]. The country shares its borders with Iraq on the north-west border, Saudi Arabia on the south and south-west borders, and the Arabian Gulf coast on the eastern side (Fig. 1), and it has a land area of 17,82 km² divided into six governorates [2].The estimated population is about 4.92 million, with Kuwaitis accounting for nearly 32% [3]. Kuwait is a member of the Gulf Cooperation Council (GCC), which was formed in 1981 due to these countries’ deep historical, social, religious, and cultural links [4].

Map of the State of Kuwait (Al-Haroun, Y. (2015))

Kuwait’s economy depends mainly on oil production, which was discovered in 1937. Oil revenues account for 90% of the total government revenues, and this opens the door to the prosperity of the Kuwaiti community [5]. In Kuwait, about 5.8% of the Gross Domestic Product (GDP) was spent on the public healthcare sector in 2021 [6]. Kuwait ranked 49 on the Human Development Index (HDI) with a value of 0.847 [7].

Healthcare system in Kuwait

Over the last two decades, the health system in Kuwait has evolved rapidly with significant advancements due to the increased government expenditure on the healthcare system, with 8.9% of total budget spending in 2019 leading to many healthcare public-sector projects completed or under construction [8]. This is reflected in the health index score, with a score of 77.3. Kuwait ranks 42nd globally and 3rd in the GCC countries after the United Arab Emirates and Qatar in 2023 [9]. In Kuwait, 80% of the healthcare is provided by the public sector, and the remaining 20% is provided by the private sector [10] (Fig. 2). The Ministry of Health (MOH) is the governing body for the healthcare system through a network of healthcare centers and hospitals in six different health districts. The health districts are Kuwait City, Hawali, Ahmadi, Al Jahra, Al Farwaniya and Al Sabah, and each district self-governs for financial, administrative, training, and management of healthcare delivery [11]. There are 14 hospitals and 93 healthcare centers and clinics under MOH [12], with ratios of physicians and nurses per 1000 populations of 2.9 and 7.1, respectively [8]. The MOH works closely with key stakeholders in national health workforce governance, which include but are not limited to the Kuwait Institute for Medical Specialization (KIMS), the Agency for Medical Responsibility, the Kuwait Medical Association (KMA), and Kuwait University [8].

Providers of the Healthcare System in Kuwait

Emergency medicine specialty

Emergency Medicine (EM) is essential and valuable for different fields within the specialty and the healthcare system [13]. In line with the increased number of emergency physicians in EM, the specialty has undergone significant evolution, encompassing advancements in diagnostic techniques, treatment modalities, payment structures, and best practice guidelines. Additionally, EM has expanded its scope, giving rise to numerous subspecialties while continually exploring new frontiers in medical care [14]. Furthermore, some emergency departments (EDs) have evolved to include specialized units focused on specific patient groups and medical conditions, including orthopedics, oncology, and geriatric care so as to optimize patient treatment by concentrating expertise and resources, ultimately improving care quality and reducing overall healthcare costs [15].

The development of the EM system has been categorized into stages of underdeveloped, developing, and mature based on several features that look at the specialty, patient-care, and management systems, in addition to academic features [16]. EM specialty is considered well-established and mature in the United States (US), United Kingdom, Australia, Canada, Hong Kong, and Singapore, as the specialty witnessed an early development during the 70 s and 80 s [17]. Since then, EM has started its globalization journey to be recognized and developed in many countries across all continents [18]. However, the survey on the status of EM conducted by the American College of Emergency Physicians (ACEP) International Ambassador involving 63 countries around the world showed a high recognition of the specialty at 86%, but in low-income countries, the specialty still is in its developing stage with a limited number of emergency physicians, board-certified emergency physicians, and absence of EM peer-reviewed journals [19].