National Assessment of Emergency, Intensive Care, and Anesthesia Physician Distribution in Saudi Arabia, 2023: Implications for Emergency Care Access.

Background: In line with Saudi Arabia's Vision 2030, transforming the health workforce has become a central priority, particularly to address persistent geographic and sectoral inequities and imbalances in national workforce participation within critical specialties such as emergency medicine, intensive care, and anesthesia. Despite national workforce expansion, no comprehensive assessment has quantified the distribution of these physicians across regions and sectors. Objectives: This study aims to examine the distribution and density of emergency, intensive care, and anesthesia physicians across Saudi Arabia's 20 health regions, assess disparities by sector and nationality, and quantify inequality using Gini coefficients. Methods: This cross-sectional study utilized secondary data sourced from the Ministry of Health's 2023 Statistical Yearbook. Physician counts were categorized by sector: the Ministry of Health, other governmental entities, and the private sector. Regional physician-to-population ratios were calculated, and inequality was assessed using Lorenz curves and the Gini coefficient. Results: In 2023, Saudi Arabia had 4999 emergency physicians, 4559 anesthesiologists, and 3185 intensivists, with approximately 65% employed by the Ministry of Health. Saudi workforce participation varied substantially, reaching 46% in emergency medicine but remaining lower in intensive care (37%) and anesthesia (22%). From 2019 to 2023, physician densities increased across all three specialties to 14.8 per 100,000 for emergency medicine, 13.5 for anesthesia, and 9.4 for intensive care, levels favorable relative to international benchmarks. Despite this growth, marked geographic disparities persisted: Riyadh and Jeddah had the largest absolute numbers but lower population-adjusted densities, whereas smaller regions showed higher per-capita ratios despite limited infrastructure. Geographic inequality was moderate across specialties, with Gini coefficients of 0.52 for anesthesia, 0.49 for intensive care, and 0.45 for emergency medicine. Conclusion: Despite overall workforce growth, Saudi Arabia's acute care physicians remain unevenly distributed: urban centers house most staff but have lower per-capita coverage, whereas peripheral regions have higher ratios but limited capacity. Addressing national workforce participation and optimizing regional deployment are essential for equitable care.