The United Arab Emirates. Abu Dhabi Healthcare Reform: Improving Quality through a Single Payment System

Subashnie Devkaran

CONTENTS

Background..........................................................................................................353

Details of the Success Story...............................................................................355

The Reform Time-Line.......................................................................................356

The Impact of the Abu Dhabi Healthcare Reform Program........................356

Transferability of the Exemplar........................................................................358

Prospects for Further Success...........................................................................358

Conclusion...........................................................................................................359

Background

The United Arab Emirates (UAE) is a federation of seven emirates. The capital and largest emirate is Abu Dhabi, followed by Ajman, Dubai, Fujairah, Ras al-Khaimah, Sharjah, and Umm al-Quwain (Table 47.1). Since independence

TABLE 47.1

UAE Demographics (July 2016)

Indicator

Value

UAE population total

9,267,701

Ratio of Emirati to expatriates

1:9

Deaths per day

47

Births per day

261

Source: United Nations.

in 1971, the UAE has focused on the delivery of high-quality healthcare. The Ministry of Health, established in 1972, is the federal body responsible for healthcare delivery, healthcare policy, healthcare professional practice, and education (Douglas, 2015).

In the early 2000s, reforms to the UAE health system, involving devolution of healthcare regulation, resulted in decentralized funding, decision-making, and independent health authorities for Dubai and Abu Dhabi. The major reforms were predicated on numerous factors. First, there were increases in per capita healthcare spending caused by immigration-driven population growth and the increasing burden of lifestyle diseases and chronic diseases due to sedentary lifestyles and aging. Second, there was diminished trust in local healthcare services and a perception that healthcare in the UAE was inferior to that of many developed countries. Many Emiratis chose to travel to the West for treatment (particularly to Germany, Switzerland, and the United States), even when the procedures were available in the UAE. The costs of sending Emiratis abroad for lengthy treatment regimens created many challenges. In addition, the UAE 2021 Vision set ambitious targets to increase the quality of healthcare to international best practice standards (Table 47.2).

TABLE 47.2

UAE 2021 Vision Indicators

Indicators

2012 Result

2021 Target

Deaths from cardiovascular disease per 100,000 population

211

158.2

Prevalence of diabetes

19.02%

16.28%

Deaths from cancer per 100,000 population

78

64.2

Average healthy life expectancy

67

73

Physicians per 1,000 population

1.5

2.9

Nurses per 1,000 population

3.5

6

Prevalence of smoking

21.6% (men) 1.9% (women)

15.7% (men) 1.66% (women)

Percentage of accredited health facilities

46.8%

100%

Source: UAE Vision 2021.

In 2007, under the new Dubai Health Authority, Dubai advocated the adoption of private health insurance and private providers were promoted. The new Health Authority-Abu Dhabi took a more radical stance by mandating private health insurance for all its residents in 2006 (Vetter and Boecker, 2012). This chapter focuses on the improvement story of the Abu Dhabi health system and its transformation from a fully government-funded sector to a predominantly private sector in just 1 decade (2005-2015).

 
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