Out-of-pocket health expenditure and the health financing mix in Gulf Cooperation Council countries, 2000–2023: a descriptive analysis of WHO data

Background Out-of-pocket (OOP) expenditure is an important component of health financing, but national OOP shares should be interpreted alongside the wider financing mix. This study compared OOP shares and financing composition across the six Gulf Cooperation Council (GCC) countries from 2000 to 2023. Methods The analysis used the March 2026 release of the WHO Global Health Expenditure Database. OOP payments, government and compulsory schemes, and voluntary schemes were expressed as percentages of current health expenditure (CHE). Descriptive statistics, changes between 2000 and 2023, and country-specific linear trends were calculated. Additional analyses examined periods around documented changes in data sources or classifications. Results OOP shares were lower in 2023 than in 2000 in five countries, with the largest reductions in Qatar and Kuwait; Bahrain showed a small increase. Saudi Arabia’s OOP share declined from 18.46 to 14.12%. In 2023, government and compulsory schemes were the largest financing component in all six countries, ranging from 59.27% of CHE in Bahrain to 88.55% in Kuwait. Saudi Arabia’s financing trends spanned documented changes in insurance classification and OOP source data. Conclusion OOP shares and the wider financing mix differed across GCC countries between 2000 and 2023. These patterns should be interpreted in the context of documented changes in data sources and financing classifications.