Dubai: Planning for health

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The focus of Dubai’s health care sector is set to undergo a major shift, with greater emphasis to be placed on prevention rather than treatment, a policy that aims both to better meet the changing needs of the community and also rein in an expanding health budget.

In December, the Dubai Health Authority (DHA) announced it would be stepping up efforts to raise public awareness of non-communicable diseases (NCDs), especially lifestyle illnesses such as diabetes, cardiovascular disease, obesity and hypertension.

A series of reports issued last year by the DHA highlighted the extent to which lifestyles were undermining the health of locals. One study showed that 19% of Dubai’s residents exercised sufficiently to remain healthy, a figure that fell to 7% for men between the ages of 40 to 59, with the lack of activity linked to excessive weight gain and a higher risk of diabetes, heart attacks and strokes.

Other DHA data shows that one in four deaths in the UAE will be the result of cardiovascular disease, but that up to 80% of these deaths are preventable through lifestyle modification. Another health threat is diabetes. Official figures show that around 20% of the UAE’s population have been diagnosed with diabetes, though the actual figure is believed to be higher, as many residents are not aware they are suffering from the illness.

“The increasing rate of those suffering from non-communicable diseases is alarming,” Thomas J Murray, the CEO of American Hospital, told OBG. “Any efforts to encourage individuals to adopt preventative measures, whether they are to simply heighten awareness or to actually increase the frequency of regular check-ups, should be supported.

However, I strongly urge that international best practises and standards are employed to maximise cost efficiency and avoid over usage, which would place a strain on the system. In the long run, if implemented successfully, savings should far outweigh the initial capital outlay.”

The government is of the same mind. To help improve these figures and raise awareness, the DHA has introduced special health screening packages, offered at reduced costs, with the aim of encouraging residents to have regular check-ups and have their health monitored before problems develop.

The diabetes package covers four visits to a doctor, blood and urine tests, and dental and eye check-ups for one year at a total cost of $400, around 25% less than the fee if each appointment and test was scheduled individually. Another of the packages caters directly to women’s health needs, providing two appointments with a doctor, one of which includes a complete blood test, a Pap smear and a mammogram for women over 40.

According to Dr Maha Ali Hassan, the DHA’s acting head of business development and projects, the high cost of screening and lack of insurance cover for preventive health can serve as a disincentive to people from having the necessary tests carried out and receiving advice about making better lifestyle choices.

“We want patients to be able to utilise the services we have available at a reasonable price, for the sake of their health,” Hassan told the UAE daily The National in December. “Sometimes people need a boost to help them to cut habits in their life and this is our way of motivating them.”

In mid-December, the DHA also signed a memorandum of understanding with the World Health Organisation (WHO) to establish a framework for cooperation to develop strategies, policies and action plans tackling priority health problems, especially those related to NCDs, in the emirate and the rest of the UAE.

Under the agreement, the WHO will assist Dubai in formulating and implementing programmes for the prevention and control of NCDs, setting up a risk factors surveillance system, developing health promotion programmes, establishing capacity building for DHA staff and developing community participation initiatives.

The new schemes are hoped to have an impact, as it is estimated that spending on public health care in Dubai and the rest of the UAE will increase by 250% over the next 15 years, with the growing calls on the health budget mainly due to lifestyle-related illnesses. This would take the UAE’s total health care budget to some $33bn a year, with the allocation to Dubai representing a significant slice of this spending.

“Currently in Dubai, total expenditure on health care spending represents only 2.7% of GDP, whereas the global average for developed economies is closer to 7% or 8%,” David Hadley, the CEO of Emirates Healthcare, told OBG. “If Dubai and the UAE want to achieve real progress, they should begin incrementally increasing expenditure similar to that of a high-income country.”

Another route to reducing costs and boosting efficiency is likely to be put in place soon, with Dubai looking to develop partnerships with the private sector to help ease the calls on government-funded services. The DHA is hoping that non-state health providers will meet more than half of the new demand, officials have said.

According to Laila Al Jassmi, the DHA’s CEO of the health policy and strategy sector, such cooperation would lead to cost rationalisation and improved services. The DHA is working with Dubai’s Executive Council to draft legislation formalising public-private partnerships for health services, and Al Jassmi said the law would streamline services and protect the rights of both the state and private investors by setting out a clearly defined operational model.

By trying to tackle Dubai’s health problems before they develop, through educational programmes, screening and the promotion of preventative measures, the DHA and other agencies may be able to rein in expenditure as well as improve the health of the emirate.

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