Noncommunicable Diseases and Hospital Utilization in Kuwait: A Generalizable Approach Using the World Health Survey

Abstract

Background: Kuwait and countries in the Arabian Gulf region face an alarming prevalence of noncommunicable diseases (NCDs) that strain their health systems and threaten their economies. To quantify a key dimension of the burden, we estimated the risk of hospital utilization in Kuwait associated with diagnoses of the most prevalent NCDs, excluding cancer, using a generalizable approach suitable for cross-country disease burden comparisons and assessments of prevention effectiveness. Methods: The study analyzed responses from a nationally representative sample of 2,165 individuals with self-reported hospital admissions over 12 months and NCD diagnoses from the World Health Survey in Kuwait in 2010. Hospital utilization rates were examined for individuals diagnosed with hypertension, diabetes mellitus, asthma, chronic lung condition, heart disease, and stroke rates and adjusted for demographic and socioeconomic factors. Count regressions were used to estimate the association between individual NCDs while adjusting for other covariates. Results: Using negative binomial regressions, we found that hypertension, the most common NCD in Kuwait, was associated with 75% higher hospital utilization. In addition, heart disease was associated with a 495% increase in hospital utilization rates after adjusting for potential confounders. Many other demographic, socioeconomic, and behavioral characteristics confounded the sizable increase in the risk of hospital admissions associated with NCDs. Conclusions: We estimated the substantial burden on curative services associated with NCDs in Kuwait through a standardized approach to compare hospital utilization rates associated with various NCDs; this approach is generalizable to more than 70 countries that participated in the World Health Survey.