1. TREATMENT ABROUD BY Dr. ADNAN ABEL Associate professor Faculty of Medicine Kuwait University

2. OUT LINE Western perspective Abroad treatment history of Kuwait Analytical view of 2008 Recommendation Kuwait constitution

3. WESTERN PERSPECTIVE

4. WESTERN PRESPICTIVE The increasing costs of Medicare. Countries promoting health tourism. The growth of so-called “5-star hospitals”. Increasingly mobile patients.

5. The Increasing cost of medical care CountryKnee Surgery cost U.S & U.K.$20,000 Thailand$6,000 India$7,000 Kuwait$12,000

7. ABROAD TREATMENT HISTORY OF KUWAIT

8. 1949-1990 Convalescence Cancer Cardiovascular Private

9. 1992-present Individuals Expense: ◦ Middle class ◦ Dental care ◦ Plastic surgery ◦ Upper class  U.S. & U.K.

10. 1992-present Government ◦ Ministry of health ◦ Ministry of interior ◦ Ministry of Defense ◦ K.O.C. ◦ National guard

11. Process for Abroad Treatment Director of treatment abroadUndersecretaryHospital Manager Committee: treating doctor, 2 consultants, and head of department Patient No V

14. ANALYTICAL VIEW OF 2008

15. Overview About 2686 patients To more than 17 countries Most to Europe No clear/specific criteria of selection All conditions may send abroad

16. Referred Countries

17. Diagnosis Demographics

18. Patients Demographics (Age), 2008

19. Duration of Stay

20. Patient Accompany Demographics

21. Who Should Go….?!! DIAGNOSIS COUNTR Y STAY PER DAY Chronic SinusitisUK63 PsoriasisEgypt50 Recurrent PancreatitisFrance178

22. Who Should Go….?!! DIAGNOSIS COUNTRY STAY PER DAY Small finger swellingUK?? Chronic Lower back painUK30 Micro-opthalamus Left Eye USA72

23. Who Should Go….?!! DIAGNOSIS COUNTR Y STAY PER DAY Evisceration of the eye USA53 Cardiac DiagnosisUK28 Hypo-Plastic ThumbUSA34

24. Reasons for Abroad Treatment Political Ailing medical system Patients perspective of the medical system

27. Patients perspective of the medical sector Lack of trust ◦ Media ◦ Members of the Parliament ◦ V.I.P’s ◦ Diwnaya

28. Patients perspective of the medical sector Long waiting time Lack of communication Not Patient focused

29. Real Reasons?

30. Other Causes Aging population Technology Specialization Philosophy (care at any cost)

31. RECOMMENDATION

32. Recommendation Health reform Treatment abroad department: ◦ Vision ◦ Mission ◦ Strategy

33. NUNBER 1 ENEMY for Implementing a Strategy is Culture (people)

34. Recommendation (continued) Transparency Code for illnesses sent abroad Clinical auditing: ◦ Lung transplant:  6 patients from 1992-2002

35. Recommendation (continued) Partnership with other top healthcare providers Telemedicine Medical robot

36. Constitution of Kuwait