Regional Variation in the Neurosurgical Workforce in Saudi Arabia

Objectives: To highlight the disparity in the regional distribution of neurosurgical workforce in the Kingdom of Saudi Arabia (KSA) and to correlate the provision of neurosurgeons across the regions with several parameters. Methods: The 13 administrative emirates of provinces in KSA were grouped into five geographical regions (central, western, eastern, southern, and northern). The density of neurosurgeons was calculated for each region. The distribution of neurosurgeons across the regions was correlated with several parameters using Pearson coefficient test. Results: This study examined 238 neurosurgeons working in 85 neurosurgical centers in KSA. The regional median (range) density of neurosurgeons was 7.1 (3.1-10.2) per million population and 9.3 (2.3-23.3) per thousand square kilometer area. The regional provision of neurosurgeons correlated significantly with the distribution of KSA-national (p=0.031), KSA-certified (p=0.0004), Government Hospitals (GHs) (p=0.0012), and private hospitals (PHs) (p=0.0359) funded neurosurgeons. The regional allocation of neurosurgeons also correlated positively with the distribution of the total neurosurgical centers (p=0.048), the PHs centers (p=0.0057) but not the GHs centers (p=0.3296). Furthermore, a mismatch was observed between the regional distribution of the neurosurgical workforce and the provision of neurosurgeons according to their GHs’ sub-divisions, regional population, and area. Conclusions: The regional distribution of neurosurgeons in KSA was uneven. The density of neurosurgeons was the lowest in the southern and northern regions. There was disparity in the number of neurosurgeons employed by the various GHs’ sub-divisions and in the allocation of GHs’ neurosurgical centers across the regions. Easy access to quality neurosurgical care is imperative. Policy makers should take this into consideration in the future planning of regional neurosurgical services in KSA.