Trends and Regional Variations in Bed Density in Ministry of Health Hospitals in Saudi Arabia: A Retrospective Analytical Study (2018–2022)

Introduction Hospital bed density is a key indicator of healthcare system capacity. In Saudi Arabia, total hospital bed density is lower than the global benchmark. This study aims to examine national trends and regional variations in bed density per 1,000 population in Ministry of Health (MOH) hospitals across Saudi Arabia. Methods This retrospective study analyzed secondary data from the Saudi Open Data Platform on bed density in MOH hospitals across all regions of Saudi Arabia between 2018 and 2022. Other public and private hospitals are excluded from this analysis. The data were analyzed using descriptive statistics, trend analysis, the Lorenz curve, and the Gini index. Results Between 2018 and 2022, population growth of approximately 6.6% outpaced the increase in bed capacity in MOH hospitals (4.1%), resulting in a slight decline in MOH bed density nationally from 1.45 to 1.41 beds per 1,000 population, with periodic fluctuations. The national distribution of beds in MOH hospitals showed relative equality, with a Gini index ranging from 0.208 in 2018 to 0.211 in 2022. However, marked regional disparities were observed. At MOH hospitals, bed density was 1.0–1.3 beds per 1,000 population in large regions, including Riyadh, Makkah, and the Eastern Province, compared with 3.1–3.9 beds per 1,000 population in smaller regions, including Al-Jouf, Al-Bahah, and the Northern Borders. Similar patterns were observed for beds in intensive care units and emergency departments. Of the 287 MOH hospitals, 221 (77.0%) were community-level facilities with fewer than 200 beds, and 66 (23.0%) were large hospitals with more than 200 beds. Nearly two-thirds (60.6%) of the large hospitals were located in Riyadh, Makkah, and the Eastern Province. Conclusion Although the national allocation of beds in MOH hospitals appears relatively equitable, bed density per 1,000 population has declined slightly due to population growth, with substantial regional disparities. Continuous monitoring of bed-density indicators, strategic planning of hospital capacity, and strengthening of community-based services are required to reduce pressure on inpatient services, support equitable access, and align with Saudi Vision 2030 and the national healthcare system goals.