Health Statistics 2013 Health Authority Abu Dhabi Reliable Excellence in Healthcare www.haad.ae/statistics www.haad.ae/statistics-xl 27 November 2014
Contents Overview Stable vision 2 Achieving our vision the journey so far 3 Statistical highlights 4 Public Health highlights 5 Investor highlights 6 Benchmarks 7 Population Population various breakdowns 9 Births and Deaths 11 Leading causes of death 13 Injury deaths 15 Communicable diseases 16 Cancer 17 Episodes and activities Episodes various analyses 22 Activities by type 25 Providers Provider overview 27 Labour productivity 28 Hospitals 29 Hospital inpatient profile 30 Beds including critical care 31 Centres and Clinics 33 Blood bank 34 Market structure 35 Claims Claims 38 Payers Payer members 40 Payer claims 41 Financing Enhanced plans premiums 43 Enhanced plans limits 44 Enhanced plans benefits 45 Financing model, spend distribution 46 1 Note The data presented have been prepared to the best of our knowledge at time of release. Although effort has been invested to creating consistency and coherence, this should be considered work in progress. Feedback on content and layout are welcome.
Stable vision Elements of the HAAD 2006 vision have guided significant healthcare reform: In the Emirate of Abu Dhabi, everyone has access to healthcare. A system encompassing the full spectrum of health - protecting, promoting, sustaining and restoring services across the territory of the Emirate. Person Quality driven by ambitious improvement targets set by the regulatory authority of the Emirate and reflected in the regularly monitored and published key performance indicators of the system. Payer Provider There is mandatory health insurance for all Abu Dhabi residents. The financing system is flexible to manage for change over time and the degree of subsidy should be managed as efficiently as possible. An open system for all certified providers of health services delivers world-class quality care and outcomes in compliance with the highest international standards. 2
Achieving our vision the journey so far In 2006 we first defined a vision for Abu Dhabi s health system with the mission to Ensure Reliable Excellence in Healthcare. This vision has guided major reforms and continues to inform daily decisions in healthcare. The Health Authority Abu Dhabi (HAAD) was created to track and steer progress towards realising the vision and, to measure returns on investments for a healthy society. HAAD regulates all healthcare actors public/private, provider/payer/professionals by licensing, setting clear and simple rules, e.g. minimum standards for facilities and ensuring compliance. HAAD does not own, build or manage healthcare facilities, treat patients, pay for treatment (insurers and other payers do) or pay the private sector to partner. SEHA (Arabic for health ) is the largest public provider; it owns and develops existing public healthcare facilities, including partnerships with 2 renowned overseas operators to manage its facilities. Everyone has access to healthcare via mandatory health insurance. A first in the region, in 2006 Abu Dhabi guaranteed access to healthcare for all expatriates by mandating health insurance and linking it to resident permits. In 2008 the old Ministry of Health s health cards for Nationals were replaced with Thiqa health insurance, which provided free at the point of care access to care in both public and private sectors and the freedom to choose the provider. World-class quality care and outcomes with quality regularly monitored and published. In support of improving quality, HAAD develops clinical care and service standards tailored to Abu Dhabi across the health sector. In 2012, Abu Dhabi Health Regulations (Policy Manuals) were published for implementation across the healthcare sector. Since 2011, we have been working on the development of a comprehensive, consistent and trustworthy provider rating system that would allow benchmarking of the quality of services among Abu Dhabi providers as well as internationally. HAAD has disseminated a number of quality metrics to improve quality. Capacity has improved, for instance, since 2009 the number of hospital beds available to the population has increased by 21% (681). However, many challenges remain, for example, whilst under 5 year olds mortality rate (8 per 1 000 live births) is among the best of GCC countries, it is still above that of the UK (5 per 1 000 live births) and Singapore (3 per 1 000 live births). Full spectrum of health services. Our model of care sets out services which are appropriate, convenient and well coordinated around patients needs. Prevention. Disease prevention and health promotion are cornerstones of our public health strategy to reduce burden of diseases at onset in vulnerable population. This requires continuous collaboration with strategic stakeholders, e.g. municipalities on tobacco control, schools on healthy eating and exercise, police on road safety and employers on workplace health promotion. Screening for health risks. When Nationals were first screened for various health risk factors in a programme called Weqaya (Arabic for prevention ), it showed that 71% had at least one cardiovascular diseases (CVD) risk factor; many were unaware thus unable to seek care, and risk factors are projected to increase. Community-based services help patients manage their chronic conditions, like diabetes, on a daily basis. Some diabetes services now offer integrated consultation, diagnostic and pharmacy services to people with diabetes. Another creative solution is to treat patients, particularly those who are frail, in their homes. Specialty care. Competition for patients has helped the creation of new services and increased convenience and efficiency for existing services. There is clear evidence that the Strategy to encourage investment in both public and private healthcare provision is now delivering major benefits. During 2013 there has been a marked reduction of existing service gaps. There has been 20% growth in the numbers of Emergency Physicians, 41% growth in Neonatologists and 21% increase in Paediatric and Orthopedic doctors respectively. Critical care doctors have grown by 14%. Obstetrics and Gynecology doctors have grown by 30%. Full detail of these improvements are included in The Capacity Masterplan Pages C8 and C9. Health facilities and clinicians. The desire is to treat patients outside hospitals wherever possible, however, to account for population increase, several private providers have opened new acute and sub-acute care facilities. 10 new private hospitals have opened in the last 5 years adding 780 beds. In addition, 350 new clinics and centres have opened, with more planned, in both private and public sectors. During 2013 the number of facilities offering healthcare has also grown by 11% to 1 626 27. The challenge is to manage potential oversupply in some areas and to ensure hospitals operate with both quality and cost comparable with international benchmarks. In the last 5 years the number of doctors per 10 000 population has increased from 23 to 25 (9% increase) and nurses from 42 per 10 000 population to 52 (24% increase). Ambulance services. Good hospitals are worthless if patients cannot get there. The police provide emergency ambulance services. HAAD is working with them to develop a more integrated service that responds to a wider range of health emergencies and ensures the patients are taken to the most appropriate facility. Predominantly private providers. Based on positive experience both locally and regionally, we would like private operators to provide most healthcare, as well as to continue to add required new capacity. Private Investors are generally more responsive to market needs than the public sector. During 2013 the private sector was responsible for 74% of the growth in physician numbers and most of the growth in facilities C8,C9. HAAD continues close monitoring of providers both public and private against robust clinical indicators to ensure high quality of care is provided. A Flexible and efficient financial system. We want to pay providers for the patients they actually treat and the quality of that treatment, as well as limit direct subsidies to public providers. The DRG system introduced in 2010, and fully implemented for all hospitals inpatients in 2013, promotes efficiency: it pays hospitals on the basis of how sick patients are, not how long they stay or how many health services they are provided with. HAAD is focussed on improving the reimbursement system to ensure adequate reimbursement levels that are based on reference prices and a revision of the tariff is expected soon. 3
Statistical highlights There are more insurance contracts (3.3m) than residents Population 2.73m residents, 18% Nationals Median age 19.6 for Nationals and 31.7 for Expatriates 35 945 births and 3 015 deaths Financing Episodes* Payers Claims Providers 14.3 million Episodes*: 1.4% inpatient (193 996) 39% by Nationals 49% by hospitals 83.9 million Activities**: 44% Consultations 7% Services and procedures 5% Dental 20% Drugs 4% Materials 21% DRGs (HCPCS) 39 licensed payers provide health insurance for the entire population 21.3 Million claims submitted 99.1 % of claims for outpatients 6 864 physicians, 1 220 dentists, 14 235 nurses and 5 332 allied health professionals and 2 396 pharmacists 1 626 licensed facilities including: 41 hospitals (3 864 beds***) 922 centres and clinics 502 pharmacies 4 Note * An Episode is an inpatient Encounter or a set of outpatient Encounters linked to the same clinical case based on the patient (identified by insurance member ID), and principal diagnosis. An Episode clinician is the clinician responsible for consultation.** percentages by value ***the total number of reported operational beds and licensed beds for new facilities
Public health highlights Population. 18% of residents are Nationals, of whom 69% are under 30 and more than half are under 20 9. Expatriates are predominantly aged between 20 and 40 9. A significant share are employed in construction and accommodated in labour camps. The introduction of mandatory health insurance in 2006 provided all residents in Abu Dhabi access to high quality care. The population continues to grow rapidly. Birth. The UAE s Total Fertility Rate has declined from 4.4 to 1.7 per woman between 1990 and 2011 (World Health Statistics 2013 (WHO)). Declining birth rates are attributed to urbanisation, delayed marriage, changing attitudes about family size, and increased education and work opportunities for women. Death. Mortality rates have also declined steadily 11,12 over the past years. Infant mortality is now comparable with other developed countries 7 and the WHO has reported a decrease in the under 5 mortality rate from 22 to 7 per 1 000 live births between 1990 and 2011 across the UAE. In 2013, the diseases of circulatory system caused the highest number of deaths, accounting for 36.7% of all death cases registered in the Abu Dhabi Emirate. External causes of morbidity and mortality and neoplasms are the second and third highest causes of death 13,14. Injuries. Injuries are the second leading cause of death (19.6%) and healthy life years lost in Abu Dhabi. Fatal injuries are caused primarily by road traffic (62%), followed by injuries due to falls and falling objects (11%), and suicide (8%). Occupational injuries and childhood injuries are accounting for 18.4% and 12.2% of total injury deaths, respectively. 13-15 Non-communicable diseases. The Emirate has high rates of chronic diseases related to lifestyle, such as obesity, diabetes, and cardiovascular diseases. Cardiovascular diseases accounted for 36.7% of all death cases in 2013. Adult Nationals were screened for cardiovascular risk factors in 2008 as a condition for enrollment in Thiqa insurance. Without major changes, these rates are set to increase further as the young population ages. Individuals thought to be at high risk of cardiovascular disease are being followed up. Cancer caused 12.9% of all deaths in the Emirate in 2013. Lymphoid, Haematopoietic and related tissue cancers are the dominant cancers in Abu Dhabi. Late detection of breast cancer leads to significant increases in mortality. Adult female Nationals aged 40-69 are being screened for breast cancer as part of their Thiqa insurance renewal. Education and awareness campaigns have increased screening rates for all nationalities. Communicable diseases. Rates of childhood communicable diseases are very low, due to immunization programs targeting children aged <5 years 16. Expatriates are screened for communicable diseases before acquiring residence status 16. Respiratory infections are the second most common non-life threatening condition in the Emirate after signs, symptoms and illdefined conditions, accounting for 11.1% of Episodes across all healthcare facilities 23. Respiratory infections mostly impact workforce productivity and quality of life. 5 Notes The superscripts in pages 5 and 6 refer to the specific pages of this publication where more detailed information can be found
Investor highlights Population. The population is concentrated on or nearby Abu Dhabi island C34. Areas of growth in the short to medium term are expected to be just off the island (Mohammed Bin Zayed city, Capital district, Shamkha and the islands adjacent to Abu Dhabi island) and Al Ain city. At the end of 2013 there were 0.48m National Thiqa members, 1.34m Basic members and 1.49m Enhanced members 41. Recent annual population growth has averaged 7.7% and is considered to be among the highest population growth rates in the world*. Demand. Aggressive growth in demand is expected for general medical services and services linked to lifestyle-related diseases, e.g. diabetes and cardiovascular diseases and cancer with larger volume increases in outpatient settings C37. Supply. Since the end of 2012 there has been 22% growth in the number of licensed physicians and dentists C8,C9 and 11% growth in the number of licensed facilities**. It is estimated that by 2022 up to 4 800 additional doctors and 13 000 nurses will be required. If turnover remains high, this translates into up to 1 700 doctors and 2 900 nurses to be recruited annually C36. HAAD demand projections C26 also indicate that in 2020 demand for inpatient services may require over 2 200 additional beds (based on current occupancy rate). However, there are currently 16 hospitals under construction that are more than 50% complete, which should provide up to 2 859 beds C31,C32. This is an increase of 700 beds under construction compared to 2012, which signals significant future capacity to meet the required demand C32. Capacity gaps. Capacity gaps exist in Intensive and Critical Care Medicine, Emergency Care, Neonatology, Paediatrics, Oncology, Orthopaedics, Rehabilitation and Psychiatry C9. Sub-specialty gaps exist in Paediatric and Paediatric Surgery. Adult Surgical sub-specialties including Neurosurgery, Plastics, Surgical Oncology are all undersupplied in Abu Dhabi. Significant new inpatient capacity is anticipated during 2014 and 2015 C30,C31 particularly in acute care services with the planned supply of Intensive and Critical care and Emergency Bays addressing the current shortfalls in these types of services by 2016 C32. Overall bed occupancy rates vary by facility, but are lower than optimal 30 indicating low efficiency. Bed occupancy in ICU, NICU, PICU, CICU, CCU and Isolation was consistently over the optimal 75% during 2011 34. Reimbursement. HAAD sets prices for the Basic product uniformly. Providers negotiate prices with Payers for Enhanced plans, generally as a multiple of Basic product rates. Thiqa rates are equivalent to Daman s most generous Enhanced plan. DRGs were introduced for the Basic product in 2010, and mandated for all hospital inpatients in 2013. In 2013, more outpatient payments were needed based on Evaluation and Management (E & M) codes, where payment reflected the severity of the patient s condition not the grade of doctor seen. Provider market. Government-subsidised SEHA hospitals provided care in 61% of all inpatient Episodes (2% increase from 2012) and 38% of all hospital outpatients (1% decrease from 2012) 23. The largest independent groups are Al Noor and NMC 30. International providers have come to Abu Dhabi, generally on the basis of a management service agreement, such as the Cleveland Clinic for SEHA s SKMC and Johns Hopkins for SEHA s Tawam. Payer market. Overall, the competitive Enhanced health insurance market has increased to almost 1.49m members. Over 50% of this market is held by three payers Daman (34%), ADNIC (14%) and Oman (7.5%) 42. Average Enhanced premium per member increased in 2013 by 10% to 3 380AED 40. Daman also administers Thiqa and Basic products. Claims per member have risen from 4.6 in 2009 to 6.5 in 2013 39. On average payers take 51 days to remit claims 42. 6 Note *SCAD, http://www.scad.ae/en/statistics/pages/statistics.aspx?themeid=4 ** Percentage growth needs to be interpreted with caution, due to the fact of having some services within SEHA facilities holding a separate license.
Benchmarks Abu Dhabi Population growth, 2001-2011 7.5 Life expectancy at birth (years), Males 75.2 Females 78.7 Injury mortality/100'000 population 29 Bahrain 7.2 78 80 33 Germany 0 78 83 25 Kuwait 3.4 80 80 28 Oman 2.2 70 76 39 Qatar 11.2 83 81 36 Saudi Arabia 3.1 74 77 68 Singapore 2.6 80 85 21 UAE 9.2 75 77 38 UK 0.5 79 82 25 USA 0.9 76 81 53 Abu Dhabi Bahrain Germany Kuwait Oman Qatar Under 5 mortality rate /1000 live births 8.0 10 4 11 9 8 Infant mortality rate / 1'000 live birth 6.3 3 7 6 9 9 Beds/1'000 population 1.4 2.3 Adjusted* 1.8 2.0 1.8 1.2 8.2 Physicians /10'000 population 25.1 14.9 17.9 20.5 27.6 36.9 Nurses / 10'000 population 52.1 38.6 45.5 44.9 73.7 113.8 Saudi Arabia 9 8 2.2 9.4 21 Singapore UAE UK USA 3 5 7 8 2 4 6 6 2.7 1.9 3.0 3.0 19.2 19.3 24.2 27.7 40.9 63.9 94.7 98.2 7 Notes Sources * Adjusted for fair international comparisons as the population in Abu Dhabi is young and is not expected to use hospital beds as frequently as older populations. The adjustment is made by mapping the population age structure of Abu Dhabi to that of Germany, using German resource consumption profiles. Life expectancy 2012 for Abu Dhabi Emirate, 2011 for others, Infant and under 5 mortality rates and clinicians Abu Dhabi 2013 others 2005-2012. WHO Statistical Information System/World Health Statistics 2013, Public health department, HAAD population estimates, SCAD, and Health Statistics Analysis
Population Financing Episodes Payers Claims Providers 8
Population by age, gender and nationality National Expatriate Age band All Male Female Total Male Female Total 85+ 2'222 804 875 1'679 224 319 543 80-84 2'931 887 881 1'768 505 658 1'163 75-79 4'898 1'375 1'163 2'538 1'059 1'301 2'360 70-74 Female Male 8'709 2'168 2'083 4'251 2'211 2'248 4'459 65-69 National 14'369 2'809 2'671 5'480 5'175 3'715 8'890 60-64 Expatriate 31'964 3'419 3'902 7'321 17'896 6'746 24'643 55-59 72'431 4'122 5'790 9'911 49'630 12'890 62'519 50-54 108'350 4'743 6'687 11'430 76'921 19'998 96'920 45-49 160'803 6'741 8'651 15'391 117'005 28'408 145'412 40-44 240'306 8'766 11'607 20'373 176'354 43'579 219'934 35-39 322'479 13'939 17'390 31'329 227'278 63'872 291'150 30-34 446'231 19'355 22'270 41'625 318'837 85'768 404'605 25-29 501'623 22'372 24'011 46'383 364'737 90'504 455'240 20-24 254'154 23'591 23'412 47'003 161'384 45'767 207'151 15-19 103'511 24'790 23'621 48'411 30'879 24'221 55'100 10-14 120'720 27'862 27'303 55'165 33'879 31'676 65'555 05-09 152'667 34'351 33'262 67'613 43'903 41'150 85'053 0-4 184'190 39'707 37'990 77'696 54'839 51'655 106'494 Total 2'732'557 241'801 253'567 495'368 1'682'714 554'475 2'237'189 Notes HAAD is collaborating with SCAD to align figures with official SCAD estimates The total National population and the regional distribution are based on SCAD data 9 Source SCAD population estimates for Nationals, as well as additional HAAD assumptions and analysis based on raw insurance data
Population by region and nationality 6.0% 13.9% 40.8% 23.0% Western Eastern Abu Dhabi 53.1% 63.1% Region National Expatriate Total National Expatriate Abu Dhabi 263'207 1'411'639 1'674'846 15.7% 84.3% Eastern 202'266 515'247 717'513 28.2% 71.8% Western 29'895 310'304 340'199 8.8% 91.2% Total 495'368 2'237'189 2'732'557 Notes HAAD is collaborating with SCAD to align figures with official SCAD estimates The total National population and the regional distribution are based on SCAD data 10 Source SCAD population estimates for Nationals, as well as additional HAAD assumptions and analysis based on raw insurance data
Births and deaths Total By Region Rates By Nationality and Gender Number % Number National Expatriate NA 2012 2013 National Males Abu Dhabi Eastern Western NA Abroad Live Births 34'358 35'945 43% 51% 22'250 12'144 1'313 6 232 13.2 13.3 16.9 3.9 7'958 7'618 10'301 10'015 27 26 Deaths 2'923 3'015 31% 70% 1'717 983 199 1 115 1.1 1.0 1.4 0.6 567 364 1 1546 537 Total Still births 104 149 38% 30% 106 41 2 0 4.1 4.8 3.4 1.5 18 20 19 25 25 26 2 3 11 Neonatal mortality 135 155 46% 48% 89 63 3 4.3 4.0 5.2 2.3 36 35 1 39 44 Infant mortality 217 227 45% 50% 125 93 7 2 6.3 5.6 7.7 5.3 52 49 1 62 63 Child mortality (1-4) 64 59 37% 56% 26 29 3 1 1.6 1.2 2.4 2.3 14 8 19 18 Abu Dhabi Eastern Western Male Female NA Male Female NA Male Female NA Death by Age Group 0-6 days 94 105 52% 49% 62 41 2 3% 4% 4% 1% 27 27 1 24 26 7-27 days 41 50 34% 48% 27 22 1 2% 2% 2% 1% 9 8 15 18 28-364 days 82 72 42% 54% 36 30 4 2 2% 2% 3% 2% 16 14 23 19 1-4 64 59 37% 56% 26 29 3 1 2% 2% 3% 2% 14 8 19 18 5-9 33 19 47% 53% 10 8 1 1% 1% 1% 0% 5 4 5 5 10-14 26 36 50% 69% 15 15 3 1 2 1% 1% 2% 2% 14 4 11 7 15-19 51 46 70% 76% 22 15 3 6 2% 1% 2% 2% 27 5 8 6 20-24 126 109 36% 89% 67 21 15 6 4% 4% 2% 8% 34 5 63 7 25-29 195 201 19% 83% 109 52 26 14 7% 6% 5% 13% 29 10 138 24 30-34 175 185 15% 88% 118 38 26 3 6% 7% 4% 13% 17 10 146 12 35-39 154 180 22% 84% 107 47 17 9 6% 6% 5% 9% 33 6 118 23 40-44 194 183 12% 87% 111 44 22 6 6% 6% 4% 11% 15 7 145 16 45-49 217 220 10% 84% 135 60 16 9 7% 8% 6% 8% 15 8 170 27 50-54 235 231 16% 80% 128 75 23 5 8% 7% 8% 12% 21 17 164 29 55-59 240 259 17% 77% 143 90 16 10 9% 8% 9% 8% 23 22 177 37 60-64 192 208 24% 65% 122 75 7 4 7% 7% 8% 4% 30 19 106 53 65-69 168 197 42% 64% 113 74 1 9 7% 7% 8% 1% 46 37 80 34 70-74 190 193 50% 52% 111 70 2 10 6% 6% 7% 1% 57 39 44 53 75-79 137 140 44% 52% 81 49 1 9 5% 5% 5% 1% 33 29 40 38 80-84 131 136 59% 51% 72 58 2 4 5% 4% 6% 1% 45 35 24 32 85+ 178 186 58% 45% 102 70 9 5 6% 6% 7% 5% 57 50 26 53 Note Rates: crude birth and death rates calculation are based on internal HAAD population estimates (per 1 000) other rates based on crude births (per 1 000), data s of 31st March 2014; HAAD and SCAD are collaborating to align with official SCAD data 11 Source Birth and Death notifications; Health Statistics Analysis
Births and deaths time series 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Note 40 30 20 10 0 Crude birth rates 50 National Expatriate Aggregate 4.0 3.0 2.0 1.0 0.0 Crude death rates Rates based on internal HAAD population estimates; HAAD and SCAD are collaborating to align with official SCAD data Presented data include cases where nationality is not available Year Total National Rate Expatriate Rate % Nationals 1985 18'874 6'376 46.9 12'498 29.1 34% 1986 19'700 6'328 45.2 13'372 30.3 32% 1987 20'667 6'400 43.8 14'267 30.7 31% 1988 22'113 6'668 43.3 15'445 31.6 30% 1989 21'686 6'647 41.0 15'039 29.2 31% 1990 21'750 6'652 39.1 15'098 27.9 31% 1991 20'246 6'729 37.8 13'517 23.7 33% 1992 20'456 7'202 38.3 13'254 22.1 35% 1993 20'410 7'928 40.4 12'482 19.8 39% 1994 21'505 8'060 39.1 13'445 20.2 37% 1995 20'425 8'261 37.1 12'164 16.9 40% 1996 20'095 8'697 38.1 11'398 15.4 43% 1997 20'017 8'917 37.2 11'100 14.3 45% 1998 20'348 8'435 33.5 11'913 14.5 41% 1999 21'303 8'948 33.9 12'355 14.3 42% 2000 23'525 9'783 35.2 13'742 15.1 42% 2001 23'974 10'349 34.9 13'625 15.6 43% 2002 24'317 10'714 34.5 13'603 15.1 44% 2003 24'990 11'279 34.6 13'711 14.7 45% 2004 26'215 12'021 35.2 14'194 14.7 46% 2005 27'112 12'254 35.3 14'858 15.8 45% 2006 25'738 12'165 33.8 13'573 10.9 47% 2007 27'002 12'857 34.7 14'145 10.7 48% 2008 28'456 13'040 32.4 15'416 8.9 46% 2009 29'044 13'479 28.3 15,565 7.0 46% 2010 29'502 13'635 31.5 15,867 7.5 46% 2011 32'034 14'636 33.8 17,398 8.3 46% 2012 34,358 15'170 31.8 19,131 8.6 44% 2013 35'945 15'576 32.7 20,316 9.2 43% Year Total National Rate Expatriate Rate % Nationals 1985 1'275 520 3.8 755 1.8 41% 1986 1'356 492 3.5 864 2.0 36% 1987 1'444 528 3.6 916 2.0 37% 1988 1'480 551 3.6 929 1.9 37% 1989 1'561 571 3.5 990 1.9 37% 1990 1'628 572 3.4 1'056 1.9 35% 1991 1'774 652 3.7 1'122 2.0 37% 1992 1'829 690 3.7 1'139 1.9 38% 1993 1'946 689 3.5 1'257 2.0 35% 1994 1'963 614 3.0 1'349 2.0 31% 1995 2'166 722 3.2 1'444 2.0 33% 1996 2'050 723 3.2 1'327 1.8 35% 1997 2'105 708 3.0 1'397 1.8 34% 1998 2'098 758 3.0 1'340 1.6 36% 1999 2'206 792 3.0 1'414 1.6 36% 2000 2'250 822 3.0 1'428 1.6 37% 2001 2'574 928 3.1 1'646 1.9 36% 2002 2'612 849 2.7 1'763 2.0 33% 2003 2'493 913 2.8 1'580 1.7 37% 2004 2'489 887 2.6 1'602 1.7 36% 2005 2'443 820 2.4 1'623 1.7 34% 2006 2'380 821 2.2 1'559 1.5 34% 2007 2'750 990 2.6 1'760 1.5 36% 2008 2'949 981 2.4 1'947 1.1 33% 2009 2'988 983 2.4 1'990 1.3 33% 2010 2'879 967 2.2 1'888 1.0 34% 2011 2'902 940 2.2 1,958 1.0 32% 2012 2'923 976 2.3 1,945 0.9 33% 2013 3'015 932 2.2 2,083 0.9 31% 12 Source MOH statistics, Preventive Medicine Department annual reports, Public Health and Policy; Health Statistics Analysis
Causes of death Endocrine, nutritional and metabolic diseases 2% Congenital malformations, deformations and chromosomal abnormalities 2% Injury, poisoning and certain other consequences of external causes 3% Other causes 24% Neoplasms 16% Diseases of the circulatory system 37% External causes of morbidity 16% 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 Codes Total 3'015 2'923 2'902 2'879 2'988 2'949 2'742 2'450 2'446 2'489 2'492 2'617 2'574 I00-I99 Diseases of the circulatory system 1'107 1'135 1'089 762 707 697 506 378 424 413 624 778 622 V00-Y99 External causes of morbidity 485 451 481 202 632 464 621 503 565 563 574 614 600 S00-T98 Injury, poisoning and certain other consequences of external causes 105 81 100 385 57 85 C00-D49 Neoplasms 468 474 461 461 397 360 370 315 294 298 276 289 252 Q00-Q99 Congenital malformations, deformations and chromosomal abnormalities 73 85 98 144 199 120 177 131 156 146 152 199 190 E00-E89 Endocrine, nutritional and metabolic diseases 62 63 72 194 210 79 201 130 133 126 103 73 65 Other 715 634 601 731 786 1144 867 993 874 943 763 664 845 Note Causes of death classified according to WHO ICD-10; where Neoplasms include: malignant (388 death cases), Other (80 death cases): benign, uncertain, and other unspecified behavior. Injury codes are part of the group codes S00-Y99. 13 Source Death notifications; Health Statistics Analysis
Causes of death National Expatriate By Gender By Age Group By Gender By Age Group Cases NA 0-1 1-15 15-30 30-45 45-60 60+ 0-1 1-15 15-30 30-45 45-60 60+ Codes Total 3'015 567 364 1 102 49 110 88 106 477 1'546 537 125 65 246 460 604 583 I00-I99 Diseases of the circulatory system 1'107 183 123 6 7 21 24 46 202 669 132 12 3 62 193 310 221 V00-Y99 External causes of morbidity 485 103 21 3 15 56 30 7 13 326 35 5 18 120 133 71 14 C00-D49 Neoplasms 468 91 58 7 9 12 28 93 170 149 1 15 17 37 104 145 R00-R99 Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified 151 14 16 4 2 1 23 78 43 4 1 6 27 29 54 A00-B99 Certain infectious and parasitic diseases 130 30 26 1 2 1 5 2 45 47 27 2 3 12 20 37 J00-J99 Diseases of the respiratory system 127 26 26 4 2 3 5 38 35 40 3 4 8 11 49 S00-T98 Injury, poisoning and certain other consequences of external causes 105 20 9 6 10 7 2 4 71 5 2 1 25 26 21 1 P00-P96 Certain conditions originating in the perinatal period 91 21 16 34 3 24 30 54 Q00-Q99 Congenital malformations, deformations and chromosomal abnormalities 73 16 18 1 28 3 4 22 16 30 6 1 1 K00-K95 Diseases of the digestive system 70 12 13 4 2 1 1 5 12 31 14 3 1 1 11 11 18 N00-N99 Diseases of the genitourinary system 62 15 15 1 1 1 3 24 16 16 1 2 11 18 E00-E89 Endocrine, nutritional and metabolic diseases 61 17 9 2 1 1 2 4 16 21 14 2 2 2 3 11 15 G00-G99 Diseases of the nervous system 30 9 2 1 2 3 1 2 2 9 10 2 9 4 1 3 O00-O99 Pregnancy, childbirth and the puerperium 22 7 6 13 4 5 8 1 M00-M99 Diseases of the musculoskeletal system and connective tissue 16 2 5 1 2 4 8 1 3 6 D50-D89 Diseases of the blood and blood-forming organs and certain disorders involving the 14 1 1 1 1 12 2 3 1 4 1 1 immune mechanism L00-L99 Diseases of the skin and subcutaneous tissue 2 2 1 1 NA 1 1 1 Note Causes of death classified according to WHO ICD-10; where Neoplasms include: malignant, benign, uncertain, and other unspecified behavior, and Injuries codes are part of the group codes S00-Y99. 14 Source Death notifications; Health Statistics Analysis
Injury deaths 2008 2009 2010 2011 2012 2013 2008 2009 2010 2011 2012 2013 2008 2009 2010 2011 2012 2013 Homicide Drowning 3% 4% Fire/Flame, Burn 4% Poisoning 4% Suicide 8% Falls/Falling Object 11% Electricity 1% Other 3% Road Traffic Injuries (RTI) 62% Cases, by Year* Mechanism 2013 2012 2011 2010 2009 2008 Road Traffic Injuries (RTI) 365 303 342 379 456 430 Falls/Falling Object 66 55 64 66 55 56 Suicide 49 62 47 42 52 66 Poisoning 24 16 7 10 12 3 Fire/Flame, Burn 22 8 18 8 25 15 Drowning 20 29 12 17 23 14 Homicide 19 12 7 10 16 11 Electricity 8 11 14 6 20 11 Other 18 18 26 13 21 17 Total 591 514 537 551 680 623 Rates per 100'000** 40 30 20 10 0 4.0 3.0 2.0 1.0 0.0 1.5 1.0 0.5 0.0 Road Traffic Injuries (RTI) Poisoning Homicide 4.0 Falls/Falling Object 3.0 2.0 1.0 0.0 2.0 1.5 1.0 0.5 0.0 1.5 1.0 0.5 0.0 Fire/Flames Electricity 4.0 3.0 2.0 1.0 0.0 2.5 2.0 1.5 1.0 0.5 0.0 3.0 2.0 1.0 0.0 Nationals Expatriates Total Suicide Drowning Other Road Traffic Deaths, N=365 Occupational Injury Deaths, N=109 Childhood Injury Deaths (0-19 yrs), N=72 Car Pedestrian Truck Bus Pickup/van/minibus 7% 6% 6% 18% 55% Falls/Falling Object Road Traffic Injuries (RTI) Suffocation Electricity 6% 5% 30% 42% Road Traffic Injuries (RTI) Falls/Falling Object Homicide 8% 8% 60% Motorcycle Bicycle All-terrain vehicle Unknown/Other 2% 1% 1% 5% Fire/Flame, Burn Drowning Other 3% 1% 14% Drowning Poisoning Other 7% 4% 13% * Definition of fatal injuries: Mortality cases with underlying cause of death codes (S00-T98) in ICD-10 Chapter 19 and external cause codes (V01-Y98) excluding complications of medical and surgical care (Y40-Y84). ** Scales differ across charts. For data source please refer to www.haad.ae/statistics-xl. 15 Source Active Surveillance. HAAD Death notification data complemented by investigation into the causes of injury using medical records and police reports - Public Health and Research Division; Health Statistics Analysis.
Communicable diseases Preventable Screened Disease 2011 2012 2013 Total National Expatriate 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+ 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+ Chickenpox 11'768 9'872 4'581 533 363 85 21 21 19 16 4 1 3 1 1 0 0 497 412 141 81 539 850 510 274 117 50 19 14 5 4 Malaria 2'731 2'719 2'203 1 1 1 22 13 10 39 548 513 341 219 161 120 119 68 21 6 Other Food Poisoning 667 1'147 1'237 292 48 15 5 20 12 14 6 4 1 2 3 264 54 16 11 33 105 97 67 57 49 32 20 6 4 Scabies 585 758 1'001 16 14 12 11 16 13 11 5 8 4 4 2 4 4 52 32 19 15 122 214 167 86 71 46 26 16 10 1 Viral Hepatitis B 673 665 699 1 1 2 6 21 48 38 27 22 10 5 8 3 13 1 6 47 82 108 78 52 41 33 26 10 10 Viral Hepatitis C 580 528 546 2 1 2 6 5 6 8 17 5 12 5 8 2 1 2 14 58 64 61 66 64 48 50 19 20 Seasonal Infuenza 282 297 410 107 34 7 4 7 5 12 7 2 1 1 1 5 10 37 19 9 3 8 23 33 25 14 9 5 8 4 10 Pulmonary Tuberculosis 380 350 311 1 2 5 3 6 3 2 3 3 2 1 8 2 4 46 64 52 27 22 14 12 13 5 11 Viral Hepatitis A 138 279 271 16 31 23 5 5 4 4 1 45 51 27 11 15 14 6 8 1 2 1 1 Typhoid Fever 394 443 248 6 2 2 1 3 3 4 2 10 15 8 6 39 48 32 20 19 13 11 4 Scarlet Fever 239 201 198 61 29 2 61 41 3 1 Mumps 194 198 174 26 15 5 3 2 1 1 3 1 1 26 32 8 1 4 17 13 3 8 1 1 2 Extra Pulmonary Tuberculosis 182 192 169 1 1 3 1 1 1 4 1 1 1 1 25 42 31 19 15 10 4 3 1 3 Syphilis 99 88 162 2 1 1 2 5 4 3 2 2 6 26 32 20 16 12 11 12 5 Other STIs 363 136 132 2 7 22 21 13 10 4 1 3 9 13 10 9 5 2 1 Measles 48 56 122 36 12 5 2 1 2 7 1 28 8 1 1 5 6 7 Brucellosis 75 135 99 2 3 2 1 1 4 2 1 1 1 1 2 3 1 10 22 11 4 12 2 8 3 2 Giardia Lambia 82 103 94 8 2 1 1 1 1 1 15 3 2 2 6 12 17 10 5 4 1 2 Gonorrhoea 42 44 92 3 2 6 15 3 5 3 2 3 1 10 15 14 6 3 1 Viral Meningitis 37 52 59 11 10 4 1 5 11 5 1 5 2 1 1 2 Whooping Cough 39 53 38 25 1 10 2 Rubella 42 18 15 1 1 1 4 3 1 4 Acute Encephalitis 10 26 11 1 1 2 1 2 1 1 1 1 Acute Flaccid Paralysis 14 21 10 1 2 1 3 1 2 Other Viral Hepatitis 1 14 5 1 3 1 Tetanus 3 2 2 1 1 Other 422 875 1'268 148 44 20 44 22 20 23 14 14 3 4 7 3 9 250 53 19 21 51 100 112 86 75 44 44 23 7 8 Note 16 Preventable: Diseases preventable by vaccination; Screened: Adult expatriates are screened on application or renewal of residence visa, some data where updated by the Communicable Diseases Department. Source HAAD infectious diseases notification data 2011-2013 BI report - Public Health and Policy; Health Statistics Analysis
Cancer incidence 2012 By nationality National 28% Expatriate 72% By gender Cancer incidence 2012 Rate per 100'000 population Total Male Female Total Male Female Total 1'729 805 924 63.3 41.8 114.4 National 481 181 300 97.1 74.9 118.3 Expatriate 1'248 624 624 55.8 37.1 112.5 Female 53% Male 47% 17 Source Cancer incidence data for 2012 are based on data as of April 2013, Cancer Prevention and Control Section, Public Health and Research Dept., Health Statistics Analysis
Cancer incidence 2012 Total Male Female National Expatriate NA Breast (Excludes Skin Of Breast C44.5) 26% 380 Hematopoietic And Reticuloendothelial Systems 29% 187 Breast (Excludes Skin Of Breast C44.5) 26% 376 115 128 127 Hematopoietic And Reticuloendothelial Systems 155 154 151 Colorectal 351 Lymph Nodes Thyroid Gland Prostate Gland Bronchus And Lung Stomach Bladder 35% 25% 35% 33% 23% 48 78 20% 56 26% 53 30% 50 426 124 157 287 Lymphoid, haematopoietic and related tissue Breast Female Genital Organs Digestive Organs Thyroid and Other Endocrine Glands Eye, Brain and Other Parts of Central Nervous System Mesothelial and soft tissue Urinary Tract Respiratory System and Intrathoracic Organs 44% 8% 11% 41% 54% 43% 54 34% 44 45% 40 15% 26 Colorectal 15% Lymph Nodes 34% Prostate Gland Bladder Bronchus And Lung 116 112 127 20% 23% 26% 153 44 43 Brain 13% 30 Stomach 29% 24 Thyroid Gland 9% 23 56 172 76 93 Hematopoietic And Reticuloendothelial Systems Lymphoid, haematopoietic and related tissue Digestive Organs Male Genital Organs Urinary Tract Eye, Brain and Other Parts of Central Nervous System Respiratory System and Intrathoracic Organs Mesothelial and soft tissue Thyroid and Other Endocrine Glands Unknown Primary Site 37% 28% 36% 33% 26% 21% 31% 56% 39 47% 34 Colorectal Thyroid Gland Lymph Nodes 51 73 Corpus Uteri 66 Ovary Cervix Uteri Stomach 46% 100 39% 64 44% 55 115 114 38% 48 45% 47 24% 37 19% 31 31% 26 235 253 Corpus Uteri 45% 47 Skin 0% 25 Pancreas 15% 20 Lip, Oral Cavity and Pharynx 19% 27 Brain 29% 17 Other Sites 22% Unknown Primary Site 449 44% 25 Other Sites 18% Bones, Joints and Articular Cartilage of Limbs 209 50% 14 Other Sites 32% 123 Lip, Oral Cavity and Pharynx Bones, Joints and Articular Cartilage of Limbs 25% 12 12 Skin Other and ill Defined- Sites 0% 14 12 Other and ill Defined- Sites 7 18 Source Cancer incidence data for 2012 are based on data reported as of April 2013, Cancer Prevention and Control Section, Public Health and Research Dept., Health Statistics Analysis Breast 2
Cancer death cases By nationality By gender Expatriate 67% National 33% Cancer death cases Rate per 100'000 population Total Male Female Total Male Female Total 388 212 176 14.2 12.2 25.8 Female 45% Male 55% National 128 78 50 25.8 32.3 19.7 By site Expatriate 260 134 126 11.6 8.0 22.7 All Male Female Trachea, bronchus and lung 11.6% Trachea, bronchus and lung 16.5% Breast 25.6% Breast 11.6% Leukaemia 13.7% Liver and intrahepatic bile ducts 8.5% Leukaemia 11.1% Liver and intrahepatic bile ducts 13.2% Leukaemia 8.0% Liver and intrahepatic bile ducts 11.1% Colorectum 9.0% Colorectum 7.4% Colorectum 8.2% Stomach 6.6% Cervix uteri 6.8% Stomach 6.4% Brain, nervous system 6.6% Stomach 6.3% Brain, nervous system 5.7% Pancreas 6.1% Trachea, bronchus and lung 5.7% Pancreas 5.1% Prostate 4.2% Ovary 5.1% Cervix uteri 3.3% Bladder 3.3% Brain, nervous system 4.5% Kidney, renal pelvis and ureter 2.6% Multiple myeloma 3.3% Pancreas 4.0% Other 23.4% Other 17.5% Other 18.2% 19 Note Source Data need to be interpreted with caution, due to undercounting and ambiguity about the overall population (denominator) Death Notifications 2013, Health Statistics Analysis
Cancer death cases by age group 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 60 50 40 30 20 10 0 9 9 5 0.0 0.0 0.1 3 0.0 6 0.0 45 40 22 16 17 18 6 0.4 0.6 0.0 0.0 0.1 0.1 0.1 Cases Rate per 1000 48 1.5 47 3.3 41 4.7 5.7 28 3.8 11 8.1 18 9.0 8.0 7.0 6.0 5.0 4.0 3.0 2.0 1.0 0.0 Age %National %Female 0-4 11% 22% 5-9 40% 60% 10-14 0% 22% 15-19 67% 33% 20-24 33% 33% 25-29 31% 63% 30-34 33% 33% 35-39 0% 53% 40-44 22% 50% 45-49 0% 59% 50-54 29% 47% 55-59 23% 50% 60-64 17% 58% 65-69 34% 43% 70-74 54% 41% 75-79 39% 29% 80-84 73% 36% 85+ 78% 28% Note Data need to be interpreted with caution, due to undercounting and ambiguity about the overall population (denominator). 20 Source Death Notifications 2013, Health Statistics Analysis
Population Financing Episodes Payers Claims Providers 21
Episodes by type, setting and nationality Clinic Inpatient ER N/A Center National Hospital Outpatient Expatriate Provider type Setting Nationality 2013 SEHA 2012 SEHA 2011 SEHA 2010 SEHA Total 14'344'192 35% 12'765'198 37% 11'361'157 37% 10'998'469 34% Hospital 6'969'966 39% 6'311'459 40% 5'774'551 40% 5'954'723 38% Inpatient 193'996 61% 163'859 59% 130'219 65% 136'725 63% ER 64'967 88% 60'124 88% 45'138 94% 36'576 95% National 26'492 95% 29'886 94% 21'216 97% 18'311 98% Expatriate 25'281 86% 26'102 87% 21'232 92% 17'469 95% N/A 13'194 80% 4'136 43% 2'690 76% 796 22% Non-ER 129'029 47% 103'735 42% 85'081 49% 100'149 51% National 40'941 63% 33'484 66% 28'894 67% 40'878 75% Expatriate 56'931 41% 44'576 37% 40'135 41% 43'793 45% N/A 31'157 37% 25'675 21% 16'052 39% 15'478 4% Outpatient 6'775'970 38% 6'147'600 39% 5'644'332 40% 5'817'998 38% ER 728'900 72% 828'293 81% 655'394 97% 575'654 95% National 365'826 78% 440'637 87% 354'837 99% 321'781 96% Expatriate 330'358 66% 368'230 75% 297'177 96% 251'751 93% N/A 32'717 64% 19'426 46% 3'380 61% 2'123 61% Non-ER 6'047'070 34% 5'319'307 33% 4'988'938 32% 5'242'343 31% National 1'935'277 57% 1'779'900 58% 1'647'896 57% 1'875'221 53% Expatriate 3'695'273 24% 3'121'611 22% 2'907'096 22% 3'000'493 21% N/A 416'520 14% 417'796 6% 433'946 2% 366'629 2% Centre 6'765'800 35% 5'860'605 38% 5'049'446 38% 4'528'463 31% National 3'107'622 54% 2'771'498 60% 2'269'165 63% 1'974'079 54% Expatriate 3'366'210 19% 2'794'952 19% 2'497'339 19% 2'340'605 15% N/A 291'969 11% 294'155 5% 282'941 1% 213'779 1% Clinic 608'425 0% 593'134 3% 537'160 2% 515'283 1% National 137'855 1% 131'091 5% 103'564 7% 107'613 2% Expatriate 444'167 0% 425'743 2% 394'009 0% 380'371 0% N/A 26'403 0% 36'300 1% 39'588 0% 27'298 0% Notes An Episode is an inpatient Encounter or a set of outpatient Encounters linked to the same clinical case based on the patient (identified by insurance member ID), and principal diagnosis. An Episode clinician is the clinician responsible for consultation. Episodes are attributed to facility types according to Episode Clinician facility as per clinician licensing database. Non-SEHA ER Episodes are underrepresented because of miscoding of ER Encounter types as outpatient. 2010 data represents estimates based on Encounters reported in 2010 eclaims and Encounter/Episode ratios. SEHA episodes include Self-pay. Centres and Clinics episodes are outpatients. 22 Source Cube 2013; Health Statistics Analysis
Episodes by diagnosis group, % of volume 23 Outpatient Inpatient Total Non-ER ER Non-ER ER % of Total Episodes 100 93.8 4.6 0.9 0.7 Signs, symptoms and ill-defined conditions 19.1 19.0 21.9 27.3 15.4 Respiratory infections 11.1 10.9 16.8 3.4 6.2 Musculoskeletal diseases 8.7 8.9 6.2 2.8 2.3 Endocrine disorders excluding diabetes 6.8 6.9 3.9 8.8 12.2 Respiratory diseases 6.7 6.8 5.9 3.8 5.0 Digestive diseases 6.7 6.7 7.2 7.5 8.6 Cardiovascular diseases 4.8 4.8 3.5 5.4 8.2 Nutritional deficiencies 4.5 4.7 1.6 3.6 3.5 Infectious and parasitic diseases 4.5 4.6 2.7 2.9 4.7 Genitourinary diseases 4.4 4.4 4.4 3.6 4.8 Skin diseases 4.1 4.2 2.7 1.6 2.1 Diabetes mellitus 3.8 3.9 2.7 3.0 5.1 Sense organ diseases 3.5 3.6 2.4 1.1 1.3 Injuries 3.2 2.8 11.5 2.5 5.9 Neuropsychiatric conditions 2.5 2.5 2.1 2.6 4.8 Oral conditions 2.5 2.6 0.8 0.4 0.4 Maternal and Perinatal conditions 2.1 1.9 2.7 16.6 6.0 Cancer 0.4 0.4 0.3 1.7 1.4 Congenital anomalies 0.3 0.3 0.1 1.4 0.9 RTA 0.1 0.0 0.7 0.2 1.1 100.0 100.0 100.0 100.0 100.0 Notes Episodes are attributed to diagnosis groups according to principal diagnoses. Data should be interpreted with caution, particularly for categories with low counts. Source Cube 2013; Health Statistics Analysis; diagnosis groups based on WHO classification of diagnoses ICD 9
Episodes by diagnosis group, % of value Total Outpatient Inpatient 100.0% 66.8% 33.2% Break down * Break down * Procedures Drugs Supplies Services DRG Procedures Services Drugs Supplies % of Total value 100 66.0 27.3 4.0 2.7 100 61.0 18.1 14.1 4.1 2.6 Signs, symptoms and ill-defined conditions 20.1 20.1 12.6 3.9 1.0 2.6 20.1 11.9 4.2 1.4 2.5 0.1 Diabetes mellitus 8.5 12.0 5.7 5.5 0.9 0.0 1.3 0.6 0.3 0.1 0.2 0.1 Cardiovascular diseases 7.5 5.8 3.1 2.4 0.3 0.0 11.1 7.9 1.0 1.8 0.0 0.4 Respiratory infections 6.9 8.0 5.3 2.6 0.0 0.0 4.7 3.0 1.3 0.3 0.1 0.0 Musculoskeletal diseases 6.5 7.6 5.7 1.7 0.1 0.0 4.4 1.8 0.9 0.3 0.2 1.2 Maternal and Perinatal conditions 5.8 3.0 2.7 0.3 0.0 0.0 11.6 10.6 0.6 0.4 0.0 0.0 Genitourinary diseases 4.9 5.1 4.0 1.0 0.1 0.0 4.6 2.0 1.9 0.6 0.0 0.1 Digestive diseases 4.7 3.7 2.5 1.1 0.0 0.0 6.7 4.6 1.5 0.5 0.1 0.1 Oral conditions 4.6 6.6 6.5 0.1 0.0 0.0 0.6 0.2 0.3 0.1 0.0 0.0 Endocrine disorders excluding diabetes 4.5 5.1 2.9 2.1 0.1 0.0 3.4 2.4 0.3 0.2 0.5 0.0 Respiratory diseases 4.4 4.0 2.4 1.4 0.2 0.0 5.2 2.7 1.0 1.5 0.0 0.1 Neuropsychiatric conditions 4.4 3.4 1.8 1.1 0.5 0.0 6.4 1.5 0.6 4.0 0.1 0.3 Injuries 4.1 2.3 1.9 0.3 0.1 0.0 7.7 4.7 1.9 1.0 0.0 0.1 Infectious and parasitic diseases 3.2 2.8 1.8 1.0 0.0 0.0 3.8 3.2 0.3 0.3 0.0 0.0 Sense organ diseases 3.1 3.3 2.5 0.4 0.4 0.0 2.6 0.4 1.3 0.6 0.2 0.2 Skin diseases 2.4 3.0 2.1 0.9 0.1 0.0 1.1 0.5 0.4 0.1 0.0 0.0 Cancer 2.1 1.8 0.8 1.0 0.1 0.0 2.6 1.9 0.2 0.4 0.1 0.0 Nutritional deficiencies 1.4 1.9 1.5 0.4 0.0 0.0 0.2 0.2 0.1 0.0 0.0 0.0 Congenital anomalies 0.8 0.4 0.2 0.1 0.1 0.0 1.8 1.0 0.1 0.6 0.0 0.0 RTA 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 * Breakdown values reflect proportions of the total value (claimed amount) of each grouping (Outpatient and Inpatient) 24 Notes Episodes are attributed to diagnosis groups according to principal diagnoses. Data should be interpreted with caution, particularly for categories with low counts. Source Cube 2013; Health Statistics Analysis; diagnosis groups based on WHO classification of diagnoses ICD 9.
Activities by classification type, % of value Drug 20% Service 7% HCPCS 4% Dental 4% DRG 21% * Dark area indicates proportion of outpatients CPT 44% Current Procedural Terminology (CPT) Sections 100% OP* Drug 100% OP* Pathology & Laboratory 39.7% Antineoplastic And Immunomodulating Agents 15.7% Evaluation & Management (E&M) 36.8% Cardiovascular System 13.9% Diagnostic Ultrasound 7.2% Alimentary Tract And Metabolism (Excluding Drugs Used In Diabetes) 12.7% Radiology 5.5% Drugs used in diabates 12.5% Eye & Ocular Adnexa 1.7% Antiinfectives For Systemic Use 11.2% Integumentary 1.4% Blood And Blood Forming Organs 8.1% Musculoskeletal 1.4% Respiratory System 8.1% Respiratory System 1.4% Musculo-Skeletal System 4.7% Digestive System 1.2% Nervous System 4.5% Urinary System.8% Dermatologicals 2.2% Nuclear Medicine.8% Genito-Urinary System And Sex Hormones 2.1% Auditory System.4% Sensory Organs 1.8% Cardiovascular System.3% Systemic Hormonal Preparations, Excluding Sex Hormones And Insulins 1.4% Radiation Oncology.3% Various.9% Female Genital System.3% Antiparasitic Products, Insecticides And Repellents.2% Maternity Care & Delivery.3% Male Genital System.2% DRG 100% OP* Nervous System.1% Newborns & Other Neonates 19.1% Breast Mammography.2% Respiratory System 13.7% Other CPT.1% Childbirth 13.6% Circulatory System 10.6% Digestive System 7.9% Service Codes ** 100% OP* Musculoskeletal System & Connective Tissue 6.4% Per Diem - Long Term Stay 38.5% Nervous System 4.1% Per Diem - Haemodialysis 25.6% Female Reproductive System 3.2% Per Diem - Day Stay (Day care) Surgical Case - Inclusive 13.9% Skin, Subcutaneous Tissue & Breast 3.2% Outlier Payment 10.0% Ear, Nose, Mouth & Throat 3.0% Per Diem - Short Stay 6.8% Infectious & Parasitic Diseases Of Systemic Or Unspecified Sites 2.7% Per Diem - Day Stay (Day care) Medical Case - Inclusive 1.1% Hepatobiliary System & Pancreas 2.6% Per Diem - ICU/CCU - Daily Rate (Day 1 to 7).5% Urinary Tract 2.6% Comprehensive Screening Evaluation and Management by Clinician.4% Endocrine, Nutritional & Metabolic Systems 2.1% Per Diem - Automated Peritoneal Dialysis.4% Diseases & Disorders Of Blood, Blood Forming Organs, Immunological System 1.1% Per Diem - Ward or Shared Room - Daily Rate (Day 1 to 3).3% Myeloproliferative System & Poorly Differentiated Neoplasms 1.1% Per Diem Intensive - Care Unit.2% Mental Diseases & Disorders 1.0% Per Diem - NICU - Daily Rate (Day 22 and More).2% Male Reproductive System.6% Per Diem - NICU - Daily Rate (Day 1 to 7).2% Injuries, Poisonings & Toxic Effects Of Drugs.5% Non-Surgical Cleansing of a Wound.2% Eye.2% Room and Board: First Class Room.2% Other DRG.8% Operating Room and Services.2%.0% Intensive Care Unit.2% Dental 100% OP* Per Diem - Ward or Shared Room - Daily Rate (Day 4 to 8).1% Restoration 35.4% Neonatal Intensive Care Unit.1% Diagnostic 11.7% Per Diem - Ward or Shared Room - Daily Rate (Day 8 and More).1% Oral And Maxillofacial 10.9% Per Diem - SCU - Daily Rate (Day 1 to 3).1% Orthodontics 10.0% Per Diem - PICU - Daily Rate (Day 22 and More).1% Endodontics 9.2% Per Diem - NICU - Daily Rate (Day 8 to 14).1% Adjunctive General Procedures 9.0% Operating Room Services - General Classification.1% Prevention 6.4% Per Diem - Special Care Baby Unit.0% Fixed Prosthodontic Procedure 4.8% Other services.4% Periodontics 2.0% Removable Prosthodontic Procedure 0.7% Notes Not all drugs have been mapped to the appropriate ATC code http://en.wikipedia.org/wiki/atc_code_a02; HCPCS CMS Hospital Outpatient Payment system includes 90% unclassified drugs. **Service codes are an Abu Dhabi Emirate specific classification maintained by HAAD HSF to complement the CPT classification for billing purposes. DRG: Diagnosis-Related Group. 25 Source Cube 2013; Health Statistics Analysis
Population Financing Episodes Payers Claims Providers 26
Providers Store 4% Clinic 21% Other 5% Hospital 3% Pharmacy 31% Centers (various) 36% Facilities Clinicians Total SEHA Abu Dhabi Eastern Western Total Physicians SEHA Dentists SEHA Nurses& Pharmacists Alternative SEHA AHP SEHA Midwifes Medicine SEHA Total 1'626 10% 1'102 441 83 30'083 6'864 43% 1'220 21% 14'235 49% 5'332 40% 2'396 30% 36 0% Hospital 41 32% 22 13 6 16'915 4'536 53% 214 21% 9'375 60% 2'753 58% 33 45% 4 0% Centers (various) 587 13% 418 148 21 6'265 1'647 24% 869 20% 2'172 32% 1'542 32% 4 75% 31 0% Center 411 11% 295 105 11 5'519 1'567 24% 867 20% 1'952 29% 1'113 37% 3 100% 17 0% Mobile 16 56% 12 3 1 23 1 100% 8 50% 14 93% Rehabilitation 121 1% 89 31 1 268 11 0% 1 0% 36 0% 205 2% 1 0% 14 0% Diagnostic 23 30% 14 6 3 239 48 33% 10 80% 181 29% Dialysis 10 100% 3 2 5 123 118 100% 5 100% Fertilization 6 17% 5 1 93 21 10% 48 13% 24 33% Clinic 335 1% 204 107 24 613 137 1% 89 353 1% 34 0% Pharmacy 502 14% 327 145 30 2'065 2'065 32% Store 72 8% 64 8 120 120 8% Other 89 2% 67 20 2 4'105 544 23% 48 63% 2'335 25% 1'003 7% 174 22% 1 0% National Male 337 44% 35 37% 26 4% 89 30% 3 0 Female 582 75% 103 56% 267 35% 372 55% 53 60% 0 Expatriate Male 4'130 39% 684 16% 3'220 35% 2'379 32% 1'272 27% 21 0% Growth rate (CAGR 2007-13) Female 1'811 40% 397 18% 10'718 53% 2'489 46% 1'066 32% 15 0% 2013 2012 2011 2010 2009 2008 2007 CAGR NA Male 2 100% 1 0% 2 50% 1 0% 1 0% 0 Hospital 41 39 35 33 39 37 33 3.7 Female 2 50% 0 2 0% 2 0% 1 0% 0 Centers (various) 587 540 494 429 365 386 389 7.1 Breakdown by Region Clinic 335 316 265 239 207 196 188 10.1 Abu Dhabi 4'724 35% 849 17% 9'633 44% 3'853 31% 1'613 22% 32 0% Pharmacy 502 454 427 408 405 369 358 5.8 Eastern 1'811 57% 332 24% 3'925 58% 1'245 61% 660 43% 4 0% Store 72 69 67 60 61 62 63 2.3 Western 329 76% 39 64% 677 66% 234 79% 123 68% 0 Notes Definitions of categories as per Health Facilities Licensing criteria, see www.haad.ae Behavioral Science Pavilion is considered part of SKMC as it is under SKMC management Liwa licensed as a hospital, however, doesn't have inpatients, therefore classified as a Centre Zayed Military Hospital is excluded from the Hospital list, but counted in the provider page both facility and clinicians 27 Source Clinicians licensing database; facility licensing database
Hospital labour productivity 28 Source Cube 2013; HAAD licensing database; Health Statistics Analysis
Hospitals Episodes, 000's Staff Beds Indicators Ambulances Region Hospital Inpatient Outpatient ER Non-ER ER Non-ER Total 65.0 129.0 728.9 6'047.1 16'354 4'312 171 9'202 2'669 3'864 56% * 3.7 * 93 SEHA 57.9 61.0 521.3 2'050.5 9'725 2'402 49 5'652 1'622 2'503 64% * 4.7 * 49 Eastern MF2058 Tawam 9.0 12.5 86.9 381.9 1'997 518 2 1'130 347 451 71% 5.4 6 Abu Dhabi MF1079 Al Corniche 6.2 15.5 13.4 102.6 711 143 531 37 257 61% 2.6 2 Eastern MF2057 Al Ain 11.5 9.7 82.5 301.1 1'377 317 838 222 342 80% 4.7 5 Abu Dhabi MF2006 Al Mafraq 11.5 9.6 74.0 406.2 1'691 487 1 929 274 387 56% 3.7 2 Abu Dhabi MF2007 SKMC 10.3 6.7 119.3 490.2 2'688 633 23 1'513 519 675 57% 8.3 12 Abu Dhabi MF2003 Al Rahba 4.8 3.9 66.2 121.6 580 131 3 359 87 153 64% 4.1 3 Western MF2066 Madinat Zayed 2.2 2.2 35.2 105.1 352 83 10 185 74 124 35% 3.7 6 Western MF2065 Ghayathi.7.2 13.1 38.1 87 24 2 43 18 30 57% 6.8 4 Western MF2064 Al Silla.5.2 9.7 26.2 70 21 2 37 10 29 14% 2.1 3 Eastern MF2060 Al Wagan.5.1 6.8 45.5 43 12 2 26 3 15 9% 0.8 1 Western MF2046 Delma.5.3 6.9 12.5 48 16 2 17 13 22 1% 0.1 2 Western MF2009 Al Mirfa.2.2 7.3 19.5 81 17 2 44 18 18 7% 1.1 3 Total licensed staff Physicians Dentists Nurses & Midwifes AHP &Pharmacists Bed Capacity Bed Occupancy ALOS Notes Mubadala Abu Dhabi MF2467 Health Point.0.3.0 5.7 118 24 5 54 35 80 Other 7.04 67.75 207.63 3'990.9 6'511 1'886 117 3'496 1'012 1'281 36% * 1.8* 44 Abu Dhabi MF104 Emirates French.0.1.0 53.9 91 27 3 48 13 12 8% 5.1 1 Abu Dhabi MF118 Al Noor - Khalifa St..0 6.2 9.7 466.4 535 197 9 233 96 117 34% 2.3 3 Abu Dhabi MF131 Al Salama.2 2.0 8.6 198.7 235 77 6 117 35 40 10% 0.7 4 Abu Dhabi MF1954 Life Line.0 3.7 2.6 238.9 297 99 3 153 42 25 60% 1.5 1 Abu Dhabi MF213 Dar Al Shifa.0 1.0 20.2 122.1 149 42 4 69 34 17 12% 0.7 3 Abu Dhabi MF2222 Life Line - Al Musafah.0 3.4 7.7 181.5 183 54 2 99 28 36 14% 0.5 2 Abu Dhabi MF2270 Al Noor - Airport Road.1 9.5 12.4 357.9 559 185 7 285 82 117 39% 1.8 2 Abu Dhabi MF23 Al Ahalia.0 6.1 2.5 452.3 261 107 6 98 50 50 62% 1.8 7 Abu Dhabi MF2349 Lifecare - Al Mafraq.0.1.0 57.6 78 28 1 40 9 50 Abu Dhabi MF2503 Burjeel.4 7.0 14.5 183.6 480 129 10 272 69 115 16% 0.9 Abu Dhabi MF254 Al Raha.1.5.7 59.6 52 24 7 12 9 13 8% 0.6 1 Abu Dhabi MF2934 Universal.4 1.0.0 30.7 182 69 1 76 36 31 Abu Dhabi MF3048 Provita International Medical Centre 155 5 136 14 40 24% Abu Dhabi MF3078 Long Term Custodial Care Centre 82 76 6 70 2% Abu Dhabi MF394 N M C Specialty 4.0 5.0 10.3 399.5 861 225 21 487 128 92 62% 2.3 5 Abu Dhabi MF687 Gulf Diagnostic Centre.0.8.0 213.0 152 66 5 44 37 9 2% 0.1 1 Abu Dhabi MF772 National.0.3.0 66.8 94 38 3 40 13 22 1% 0.2 1 Eastern MF1589 Al Noor - Al Ain.0 4.5 26.6 330.5 363 117 4 169 73 50 36% 1.5 2 Eastern MF1974 N M C Specialty - Al Ain 1.5 2.1 10.9 175.3 407 98 9 256 44 55 20% 1.1 1 Eastern MF2259 Al Ain Cromwell Women & Children Hospital.0 5.0 20.4 79.5 221 56 2 136 27 67 11% 0.6 1 Eastern MF233 Emirates International.0.9 33.7 47.7 109 51 40 18 25 16% 1.5 1 Eastern MF2555 Ain Al Khaleej.2.4 7.1 61.5 226 50 7 129 40 80 Eastern MF3345 Provita International Medical Centre - Al Ain 84 6 70 8 24 10% Eastern MF3590 Long Term Medical And Rehabilitation Hospital 169 10 141 18 32 6% Eastern MF404 Oasis.1 6.9 2.0 108.5 225 62 130 33 51 76% 2.0 1 Eastern MF464 Specialised Medical Care.0.3 5.6 49.6 82 30 3 31 18 21 5% 1.3 1 Western MF439 Al Rewaise.0 1.0 12.0 55.7 179 34 4 109 32 20 10% 0.7 6 Total number of beds for SEHA facilities as of July, 2014, Others as of 31st December 13 and licensed beds for the new facilities was used; Episodes are attributed to facilities according to Episode Clinician facility as per clinician licensing database, Military Hospital is excluded. * These totals exclude Western Region facilities (Average Occupancy = 28%, ALOS = 3.0) and new facilities that are still ramping up their activity with less than two years of operations (Average Occupancy = 6%, ALOS = 0.8). 29 Source Hospital submissions, Operation Centre, Clinician Licensing Database
Hospital inpatient profile by value Hospital 100 Top 5* 1st 2nd 3rd 4th 5th Tawam 16 Signs, Symptoms And Ill-Defined (23.7%) Maternal And Perinatal Conditions (11.5%) Cardiovascular Diseases (8.2%) Cancer (8.0%) Infectious And Parasitic Diseases (7.6%) SKMC 16 Cardiovascular Diseases (23.6%) Neuropsychiatric Conditions (10.3%) Congenital Anomalies (9.1%) Infectious And Parasitic Diseases (8.7%) Signs, Symptoms And Ill-Defined (8.0%) Al Mafraq 12 Injuries (18.4%) Signs, Symptoms And Ill-Defined (17.1%) Cardiovascular Diseases (15.7%) Maternal And Perinatal Conditions (10.1%) Digestive Diseases (6.2%) Al Ain 10 Signs, Symptoms And Ill-Defined (19.0%) Cardiovascular Diseases (14.4%) Maternal And Perinatal Conditions (12.5%) Injuries (10.9%) Digestive Diseases (8.1%) Al Corniche 8 Signs, Symptoms And Ill-Defined (52.5%) Maternal And Perinatal Conditions (45.8%) Genitourinary Diseases (1.1%) Cancer (0.3%) Endocrine Disorders (0.2%) Al Noor - Airport Road 5 Maternal And Perinatal Conditions (27.4%) Signs, Symptoms And Ill-Defined (27.3%) Cardiovascular Diseases (14.5%) Digestive Diseases (8.5%) Injuries (4.1%) Al Rahba 5 Signs, Symptoms And Ill-Defined (29.3%) Maternal And Perinatal Conditions (22.8%) Cardiovascular Diseases (10.1%) Injuries (8.1%) Infectious And Parasitic Diseases (7.6%) N M C Specialty 3 Cardiovascular Diseases (24.3%) Maternal And Perinatal Conditions (12.8%) Signs, Symptoms And Ill-Defined (11.4%) Digestive Diseases (11.4%) Respiratory Infections (9.1%) Burjeel 3 Maternal And Perinatal Conditions (18.9%) Cardiovascular Diseases (18.3%) Signs, Symptoms And Ill-Defined (12.8%) Digestive Diseases (11.3%) Respiratory Diseases (6.5%) Al Noor - Khalifa St. 3 Maternal And Perinatal Conditions (25.4%) Signs, Symptoms And Ill-Defined (19.9%) Endocrine Disorders (12.3%) Digestive Diseases (11.9%) Cardiovascular Diseases (8.7%) Provita International Medical Centre 2 Neuropsychiatric Conditions (68.0%) Injuries (18.2%) Respiratory Diseases (6.8%) Congenital Anomalies (5.2%) Cardiovascular Diseases (1.3%) Al Ahalia 2 Cardiovascular Diseases (21.7%) Digestive Diseases (14.4%) Maternal And Perinatal Conditions (11.7%) Musculoskeletal Diseases (10.0%) Signs, Symptoms And Ill-Defined (9.0%) Madinat Zayed 2 Maternal And Perinatal Conditions (13.4%) Injuries (12.9%) Cardiovascular Diseases (12.7%) Signs, Symptoms And Ill-Defined (12.5%) Digestive Diseases (10.9%) Oasis 1 Maternal And Perinatal Conditions (42.5%) Signs, Symptoms And Ill-Defined (37.2%) Respiratory Infections (6.0%) Digestive Diseases (4.9%) Respiratory Diseases (3.0%) Al Noor - Al Ain 1 Maternal And Perinatal Conditions (18.4%) Digestive Diseases (15.6%) Musculoskeletal Diseases (12.8%) Signs, Symptoms And Ill-Defined (11.3%) Cardiovascular Diseases (10.7%) Long Term Medical And Rehabilitation Hospital 1 Neuropsychiatric Conditions (62.4%) Cardiovascular Diseases (20.0%) Congenital Anomalies (6.3%) Sense Organ Diseases (5.2%) Respiratory Diseases (4.0%) N M C Specialty - Al Ain 1 Cardiovascular Diseases (18.9%) Maternal And Perinatal Conditions (18.4%) Digestive Diseases (14.6%) Signs, Symptoms And Ill-Defined (13.9%) Musculoskeletal Diseases (8.5%) Behavioral Sciences Pavilion 1 Neuropsychiatric Conditions (99.0%) Oral Conditions (1.8%) Signs, Symptoms And Ill-Defined (0.6%) Cardiovascular Diseases (0.3%) Infectious And Parasitic Diseases (0.1%) Life Line 1 Maternal And Perinatal Conditions (19.2%) Digestive Diseases (18.9%) Cardiovascular Diseases (15.9%) Signs, Symptoms And Ill-Defined (11.5%) Respiratory Infections (6.2%) Al Ain Cromwell Women & Children Hospital 1 Maternal And Perinatal Conditions (46.0%) Signs, Symptoms And Ill-Defined (22.3%) Respiratory Infections (9.9%) Digestive Diseases (9.1%) Respiratory Diseases (7.5%) Life Line - Al Musafah 1 Digestive Diseases (22.9%) Cardiovascular Diseases (21.4%) Respiratory Infections (15.8%) Respiratory Diseases (9.0%) Infectious And Parasitic Diseases (6.2%) Al Salama 1 Musculoskeletal Diseases (17.3%) Maternal And Perinatal Conditions (15.6%) Digestive Diseases (14.7%) Signs, Symptoms And Ill-Defined (13.6%) Respiratory Infections (9.1%) Al Rewaise Maternal And Perinatal Conditions (29.1%) Signs, Symptoms And Ill-Defined (18.9%) Digestive Diseases (14.9%) Cardiovascular Diseases (12.5%) Respiratory Infections (10.4%) Provita International Medical Centre - Al Ain Neuropsychiatric Conditions (41.8%) Cardiovascular Diseases (23.8%) Congenital Anomalies (16.7%) Injuries (16.2%) Maternal And Perinatal Conditions (1.6%) Emirates International Endocrine Disorders (31.3%) Digestive Diseases (15.5%) Maternal And Perinatal Conditions (12.0%) Signs, Symptoms And Ill-Defined (9.3%) Cardiovascular Diseases (6.8%) Ghayathi Cardiovascular Diseases (22.3%) Digestive Diseases (13.7%) Respiratory Infections (13.3%) Neuropsychiatric Conditions (9.9%) Maternal And Perinatal Conditions (8.3%) Dar Al Shifa Maternal And Perinatal Conditions (37.1%) Signs, Symptoms And Ill-Defined (18.9%) Digestive Diseases (16.8%) Respiratory Infections (6.3%) Respiratory Diseases (5.2%) Gulf Diagnostic Centre Respiratory Diseases (35.6%) Cardiovascular Diseases (10.0%) Genitourinary Diseases (9.0%) Musculoskeletal Diseases (8.3%) Digestive Diseases (7.7%) Al Raha Respiratory Diseases (17.6%) Maternal And Perinatal Conditions (15.8%) Respiratory Infections (14.8%) Musculoskeletal Diseases (11.7%) Signs, Symptoms And Ill-Defined (10.1%) Al Wagan Respiratory Infections (53.2%) Respiratory Diseases (13.6%) Endocrine Disorders (9.9%) Neuropsychiatric Conditions (6.3%) Digestive Diseases (6.2%) Al Silla Maternal And Perinatal Conditions (21.5%) Cardiovascular Diseases (16.3%) Respiratory Infections (12.0%) Signs, Symptoms And Ill-Defined (11.5%) Neuropsychiatric Conditions (11.4%) Al Mirfa Maternal And Perinatal Conditions (31.4%) Signs, Symptoms And Ill-Defined (15.2%) Cardiovascular Diseases (15.1%) Respiratory Infections (10.1%) Digestive Diseases (5.4%) Specialised Medical Care Genitourinary Diseases (24.4%) Respiratory Infections (23.0%) Maternal And Perinatal Conditions (16.8%) Respiratory Diseases (13.8%) Digestive Diseases (9.7%) Ain Al Khaleej Endocrine Disorders (24.4%) Digestive Diseases (16.8%) Respiratory Infections (14.6%) Respiratory Diseases (8.7%) Signs, Symptoms And Ill-Defined (6.2%) Delma Maternal And Perinatal Conditions (24.3%) Signs, Symptoms And Ill-Defined (19.7%) Digestive Diseases (14.1%) Infectious And Parasitic Diseases (9.4%) Cardiovascular Diseases (6.9%) National Digestive Diseases (30.0%) Injuries (13.6%) Genitourinary Diseases (12.3%) Cardiovascular Diseases (10.4%) Skin Diseases (8.2%) Emirates French Injuries (14.6%) Maternal And Perinatal Conditions (13.9%) Genitourinary Diseases (13.9%) Respiratory Diseases (11.9%) Digestive Diseases (11.4%) Lifecare - Al Mafraq Infectious And Parasitic Diseases (80.5%) Respiratory Diseases (17.9%) Respiratory Infections (1.6%) 0 (0.0%) 0 (0.0%) Universal Cardiovascular Diseases (16.5%) Neuropsychiatric Conditions (15.1%) Injuries (13.6%) Genitourinary Diseases (12.1%) Respiratory Infections (9.5%) * Dark area in pie chart represents share of top 5 Diagnosis groups within the total value of provider s services 30 Note Attribution to diagnosis groups is based on principal diagnosis and does not necessarily reflect the full spectrum of services provided by respective healthcare facilities Source Cube 2013; Health Statistics Analysis; diagnosis groups based on WHO classification of diagnoses ICD 9
Bed capacity by bed type Facility Acute Acute Intermediate Acute Specialty Adult Critical Care Pediatric Critical Care SubAcute Designation Subset General Med / Surg Obstetrics/GYN Paediatric VIP Med/Surg Intermediate Care Unit Pediatric Intermediate Care Special Care Baby Unit Total All 3'864 SEHA 2'503 1052 306 270 80 41 13 88 23 118 10 61 16 88 16 105 26 156 24 10 Telemetry Al Ain 342 149 24 48 8 8 16 20 10 14 6 33 6 Al Corniche 257 174 11 4 35 4 29 Al Mafraq 387 198 21 46 12 14 26 10 17 16 16 11 Al Mirfa 18 16 2 Al Rahba 153 46 23 21 2 10 18 33 Al Silla 29 27 2 Al Wagan 15 15 Delma 22 13 2 2 3 2 Ghayathi 30 25 2 3 Madinat Zayed 124 44 24 22 11 8 7 4 4 SKMC 675 292 69 14 21 7 23 29 30 29 20 123 18 Tawam 451 227 38 62 22 5 6 15 14 20 26 6 10 Other 1'361 N M C Specialty 92 51 12 11 4 1 Al Noor 117 46 38 3 5 15 Al Noor - Airport Road 117 38 30 12 4 6 10 Burjeel Hospital 115 35 15 14 6 Al Noor - Al Ain 50 27 11 1 2 3 3 Life Line Hospital Al Musafah 36 19 1 N M C Specialty - Al Ain 55 18 10 6 3 3 4 Al Rewaise 20 14 4 Dar Al Shifaa 17 12 Emirates International 25 12 Gulf Diagnostic Centre 9 8 Specialized Medical Care 21 7 Al Ain Cromwell Women & Childrens Hospital 67 6 2 Provita International Medical Centre 40 40 Al Salama 40 10 1 Al Ahalia 50 10 5 10 2 Oasis 51 37 10 4 Emirates French 12 5 LLH 25 3 4 Al Raha 13 12 Disabled Custodial Care Centre 70 70 Provita International Medical Centre - Al Ain 24 24 Long Term Medical And Rehabilitation 32 38 National 22 16 Lifecare* 50 Ain Al Khaleej Hospital* 80 Universal* 31 Health Point* 80 Thereof: Isolation Burn Unit Cardiac Care Unit (CCU) Medical Intensive Care Unit Medical/ Surgical ICU Surgical Intensive Care Unit NICU PICU Behavioural Sciences Long-term-care/ LTVU Pediatric Extended Care Unit (PECU) Notes SEHA Facilities bed capacity as of July 2013, Other than SEHA bed capacity as of 31st December 2013 Bed type breakdown for Other than SEHA facilities does not match with the totals due to the different reporting time period and the change in bed type classification during 2012 and 2013. * Licensed beds are reported for new facilities. 31 Source Operation Centre, SEHA
Bed occupancy 100% CICU 100% NICU SEHA Other 75% 75% 50% 50% 25% 25% 0% 100% 75% 50% 25% CCU 0% PICU 100% 75% 50% 25% 0% 100% Medical/Surgical ICU 0% 100% SCBU 75% 75% 50% 50% 25% 25% 0% Notes Jan Apr Jul Oct Presented bed occupancy is for the selected bed type Incomplete submissions from some facilities Optimal occupancy is 85% for normal beds and 75% for critical care beds 0% Jan Apr Jul Oct 32 Source 2013 Bed census (HAAD Operation Centre)
Centres & clinics SEHA Other Notes Non-SEHA facilities with more than 10 clinicians; Some centres Episodes were reported under the managing hospital Includes estimates based on the number of clinicians and average productivity Physicians Dentists Nurses AHP&Pharmacists Episodes (best estimate) Region Facility Episodes (best estimate) Region Facility Episodes (best estimate) Total 2'339'645 397 177 698 498 Total 5'034'581 1'387 781 1'827 1'082 Dr. Ahmed Abu Sharia Medical Centre 13'675 3 3 5 0 Abu Dhabi Baniyas 163'895 7 2 6 7 Abu Dhabi Imperial College London Diabetes Centre 123'209 56 0 33 34 Samaya Specialized Hospital 13'340 6 1 7 5 Khalifa A 146'285 24 6 37 28 Al Noor Hospital Speciality Clinics- Al Musafah 99'916 22 2 10 14 American Center For Psychiatry & Neurology 12'191 18 0 5 15 Bain Al Gesreen 120'263 30 6 41 25 Al Musaffah Al Alhli Medical Centre 73'015 9 1 4 3 Gulf International Cancer Center 11'879 5 0 6 7 Other 115'938 16 6 34 17 Proficiency Central Laboratories 62'581 4 0 0 25 Capital Medical Centre For Health Screening 11'879 5 0 10 5 Al Bateen 88'593 11 0 14 1 Prince Specialized Medical Centre 60'753 24 3 76 20 Open Mri For Spine Surgery-Abu Dhabi Branch 11'879 5 0 2 5 Shahama 69'878 17 4 22 20 Nmc Day Surgery Centre 59'397 21 4 53 15 National Petroleum Construction Company Medical Centre 11'188 2 0 15 2 Al Khalidiya Urgent Care 61'777 6 0 19 0 Al Musaffah Al Alhli Medical Centre 59'296 11 1 8 3 Al Bustan Medical Centre 10'300 4 7 8 0 Al Ettihad Urgent Care 56'617 5 0 12 3 Al Noor Hospital Clinics - Al Mussaffah 57'897 10 0 9 1 Adco Medical Centre 10'119 14 0 15 3 Al Zafarana 50'387 7 0 14 1 Advance Cure Diagnostic Centre 51'735 24 1 8 10 Dr. Firas Dental And Orthodontic Centre 9'870 0 11 3 10 Samha 46'777 9 5 18 7 Amrita Midical Centre 49'993 21 7 14 9 Alnoor Hospital Medical Center - Alsalam Living City 9'504 4 0 4 4 Al Rowda 43'457 5 0 10 2 New National Medical Centre 49'749 22 2 26 8 Fakih Medical Centre 9'504 4 0 8 0 Disease Prevention And Screening Centre 40'390 17 0 18 57 Al Salama One Day Surgery Center 47'916 21 0 21 8 Middle East Specialized Medical Centre 9'441 6 1 3 3 Al Mafraq Dental Centre 31'650 0 27 0 36 Ibn Al Nafis Medical Centre 46'241 14 2 5 14 Mezyad Medical Centre 9'218 5 1 5 0 Abu Dhabi City Dental Centre 27'273 0 30 8 10 Al Kamal Medicdal Poly Clinics 42'360 5 5 4 0 Healthway Medical Centre 8'657 4 2 7 3 Disease Prevention And Screening Centre - Mussafah 23'759 10 0 7 25 Home Health Medical Centre 40'348 7 2 6 1 Health Plus Fertility Centre 8'589 6 0 12 5 Al Zafra Dental Centre 22'471 0 10 6 11 Taha Medical Centre 40'278 10 7 8 6 Tabarak Medical Centre 7'341 3 3 5 0 Al Khatim 18'412 6 2 10 4 Al Wahda Medical Centre 39'976 6 2 5 0 Advanced Center For Day Care Surgery 6'897 8 1 6 1 Madinat Mohamed Bin Zayed Healthcare Centre 16'068 7 2 14 6 Al Borg Diagnostic Centre For Laboratories & X Ray 37289 2 0 0 20 Merhi Dental & Orthodontic Centre 6'751 0 10 2 6 Seha Dialysis Services Sheikh Khalifa Medical City 13'650 0 0 45 1 Gulf Radiology &Laboratory 36'836 4 0 0 12 Health Plus Family Health Centre 6'744 3 6 5 1 Mafraq Dialysis Centre 13'279 0 0 38 4 Cosmesurge Emarites Hospital For One Day Surgery 36'492 28 3 39 13 American Fertility Centre 6'640 8 0 23 6 Abu Dhabi Blood Bank 7'128 3 0 1 8 Abu Dhabi Marine Operating Company Clinic 35'638 15 0 10 4 Cosmesurge & Emarites Hospital For One Day Surgery Branch 6'572 5 1 9 2 Eastern Al Yahar 95'326 12 5 20 3 Harley Street Medical Centre 35'638 15 0 22 4 Abu Dhabi Knee And Sports Medicine Centre 5'816 6 0 12 6 Al Jahili 94'549 19 0 20 6 Nadia Medical Centre 34'918 7 1 7 0 Nora Medical Poly Clinics 4'788 1 4 2 4 Neima 94'446 15 3 24 9 Advanced American Dental Centre 30'886 0 13 1 7 Lotus Holistic Alternative Medical Centre 4'752 1 1 6 5 Mezyed 90'148 18 3 17 7 Al Mafraq Medical Centre 29'612 5 3 10 9 Al Reyada Medical Centre 4'672 6 2 10 3 Al Maqam 78'577 13 4 18 8 Solutions Medical Center 28'511 10 2 6 4 American Crescent Health Care Centre 4'573 6 0 8 7 Muweiji 78'041 18 7 21 20 Magrabi Specialized Hospital 26'944 20 0 27 5 Royal Spanish Center Lasik Eyes & Cosmetic 4'546 6 0 2 4 Al Masoudi Primary Health Care Centre 72'252 12 2 14 2 Al Hendawy Medical Centre 26'814 11 0 4 5 Shadi International Dental & Orthodontic Centre 4'210 0 9 4 9 Al Khabisi Clinic 64'667 11 2 14 2 Apollo Medical Centre 26'191 5 2 6 2 Dr.Munir Silwadi Dental Centre 4'089 0 11 0 6 Al Qua'A 51'495 6 2 12 5 Al Rafa Medical Centre 24'946 11 1 7 7 Canadian Medical Centre 3'862 4 2 21 11 Hili 49'165 6 1 10 2 American European Medical Centre 24'745 13 1 14 4 Adams Medical Centre 3'426 6 2 2 1 Tawam Dental Centre 42'512 0 39 0 64 Dar Alshifa Medical Centre 22'886 5 1 9 0 Mekkah Specialized Polyclinic 3'415 4 1 2 5 Niyadat 41'726 9 1 12 5 Adnoc Medical Centre 22'867 29 12 34 41 Al Ahli Specialists Medical Centre 3'013 4 2 7 0 Oud Al Toba Primary Health Care Centre 39'830 6 0 13 3 Alriyadh Medical Centre 22'629 7 4 8 0 Venecia Medical Center For Rehabilitation 2'376 1 0 5 5 Zakher 39'494 7 2 10 2 Sadd Maareb Medical Centre 22'522 7 3 6 2 National Reference Laboratory 1'436 1 0 0 18 Al Hayer 30'394 7 2 10 0 Miami Emirates Medical Complex 22'419 6 2 3 3 Other 1'424'201 283 337 393 292 SEHA Dialysis Services Tawam Hospital 28'364 0 0 14 0 Prime Medical Centre 22'045 11 1 11 4 Eastern Imperial College Diabetes Centre - Al Ain Branch 74'975 17 0 24 15 Swaihan 24'827 6 1 11 2 Well Health Medical Centre 21734 5 2 4 5 Al Sultan Advanced Medical Clinics 58'098 12 2 12 5 Remah 22'149 5 0 8 2 Almadina Medical Center For Special Clinics 21'528 9 0 2 3 Al Madar Medical Centre - Branch 53'758 14 13 27 9 Other 14'885 6 0 9 5 Zakum Development Zadco Medical Centre 21'383 8 1 4 0 Al Noor Hospital Clinics - Al Ain 42'491 12 0 4 4 Disease Prevention And Screening Centre-Alain 11'644 11 0 13 28 Remax Medical Centre 21'383 2 7 4 0 Bin Sulaiman Medical Centre 29'979 5 3 4 0 Al Khazna 9'821 3 1 9 0 Health Plus Diabetes And Endocrinology 21'383 9 0 8 8 Mubarak Medical Centre 24'364 8 3 7 3 Tawam ivf Centre 6'024 2 0 6 8 Dr. Ahmed Hassan Fikri Medical Centre 20'954 9 1 6 0 Dr. Khalid Aljamal Medical Center 17'501 8 5 12 2 Blood Bank Centre 2'376 1 0 0 15 Al Rayyan Medical Clinic 20'412 3 1 3 4 Royal Care Medical Centre 16'631 2 5 4 1 Western Al Dhafra Family Medicine Centre 42'714 10 0 19 5 Oxford Medical Centre 19'880 9 4 8 1 Fine Care Specialized Medical Centre 16'631 5 2 6 0 Liwa Hospital 21'767 8 2 16 10 Almazroui Hospital One Day Surgery 19'718 19 2 12 10 Al Khaleej Medical Centre 13'838 1 0 0 10 Other 14'506 6 0 4 12 Dar Al Mouasah Diagnostic Centre 19'448 5 0 0 13 Arabic Canadian Medical Centre 11'879 5 0 2 10 Etihad Airways Polyclinic 19'007 8 0 13 1 Alnoor Hospital Clinics - Alain-Branch 7'128 3 0 6 2 National Rehabilitation Centre 19'007 8 0 24 24 Morani Orthodontic Center & General Medical 5'731 0 9 0 4 Universal Specialty Medical Center 19'007 6 2 8 6 Emirates International Poly Clinic 5'697 4 4 5 3 Physicians Dentists Nurses AHP & Pharmacists Golden Sand Medical Centre 18'970 5 2 4 1 Cosmo Health Medical Polyclinics 4'752 1 1 11 0 Al Amal Medical Centre 16'631 6 1 6 4 Ideal Medical Center - Al Ain Branch 4'495 0 7 5 0 First Medical Center 16'631 2 5 5 0 Cosmesurge & Emirates Hospital For One Day Surgery Polyclinic 3'333 2 1 8 1 Aesthetic Skin Care Centre 16'631 4 3 6 2 Health & Beauty Polyclinic 2'402 1 4 5 5 Health & Life Medical Centre 16'631 5 2 5 1 Uae University Clinics - Tawam Clinic 2'215 1 0 20 0 Grace Medical Centre 16'631 7 0 77 9 Other 690'141 117 169 143 104 Seha Emirates One Day Surgery Centre 15'857 15 2 11 4 Western Al- Noor Hospital Clinics - Madinat Zayed 58'220 10 0 8 11 Healthplus Womens Health Centre 15'410 5 0 9 0 Alnoor Hospital Speciality Clinics - Madinet Zayed 30'534 12 4 10 1 Consultant Medical Centre 14'456 7 0 5 1 Al Noor Hospital Speciality Clinics - Almirfa 14'214 6 1 3 3 Exeter Medical Centre 14'410 18 0 4 6 Habshan Clinic 2'073 1 0 63 0 Ruwais Housing Medical Centre 14'255 4 2 18 8 Other 135'301 17 5 39 2 Physicians Dentists Nurses AHP & Pharmacists 33 Source Cube 2013; Professionals licensing database; Extrapolation and Facility submissions
Blood bank donors National Expatriate Year 2013 2012 2011 2010 2009 2008 2007 2006 Donors 33'059 26'819 27'094 25'850 24'758 21'834 19'461 16'737 National 5'747 5'077 3'794 4'240 4'116 3'832 3'311 2'664 Expatriate 27'312 21'742 23'300 21'610 20'642 18'002 16'150 14'073 14'073 16'150 18'002 20'642 21'610 23'300 21'742 27'312 Units donated 30'315 26'819 27'094 25'850 24'758 22'379 19'849 17'129 O + 11'356 10'279 10'141 9'441 8'960 8'314 7'242 6'396 A + 7'448 6'705 6'704 6'620 1'430 5'840 5'263 4'548 B + 6'384 5'364 5'740 5'423 6'421 4'294 4'040 3'396 AB + 1'843 1'555 1'767 1'727 705 1'302 1'074 857 O - 1'688 1'501 1'310 1'274 5'130 1'346 1'101 953 2'664 3'311 3'832 4'116 4'240 3'794 5'077 5'747 2006 2007 2008 2009 2010 2011 2012 2013 A - 833 705 706 711 483 667 587 501 B - 624 576 575 521 1'493 501 426 381 AB - 139 134 151 133 136 115 116 97 34 Source Abu Dhabi Blood Bank, Health Statistics Analysis
Inpatient market by value Diagnosis group 100 Top 5* 1st 2nd 3rd 4th 5th Signs, symptoms and ill-defined conditions 19 Al Corniche (21.6%) Tawam (20.2%) Al Mafraq (10.6%) Al Ain (9.4%) Al Rahba (7.0%) Maternal and Perinatal conditions 15 Al Corniche (24.2%) Tawam (12.5%) Al Noor - Airport Road (8.8%) Al Mafraq (8.0%) Al Ain (8.0%) Cardiovascular diseases 13 SKMC (28.2%) Al Mafraq (14.0%) Al Ain (10.3%) Tawam (10.2%) N M C Specialty (5.8%) Injuries 8 Al Mafraq (27.6%) SKMC (14.9%) Tawam (14.3%) Al Ain (13.1%) Neuropsychiatric conditions 7 SKMC (21.5%) Provita International Medical Centre (19.7%) Behavioral Sciences Pavilion (14.6%) Long Term Medical And Rehabilitation Hospital (12.2%) Provita International Medical Centre (5.0%) Tawam (10.8%) Digestive diseases 7 SKMC (12.8%) Al Ain (11.6%) Al Mafraq (11.1%) Tawam (9.6%) Al Noor - Airport Road (6.1%) Respiratory diseases 5 Tawam (21.4%) SKMC (21.3%) Al Mafraq (11.5%) Al Ain (10.6%) Burjeel (3.9%) Infectious and parasitic diseases 5 SKMC (28.4%) Tawam (25.7%) Al Mafraq (10.8%) Al Ain (8.0%) Al Rahba (7.3%) Musculoskeletal diseases 5 Abu Dhabi Knee And Sports Medicine Centre (44.3%) SKMC (9.6%) Tawam (6.8%) Al Mafraq (6.4%) Al Ain (6.3%) Respiratory infections 4 SKMC (14.8%) Al Ain (13.4%) Tawam (11.5%) Al Mafraq (10.5%) N M C Specialty (6.6%) Endocrine disorders excluding diabetes 4 Tawam (30.4%) SKMC (20.5%) Al Noor - Khalifa St. (9.6%) Al Mafraq (8.8%) Al Ain (5.5%) Cancer 3 Tawam (42.4%) SKMC (22.9%) Al Mafraq (12.3%) Al Ain (6.7%) N M C Specialty (2.6%) Genitourinary diseases 3 Tawam (21.2%) SKMC (13.3%) Al Mafraq (12.1%) Al Ain (9.1%) Burjeel (5.8%) Congenital anomalies 2 SKMC (65.6%) Tawam (9.9%) Provita International Medical Centre (5.3%) Long Term Medical And Rehabilitation Hospital (4.3%) Provita International Medical Centre - Al Ain (3.4%) Diabetes mellitus 1 SKMC (23.2%) Al Mafraq (21.1%) Al Ain (15.1%) Tawam (12.8%) Al Rahba (4.9%) Skin diseases 1 SKMC (20.3%) Al Mafraq (17.7%) Al Ain (13.8%) Tawam (9.0%) N M C Specialty (6.1%) Sense organ diseases 1 Al Mafraq (44.0%) Long Term Medical And Rehabilitation Hospital (12.7%) Al Ain (12.2%) SKMC (9.2%) Tawam (6.0%) Oral conditions SKMC (52.4%) Tawam (16.7%) Al Mafraq (10.1%) Behavioral Sciences Pavilion (6.8%) Al Rahba (3.0%) Nutritional deficiencies SKMC (24.2%) Tawam (17.8%) Al Mafraq (10.6%) Al Ain (8.4%) Al Noor - Airport Road (7.8%) RTA Al Rahba (43.9%) Al Mafraq (25.8%) Al Ain (15.9%) Madinat Zayed (14.3%) * Dark area in pie chart represents share of top 5 providers within the total value of diagnosis group 35 Note Attribution to diagnosis groups is based on principal diagnosis and does not necessarily reflect the full spectrum of services provided by respective healthcare facilities Source Cube 2013; Health Statistics analysis; diagnosis groups based on WHO classification of diagnoses ICD 9
Population Financing Episodes Payers Claims Providers 36
Outpatient market by value Diagnosis group 100 Top 5* 1st 2nd 3rd 4th 5th Signs, symptoms and ill-defined conditions Diabetes mellitus 10 23 Tawam (15.8%) SKMC (7.3%) Al Mafraq (4.6%) Imperial College London Diabetes Centre - Abu Dhabi (44.5%) Imperial College London Diabetes Centre - Al Ain (19.8%) Oral conditions 7 Tawam Dental Centre (9.4%) Al Mafraq Dental Centre (6.4%) SEHA Dialysis Services Sheikh Khalifa Medical City (4.2%) SKMC (3.7%) Tawam (3.2%) Al Ain (2.1%) Abu Dhabi City Dental Centre (4.3%) SEHA Dialysis Services Tawam Hospital (3.4%) Bain Al Gesreen (3.5%) Al Zafra Dental Centre (3.0%) Respiratory infections 7 Al Noor - Khalifa St. (5.4%) Al Noor - Airport Road (5.0%) N M C Specialty (3.3%) Burjeel (2.7%) Tawam (2.7%) Musculoskeletal diseases 7 SKMC (7.1%) Al Noor - Khalifa St. (5.8%) Burjeel (5.7%) Tawam (5.0%) Al Mafraq (4.8%) Genitourinary diseases 6 SKMC (7.4%) American Fertility Centre (7.3%) Tawam (5.2%) Al Noor - Khalifa St. (4.6%) Burjeel (4.5%) Cardiovascular diseases 5 SKMC (10.8%) Al Mafraq (5.6%) Al Noor - Khalifa St. (5.4%) Tawam (5.3%) Burjeel (4.9%) Endocrine disorders excluding diabetes Sense organ diseases 4 5 Tawam (20.5%) SKMC (16.1%) Samaya Specialised Hospital (12.3%) Imperial College London Diabetes Centre - Abu Dhabi (12.6%) Imperial College London Diabetes Centre - Al Ain (6.5%) Al Mafraq (5.8%) Al Noor - Khalifa St. (9.4%) Magrabi Specialised (8.1%) SKMC (6.1%) Al Mafraq (5.5%) Respiratory diseases 4 SKMC (7.6%) Al Noor - Airport Road (7.2%) Al Noor - Khalifa St. (6.9%) Tawam (4.5%) Al Noor - Al Ain (4.1%) Digestive diseases 4 SKMC (7.6%) Burjeel (6.5%) Tawam (6.3%) Gulf Diagnostic Centre (4.9%) Al Noor - Khalifa St. (4.9%) Neuropsychiatric conditions 4 Behavioral Sciences Pavilion (15.6%) SKMC (10.6%) Tawam (8.3%) Al Ain (8.3%) Al Mafraq (4.8%) Maternal and Perinatal conditions 3 Al Corniche (13.5%) Al Noor - Airport Road (9.3%) Al Noor - Khalifa St. (7.3%) Tawam (4.8%) Injuries 3 SKMC (7.0%) Al Mafraq (6.6%) Al Ain (6.1%) Al Noor - Airport Road (5.9%) Tawam (4.7%) Skin diseases 3 SKMC (8.9%) Al Noor - Khalifa St. (6.6%) Al Mafraq (5.0%) Tawam (4.4%) Al Ain (4.2%) Infectious and parasitic diseases 2 Tawam (9.4%) SKMC (7.4%) Burjeel (7.4%) Al Noor - Khalifa St. (5.4%) Al Noor - Airport Road (4.1%) Cancer 2 Tawam (25.0%) Al Mafraq (23.5%) SKMC (22.0%) Nutritional deficiencies 2 Imperial College London Imperial College London Diabetes Diabetes Centre - Al Ain (23.5%) Centre - Abu Dhabi (14.9%) Congenital anomalies SKMC (31.6%) Tawam (15.7%) Al Noor - Airport Road (8.2%) Gulf International Cancer Centre (5.3%) SKMC (7.5%) Gulf Diagnostic Centre (3.0%) Tawam (2.9%) Emirates Outreach Healthcare Services (6.0%) Tawam Molecular Imaging Centre (4.3%) Al Mafraq (5.4%) RTA SKMC (29.3%) Al Mafraq (16.0%) N M C Specialty (11.9%) Al Ain (9.5%) Al Rewaise (5.2%) Notes Pharmacies are excluded. Attribution to diagnosis groups is based on principal diagnosis and does not necessarily reflect the full spectrum of services provided by respective healthcare facilities. * Dark area in pie chart represents share of top 5 providers within the total value of diagnosis group 37 Source Cube 2013; Health Statistics analysis; diagnosis groups based on WHO classification of diagnoses ICD 9
Population Financing Episodes Payers Claims Providers 38
Claims Average Claim net per Claim (AED) (1) Claims (000) (2) Claims per member 2013 2013 2012 2011 2010 2009 2013 2012 2011 2010 2009 Inpatient 11'819 197 166 145 166 146 0.06 0.05 0.05 0.06 0.06 Inpatient Basic 9'082 44 42 39 35 25 0.03 0.03 0.03 0.03 0.03 Inpatient Enhanced 10'157 66 52 46 55 50 0.05 0.03 0.04 0.05 0.05 Inpatient Thiqa 14'438 88 72 60 76 71 0.18 0.16 0.14 0.18 0.18 Outpatient 355 21'069 19'684 17'186 12'918 10'443 6.43 6.22 6.10 4.84 4.52 Outpatient Basic 174 5'260 4'964 4'029 2'928 2'107 3.9 3.7 3.0 2.4 2.3 Outpatient Enhanced 339 8'841 7'620 6'963 4'146 3'932 6.0 5.6 6.6 4.0 4.0 Outpatient Thiqa 513 6'968 7'100 6'193 5'844 4'404 14.5 15.5 14.0 13.8 11.2 Total 462 21'266 19'850 17'331 13'084 10'589 6.5 6.3 6.1 4.9 4.6 Notes (1) Average Claim net per Claim, represents amount claimed by provider, subject to full or partial rejection by the payer (2) Numbers of claims with Encounter start date in respective years. These include electronic claims of Abu Dhabi providers for members with insurance provided by payers from outside of Abu Dhabi, self-pay and funded mandates 39 Source Cube 2013; Health Statistics Analysis
Payer members Enhanced 45% Notes Members Thiqa 15% Basic 40% Members Market Share 2013 2012 2011 2010 2009 2008 Change from 2012-2013 Contracts 2013 PPMPA (1) 2013 Total 3'307'365 3'163'795 2'812'307 2'671'391 2'312'569 2'260'749 143'570 3'321'968 2'763 Thiqa 482'452 457'845 448'143 422'239 394'618 383'795 24'607 482'803 Basic 1'335'680 1'341'405 1'306'931 1'204'418 936'207 944'344-5'725 1'340'364 602 Total Enhanced 100.0% 1'489'233 1'364'545 1'057'233 1'044'734 981'744 932'610 124'688 1'498'801 3'380 Daman 40.0% 596'056 457'637 324'083 299'089 301'447 304'649 138'419 601'230 4'450 Oman 10.7% 159'353 167'933 73'423 171'478 205'690 155'735-8'580 159'376 2'844 ADNIC 9.6% 142'373 141'486 149'904 151'654 90'190 97'058 887 142'373 4'483 Al Dhafra 8.8% 130'674 192'635 71'009 12'590 957 14'087-61'961 130'744 940 Al Hilal Takaful 3.9% 57'760 26'809 20'964 11'075 5'003 30'951 57'763 1'762 Al Wathba 2.8% 41'257 52'140 52'034 48'038 41'583-10'883 41'265 3'337 Orient 2.7% 40'842 34'580 30'476 26'742 1'524 24'337 6'262 40'844 2'548 Insurance House - PSC 2.2% 33'147 25'834 7'313 33'147 1'378 AXA 2.1% 32'007 11'938 22'532 886 3'537 3'044 20'069 32'158 4'288 Takaful Emarat 1.9% 28'795 25'365 316 1'600 16'222 12'721 3'430 28'795 1'050 Al Buhaira 1.8% 26'593 30'479 61'983 49'838 51'215 25'083-3'886 26'595 1'158 Green Crescent 1.3% 20'091 24'969 43'894 70'881 21'341-4'878 20'498 2'081 EIC 1.3% 19'877 20'849 29'691 17'721 15'167 26'517-972 19'877 2'714 Al Ain Ahlia 1.3% 18'938 8'441 4'154 24'419 23'857 4'707 10'497 18'938 2'606 Al Sagr 1.1% 16'304 19'741 15'327 27'661 94'758-3'437 16'318 2'442 Abu Dhabi Takaful 0.9% 13'281 14'086 22'233 1'131-805 13'282 4'007 Aman 0.9% 13'161 4'663 4'595 286 258 916 8'498 13'178 1'207 Qatar 0.9% 12'736 7'691 11'569 6'305 9'332 10'381 5'045 12'737 3'907 RAK 0.8% 12'049 8'331 8'966 10'508 11'368 8'827 3'718 12'152 2'464 ALICO 0.8% 11'228 11'350 8'566 10'384 1'030 6'431-122 13'532 4'412 Al Khazna 0.5% 7'293 20'039 11'532 78'147 137'648 90'229-12'746 8'518 1'545 NoorTakaful 0.5% 6'910 5'376 1'625 2'094 47 1'534 6'910 3'512 Dubai National 0.4% 5'828 65 5'763 5'828 2'648 Saudi Arabian 0.3% 4'956 3'656 2'602 2'445 469 1'300 4'968 6'834 Union 0.3% 4'867 4'092 1'344 775 4'867 3'000 Al Fujairah 0.3% 4'730 7'584 5'676 4'099 36 2'112-2'854 4'730 1'423 Al-Ittihad 0.3% 4'355 4'292 3'588 63 4'385 3'074 Arabia 0.3% 3'882 4'660 1'660 1'076 443 49-778 3'882 2'842 United 0.2% 3'408 9'409 4'012 825 3'645 1'887-6'001 3'408 2'934 Arabian Scandinavian 0.2% 3'379 4'496 26 29 1 4'489-1'117 3'386 1'493 NGI 0.2% 2'674 957 1'026 2'798 627 792 1'717 2'674 3'891 Alliance 0.2% 2'546 2'266 463 14'822 881 40'960 280 2'546 2'926 Salama 0.1% 2'133 1'508 688 622 1'726 926 625 2'133 3'289 Royal and Sun Alliance 0.1% 1'843 1'560 946 1'381 781 9 283 1'843 7'414 Dubai Insurance Co. 0.1% 1'735 1'547 337 170 2'486 188 1'749 3'958 Methaq Takaful 0.1% 1'462 386 20'659 17'002 1'076 1'462 2'208 Lebanese 0.0% 517 2'363 6'139 7'044 3'596 1'437-1'846 517 2'904 Sharjah 0.0% 193 3'332 4'110-3'139 193 674 (1) Average Premium per Member Per Annum Market share applies to Enhanced products, some of the payers reported Enhanced members from other Emirates Members of Al Watania insurance are not included The Basic Product: for individuals (including limited income investors) with limited income in accordance with the threshold set by the Regulations and dependents of non- Nationals who are not eligible to be covered by the non-national s employment based insurance The Enhanced Product: for individuals above the income threshold set by the Regulations for the Basic Product and available to all non-nationals 40 Source Cube 2013; Health Statistics Analysis
Payer claims Enhanced 40.77% Enhanced 37% Basic 13% Claim count Basic 25.51% Claim net (1) Thiqa 33.72% Thiqa 50% Claim net (1) Claim count 2013 2012 2011 2010 2009 2008 Change 2012-2013 Days to Remit (2) 2013 Average Claim net per Claim 2013 Claims per Member 2013 Total 100% 100% 100% 100% 100% 100% 6% 51 470 6.3 Thiqa 33.72% 36.42% 35.49% 45.35% 42.22% 0.00% -1% 53 695 14.7 Basic 25.51% 25.40% 23.12% 22.47% 20.12% 32.83% 7% 46 246 4.0 Total Enhanced 100% 40.77% 38.18% 41.40% 32.18% 37.66% 67.17% 14% 50 424 5.7 Daman 34.0% 13.85% 11.44% 11.65% 15.27% 15.63% 32.02% 29% 51 515 4.9 ADNIC 14.5% 5.92% 6.21% 6.89% 5.62% 0.40% 0.82% 1% 49 441 8.7 Oman 7.5% 3.04% 2.86% 2.52% 3.31% 7.61% 13.03% 13% 34 376 4.0 Al Wathba 4.8% 1.97% 2.06% 2.02% 1.33% 0.85% 0.00% 2% 99 276 10.0 Al Dhafra 4.6% 1.89% 1.83% 1.06% 0.00% 0.30% 0.80% 10% 58 267 3.0 AXA 2.6% 1.07% 1.10% 0.67% 0.00% 0.14% 0.00% 3% 47 431 7.0 Al Hilal Takaful 3.8% 1.57% 1.01% 0.80% 0.32% 0.00% 0.00% 65% 62 281 5.7 Saudi Arabian 1.5% 0.63% 0.45% 0.33% 0.13% 0.01% 0.09% 50% 610 27 Qatar 2.6% 1.07% 0.93% 0.82% 0.26% 0.14% 0.92% 22% 60 335 17.6 Insurance House - PSC 3.0% 1.22% 0.57% 0.00% 0.00% 0.00% 0.00% 126% 243 7.7 Takaful Emarat 2.5% 1.02% 0.28% 0.03% 0.00% 0.00% 0.00% 283% 38 284 7.4 EIC 2.5% 1.02% 1.14% 1.24% 0.51% 0.66% 1.81% -5% 62 276 10.7 ALICO 1.5% 0.61% 0.65% 1.17% 0.29% 1.18% 1.19% 0% 122 423 11.4 Al Ain Ahlia 1.6% 0.63% 0.50% 0.97% 0.75% 0.69% 0.16% 35% 58 373 7.0 Orient 1.5% 0.62% 0.60% 0.99% 0.36% 3.46% 3.34% 10% 48 356 3.2 Abu Dhabi Takaful 1.5% 0.62% 0.66% 0.78% 0.40% 0.46% 1.18% 0% 320 9.8 Green Crescent 1.1% 0.47% 1.16% 3.77% 1.12% 0.63% 0.00% -57% 75 294 4.9 RAK 1.2% 0.49% 0.28% 0.50% 0.31% 0.38% 0.73% 85% 109 277 8.6 Al Sagr 1.0% 0.42% 0.49% 0.79% 0.02% 3.05% 6.65% -7% 83 318 5.5 Aman 1.1% 0.46% 0.15% 0.09% 0.00% 0.02% 0.00% 235% 99 212 7.3 Al Buhaira 0.9% 0.36% 0.70% 1.50% 0.98% 0.79% 1.38% -45% 168 268 2.8 NGI 0.6% 0.23% 0.31% 0.35% 0.01% 0.02% 0.06% -22% 52 367 18.1 NoorTakaful 0.5% 0.20% 0.17% 0.17% 0.06% 0.01% 0.00% 24% 53 325 6.1 Dubai Insurance Co. 0.4% 0.15% 0.49% 0.14% 0.00% 0.00% 0.00% -68% 41 401 18.0 Arabia 0.4% 0.15% 0.07% 0.15% 0.07% 0.01% 0.03% 129% 68 403 7.9 Royal and Sun Alliance 0.2% 0.09% 0.04% 0.04% 0.03% 0.01% 0.00% 112% 641 10.1 United 0.4% 0.18% 0.25% 0.17% 0.00% 0.16% 0.07% -26% 55 321 10.8 Al Khazna 0.5% 0.19% 0.65% 0.57% 0.85% 0.75% 2.51% -70% 192 285 5.3 Al-Ittihad 0.3% 0.14% 0.16% 0.04% 0.00% 0.00% 0.00% -9% 164 324 6.7 Union 0.2% 0.10% 0.03% 0.05% 0.00% 0.00% 0.00% 312% 75 320 4.3 Alliance 0.2% 0.07% 0.06% 0.07% 0.00% 0.17% 0.00% 32% 47 282 5.9 Salama 0.1% 0.04% 0.04% 0.05% 0.02% 0.01% 0.12% 31% 175 426 4.4 Arabian Scandinavian 0.3% 0.11% 0.10% 0.03% 0.00% 0.00% 0.06% 8% 59 137 6.6 Al Fujairah 0.1% 0.05% 0.07% 0.08% 0.01% 0.07% 0.09% -27% 78 271 2.2 Sharjah 0.1% 0.06% 0.34% 0.15% 0.00% 0.00% 0.00% -82% 211 62 Methaq Takaful 0.1% 0.04% 0.24% 0.67% 0.09% 0.00% 0.00% -84% 118 320 5.0 Dubai National 0.1% 0.03% 0.00% 0.00% 0.00% 0.00% 0.00% 5728% 63 310 1.2 Lebanese 0.1% 0.01% 0.08% 0.11% 0.04% 0.06% 0.01% -83% 44 271 5.0 Notes (1) Claim net represents amount claimed by provider, subject to full or partial rejection by the payer (2) Days to Remit is measured as average number of days to submit AED 1 from first Claim Submission Date to first Remittance Date Claims of Al Watania Insurance are not included; The Basic Product: for individuals (including limited income investors) with limited income in accordance with the threshold set by the Regulations dependents of non- Nationals who are not eligible to be covered by the non-national s employment based insurance; the Enhanced Product: for individuals above the income threshold set by the Regulations for the Basic Product and available to all non-nationals 41 Source Cube 2013; Health Statistics Analysis
Population Financing Episodes Payers Claims Providers 42
Enhanced plans premiums Average Gross Premium for Enhanced Product 7'893AED 4'456AED 3'458AED 2'527AED 680AED [600-999 AED] 1'533AED [1'000-1'999 AED] [2'000-2'999 AED] [3'000-3'999 AED] [4'000-4'999AED] Number of Contracts [5'000+ AED] 434'900 170'605 225'942 201'646 136'515 328'980 Notes This data is only for Enhanced products The Enhanced Product: for individuals above the income threshold set by the Regulations for the Basic Product and available to all non-national The Basic Product: for individuals (including limited income investors) with limited income in accordance with the threshold set by the Regulations and dependents of non- Nationals who are not eligible to be covered by the non-national s employment based insurance 43 Source Cube 2013 and Products Search Engine Database; Health Financing Strategy Analysis
Enhanced plans limits 2012 Benefit Level Equivalent to Basic product benefit level Better than Basic product benefit level Geographic Coverage Annual Limit AED millions % Cover Outside Network + Home Country, 11% Other (7%) 5.00 (1%) 2.50 (3%) 1.50 (2%) 100 (20%) 1.00 (14%) Member % + International, 56%.50 (17%).35 (2%) 80 (37%).30 (27%) 70 (4%) 50 (4%) 20 (1%) + Other Emirates, 33%.25 (27%) 0 (34%) Note This data is only for Enhanced products. About 21% of the enhanced plans contracts are excluded due to non compliance with reporting of benefits information. 44 Source Cube 2012 and Products Search Engine Database; Health Financing Strategy Analysis
Capacity Masterplan 27 November 2014
Contents Model of Care Abu Dhabi s model of care Model of care How health services are currently used, what s wrong? Model of care what s new Key themes for healthcare reforms Capacity Gaps* Current service balance Service capacity balance by specialty Clinician sub-specialty gaps IPC capacity gap, top Medical Board reasons for sending paediatric patients abroad IPC capacity gap, Medical Board classified reasons for sending abroad IPC Medical Board approvals for treatment abroad compared to the Abu Dhabi population. 2008-2013 trends IPC capacity gap, categorised as Services not available breakdown by volume of patient treated abroad Capacity Management* Planning for healthcare services Service capacity balance by location Improving capacity management through regulating clinical service lines List of Abu Dhabi clinical service lines Centralised, Regional and Standard services, by % total Abu Dhabi DRG volumes Centralised, Regional and Standard services, by % total Abu Dhabi DRG volumes (Paediatric) Paediatric DRGs coverage in Abu Dhabi Emirate Coverage of Regionally required DRG in Abu Dhabi Emirate C3 C4 C5 C6 C8 C9 C10 C11 C12 C13 C14 C16 & C17 C18 C19 C20 C21 C22 C23 C24 *Detailed plans for specific locations and services are available on www.shafafiya.org Note The data presented have been prepared to the best of our knowledge at time of release. Although effort has been invested to creating consistency and coherence, this should be considered work in progress. Feedback on content and layout are welcome. C1
Contents Demand & Supply Projections* Inpatient current supply and projected demand C26 Projected demand by Abu Dhabi planning region C27 Projected inpatient demand by Abu Dhabi planning region, by number of beds C28 Current health facility locations C29 Supply projections C30 & 31 Inpatient current and projected demand, by number of beds and Emergency bays C32 Assumptions Population density Population growth, scenarios Demand projections Demand projections based on WHO disease classification Demand projections for doctors by specialty Recommendations Planning recommendations Facility recommendations for developers, investors, and healthcare Providers Service recommendations for investors and developers Recommendation for allocation of land and service provision Access requirements C34 C35 C36 C37 C38 C40 C41 C42 C43 C44 *Detailed plans for specific locations and services are available on www.shafafiya.org Note The data presented have been prepared to the best of our knowledge at time of release. Although effort has been invested to creating consistency and coherence, this should be considered work in progress. Feedback on content and layout are welcome. 47 C1
Population Facilities Clinicians Ratios 2030 Plan growth 2030 requirements 2030 planned Projects under way Population Growth Region District Gap now Type Abu Dhabi Desert Villages Rural 28,480 #NAME? 10,963 None 81,520 110,000 Al Falah Rural 4,028 #NAME? 1,996 None 95,972 1 1 100,000 Ghantoot District Rural 2,478 #NAME? - None 97,522 1 100,000 Abu Dhabi Island Urban 313,809 #NAME? 44,004 229 13 182 2,529 3,878 430 1,284 6.2 8.1 12.4 111,191 425,000 CBD/Financial Centre Urban 174,625 #NAME? 14,141 124 5 86 1,131 1,663 241 539 5.2 6.5 9.5 15,375 1 190,000 Musaffah Urban 141,268 #NAME? 2,256 36 31 161 194 21 68 2.2 1.1 1.4 (41,268) 1 1 3 100,000 Bani Yas Rural 47,245 #NAME? 27,267 43 37 162 106 57 73 7.8 3.4 2.2 22,755 4 70,000 Al Shahama Rural 37,831 #NAME? 16,361 10 10 45 47 14 24 2.6 1.2 1.2 72,169 1 1 1 110,000 Shamkhah Rural 15,839 #NAME? 10,674 None 1 114,161 130,000 Al Rahba Rural 15,315 #NAME? 13,038 1 1 132 325 5 89 0.7 8.6 21.2 94,685 1 110,000 New Port City Rural 11,740 #NAME? 4,565 None 138,260 2 150,000 Capital District South Urban 9,247 #NAME? 33 None 1 45,753 1 1 55,000 Bain Al Jesrain Urban 7,694 #NAME? 4,927 3 3 33 42 10 17 3.9 4.3 5.5 17,306 1 1 25,000 Khalifa City A Urban 5,317 #NAME? 2,703 11 1 10 78 74 17 75 20.7 14.7 13.9 64,683 1 1 6 70,000 Grand Mosque District Urban 5,257 #NAME? 1,837 None 1 114,743 1 1 120,000 Inner Islands Urban 2,804 #NAME? 480 1 2 4 3.6 0.7 1.4 17,196 1 20,000 Capital District North Urban 2,371 #NAME? 2,121 2 1 1 426 792 36 302 8.4 179.7 334.0 67,629 1 3 70,000 Al Mina Urban 1,070 #NAME? 53 7 4 87 103 25 62 37.4 81.3 96.3 98,930 100,000 Al Raha Urban 827 #NAME? 397 2 1 1 41 42 9 12 49.6 50.8 119,173 1 120,000 Yas Island Urban 776 #NAME? 1 None 99,224 100,000 Mohamed Bin Zayed City Urban 328 #NAME? 95 2 2 1 2 4 2 3.0 6.1 49,672 1 1 4 50,000 Saadiyat Urban 122 #NAME? None 119,878-120,000 Airport District Urban 98 #NAME? 32 6 4 8 11 5 11 81.6 112.2 49,902 50,000 Lulu Island Urban 75 #NAME? None 19,925 1 20,000 Capital District Urban #NAME? None 240,000 2 240,000 Mohamed Bin Zayed Centre Urban #NAME? None 80,000 1 80,000 South Hudayriat Island Rural #NAME? None 100,000 1 100,000 Marina Village Urban #NAME? 3 2 1 3 6 5,000 5,000 Al Suwwah Urban #NAME? None 30,000 1 1 30,000 Al Reem Urban #NAME? None 200,000 200,000 Al Ain Umm Ghaffa Rural 8,851 #NAME? 5,873 None 3,049 11,900 Nahel Rural 5,196 #NAME? 2,377 None 4,804 1 1 10,000 Industrial City Rural 48,803 #NAME? 18 8 5 14 5 1 5 1.0 0.3 0.1 30,937 1 79,740 Al Salamat/Al Yaher Urban 37,544 #NAME? 23,400 1 1 1 3 1 6 0.3 0.1 0.0 36,456 1 1 2 74,000 Al Dhahra Rural 4,958 #NAME? 715 None 1,042 6,000 Abu Krayyah Rural 4,108 #NAME? 655 None 892 1 1 5,000 Al Saad Rural 3,829 #NAME? 702 None 1,171 1 5,000 Al Araad Rural 3,791 #NAME? 139 None 209 1 4,000 Abu Samra Rural 1,942 #NAME? 286 None 558 1 2,500 Al Ain City Urban 343,002 #NAME? 100,298 186 7 148 1,733 2,864 318 968 4.5 5.1 8.3 364,298 3 8 707,300 Al Quaa Rural 12,512 #NAME? 4,912 1 8 13 3 0.8 0.6 1.0 10,488 23,000 Al Wagan Rural 11,865 #NAME? 3,330 1 1 17 29 1 4 0.8 1.4 2.4 18,135 1 1 1 30,000 Al Hayer Rural 11,484 #NAME? 2,570 3 3 25 34 4 3 2.6 2.2 3.0 20,516 2 32,000 Al Dhaher Rural 10,641 #NAME? 7,325 1 1 13 20 3 4 0.9 1.2 1.9 3,709 1 1 14,350 Remah Rural 8,187 #NAME? 683 6 9 2 1.2 0.7 1.1 1,313 1 9,500 Sweihan Rural 7,880 #NAME? 713 1 1 8 11 1 1 1.3 1.0 1.4 32,120 1 2 40,000 Al Khazna Rural 7,350 #NAME? 1,071 2 2 4 13 1 2.7 0.5 1.8 1,650 9,000 Mezyad Rural 6,407 #NAME? 3,809 None 1 1,993 1 1 8,400 Al Shwaib Rural 3,260 #NAME? 1,546 4 3.1 0.9 1.2 2,240 1 5,500 Al Fagah Rural 2,089 #NAME? 378 1 1 3 3 4.8 1.4 1.4 1,411 1 3,500 Western Liwa Rural 20,000 #NAME? 661 5 1 1 8 17 5 32 1.0 0.4 0.9 45,000 65,000 Madinat Zayed Rural 29,000 #NAME? 6,785 16 2 11 175 256 23 107 4.5 6.0 8.8 11,000 1 1 40,000 Ruwais Rural 16,000 #NAME? 1,270 50 100 7 14 2.5 3.1 6.3 114,000 1 130,000 Mirfa Rural 15,000 #NAME? 3,676 4 1 3 32 61 3 17 2.7 2.1 4.1 60,000 75,000 Ghayathi Rural 8,000 #NAME? 3,898 6 5 38 63 5 18 7.5 4.8 7.9 7,000 1 15,000 Sila'a Rural 5,000 #NAME? - 1 1 22 39 2 10 2.0 4.4 7.8 65,000 70,000 Delma Island Rural 5,000 #NAME? 2,139 1 1 23 25 2 10 2.0 4.6 5.0 5,000 1 10,000 Capacity Gap Severe Note: Abu Dhabi and Al Gharbia populations based on SCAD 2005 census. Al Ain population based on 2008 UPC estimate. Moderate Source: Population: SCAD, UPC 2030 plans. Clinicians and Facilities: Licensing database. Planned Facilities ; SEHA, UPC 2030 plans, HAAD Planning analysis. None Model of Care Capacity Gaps Capacity Management Model of care How health services should be used DRAFT Patient self-care Non-emergency/elective Capacity Masterplan Total % National Nationals Total Hospitals Clinics Nearby hospital Doctors Nurses Dentists Other Facilities /10000 Doctors /1000 Nurses /1000 Hospitals required Clinic required Hospitals Clinics Hospitals Clinics 2030 Population Remote support Outpatient Clinic Elective Admission Screening Ambulance Check-up Urgent Care Centre Disease Emergency Triage ER management Admission. Preventative Emergency Including diagnostics Source Institute of Medicine 2001 Crossing the Quality Chasm, Bodenheimer et al 2002 JAMA, Department of Health UK 2001 Reforming Emergency Care, Picker Institute, Strategy analysis 11 Demand & Supply Projections Current and projected demand, by Episodes and beds Acute Overnight Episodes Bed Occupancy 2011 Actual 2016 2021 2026 2031 122,345 184,102 223,539 276,589 332,040 Acute Overnight Beds Current (58%) 3,289 3,992 5,223 6,769 7,061 Sub Acute Overnight Episodes Sub Acute Overnight Beds Intermediate (70%) 3,308 4,328 5,609 5,850 Target (85%) 2,724 3,564 4,619 4,818 N/A 3,216 4,233 5,461 6,738 224 342 438 449 525 ICU beds 146 175 209 245 281 Emergency Bays N/A 789 987 1,182 1,379 Notes :Sub Acute beds include: Rehabilitation, Palliative care, Maintenance, Older Persons and Psychogeriatric care; ICU beds exclude Paediatrics, NICU, CCU, etc. Acute Overnight beds exclude day case beds. Sub acute numbers of beds adjusted Source: TAHPI, Health Facility briefing system, reference data is based on data extracted from the Australian Institute of Health and Welfare, supplemented by data from the USA inpatient sample and UK Hospital Episode Statistics Online (HES) Assumptions Projected bed numbers from 2016 onwards are based on International Average ALOS and 75% occupancy for ICU beds. Population growth based on: Abu Dhabi Urban Planning Council 2030 Plan projections, Advantaged socio-economic class and with life expectancy >77years. Expatriate utilisation increases from 45% of UAE National utilisation to 55% of UAE National utilisation. Sub acute number of beds adjusted to meet international benchmark C17 Assumptions Population (millions) Population growth, scenarios As at 31 December 2010 Draft 4.0 Population growth, Scenarios High 3.5 Low National Expatriate Year Low High 3.0 2011 411'200 1'945'000 2'045'000 2012 416'150 1'970'000 2'190'000 2.5 2013 422'200 2'060'000 2'350'000 2.0 2014 429'400 2'130'000 2'505'000 2015 437'800 2'175'000 2'675'000 1.5 2016 445'800 2'250'000 2'850'000 2017 453'600 2'310'000 3'045'000 1.0 2018 460'500 2'360'000 3'240'000 2019 467'600 2'400'000 3'400'000 0.5 2020 473'600 2'475'000 3'575'000 0.0 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Note HAAD and SCAD are collaborating to align figures with official SCAD estimates; Estimates presented here are for internal HAAD use only Projections for Nationals are rounded to the nearest 2.5% variance between high and low, and those for Expatriates at 5%. Source SCAD population estimates; additional HAAD assumptions and analysis based on raw insurance data` 73 Recommendations Land requirements Guidelines for urban planners DRAFT For planning purposes, land must be available for hospitals, clinics and ambulance stations to serve anticipated population as per the following guidelines: Population (000 s people) Land provision options Residential Transient1 Land area Co-location GFA 4 OR (m 2 000 s) OR OR (m 2 000 s) Parking (spaces) Minimum service requirement Estimated Resources Clinics2 4-5 12-15 6? 3 2.5 25 Primary care 2 Physicians Pharmacy services (on-site or 8-12 24-36 7? 3 within 10 min walk) 3 30 4-6 Physicians Laboratory service 12-30 36-90 8.5 3? 3.5 35 7-14 Physicians 30-40 90-120 12 3? 4.5 45 15-20 Physicians Hospitals5 60-80 180-240 80 n/a n/a 3/bed Emergency services 180-240 Laboratory services Beds 6 Radiology services 90-110 270-330 100 n/a n/a 3/bed 270-330 Stand-alone building beds 6 Ambulance Stations 10-16 30-48 3? 7 n/a 10 Ambulance service (land /air) 1 Ambulance 16-40 48-120 4? 7 n/a 15 Ambulance service (land /air) 2 Ambulances Notes 1 Transient population includes staff and other non-residential visitors 2 Clinics collectively refers to Clinics, Centers and Polyclinics 3 Appropriate facilities for co-location with Clinics include Hospitals, Ambulance Stations, Mosques, Neighbourhood Commercial Centres, Sport Facilities, Community/Cultural Centres, Pharmacies, Schools and Post Offices, 4 Clinic GFA may be provided within larger commercial centre with adequate transport options and shared parking 5 If residential population is less than 60,000 or transient population is less than 180,000, land provision for a hospital facility needs to be made on a site-based analysis which considers the accesibility of existing hospital facilities 6 Optimal hospital size is 200-600 beds 7 Appropriate facilities for co-location with Ambulance Stations include Clinics, Hospitals, Civil Defense Stations, Police Stations and Municipal Offices Source HAAD Health Facility Community Guidelines 2009, Strategy analysis 5 48 C2
Abu Dhabi s model of care Healthcare in Abu Dhabi faces growing demand for services arising from an expanding population C18, C35. The current population is young and has a rate of chronic diseases that is set to increase as it ages. The current model of care in Abu Dhabi does not adequately support self care. Also, patients have undirected access to services and specialty care which leads to inappropriate use and, in turn, over-supply of services C4,C17,C18. In response HAAD is further developing its capacity management processes, its Weqaya screening programme and its approach to the continuum of care. Specialty care is not equally distributed across the 3 regions of Abu Dhabi Emirate. In addition rural primary care and subacute care is not well developed in the Emirate. In response HAAD is developing its comprehensive capacity planning process to address these issues including resolving critical shortages including rural areas in the Western and Eastern Regions. Historically, Abu Dhabi has had a relatively limited supply of healthcare services, particularly hospital beds, which led to investment in infrastructure. Achieving world-class quality care, however, is about much more than new buildings C5,C6. Before embarking on large-scale projects which affect community healthcare services long-term, it is important to be clear on what type of healthcare is appropriate for the evolving communities and population of Abu Dhabi in the 21st century. Abu Dhabi s model of care C5 describes how healthcare should look in future and is based on robust international experience*. The focus is on empowering patients. As a first step, pro-active check-ups and convenient routine follow-up should help prevent disease. When there is a condition, patients should be supported to care for themselves, where appropriate and supported by well developed primary and subacute care including home care and the integrated use of telemedicine**. In order to promote the use of home care and telemedicine HAAD has developed new At Home and telemedicine standards. This has been shown to improve quality, and improve access in rural areas. There needs to be improved access to appropriate elective and emergency care, and this should be streamlined and optimised from the patient s perspective through an emphasis on early clinical triage. Diagnostics, for instance, should be more readily available to enable one-stop-treatment. Making such ambitious changes to our healthcare system will require many decisions on what to do and what not to do. The proposed healthcare reforms with consensus from major health stakeholders C6 help clarify how priorities should be made in delivering health services and transitioning to the new model of care. 49 C3 * Impact of home care on hospital days: a meta analysis. Hughes, SL et al (1997). ** A randomised controlled trial of child psychiatric assessment conducted by videoconferencing. Alford, R et al (2000).
Model of care How health services are currently used. What s wrong? There are no systems in place to support patient self-care and management of chronic disease Ambulance Open access 1 Outpatient Primary care centre/ clinic Hospital ER Inpatient Subacute care is not (yet) fully aligned and many long term care patients are occupying acute beds Specialist Hospital admission Hospital specialist Screening Screening programmes are not (yet) fully aligned towards preventing and treating chronic conditions Notes Source Patient access to services is not streamlined: leading to over-servicing, oversupply and inappropriate service use Laboratory and radiology Diagnostics 1 Access to SEHA hospital specialists is only via referral from SEHA Centres/Clinics and ER departments. Some SEHA Hospital ER departments also direct non-emergency patients to adjacent Urgent care centres Strategy analysis Diagnostic services are not optimally integrated into treatment paths 50 C4
Desired model of care. What s new? Primary and Community Care / Prevention Home Healthcare OUTPATIENT Subacute care INPATIENT Telemedicine Remote support Disease management Consultant led Family based Care Check-up Outpatient Tertiary/Quaternary level Acute Care Ambulance Vaccination and public health programmes Urgent Care Centre ER Triage Screening Secondary level Acute care Centralized Emergency specialist services e.g., Trauma Centre, Stroke and Cardiac 51 C5 Source Strategy analysis
Key themes for healthcare reforms The following 7 major priorities have been identified: 1 Integrated continuum of care for individuals 5 Wellness and prevention public Health approach 2 Drive quality and safety as well as enhance patient experience 6 Ensure value for money + Sustainability of healthcare spend 3 Attract/retain/train workforce 7 Integrated Health Informatics and ehealth 4 Emergency preparedness Governance as a key enabler of the reform effort 52 C6 Source Abu Dhabi Health Sector Strategic Review and Performance Evaluation. May 2013.
Population Facilities Clinicians Ratios 2030 Plan growth 2030 requirements 2030 planned Projects under way Population Growth Region District Gap now Type Abu Dhabi Desert Villages Rural 28,480 #NAME? 10,963 None 81,520 110,000 Al Falah Rural 4,028 #NAME? 1,996 None 95,972 1 1 100,000 Ghantoot District Rural 2,478 #NAME? - None 97,522 1 100,000 Abu Dhabi Island Urban 313,809 #NAME? 44,004 229 13 182 2,529 3,878 430 1,284 6.2 8.1 12.4 111,191 425,000 CBD/Financial Centre Urban 174,625 #NAME? 14,141 124 5 86 1,131 1,663 241 539 5.2 6.5 9.5 15,375 1 190,000 Musaffah Urban 141,268 #NAME? 2,256 36 31 161 194 21 68 2.2 1.1 1.4 (41,268) 1 1 3 100,000 Bani Yas Rural 47,245 #NAME? 27,267 43 37 162 106 57 73 7.8 3.4 2.2 22,755 4 70,000 Al Shahama Rural 37,831 #NAME? 16,361 10 10 45 47 14 24 2.6 1.2 1.2 72,169 1 1 1 110,000 Shamkhah Rural 15,839 #NAME? 10,674 None 1 114,161 130,000 Al Rahba Rural 15,315 #NAME? 13,038 1 1 132 325 5 89 0.7 8.6 21.2 94,685 1 110,000 New Port City Rural 11,740 #NAME? 4,565 None 138,260 2 150,000 Capital District South Urban 9,247 #NAME? 33 None 1 45,753 1 1 55,000 Bain Al Jesrain Urban 7,694 #NAME? 4,927 3 3 33 42 10 17 3.9 4.3 5.5 17,306 1 1 25,000 Khalifa City A Urban 5,317 #NAME? 2,703 11 1 10 78 74 17 75 20.7 14.7 13.9 64,683 1 1 6 70,000 Grand Mosque District Urban 5,257 #NAME? 1,837 None 1 114,743 1 1 120,000 Inner Islands Urban 2,804 #NAME? 480 1 2 4 3.6 0.7 1.4 17,196 1 20,000 Capital District North Urban 2,371 #NAME? 2,121 2 1 1 426 792 36 302 8.4 179.7 334.0 67,629 1 3 70,000 Al Mina Urban 1,070 #NAME? 53 7 4 87 103 25 62 37.4 81.3 96.3 98,930 100,000 Al Raha Urban 827 #NAME? 397 2 1 1 41 42 9 12 49.6 50.8 119,173 1 120,000 Yas Island Urban 776 #NAME? 1 None 99,224 100,000 Mohamed Bin Zayed City Urban 328 #NAME? 95 2 2 1 2 4 2 3.0 6.1 49,672 1 1 4 50,000 Saadiyat Urban 122 #NAME? None 119,878-120,000 Airport District Urban 98 #NAME? 32 6 4 8 11 5 11 81.6 112.2 49,902 50,000 Lulu Island Urban 75 #NAME? None 19,925 1 20,000 Capital District Urban #NAME? None 240,000 2 240,000 Mohamed Bin Zayed Centre Urban #NAME? None 80,000 1 80,000 South Hudayriat Island Rural #NAME? None 100,000 1 100,000 Marina Village Urban #NAME? 3 2 1 3 6 5,000 5,000 Al Suwwah Urban #NAME? None 30,000 1 1 30,000 Al Reem Urban #NAME? None 200,000 200,000 Al Ain Umm Ghaffa Rural 8,851 #NAME? 5,873 None 3,049 11,900 Nahel Rural 5,196 #NAME? 2,377 None 4,804 1 1 10,000 Industrial City Rural 48,803 #NAME? 18 8 5 14 5 1 5 1.0 0.3 0.1 30,937 1 79,740 Al Salamat/Al Yaher Urban 37,544 #NAME? 23,400 1 1 1 3 1 6 0.3 0.1 0.0 36,456 1 1 2 74,000 Al Dhahra Rural 4,958 #NAME? 715 None 1,042 6,000 Abu Krayyah Rural 4,108 #NAME? 655 None 892 1 1 5,000 Al Saad Rural 3,829 #NAME? 702 None 1,171 1 5,000 Al Araad Rural 3,791 #NAME? 139 None 209 1 4,000 Abu Samra Rural 1,942 #NAME? 286 None 558 1 2,500 Al Ain City Urban 343,002 #NAME? 100,298 186 7 148 1,733 2,864 318 968 4.5 5.1 8.3 364,298 3 8 707,300 Al Quaa Rural 12,512 #NAME? 4,912 1 8 13 3 0.8 0.6 1.0 10,488 23,000 Al Wagan Rural 11,865 #NAME? 3,330 1 1 17 29 1 4 0.8 1.4 2.4 18,135 1 1 1 30,000 Al Hayer Rural 11,484 #NAME? 2,570 3 3 25 34 4 3 2.6 2.2 3.0 20,516 2 32,000 Al Dhaher Rural 10,641 #NAME? 7,325 1 1 13 20 3 4 0.9 1.2 1.9 3,709 1 1 14,350 Remah Rural 8,187 #NAME? 683 6 9 2 1.2 0.7 1.1 1,313 1 9,500 Sweihan Rural 7,880 #NAME? 713 1 1 8 11 1 1 1.3 1.0 1.4 32,120 1 2 40,000 Al Khazna Rural 7,350 #NAME? 1,071 2 2 4 13 1 2.7 0.5 1.8 1,650 9,000 Mezyad Rural 6,407 #NAME? 3,809 None 1 1,993 1 1 8,400 Al Shwaib Rural 3,260 #NAME? 1,546 4 3.1 0.9 1.2 2,240 1 5,500 Al Fagah Rural 2,089 #NAME? 378 1 1 3 3 4.8 1.4 1.4 1,411 1 3,500 Western Liwa Rural 20,000 #NAME? 661 5 1 1 8 17 5 32 1.0 0.4 0.9 45,000 65,000 Madinat Zayed Rural 29,000 #NAME? 6,785 16 2 11 175 256 23 107 4.5 6.0 8.8 11,000 1 1 40,000 Ruwais Rural 16,000 #NAME? 1,270 50 100 7 14 2.5 3.1 6.3 114,000 1 130,000 Mirfa Rural 15,000 #NAME? 3,676 4 1 3 32 61 3 17 2.7 2.1 4.1 60,000 75,000 Ghayathi Rural 8,000 #NAME? 3,898 6 5 38 63 5 18 7.5 4.8 7.9 7,000 1 15,000 Sila'a Rural 5,000 #NAME? - 1 1 22 39 2 10 2.0 4.4 7.8 65,000 70,000 Delma Island Rural 5,000 #NAME? 2,139 1 1 23 25 2 10 2.0 4.6 5.0 5,000 1 10,000 Capacity Gap Severe Note: Abu Dhabi and Al Gharbia populations based on SCAD 2005 census. Al Ain population based on 2008 UPC estimate. Moderate Source: Population: SCAD, UPC 2030 plans. Clinicians and Facilities: Licensing database. Planned Facilities ; SEHA, UPC 2030 plans, HAAD Planning analysis. None Model of Care Capacity Gaps Capacity Management Model of care How health services should be used DRAFT Patient self-care Non-emergency/elective Capacity Masterplan Total % National Nationals Total Hospitals Clinics Nearby hospital Doctors Nurses Dentists Other Facilities /10000 Doctors /1000 Nurses /1000 Hospitals required Clinic required Hospitals Clinics Hospitals Clinics 2030 Population Remote support Outpatient Clinic Elective Admission Screening Ambulance Check-up Urgent Care Centre Disease Emergency Triage ER management Admission. Preventative Emergency Including diagnostics Source Institute of Medicine 2001 Crossing the Quality Chasm, Bodenheimer et al 2002 JAMA, Department of Health UK 2001 Reforming Emergency Care, Picker Institute, Strategy analysis 11 Demand & Supply Projections Current and projected demand, by Episodes and beds Acute Overnight Episodes Bed Occupancy 2011 Actual 2016 2021 2026 2031 122,345 184,102 223,539 276,589 332,040 Acute Overnight Beds Current (58%) 3,289 3,992 5,223 6,769 7,061 Sub Acute Overnight Episodes Sub Acute Overnight Beds Intermediate (70%) 3,308 4,328 5,609 5,850 Target (85%) 2,724 3,564 4,619 4,818 N/A 3,216 4,233 5,461 6,738 224 342 438 449 525 ICU beds 146 175 209 245 281 Emergency Bays N/A 789 987 1,182 1,379 Notes :Sub Acute beds include: Rehabilitation, Palliative care, Maintenance, Older Persons and Psychogeriatric care; ICU beds exclude Paediatrics, NICU, CCU, etc. Acute Overnight beds exclude day case beds. Sub acute numbers of beds adjusted Source: TAHPI, Health Facility briefing system, reference data is based on data extracted from the Australian Institute of Health and Welfare, supplemented by data from the USA inpatient sample and UK Hospital Episode Statistics Online (HES) Assumptions Projected bed numbers from 2016 onwards are based on International Average ALOS and 75% occupancy for ICU beds. Population growth based on: Abu Dhabi Urban Planning Council 2030 Plan projections, Advantaged socio-economic class and with life expectancy >77years. Expatriate utilisation increases from 45% of UAE National utilisation to 55% of UAE National utilisation. Sub acute number of beds adjusted to meet international benchmark C17 Population (millions) Assumptions Population growth, scenarios As at 31 December 2010 Draft 4.0 Population growth, Scenarios High 3.5 Low National Expatriate Year Low High 3.0 2011 411'200 1'945'000 2'045'000 2012 416'150 1'970'000 2'190'000 2.5 2013 422'200 2'060'000 2'350'000 2.0 2014 429'400 2'130'000 2'505'000 2015 437'800 2'175'000 2'675'000 1.5 2016 445'800 2'250'000 2'850'000 2017 453'600 2'310'000 3'045'000 1.0 2018 460'500 2'360'000 3'240'000 2019 467'600 2'400'000 3'400'000 0.5 2020 473'600 2'475'000 3'575'000 0.0 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Note HAAD and SCAD are collaborating to align figures with official SCAD estimates; Estimates presented here are for internal HAAD use only Projections for Nationals are rounded to the nearest 2.5% variance between high and low, and those for Expatriates at 5%. Source SCAD population estimates; additional HAAD assumptions and analysis based on raw insurance data` 73 Recommendations Land requirements Guidelines for urban planners DRAFT For planning purposes, land must be available for hospitals, clinics and ambulance stations to serve anticipated population as per the following guidelines: Population (000 s people) Land provision options Residential Transient1 Land area Co-location GFA 4 OR (m 2 000 s) OR OR (m 2 000 s) Parking (spaces) Minimum service requirement Estimated Resources Clinics2 4-5 12-15 6? 3 2.5 25 Primary care 2 Physicians Pharmacy services (on-site or 8-12 24-36 7? 3 within 10 min walk) 3 30 4-6 Physicians Laboratory service 12-30 36-90 8.5 3? 3.5 35 7-14 Physicians 30-40 90-120 12 3? 4.5 45 15-20 Physicians Hospitals5 60-80 180-240 80 n/a n/a 3/bed Emergency services 180-240 Laboratory services Beds 6 Radiology services 90-110 270-330 100 n/a n/a 3/bed 270-330 Stand-alone building beds 6 Ambulance Stations 10-16 30-48 3? 7 n/a 10 Ambulance service (land /air) 1 Ambulance 16-40 48-120 4? 7 n/a 15 Ambulance service (land /air) 2 Ambulances Notes 1 Transient population includes staff and other non-residential visitors 2 Clinics collectively refers to Clinics, Centers and Polyclinics 3 Appropriate facilities for co-location with Clinics include Hospitals, Ambulance Stations, Mosques, Neighbourhood Commercial Centres, Sport Facilities, Community/Cultural Centres, Pharmacies, Schools and Post Offices, 4 Clinic GFA may be provided within larger commercial centre with adequate transport options and shared parking 5 If residential population is less than 60,000 or transient population is less than 180,000, land provision for a hospital facility needs to be made on a site-based analysis which considers the accesibility of existing hospital facilities 6 Optimal hospital size is 200-600 beds 7 Appropriate facilities for co-location with Ambulance Stations include Clinics, Hospitals, Civil Defense Stations, Police Stations and Municipal Offices Source HAAD Health Facility Community Guidelines 2009, Strategy analysis 5 53 C7
Current service balance To obtain an accurate picture of capacity balance in the Emirate, international benchmarking of demand by population and population type is analysed & projected forward. This data along with a number of quantitative sources including International Patient Care (IPC) data is monitored and compared to Abu Dhabi current and planned supply. Historic Capacity Gaps are in Intensive and Critical Care medicine, Emergency care, Neonatology, Paediatric, Oncology, Orthopaedic, Rehabilitation and Psychiatry C9. In previous years only modest increases in supply have occurred, however 2013 has seen major progress in addressing specialties in shortage. There has been significant growth in the specialties where capacity gaps exist, for example since the end of 2012 there has been 20% growth in Emergency Physicians, 41% growth in Neonatologists and a 21% increase in Paediatric and Orthopedic doctors respectively. Critical care doctors have grown by 14%. Obstetrics & Gynecology doctors have grown by 30%, Ophthalmologists have grown by 28% and Neurologists by 32%. Mental Health Physicians have increased by 35%. In each case additional facilities have also been opened. Further general and specialised capacity is also due to be expanded by new and existing providers in the future C31,C32. The private sector has been responsible for the largest proportion of growth (74%) in licensed physicians. Sub-specialty gaps Paediatric and Paediatric surgery sub-specialties and adult surgical sub-specialties including Neurosurgery, Plastics, Surgical Oncology remain undersupplied in Abu Dhabi C9. Health challenges. Growth in demand for healthcare services associated with the prevention and treatment of cancer, cardiovascular disease, diabetes, respiratory conditions, emergency medicine and neuropsychiatric conditions is expected to be particularly high. Growth. The number of physicians and dentists licensed within the emirate has grown by 1427 (22%) since the end of 2012 continuing to ensure wider coverage across the range of specialties. The number of facilities offering healthcare has also grown to 1,626 4. (11% increase on 2012 level) Centralised and Regional services. In order to improve coverage, concentrate clinical expertise and improve quality and cost efficiency HAAD has designated a limited number of Regional services each serving a population of ~250,000 residents. For complex and highly specialised Centralised services HAAD has designated certain highly specialised services that will only be provided by a small number of Abu Dhabi Providers to serve the whole Emirate. The detailed plans are included in pages C19 to C24. Improving capacity management through regulating clinical service lines. Since January 2013 HAAD has began licensing hospital providers for clinical services at DRG level in order to reduce duplication of services, improve the coverage of capacity gaps both at a specialty and geographic level and to meet future demand. There is clear risk of oversupply within the Emirate. HAAD is developing measures including improved alignment of supply with demand. International Patient Care Programme. The percentage of the medical board approval for the patient travel abroad as compared to the total population is showing a reducing trend and has reduced by 14 % during the period 2008-2013. Pages C10, C13 and C14 detail the major capacity gaps. 54 C8
Service capacity balance by specialty As at 31 December 2013 Specialty Gaps Physicians/Dentists % Growth in Physicians/Dentists Public Private Capacity Balance No Capacity Gap Moderate Capacity Gap Severe Capacity Gap % Private / Public Capacity Notes Growth compares 2013 to 2012. Sources: Gaps: Defined by analysis of IPC data, international benchmarking from doctors per capita, bed census analysis and analysis of regional DRG coverage, Strategy analysis. Physicians and Facilities: Licensing database. Facilities Private % Growth of Facilities Providing the Services Intensive & Critical Care Medicine 42 14% 4 1 11 22% 2 Emergency Medicine 128 20% 16 5 20 11% -1 3 Neonatology 41 41% 6 6 14 27% 1 2 Cardiology 95 20% 2 14 32 19% 5 Psychiatry 84 35% 3 19 22 29% 5 Obstetrics & Gynecology 275 30% 21 43 103 11% 3 7 Paediatrics 529 21% 32 59 118 15% 1 14 Oncology 27 4% 1 7 17% 1 General Surgery 402 23% 26 48 92 23% -1 18 Paediatric Surgery 23 21% 1 3 13 18% 2 Internal Medicine 503 20% 34 50 108 16% 1 14 Physical Medicine & Rehabilitation 21 16 Allergy & Immunology 4 4 Cardio-thoracic Surgery 32-11% 1-5 14-18% -2-1 Orthopedics 201 21% 11 24 64 14% -1 9 Family Medicine 218 27% 30 16 53 13% 3 3 Radiology 228 27% 10 38 77 12% 8 Neurology 41 41% 1 11 22 38% 1 5 Anesthesiology 333 29% 28 47 56 12% 6 Preventive Medicine Ophthalmology 194 28% 11 31 68 8% 5 Infectious Diseases 13 10 11% 1 Dentistry 1,213 28% 11 252 389 12% 3 38 Urology 100 22% 18 49 26% 10 General Medicine 2,392 20% 102 299 335 15% -1 45 Pulmonology 36 24% -1 8 22 22% -1 5 Pathology 180 15% 5 18 91 7% -3 9 Nephrology 40 33% 3 7 15 25% -1 4 Endocrinology 55 28% 4 8 23 5% 1 Dermatology 189 20% -2 34 108 23% -1 21 Gastroenterology 49 17% 5 2 24 14% 3 Alternative Therapies 36 6% 3 25 4% 1 Oral & Maxillofacial Surgery 9-1 -23 5-80% -2-18 Rheumatology 25 39% 4 3 15 25% 3 Otolaryngology (ENT) 163 15% 11 24 74 4% 2 5 Total 8,021 22% 26% 74% 3 234 0% Public Private Increase No change Decrease 55 C9
Clinician sub-specialty gaps Doctor not available 2013 2012 2011 Classification of Disease Reason for Sending Abroad Count of patients Count of patients Count of patients Paediatric Ophthalmology Paediatric retina specialist not available 1 4 Paediatric glaucoma specialist not available 1 2 2 Paediatric corneal specialist not available 2 2 Paediatric medical retina specialist not available 1 1 Post enucleation services specialist not available 1 Paediatric Spinal surgery Paediatric spinal surgeon specialist not available 32 25 7 Paediatric Orthorpedic Surgery Brachial plexus multidisciplinary team not available 6 9 13 Hand specialist not available 3 1 Hand/upper arm deformities specialist not available 1 Paediatric Orth-oncology Paediatric ortho-oncology specialist not available 3 8 1 Neurology Dystonia specialist not available 2 1 Specialized neuromuscular disorder specialist not available 1 1 1 Movement disorder specialist not available 1 1 Orthopedic Surgery Foot and ankle specialist not available 1 Hand specialist not available 2 1 Ortho-oncology specialist (Sarcoma) not available 2 3 3 Paediatric Cardiology Paediatric electrophysiology specialist not available 5 5 2 Paediatric Rheumatology Paediatric rheumatology not available 2 5 5 Paediatric Pulmonology Cystic fibrosis multidisciplinary unit not available 3 1 1 Paediatric Neurology Neuromuscular disorder specialist not available 1 1 Muscle pathologist not available 2 1 Cardiology Congenital heart disease in adult services not available 1 Metabolic Disease Expertise in metabolic field not available 1 Paediatric Ophthalmic Oncology Ophthalmic oncology specialist not available 2 8 1 Ophthalmic Oncology Onco-ophthalmology services not available 1 4 1 Neurosurgery Neuro-oncology specialist, Neuro-ophthalmic specialist not available 1 3 1 Plastic Surgery Micro vascular plastic reconstruction not available 1 Facial palsy plastic surgeon not available 1 Ear reconstruction plastic surgeon not available 2 1 Colrectal Surgery Required pelvic floor expertise not available 1 Paediatric Vascular Surgery Specialized paediatric vascular centre not available 1 3 1 Ophthalmology Glaucoma specialist not available 2 2 56 89 58 Notes Clinician sub-specialty gaps are subject to dynamic change. Source IPC 2011,2012 & 2013 Annual Statistics Report. Analysis of Medical Board referrals abroad for treatment (under International Patient Care, IPC). 56 C10
IPC capacity gap, top Medical Board reasons for sending paediatric patients abroad Medical Board Paedatric Reason for Abroad Treatment 2009-2013 45 40 35 30 25 20 15 10 5 0 Paediatric Oncology Paediatric Orthopedic Surgery Paediatric Cardiac Surgery Paediatric Neurology Paediatric Ophthalmology Paediatric Gastroenterolo gy Paediatric Pulmonology Paediatric Cardiology Paediatric Oncology/Haem atology Paediatric Plastic Surgery Paediatric Spine Surgery Paediatric Haematology Paediatric General Surgery 2013 18 27 27 22 37 20 6 21 15 11 34 7 0 20 19 1 10 6 7 8 2012 29 41 32 11 31 18 9 25 34 14 25 11 0 15 7 3 10 5 8 5 2011 40 37 29 26 21 18 17 17 16 15 14 11 9 18 8 8 7 7 6 12 2010 21 31 31 14 19 5 17 8 15 4 15 15 8 3 5 11 17 15 2009 16 28 41 2 15 4 18 16 5 4 12 19 8 3 10 15 16 Paediatric Rehabilitation Paediatric Neurosurgery Paediatric ENT Paediatric Urology Paediatric Brachial Plexus Injury Paediatric BMT follow up BMT Paediatric Note Source Paediatric age is defined to be inclusive of ages from birth and up to 18 years old. HAAD- IPC 2013 Statistic Report, IPC capacity gap analysis- planning analysis. 57 C11
IPC capacity gap, Medical Board classified reasons for sending abroad 600 568 500 400 344 300 205 199 200 108 100 14 37 0 Follow up previous Treatment Abroad Limited Services Emergency Treatment while Abroad High Risk/Complexity Service Not Available Donor Others Medical Board Classification of Reason for Sending Abroad Count of Patients % Follow up previous treatment abroad 568 38% Limited services 344 25% Emergency treatment while abroad 205 15% High risk/complexity 199 15% Service not available 108 8% Donor 14 1% Others 37 3% Grand Total 1,475 58 C12 Source IPC 2013 Statistics Report- Medical Board sub reason for sending and approving treatment abroad.
IPC Medical Board approvals for treatment abroad compared to the Abu Dhabi population. 2008-2013 trends 120 100 80 60 40 20 0 2008 2009 2010 2011 2012 2013 % Medical Board approval to the total population Linear (% Medical Board approval to the total population) The percentage of the Medical Board approvals for treatment abroad as compared to the population is showing a reducing trend and has reduced by 14% during the period 2008-2013. Note 26% of HAAD IPC approvals relate to UAE patients from Non Abu Dhabi Emirate. 59 C13 Source HAAD IPC 2013 Statistics Report; planning analysis
IPC capacity gap, categorised as Services not available breakdown by volume of patient treated abroad Pre-implantation genetic diagnosis (PGD) Paediatric Ophthalmology Paediatric Neurosurgery Renal Transplant Cardiology Paediatric Vascular Surgery Brachial Plexus Injury Paediatric Cardiology Urology Spine Surgery Ophthalmic Onocology Paediatric Pulmonology Paediatric Orthopedic Surgery Paediatric Electrophysiology Post Cardiac Transplant ENT Gastroenterology Orthopedic Surgery Paediatric Plastic Surgery BMT Plastic Surgery Ortho-Oncology Paediatric Rheumatology Paediatric Neurology Ophthalmology Neurosurgery Paediatric Ortho-Oncology Liver Transplant Post BMT Follow up Paediatric Rehabilitation Paediatric BMT Follow Up Paediatric Bone Marrow Transplant BMT follow up Donor Paediatric Spine Surgery 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 3 3 3 3 3 4 7 8 9 10 10 16 0 2 4 6 8 10 12 14 16 18 60 C14 Note Source Services not available classification by Medical Board includes the non-availability of facilities, specialised centres, equipment, programmes, clinical staff etc. IPC 2013 statistic report- Medical Board sub reason for sending abroad (Services not available) and approving treatment abroad.
Population Facilities Clinicians Ratios 2030 Plan growth 2030 requirements 2030 planned Projects under way Population Growth Region District Gap now Type Abu Dhabi Desert Villages Rural 28,480 #NAME? 10,963 None 81,520 110,000 Al Falah Rural 4,028 #NAME? 1,996 None 95,972 1 1 100,000 Ghantoot District Rural 2,478 #NAME? - None 97,522 1 100,000 Abu Dhabi Island Urban 313,809 #NAME? 44,004 229 13 182 2,529 3,878 430 1,284 6.2 8.1 12.4 111,191 425,000 CBD/Financial Centre Urban 174,625 #NAME? 14,141 124 5 86 1,131 1,663 241 539 5.2 6.5 9.5 15,375 1 190,000 Musaffah Urban 141,268 #NAME? 2,256 36 31 161 194 21 68 2.2 1.1 1.4 (41,268) 1 1 3 100,000 Bani Yas Rural 47,245 #NAME? 27,267 43 37 162 106 57 73 7.8 3.4 2.2 22,755 4 70,000 Al Shahama Rural 37,831 #NAME? 16,361 10 10 45 47 14 24 2.6 1.2 1.2 72,169 1 1 1 110,000 Shamkhah Rural 15,839 #NAME? 10,674 None 1 114,161 130,000 Al Rahba Rural 15,315 #NAME? 13,038 1 1 132 325 5 89 0.7 8.6 21.2 94,685 1 110,000 New Port City Rural 11,740 #NAME? 4,565 None 138,260 2 150,000 Capital District South Urban 9,247 #NAME? 33 None 1 45,753 1 1 55,000 Bain Al Jesrain Urban 7,694 #NAME? 4,927 3 3 33 42 10 17 3.9 4.3 5.5 17,306 1 1 25,000 Khalifa City A Urban 5,317 #NAME? 2,703 11 1 10 78 74 17 75 20.7 14.7 13.9 64,683 1 1 6 70,000 Grand Mosque District Urban 5,257 #NAME? 1,837 None 1 114,743 1 1 120,000 Inner Islands Urban 2,804 #NAME? 480 1 2 4 3.6 0.7 1.4 17,196 1 20,000 Capital District North Urban 2,371 #NAME? 2,121 2 1 1 426 792 36 302 8.4 179.7 334.0 67,629 1 3 70,000 Al Mina Urban 1,070 #NAME? 53 7 4 87 103 25 62 37.4 81.3 96.3 98,930 100,000 Al Raha Urban 827 #NAME? 397 2 1 1 41 42 9 12 49.6 50.8 119,173 1 120,000 Yas Island Urban 776 #NAME? 1 None 99,224 100,000 Mohamed Bin Zayed City Urban 328 #NAME? 95 2 2 1 2 4 2 3.0 6.1 49,672 1 1 4 50,000 Saadiyat Urban 122 #NAME? None 119,878-120,000 Airport District Urban 98 #NAME? 32 6 4 8 11 5 11 81.6 112.2 49,902 50,000 Lulu Island Urban 75 #NAME? None 19,925 1 20,000 Capital District Urban #NAME? None 240,000 2 240,000 Mohamed Bin Zayed Centre Urban #NAME? None 80,000 1 80,000 South Hudayriat Island Rural #NAME? None 100,000 1 100,000 Marina Village Urban #NAME? 3 2 1 3 6 5,000 5,000 Al Suwwah Urban #NAME? None 30,000 1 1 30,000 Al Reem Urban #NAME? None 200,000 200,000 Al Ain Umm Ghaffa Rural 8,851 #NAME? 5,873 None 3,049 11,900 Nahel Rural 5,196 #NAME? 2,377 None 4,804 1 1 10,000 Industrial City Rural 48,803 #NAME? 18 8 5 14 5 1 5 1.0 0.3 0.1 30,937 1 79,740 Al Salamat/Al Yaher Urban 37,544 #NAME? 23,400 1 1 1 3 1 6 0.3 0.1 0.0 36,456 1 1 2 74,000 Al Dhahra Rural 4,958 #NAME? 715 None 1,042 6,000 Abu Krayyah Rural 4,108 #NAME? 655 None 892 1 1 5,000 Al Saad Rural 3,829 #NAME? 702 None 1,171 1 5,000 Al Araad Rural 3,791 #NAME? 139 None 209 1 4,000 Abu Samra Rural 1,942 #NAME? 286 None 558 1 2,500 Al Ain City Urban 343,002 #NAME? 100,298 186 7 148 1,733 2,864 318 968 4.5 5.1 8.3 364,298 3 8 707,300 Al Quaa Rural 12,512 #NAME? 4,912 1 8 13 3 0.8 0.6 1.0 10,488 23,000 Al Wagan Rural 11,865 #NAME? 3,330 1 1 17 29 1 4 0.8 1.4 2.4 18,135 1 1 1 30,000 Al Hayer Rural 11,484 #NAME? 2,570 3 3 25 34 4 3 2.6 2.2 3.0 20,516 2 32,000 Al Dhaher Rural 10,641 #NAME? 7,325 1 1 13 20 3 4 0.9 1.2 1.9 3,709 1 1 14,350 Remah Rural 8,187 #NAME? 683 6 9 2 1.2 0.7 1.1 1,313 1 9,500 Sweihan Rural 7,880 #NAME? 713 1 1 8 11 1 1 1.3 1.0 1.4 32,120 1 2 40,000 Al Khazna Rural 7,350 #NAME? 1,071 2 2 4 13 1 2.7 0.5 1.8 1,650 9,000 Mezyad Rural 6,407 #NAME? 3,809 None 1 1,993 1 1 8,400 Al Shwaib Rural 3,260 #NAME? 1,546 4 3.1 0.9 1.2 2,240 1 5,500 Al Fagah Rural 2,089 #NAME? 378 1 1 3 3 4.8 1.4 1.4 1,411 1 3,500 Western Liwa Rural 20,000 #NAME? 661 5 1 1 8 17 5 32 1.0 0.4 0.9 45,000 65,000 Madinat Zayed Rural 29,000 #NAME? 6,785 16 2 11 175 256 23 107 4.5 6.0 8.8 11,000 1 1 40,000 Ruwais Rural 16,000 #NAME? 1,270 50 100 7 14 2.5 3.1 6.3 114,000 1 130,000 Mirfa Rural 15,000 #NAME? 3,676 4 1 3 32 61 3 17 2.7 2.1 4.1 60,000 75,000 Ghayathi Rural 8,000 #NAME? 3,898 6 5 38 63 5 18 7.5 4.8 7.9 7,000 1 15,000 Sila'a Rural 5,000 #NAME? - 1 1 22 39 2 10 2.0 4.4 7.8 65,000 70,000 Delma Island Rural 5,000 #NAME? 2,139 1 1 23 25 2 10 2.0 4.6 5.0 5,000 1 10,000 Capacity Gap Severe Note: Abu Dhabi and Al Gharbia populations based on SCAD 2005 census. Al Ain population based on 2008 UPC estimate. Moderate Source: Population: SCAD, UPC 2030 plans. Clinicians and Facilities: Licensing database. Planned Facilities ; SEHA, UPC 2030 plans, HAAD Planning analysis. None Model of Care Model of care How health services should be used DRAFT Patient self-care Non-emergency/elective Capacity Gaps Capacity Management Capacity Masterplan Total % National Nationals Total Hospitals Clinics Nearby hospital Doctors Nurses Dentists Other Facilities /10000 Doctors /1000 Nurses /1000 Hospitals required Clinic required Hospitals Clinics Hospitals Clinics 2030 Population Remote support Outpatient Clinic Elective Admission Screening Ambulance Check-up Urgent Care Centre Disease Emergency Triage ER management Admission. Preventative Emergency Including diagnostics Source Institute of Medicine 2001 Crossing the Quality Chasm, Bodenheimer et al 2002 JAMA, Department of Health UK 2001 Reforming Emergency Care, Picker Institute, Strategy analysis 11 Demand & Supply Projections Current and projected demand, by Episodes and beds Acute Overnight Episodes Bed Occupancy 2011 Actual 2016 2021 2026 2031 122,345 184,102 223,539 276,589 332,040 Acute Overnight Beds Current (58%) 3,289 3,992 5,223 6,769 7,061 Sub Acute Overnight Episodes Sub Acute Overnight Beds Intermediate (70%) 3,308 4,328 5,609 5,850 Target (85%) 2,724 3,564 4,619 4,818 N/A 3,216 4,233 5,461 6,738 224 342 438 449 525 ICU beds 146 175 209 245 281 Emergency Bays N/A 789 987 1,182 1,379 Notes :Sub Acute beds include: Rehabilitation, Palliative care, Maintenance, Older Persons and Psychogeriatric care; ICU beds exclude Paediatrics, NICU, CCU, etc. Acute Overnight beds exclude day case beds. Sub acute numbers of beds adjusted Source: TAHPI, Health Facility briefing system, reference data is based on data extracted from the Australian Institute of Health and Welfare, supplemented by data from the USA inpatient sample and UK Hospital Episode Statistics Online (HES) Assumptions Projected bed numbers from 2016 onwards are based on International Average ALOS and 75% occupancy for ICU beds. Population growth based on: Abu Dhabi Urban Planning Council 2030 Plan projections, Advantaged socio-economic class and with life expectancy >77years. Expatriate utilisation increases from 45% of UAE National utilisation to 55% of UAE National utilisation. Sub acute number of beds adjusted to meet international benchmark C17 Assumptions Population (millions) Population growth, scenarios As at 31 December 2010 Draft 4.0 Population growth, Scenarios High 3.5 Low National Expatriate Year Low High 3.0 2011 411'200 1'945'000 2'045'000 2012 416'150 1'970'000 2'190'000 2.5 2013 422'200 2'060'000 2'350'000 2.0 2014 429'400 2'130'000 2'505'000 2015 437'800 2'175'000 2'675'000 1.5 2016 445'800 2'250'000 2'850'000 2017 453'600 2'310'000 3'045'000 1.0 2018 460'500 2'360'000 3'240'000 2019 467'600 2'400'000 3'400'000 0.5 2020 473'600 2'475'000 3'575'000 0.0 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Note HAAD and SCAD are collaborating to align figures with official SCAD estimates; Estimates presented here are for internal HAAD use only Projections for Nationals are rounded to the nearest 2.5% variance between high and low, and those for Expatriates at 5%. Source SCAD population estimates; additional HAAD assumptions and analysis based on raw insurance data` 73 Recommendations Land requirements Guidelines for urban planners DRAFT For planning purposes, land must be available for hospitals, clinics and ambulance stations to serve anticipated population as per the following guidelines: Population (000 s people) Land provision options Residential Transient1 Land area Co-location GFA 4 OR (m 2 000 s) OR OR (m 2 000 s) Parking (spaces) Minimum service requirement Estimated Resources Clinics2 4-5 12-15 6? 3 2.5 25 Primary care 2 Physicians Pharmacy services (on-site or 8-12 24-36 7? 3 within 10 min walk) 3 30 4-6 Physicians Laboratory service 12-30 36-90 8.5 3? 3.5 35 7-14 Physicians 30-40 90-120 12 3? 4.5 45 15-20 Physicians Hospitals5 60-80 180-240 80 n/a n/a 3/bed Emergency services 180-240 Laboratory services Beds 6 Radiology services 90-110 270-330 100 n/a n/a 3/bed 270-330 Stand-alone building beds 6 Ambulance Stations 10-16 30-48 3? 7 n/a 10 Ambulance service (land /air) 1 Ambulance 16-40 48-120 4? 7 n/a 15 Ambulance service (land /air) 2 Ambulances Notes 1 Transient population includes staff and other non-residential visitors 2 Clinics collectively refers to Clinics, Centers and Polyclinics 3 Appropriate facilities for co-location with Clinics include Hospitals, Ambulance Stations, Mosques, Neighbourhood Commercial Centres, Sport Facilities, Community/Cultural Centres, Pharmacies, Schools and Post Offices, 4 Clinic GFA may be provided within larger commercial centre with adequate transport options and shared parking 5 If residential population is less than 60,000 or transient population is less than 180,000, land provision for a hospital facility needs to be made on a site-based analysis which considers the accesibility of existing hospital facilities 6 Optimal hospital size is 200-600 beds 7 Appropriate facilities for co-location with Ambulance Stations include Clinics, Hospitals, Civil Defense Stations, Police Stations and Municipal Offices Source HAAD Health Facility Community Guidelines 2009, Strategy analysis 5 61 C15
Planning for healthcare services Current capacity gaps. Geographic coverage in the urban parts of the Emirate is generally good. There are, however, severe capacity shortfalls in rural areas: During 2014/2015 HAAD seeks to centrally procure for primary care facilities to serve these locations. In more remote rural areas innovation in delivering services is required, This might include the use of mobile and visiting clinics, and clinical staff on a visiting or rotational basis. In larger settlements of the Western region, the pre-existing hospitals will need to adapt and respond to changing and growing needs; as the population grows so does the requirement for more specialised services to be available within the region. Region Abu Dhabi Eastern Western Mid-term Primary Healthcare Clinics Mobile Clinics Rotation Permanent Permanent 1 1 1 1 1 1 Khalifa B North Nahel 1 1 East Umm Ghaffa 1 1 Al Dhaher 1 Al Raad 1 Abu Karayyah 1 Abu Samarah 1 Al Saad 1 Al Sila Liwa -Hmeem -Brier Short Term 1 1 1 1 1 1 HAAD analysis C24 shows that the Western region is significantly underserved at a regional specialty level. HAAD is addressing this issue through the alignment of HAAD licensing process with healthcare demand. Significant population growth. The Abu Dhabi Urban Planning Council (UPC) 2030 Plan envisages the population of Abu Dhabi Emirate doubling C18, C35. In Abu Dhabi region Abu Dhabi Island and Musaffah population is expected to reduce over time, with aggressive growth off island and in rural areas, e.g., Mohammed Bin Zayed, Capital District, Shamkha, and Al Reem Island populations are projected to grow by over 820,000. Growth in 17 of the 28 districts is projected to exceed 60,000 in each case. Population in the villages along the road stretching east from Bani Yas and west of Al Ain city is anticipated to grow to over 74,000 transforming it from a predominately rural area to an urban corridor C18. The Al Ain city population is projected to double by 2030 with more modest growth expected in the surrounding rural areas C18. Western region population is projected to almost double to over 378,000 with the biggest growth in Ruwais, Ghayathi, Mirfa, and Liwa C18. Source Districts Ghantoot Desert Villages (Al Wathba) South West HAAD Strategy Analysis; Abu Dhabi Urban Planning Council. http://www.upc.gov.ae/ 1 1 62 C16 Note Number and location of unserved areas will be subject to review during 2014.
Planning for healthcare services Significant additional capacity is required to meet growth in demand for healthcare services as the population grows C35 and ages. In existing developed areas the emphasis is on growing existing facilities to facilitate specialisation and scale. Future development plans should be focused on the areas where there is new residential and commercial development and planned population growth. Hospitals and clinics. In compliance with the requirements of the UPC Community Facility Planning Standards C43 the 2030 projected populations, which are largely predicated on new, suburban residential developments, may require a maximum of 16 new small-to-medium general hospitals and 56 (31 Large,11 Medium and 14 Small) new clinics C18 to provide local access to the expanding communities. The actual number required will depend on many factors including the extent to which existing facilities expand or improve efficiency of services and the accessibility of new facilities already planned or under construction C30,C31 to the new residential developments. HAAD analysis of current and projected inpatient supply C30,C31,C32 shows that the number of hospital beds planned, and under construction, is sufficient to meet the projected future demand. Specialty Care. Encouraging investment in specialised care remains a key objective. Whilst significant improvements in addressing specialty shortages have been achieved more needs to be done particularly in the area of reducing the number of patients required to travel abroad for treatment. HAAD will continue to work intensively with public and private providers and investors to ensure that the planned capacity provides the right balance of specialties and service types and is located in the most appropriate locations to further reduce capacity gaps. Emergency, Critical and Intensive Care. The analysis C32 shows that sufficient capacity is planned and under construction to meet the current shortfall by 2016. The current ambulance service network will also need to expand to support populations in newly developed and remote areas C18. Clinical staff. Attracting and retaining qualified staff remains a challenge for healthcare services across the Emirate, particularly in rural areas. It is estimated that by 2022 up to 4,800 additional doctors and 13,000 nurses will be required. If turnover remains high, this translates into up to 1,700 doctors and 2900 nurses to be recruited annually C36. Clinical training and education of a world class standard must be established locally to build a sustainable healthcare workforce and service supply. The risk of potential over-supply of healthcare, particularly of acute hospital beds C32, requires careful management. For example, Khalifa City currently has 4 hospital projects C18 under construction despite a projected 2030 population of only 80,000 C18. Similarly, Al Ain city has 15 provisional hospital projects C18 with potential demand for only 3 C18. In contrast to these examples, there are few health facility projects in rural areas of the Emirate C18. HAAD will regulate to align planned supply with demand through below 3 recommendations: 1) To control over-supply, future land is to be allocated only via the UPC in accordance with planned residential developments and the healthcare needs as determined by HAAD planning. 2) Upon review of projects with allocated land in already oversupplied locations HAAD to consider, on a case by case basis, reallocating existing land to the under-supplied locations as determined by HAAD Capacity Masterplan. 3) Pre-approval for highly specialised and regionally required services be obtained via HAAD planning section prior to issuance of preliminary licence for hospitals. HAAD recommendations for urban planners and developers aim to ensure building of healthcare facilities occurs when and where demand exists, not years in anticipation C43. 63 C17
Service capacity balance by location Region District Gap Now Type Population Facilities Clinicians 2030 Plan growth Total Total Hospitals Clinics & Centres Nearby hospital Doctors /1000 Population Growth Abu Dhabi Desert Villages Rural 52,960 2 2 57,040 1L 1 110,000 Al Falah Rural 7,490 None 52,937 0 1M 1 1 60,427 Ghantoot District Rural 4,608 None 3,282 1M 1 7,890 Abu Dhabi Island Urban 583,543 229 14 182 4.3 (313,278) 5 4 270,265 CBD/Financial Centre Urban 324,723 124 5 86 3.5 667 1 1 1M 325,390 Musaffah Urban 262,695 36 1 31 0.6 (223,587) 4 2 39,108 Bani Yas Rural 87,854 43 37 1.8 (3,403) 4 0 1M 1 84,451 Al Shahama Rural 70,349 10 10 0.6 (8,339) 1 1 1 62,010 Shamkhah Rural 29,453 1 1 1 182,828 1 0 0 3M 1 1 212,281 Al Rahba Rural 28,479 1 1 1 4.6 (11,304) 17,175 New Port City Rural 21,831 None 1 1,063 1L 1 22,894 Capital District South Urban 17,195 None 1 37,805 1 1L 1 55,000 Bain Al Jesrain Urban 14,307 3 3 2.3 28,991 1 1 1M 1 43,298 Khalifa City Urban - None 2 80,000 1 8 4 1 80,000 Grand Mosque District Urban 9,776 None 1 32,418 1 1 1M 42,194 Inner Islands Urban 5,214 1 5,937 1M 1 11,151 Capital District North Urban 4,409 2 73,591 1 2 1 2M 1 78,000 Al Mina Urban 1,990 7 4 43.7 64,553 1L 66,543 Al Raha Urban 1,538 2 1 26.7 103,161 1 0 1L 1 104,699 Yas Island Urban 1,443 None 67,292 0 1l 1 68,735 Mohamed Bin Zayed City Urban 610 2 2 1.6 287,390 2 3 0 1L 1 1 288,000 Saadiyat Urban 227 None 82,058 1 0 0 2L 1 82,285 Airport District Urban 182 6 4 43.9 64,303 1 0 0 1L 1 64,485 Lulu Island Urban 139 None 23,089 1M 1 23,228 Capital District Urban 2,238 None 267,868 2 0 1L 1 270,106 Mohamed Bin Zayed Centre Urban 5,969 None 74,031 1 0 80,000 South Hudayriat Island Rural 5,969 None 94,031 0 1L 100,000 Marina Village Urban 5,969 3 2 8,163 1S 14,132 Al Suwwah Urban 5,969 None 22,938 1 1 1 28,907 Al Reem Urban 5,969 None 163,919 2L 1 169,888 Al Ain Umm Ghaffa Rural 11,725 None 1,280 1S 1 13,005 Nahel Rural 6,883 None 3,117 1S 1 10,000 Industrial City Rural 64,649 8 5 0.21 (29,122) 35,527 Al Salamat/Al Yaher Urban 49,734 1 2 1 0.1 (32,460) 1 1 0 1 1 17,274 Al Dhahra Rural 6,568 None (1,032) 1S 5,536 Abu Krayyah Rural 5,442 None 715 1S 6,157 Al Saad Rural 5,072 None (1,380) 1S 3,692 Al Araad Rural 5,022 None (1,330) 1S 3,692 Abu Samra Rural 2,573 None (1,504) 1,069 Al Ain City Urban 454,374 186 9 158 3.8 252,926 3 15 4 2M 2 707,300 Al Quaa Rural 16,575 1 1 0.5 3,912 1M 1 20,487 Al Wagan Rural 15,718 1 1 1.1 10,050 1S 1 25,768 Al Hayer Rural 15,213 3 3 1.6 15,443 1M 1 1 30,656 Al Dhaher Rural 14,096 1 1 0.9 3,902 1M 1 17,998 Remah Rural 10,845 1 1 0.6 1,499 1S 12,344 Sweihan Rural 10,439 1 1 0.8 12,884 1L 1 1 23,323 Al Khazna Rural 9,737 2 2 0.4 100 1S 9,837 Mezyad Rural 8,487 None 1 2,861 1S 11,348 Al Shwaib Rural 4,319 1 1 0.7 336 1S 4,655 Al Fagah Rural 2,767 1 1 1.1 (552) 2,215 Western Liwa Rural 50,182 5 1 0.2 14,818 1L 1 65,000 Madinat Zayed Rural 72,764 16 1 11 2.4 (10,864) 2 0 1L 1 1 61,900 Ruwais Rural 40,146 4 1 3 1.2 65,854 1 1 1L 1 106,000 Mirfa Rural 37,637 4 1 3 0.9 37,363 1L 1 1 75,000 Ghayathi Rural 20,073 6 1 5 1.9 24,827 1 1 44,900 Sila'a Rural 12,546 1 1 1.8 4,954 1 1L 1 17,500 Delma Island Rural 12,546 1 1 1.8 (4,246) 1 8,300 4,223,025 need Hospitals under way Under Construction need Clinics under way Ambulance station 2030 Population Under Process Subject to Change Capacity Gap Supply Severe Moderate None Undersupply/underserved Potential over supply L, M, S Clinic size, large, medium, small 64 C18 Source Population: SCAD, 2011 Estimate, UPC 2030 plans. Clinicians and Facilities: Licensing database. Planned Facilities ; SEHA, UPC 2030 plans, HAAD Planning analysis.
Improving capacity management through regulating clinical service lines Description Examples Centralised 1 Highly specialised Strong volumebased competency Low volume High cost Burn Care Open Heart Surgery Oncology Surgery Regional 2 (Island/Middle, Eastern and Western) Moderate complexity Time dependency Some volumebased competency Middle volume Middle cost Cardiac Catheterisation Specialist Diabetes Care Standard Non-complex High volume Low cost 1 HAAD will restrict provision of these services to a few facilities 2 HAAD will issue licenses for these services on the basis of 1 per 250,000 population Source: Categories maintained by HAAD with input from Providers, Payers, and other stakeholders Basic Diabetes Care Family Medicine Preventive Services General Surgery 65 C19
List of Abu Dhabi clinical service lines For Planning and Licensing purposes HAAD will designate Centralised, Regional and Standard services for both adult and paediatric services at Diagnostic Resource Group level (DRG) level within the following 32 clinical service lines: Burns Gynecology Orthopaedic Cardiology - Invasive Haematology Plastic surgery Cardiology - Medical Immunology and infectious disease Psychiatry Cardiothoracic surgery Neonatology Rehabilitation Dentistry Nephrology Respiratory medicine Dermatology Neurological surgery Rheumatology Endocrinology Neurology Transplant surgery ENT Obstetrics Trauma Gastroenterology Obstetric - Delivery Urology General medicine Oncology Vascular surgery General surgery Ophthalmology Notes Source As the service lines are derived from IR-DRGs, which apply to all ages, the same classification applies to both adult and paediatric service lines but is differentiated by age. Paediatric service lines are differentiated from adult as those applicable to services planned or provided for ages from birth and up to 18 years old. Paediatric service lines exclude DRGs that are not applicable to paediatric categories. All stated services line encompass all patient setting except Long Term Care (LTC). Categories maintained by HAAD with input from Providers, Payers, and other stakeholders. 66 C20
Centralised, Regional and Standard services, by % total Abu Dhabi DRG volumes 67 C21 # HAAD Service Line Centralised Regional Standard 1 Burns 99.5% 0.5% 0.0% 2 Cardiology - Invasive 5.3% 82.7% 12.0% 3 Cardiology - Medical 3.5% 44.9% 51.6% 4 Cardiothoracic surgery 100.0% 0.0% 0.0% 5 Dentistry 0.0% 0.0% 100.0% 6 Dermatology 0.0% 8.0% 92.0% 7 Endocrinology 0.5% 13.3% 86.2% 8 ENT surgery 0.5% 8.3% 91.3% 9 Gastroenterology 0.0% 1.0% 99.0% 10 General medicine 5.6% 26.6% 67.7% 11 General surgery 1.2% 4.7% 94.0% 12 Gynecology 11.1% 3.7% 85.2% 13 Haematology 3.5% 44.9% 51.6% 14 Immunology and infectious disease 0.4% 0.6% 99.0% 15 Neonatology 4.0% 13.1% 82.9% 16 Nephrology 0.0% 2.8% 97.2% 17 Neurological surgery 40.1% 4.5% 55.5% 18 Neurology 0.0% 34.4% 65.6% 19 Obstetrics 0.0% 13.3% 86.7% 20 Obstetric - Delivery 0.0% 0.0% 100.0% 21 Medical oncology 30.7% 69.3% 0.0% 22 Ophthalmology 0.0% 81.1% 18.9% 23 Orthopaedic 0.6% 13.3% 86.2% 24 Plastic surgery 0.0% 26.8% 73.1% 25 Psychiatric 0.0% 20.8% 79.2% 26 Rehabilitation 0.0% 100.0% 0.0% 27 Respiratory medicine 0.7% 7.9% 91.4% 28 Rheumatology 0.0% 39.6% 60.4% 29 Transplant surgery 100.0% 0.0% 0.0% 30 Trauma 1 100.0% 0.0% 0.0% 31 Urology 0.4% 30.5% 69.1% 32 Vascular surgery 32.5% 67.5% 0.0% Notes Centralised services may only be provided by Providers designated by HAAD to do so. Regional services may only be offered by Providers designated by HAAD to do so. The number regional providers that may be designated within each region is detailed on page C27. Standard services may be offered by all HAAD Licensed Providers. Note: Emergency cases presenting to any HAAD Licensed Facilities should be treated (in accordance with HAAD Regulations). In case the DRG falls under Centralised or Regional service line, the case should be transferred to Providers Licensed for those service lines when clinically appropriate. Percentage figures are % by volume of all DRGs within each clinical service line; Details to be published on HAAD website (www.haad.ae) 1 Trauma Service Line contains only 3 DRGs related to Head Trauma. Source Categories maintained by HAAD with input from Providers, Payers, and other stakeholders.
Centralised, Regional and Standard services, by % total Abu Dhabi DRG volumes (Paediatric) Notes # HAAD Paediatric Service Line Centralised Regional Standard 1 Paediatric Burns 96.6% 3.4% 0.0% 2 Gynecological Surg 24.1% 1.2% 72.3% 3 Neonatology 2.2% 2.8% 95.0% 4 Obstetrics 0.0% 13.3% 86.7% 5 Obstetrics/Delivery 0.0% 0.0% 100.0% 6 Paediatric Cardiology - Invasive 100.0% 0.0% 0.0% 7 Paediatric Cardiology - Medical 53.6% 27.0% 19.4% 8 Paediatric Cardiology - Open Heart Surgery 100.0% 0.0% 0.0% 9 Paediatric Dental 0.0% 0.0% 100.0% 10 Paediatric Dermatology 0.0% 47.7% 52.3% 11 Paediatric Endocrinology 0.0% 1.5% 98.4% 12 Paediatric ENT Surgery 0.5% 0.6% 98.9% 13 Paediatric Gastroenterology 0.6% 2.8% 96.5% 14 Paediatric General Medicine 6.9% 4.0% 89.2% 15 Paediatric General Surgery 0.5% 3.5% 96.0% 16 Paediatric Haematology 2.2% 49.2% 48.6% 17 Paediatric Infectious Disease 0.0% 16.7% 83.3% 18 Paediatric Nephrology 0.0% 7.4% 92.6% 19 Paediatric Neurological surgery 58.1% 39.5% 0.0% 20 Paediatric Neurology 0.0% 17.6% 82.4% 21 Paediatric Oncology 53.0% 46.8% 0.0% 22 Paediatric Ophthalmology 46.7% 0.0% 53.3% 23 Paediatric Orthopedic Surgery 2.6% 26.6% 70.9% 24 Paediatric Plastic Surgery 0.5% 31.6% 67.8% 25 Paediatric Rehabilitation 0.0% 100.0% 0.0% 26 Paediatric Respiratory 0.2% 0.4% 99.4% 27 Paediatric Rheumatology 0.0% 7.8% 92.2% 28 Paediatric Vascular Surgery 3.1% 96.9% 0.0% 29 Paeditric Urology 6.7% 49.9% 43.4% 30 Psychiatry 1.4% 95.7% 2.9% 31 Paediatric Transplant Surgery 100.0% 0.0% 0.0% 32 Paediatric Trauma 9.4% 11.3% 79.2% Grand Total 2.9% 6.0% 90.7% Centralised services may only be provided by Providers designated by HAAD to do so. Regional services may only be offered by Providers designated by HAAD to do so. The number regional providers that may be designated within each region is detailed on page C27. Standard services may be offered by all HAAD Licensed Providers. Note: Emergency cases presenting to any HAAD Licensed Facilities should be treated (in accordance with HAAD Regulations). In case the DRG falls under Centralised or Regional service line, the case should be transferred to Providers Licensed for those service lines when clinically appropriate. Percentage figures are % by volume of all DRGs within each clinical service line; Details to be published on HAAD website (www.haad.ae). Paediatric age is defined to be inclusive of ages from birth and up to 18 years old. 68 C22 Source Categories maintained by HAAD with input from Providers, Payers, and other stakeholders.
Paediatric DRG coverage in Abu Dhabi Emirate # HAAD Paediatric Service Line Count of Total DRGs Non Available DRG Percent of coverage 1 Paediatric Burns 9 1 89% 2 Gynecological Surg 27 18 33% 3 Neonatology 51 17 67% 4 Obstetrics 15 7 53% 5 Obstetrics/Delivery 12 4 67% 6 Paediatric Cardiology - Invasive 15 7 53% 7 Paediatric Cardiology - Medical 45 13 71% 8 Paediatric Cardiology - Open Heart Surgery 24 18 13% 9 Paediatric Dental 3 3 100% 10 Paediatric Dermatology 12 0 100% 11 Paediatric Endocrinology 15 5 67% 12 Paediatric ENT Surgery 33 4 88% 13 Paediatric Gastroenterology 30 5 83% 14 Paediatric General Medicine 24 1 96% 15 Paediatric General Surgery 48 12 75% 16 Paediatric Haematology 18 1 94% 17 Paediatric Infectious Disease 18 5 72% 18 Paediatric Nephrology 18 0 100% 19 Paediatric Neurological surgery 18 9 50% 20 Paediatric Neurology 42 6 86% 21 Paediatric Oncology 48 20 58% 22 Paediatric Ophthalmology 15 2 87% 23 Paediatric Orthopedic Surgery 69 21 70% 24 Paediatric Plastic Surgery 15 4 60% 25 Paediatric Rehabilitation 3 0 100% 26 Paediatric Respiratory 48 11 77% 27 Paediatric Rheumatology 12 0 100% 28 Paediatric Vascular Surgery 15 9 40% 29 Paeditric Urology 30 11 63% 30 Psychiatry 45 24 47% 31 Paediatric Transplant Surgery 9 9 0% 32 Paediatric Trauma 3 3 0% Grand Total 789 249 68% SEHA Market Share % Capacity Gap Severe Moderate None Note Percentage figures are % by volume of all DRGs within each clinical service line; Details to be published on HAAD website (www.haad.ae. Paediatric age is defined to be inclusive of ages from birth and up to 18 years old. 69 C23 Source HAAD Strategy department, health statistics, planning analysis.
Coverage of Regionally required DRGs in Abu Dhabi Emirate Severe Gap/Coverage of <= 55 Moderate Gap/ Coverage of >= 65 No gap/coverage of >= 75 Low Volume of DRGs < 15% Moderate Volume of DRGs >= 15 % High Volume of DRGs >= 40% Abu Dhabi Region Eastern Region Western Region HAAD Service Line Number of Non Available Regional DRGs Count of Regional DRGs % of Regional Coverage Burns* (Transferred DRG) 2 2 0% Cardiology - Invasive 0 14 100% Cardiology - Medical 0 23 100% Dermatology 0 5 100% Endocrinology 0 2 100% ENT Surgery 1 6 83% Gastroenterology 1 5 80% General Medicine 0 2 100% General Surgery 0 6 100% Gynecological Surg 1 1 0% Hematology 0 15 100% Infectious Disease 0 3 100% Neonatology 9 26 65% Nephrology 0 3 100% Neurological surgery 0 3 100% Neurology 1 25 96% Obstetrics 0 3 100% Oncology 2 25 92% Ophthalmology 0 6 100% Orthopedic Surgery 2 22 91% Plastic Surgery 2 11 82% Psychiatry 10 24 58% Rehabilitation 0 3 100% Respiratory 3 15 80% Rheumatology 0 2 100% Trauma 0 2 100% Urology 1 17 94% Vascular Surgery 1 11 91% Grand Total 36 282 87% SEHA Market Share % HAAD Service Line Number of Non Available Regional DRGs Count of Regional DRGs % of Regional Coverage Burns* (Transferred DRG) 0 2 100% Cardiology - Invasive 5 14 64% Cardiology - Medical 0 23 100% Dermatology 0 5 100% Endocrinology 0 2 100% ENT Surgery 3 6 50% Gastroenterology 1 5 80% General Medicine 0 2 100% General Surgery 2 6 67% Gynecological Surg 1 1 0% Hematology 1 15 93% Infectious Disease 1 3 67% Neonatology 12 26 54% Nephrology 0 3 100% Neurological surgery 0 3 100% Neurology 1 25 96% Obstetrics 0 3 100% Oncology 0 25 100% Ophthalmology 0 6 100% Orthopedic Surgery 2 22 91% Plastic Surgery 3 11 73% Psychiatry 8 24 67% Rehabilitation 0 3 100% Respiratory 3 15 80% Rheumatology 0 2 100% Trauma 0 2 100% Urology 2 17 88% Vascular Surgery 3 11 73% Grand Total 48 282 83% SEHA Market Share % HAAD Service Line Number of Non Available Regional DRGs Count of Regional DRGs % of Regional Coverage Burns* (Transferred DRG) 1 2 50% Cardiology - Invasive 14 14 0% Cardiology - Medical 5 23 78% Dermatology 1 5 80% Endocrinology 0 2 100% ENT Surgery 4 6 33% Gastroenterology 2 5 60% General Medicine 0 2 100% General Surgery 3 6 50% Gynecological Surg 1 1 0% Hematology 7 15 53% Infectious Disease 3 3 0% Neonatology 19 26 27% Nephrology 1 3 67% Neurological surgery 3 3 0% Neurology 10 25 60% Obstetrics 1 3 67% Oncology 19 25 24% Ophthalmology 3 6 50% Orthopedic Surgery 10 22 55% Plastic Surgery 11 11 0% Psychiatry 23 24 4% Rehabilitation 3 3 0% Respiratory 7 15 53% Rheumatology 1 2 50% Trauma 0 2 100% Urology 11 17 35% Vascular Surgery 11 11 0% Grand Total 174 282 38% SEHA Market Share 70 C24 Source Note HAAD Strategy Department analysis based on 18 months of DRGs claims data. *Burns DRGs in this analysis are 2 DRGS relating to medical treatment received by a patient while transferring from one facility to another facility. They do not refer to the full treatment of burns which is a centralised service.
Population Facilities Clinicians Ratios 2030 Plan growth 2030 requirements 2030 planned Projects under way Population Growth Region District Gap now Type Abu Dhabi Desert Villages Rural 28,480 #NAME? 10,963 None 81,520 110,000 Al Falah Rural 4,028 #NAME? 1,996 None 95,972 1 1 100,000 Ghantoot District Rural 2,478 #NAME? - None 97,522 1 100,000 Abu Dhabi Island Urban 313,809 #NAME? 44,004 229 13 182 2,529 3,878 430 1,284 6.2 8.1 12.4 111,191 425,000 CBD/Financial Centre Urban 174,625 #NAME? 14,141 124 5 86 1,131 1,663 241 539 5.2 6.5 9.5 15,375 1 190,000 Musaffah Urban 141,268 #NAME? 2,256 36 31 161 194 21 68 2.2 1.1 1.4 (41,268) 1 1 3 100,000 Bani Yas Rural 47,245 #NAME? 27,267 43 37 162 106 57 73 7.8 3.4 2.2 22,755 4 70,000 Al Shahama Rural 37,831 #NAME? 16,361 10 10 45 47 14 24 2.6 1.2 1.2 72,169 1 1 1 110,000 Shamkhah Rural 15,839 #NAME? 10,674 None 1 114,161 130,000 Al Rahba Rural 15,315 #NAME? 13,038 1 1 132 325 5 89 0.7 8.6 21.2 94,685 1 110,000 New Port City Rural 11,740 #NAME? 4,565 None 138,260 2 150,000 Capital District South Urban 9,247 #NAME? 33 None 1 45,753 1 1 55,000 Bain Al Jesrain Urban 7,694 #NAME? 4,927 3 3 33 42 10 17 3.9 4.3 5.5 17,306 1 1 25,000 Khalifa City A Urban 5,317 #NAME? 2,703 11 1 10 78 74 17 75 20.7 14.7 13.9 64,683 1 1 6 70,000 Grand Mosque District Urban 5,257 #NAME? 1,837 None 1 114,743 1 1 120,000 Inner Islands Urban 2,804 #NAME? 480 1 2 4 3.6 0.7 1.4 17,196 1 20,000 Capital District North Urban 2,371 #NAME? 2,121 2 1 1 426 792 36 302 8.4 179.7 334.0 67,629 1 3 70,000 Al Mina Urban 1,070 #NAME? 53 7 4 87 103 25 62 37.4 81.3 96.3 98,930 100,000 Al Raha Urban 827 #NAME? 397 2 1 1 41 42 9 12 49.6 50.8 119,173 1 120,000 Yas Island Urban 776 #NAME? 1 None 99,224 100,000 Mohamed Bin Zayed City Urban 328 #NAME? 95 2 2 1 2 4 2 3.0 6.1 49,672 1 1 4 50,000 Saadiyat Urban 122 #NAME? None 119,878-120,000 Airport District Urban 98 #NAME? 32 6 4 8 11 5 11 81.6 112.2 49,902 50,000 Lulu Island Urban 75 #NAME? None 19,925 1 20,000 Capital District Urban #NAME? None 240,000 2 240,000 Mohamed Bin Zayed Centre Urban #NAME? None 80,000 1 80,000 South Hudayriat Island Rural #NAME? None 100,000 1 100,000 Marina Village Urban #NAME? 3 2 1 3 6 5,000 5,000 Al Suwwah Urban #NAME? None 30,000 1 1 30,000 Al Reem Urban #NAME? None 200,000 200,000 Al Ain Umm Ghaffa Rural 8,851 #NAME? 5,873 None 3,049 11,900 Nahel Rural 5,196 #NAME? 2,377 None 4,804 1 1 10,000 Industrial City Rural 48,803 #NAME? 18 8 5 14 5 1 5 1.0 0.3 0.1 30,937 1 79,740 Al Salamat/Al Yaher Urban 37,544 #NAME? 23,400 1 1 1 3 1 6 0.3 0.1 0.0 36,456 1 1 2 74,000 Al Dhahra Rural 4,958 #NAME? 715 None 1,042 6,000 Abu Krayyah Rural 4,108 #NAME? 655 None 892 1 1 5,000 Al Saad Rural 3,829 #NAME? 702 None 1,171 1 5,000 Al Araad Rural 3,791 #NAME? 139 None 209 1 4,000 Abu Samra Rural 1,942 #NAME? 286 None 558 1 2,500 Al Ain City Urban 343,002 #NAME? 100,298 186 7 148 1,733 2,864 318 968 4.5 5.1 8.3 364,298 3 8 707,300 Al Quaa Rural 12,512 #NAME? 4,912 1 8 13 3 0.8 0.6 1.0 10,488 23,000 Al Wagan Rural 11,865 #NAME? 3,330 1 1 17 29 1 4 0.8 1.4 2.4 18,135 1 1 1 30,000 Al Hayer Rural 11,484 #NAME? 2,570 3 3 25 34 4 3 2.6 2.2 3.0 20,516 2 32,000 Al Dhaher Rural 10,641 #NAME? 7,325 1 1 13 20 3 4 0.9 1.2 1.9 3,709 1 1 14,350 Remah Rural 8,187 #NAME? 683 6 9 2 1.2 0.7 1.1 1,313 1 9,500 Sweihan Rural 7,880 #NAME? 713 1 1 8 11 1 1 1.3 1.0 1.4 32,120 1 2 40,000 Al Khazna Rural 7,350 #NAME? 1,071 2 2 4 13 1 2.7 0.5 1.8 1,650 9,000 Mezyad Rural 6,407 #NAME? 3,809 None 1 1,993 1 1 8,400 Al Shwaib Rural 3,260 #NAME? 1,546 4 3.1 0.9 1.2 2,240 1 5,500 Al Fagah Rural 2,089 #NAME? 378 1 1 3 3 4.8 1.4 1.4 1,411 1 3,500 Western Liwa Rural 20,000 #NAME? 661 5 1 1 8 17 5 32 1.0 0.4 0.9 45,000 65,000 Madinat Zayed Rural 29,000 #NAME? 6,785 16 2 11 175 256 23 107 4.5 6.0 8.8 11,000 1 1 40,000 Ruwais Rural 16,000 #NAME? 1,270 50 100 7 14 2.5 3.1 6.3 114,000 1 130,000 Mirfa Rural 15,000 #NAME? 3,676 4 1 3 32 61 3 17 2.7 2.1 4.1 60,000 75,000 Ghayathi Rural 8,000 #NAME? 3,898 6 5 38 63 5 18 7.5 4.8 7.9 7,000 1 15,000 Sila'a Rural 5,000 #NAME? - 1 1 22 39 2 10 2.0 4.4 7.8 65,000 70,000 Delma Island Rural 5,000 #NAME? 2,139 1 1 23 25 2 10 2.0 4.6 5.0 5,000 1 10,000 Capacity Gap Severe Note: Abu Dhabi and Al Gharbia populations based on SCAD 2005 census. Al Ain population based on 2008 UPC estimate. Moderate Source: Population: SCAD, UPC 2030 plans. Clinicians and Facilities: Licensing database. Planned Facilities ; SEHA, UPC 2030 plans, HAAD Planning analysis. None Model of Care Model of care How health services should be used DRAFT Patient self-care Non-emergency/elective Capacity Gaps Capacity Management Capacity Masterplan Total % National Nationals Total Hospitals Clinics Nearby hospital Doctors Nurses Dentists Other Facilities /10000 Doctors /1000 Nurses /1000 Hospitals required Clinic required Hospitals Clinics Hospitals Clinics 2030 Population Remote support Outpatient Clinic Elective Admission Screening Ambulance Check-up Urgent Care Centre Disease Emergency Triage ER management Admission. Preventative Emergency Including diagnostics Source Institute of Medicine 2001 Crossing the Quality Chasm, Bodenheimer et al 2002 JAMA, Department of Health UK 2001 Reforming Emergency Care, Picker Institute, Strategy analysis 11 Demand & Supply Projections Current and projected demand, by Episodes and beds Acute Overnight Episodes Bed Occupancy 2011 Actual 2016 2021 2026 2031 122,345 184,102 223,539 276,589 332,040 Acute Overnight Beds Current (58%) 3,289 3,992 5,223 6,769 7,061 Sub Acute Overnight Episodes Sub Acute Overnight Beds Intermediate (70%) 3,308 4,328 5,609 5,850 Target (85%) 2,724 3,564 4,619 4,818 N/A 3,216 4,233 5,461 6,738 224 342 438 449 525 ICU beds 146 175 209 245 281 Emergency Bays N/A 789 987 1,182 1,379 Notes :Sub Acute beds include: Rehabilitation, Palliative care, Maintenance, Older Persons and Psychogeriatric care; ICU beds exclude Paediatrics, NICU, CCU, etc. Acute Overnight beds exclude day case beds. Sub acute numbers of beds adjusted Source: TAHPI, Health Facility briefing system, reference data is based on data extracted from the Australian Institute of Health and Welfare, supplemented by data from the USA inpatient sample and UK Hospital Episode Statistics Online (HES) Assumptions Projected bed numbers from 2016 onwards are based on International Average ALOS and 75% occupancy for ICU beds. Population growth based on: Abu Dhabi Urban Planning Council 2030 Plan projections, Advantaged socio-economic class and with life expectancy >77years. Expatriate utilisation increases from 45% of UAE National utilisation to 55% of UAE National utilisation. Sub acute number of beds adjusted to meet international benchmark C17 Assumptions Population (millions) Population growth, scenarios As at 31 December 2010 Draft 4.0 Population growth, Scenarios High 3.5 Low National Expatriate Year Low High 3.0 2011 411'200 1'945'000 2'045'000 2012 416'150 1'970'000 2'190'000 2.5 2013 422'200 2'060'000 2'350'000 2.0 2014 429'400 2'130'000 2'505'000 2015 437'800 2'175'000 2'675'000 1.5 2016 445'800 2'250'000 2'850'000 2017 453'600 2'310'000 3'045'000 1.0 2018 460'500 2'360'000 3'240'000 2019 467'600 2'400'000 3'400'000 0.5 2020 473'600 2'475'000 3'575'000 0.0 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Note HAAD and SCAD are collaborating to align figures with official SCAD estimates; Estimates presented here are for internal HAAD use only Projections for Nationals are rounded to the nearest 2.5% variance between high and low, and those for Expatriates at 5%. Source SCAD population estimates; additional HAAD assumptions and analysis based on raw insurance data` 73 Recommendations Land requirements Guidelines for urban planners DRAFT For planning purposes, land must be available for hospitals, clinics and ambulance stations to serve anticipated population as per the following guidelines: Population (000 s people) Land provision options Residential Transient1 Land area Co-location GFA 4 OR (m 2 000 s) OR OR (m 2 000 s) Parking (spaces) Minimum service requirement Estimated Resources Clinics2 4-5 12-15 6? 3 2.5 25 Primary care 2 Physicians Pharmacy services (on-site or 8-12 24-36 7? 3 within 10 min walk) 3 30 4-6 Physicians Laboratory service 12-30 36-90 8.5 3? 3.5 35 7-14 Physicians 30-40 90-120 12 3? 4.5 45 15-20 Physicians Hospitals5 60-80 180-240 80 n/a n/a 3/bed Emergency services 180-240 Laboratory services Beds 6 Radiology services 90-110 270-330 100 n/a n/a 3/bed 270-330 Stand-alone building beds 6 Ambulance Stations 10-16 30-48 3? 7 n/a 10 Ambulance service (land /air) 1 Ambulance 16-40 48-120 4? 7 n/a 15 Ambulance service (land /air) 2 Ambulances Notes 1 Transient population includes staff and other non-residential visitors 2 Clinics collectively refers to Clinics, Centers and Polyclinics 3 Appropriate facilities for co-location with Clinics include Hospitals, Ambulance Stations, Mosques, Neighbourhood Commercial Centres, Sport Facilities, Community/Cultural Centres, Pharmacies, Schools and Post Offices, 4 Clinic GFA may be provided within larger commercial centre with adequate transport options and shared parking 5 If residential population is less than 60,000 or transient population is less than 180,000, land provision for a hospital facility needs to be made on a site-based analysis which considers the accesibility of existing hospital facilities 6 Optimal hospital size is 200-600 beds 7 Appropriate facilities for co-location with Ambulance Stations include Clinics, Hospitals, Civil Defense Stations, Police Stations and Municipal Offices Source HAAD Health Facility Community Guidelines 2009, Strategy analysis 5 71 C25
Inpatient current supply and projected demand, by number of beds (Acute, Subacute and Intensive Care) plus Emergency bays Beds / Service Types Current Supply Demand Based on Bed Occupancy 2015 2020 2025 2030 Total Beds 50% 5,843 7,238 8,767 11,365 3,864 56% (current) 5,264 6,517 7,890 10,217 60% 4,942 6,116 7,402 9,046 70% 4,298 5,314 6,428 7,858 Acute Overnight Beds 50% 5,408 6,734 8,186 10,710 3,617 56% (current) 4,828 6,012 7,308 9,562 60% 4,506 5,611 6,821 8,404 70% 3,863 4,810 5,847 7,203 Subacute Overnight Beds 247 70% 435 505 581 655 Intensive Care Beds 183 75% 211 243 277 335 Emergency Bays 273 491 576 694 837 72 C26 Assumptions Notes Sources Projected bed numbers from 2015 onwards are based on International Average ALOS. Rate of population growth based on: Abu Dhabi Urban Planning Council 2030 Plan projections, Advantaged socio-economic class and with life expectancy >77years. Expatriate utilisation increases from 45% of UAE National utilisation to 55% of UAE National utilisation. Subacute beds include: Rehabilitation, Palliative care, Maintenance, Older Persons and Psychogeriatric care; ICU beds exclude Paediatrics, NICU, CCU, etc.; Acute Overnight beds exclude day case beds. Demand projections are subject to further review and change as new reference data & methodology becomes available. Current supply: HAAD Operations Centre Bed Census, HAAD Planning analysis of New Facility Applications (NFAs), SEHA. Demand Projections: TAHPI, Health Facility Briefing System, reference data is based on data extracted from the Australian Institute of Health and Welfare, supplemented by data from the USA inpatient sample and UK Hospital Episode Statistics Online (HES).
Projected demand by Abu Dhabi planning region Number of Regional Providers From 2013 Regional inpatient services may only be provided by providers designated by HAAD to do so. HAAD has determined the current and future maximum number of Regional facilities for each region: 2015 2017 2020 2025 2030 Abu Dhabi and Middle Region population 1,498,000 1,723,000 1,930,549 2,276,464 2,622,379 Regional Providers (Abu Dhabi and Middle Region) 6 7 8 9 10 Al-Ain (Eastern) Region population 652,000 715,000 781,338 891,902 1,002,466 Regional Providers (Al Ain Region) 3 3 3 4 4 Al Gharbia (Western) Region population 236,016 264,526 290,851 334,725 378,600 Regional Providers (Al Gharbia Region) 1 1 1 1 2 Total Regional Facilities in Abu Dhabi 10 11 12 14 16 Methodology Based on UPC Plan 2030 projected population and derived compound annual growth rate 2012 2030 Note HAAD may vary the number of Regional facilities depending on demand and supply factors. 73 C27
Projected inpatient demand by Abu Dhabi planning region, by number of beds (Acute, Subacute and Intensive Care) plus Emergency bays 74 C28 Assumptions Notes Sources Region Bed/Service Type Curent Supply Projected Demand Beds Required By Year Actual 2013 2015 2020 2025 2030 Bed Occupancy Abu Dhabi & Middle Total Beds 50% 3,329 4,094 4,944 6,407 2,379 56% (current) 2,998 3,687 4,451 5,762 60% 2,814 3,461 4,177 5,105 70% 2,446 3,008 3,630 4,435 Acute Overnight 50% 3,092 3,801 4,602 6,021 2,194 56% (current) 2,761 3,394 4,109 5,376 60% 2,577 3,168 3,835 4,725 70% 2,209 2,715 3,287 4,050 Subacute 185 70% 237 293 342 386 Intensive Care Beds 135 75% 119 139 157 190 Emergency Bays 142 271 317 394 475 Al Ain Total Beds 50% 2,057 2,593 3,163 4,133 1,239 56% (current) 1,855 2,334 2,846 3,718 60% 1,742 2,190 2,669 3,262 70% 1,528 1,941 2,370 2,896 Acute Overnight 50% 1,885 2,414 2,965 3,879 1,177 56% (current) 1,683 2,155 2,647 3,463 60% 1,571 2,012 2,471 3,044 70% 1,347 1,724 2,118 2,609 Subacute 62 70% 171 179 199 254 Intensive Care Beds 41 75% 77 87 100 121 Emergency Bays 77 181 217 252 304 Western Total Beds 50% 457 551 659 861 246 56% (current) 411 496 593 774 60% 386 465 556 679 70% 346 412 490 599 50% 430 519 619 810 56% (current) 384 463 553 723 Acute Overnight 246 60% 358 432 516 635 70% 307 370 442 545 Subacute - 70% 27 33 40 51 Intensive Care Beds 7 75% 15 18 20 24 Emergency Bays 54 38 42 48 58 Rate of population growth based on: Abu Dhabi Urban Planning Council 2030 Plan projections, Advantaged socio- economic class and with life expectancy >77years. Expatriate utilisation increases from 45% of UAE National utilisation to 55% of UAE National utilisation. Subacute beds include: Rehabilitation, Palliative care, Maintenance, Older Persons and Psychogeriatric care; ICU beds exclude Paediatrics, NICU, CCU, etc. Acute Overnight beds exclude day case beds. Current supply: HAAD Operations Centre Bed Census, HAAD Planning analysis of New Facility Applications (NFAs), SEHA. Demand Projections: TAHPI, Health Facility briefing system, reference data is based on data extracted from the Australian Institute of Health and Welfare, supplemented by data from the USA inpatient sample and UK Hospital Episode Statistics Online (HES)
Current health facility locations H Hospital Centre Clinic Pharmacy Al 75 C29 Source HAAD Licensing database, GPS survey; not all Centre and Clinic locations shown.
Supply projections Region Total Hospital Beds With Preliminary license No. of Beds For Hospital >50% Construction No. of Beds For Hospital <50% Construction No Construction Status Total 11764 3106 383 8275 Abu Dhabi & Middle 9241 2318 310 6613 Districts Hospital Sub Type No. of Beds Construction Status Completion Date Land Public/ Private Districts Hospital Sub Type No. of Beds Construction Status Completion Date Land Public/ Private Abu Dhabi Island General Hospital 141 >50% 2015 N Private Specialised Hospital 88 >50% 2015 Y Private Al Karama Specialised Hospital 825 Planned 2019 Y Public Al Shamkha General Hospital 125 Planned Y Public Al Maryah Island General Hospital 364 >50% 2015 Y Public Bain Al Jesrain General Hospital 300 <50% 2015 Y Private Bani Yas General Hospital 25 Planned Y Private General Hospital 100 Planned Y Private General Hospital 120 Planned Y Private General Hospital 118 Planned Y Private General Hospital 90 Planned Y Private Nursing Home 72 Planned Y Private Grand Mosque District General Hospital 100 >50% Y Private General Hospital 150 >50% 2015 Y Private Specialised Hospital 100 Planned Y Private General Hospital 10 <50% Y Private General Hospital 250 >50% 2014 Y Private Specialised Hospital 100 Planned Y Private General Hospital 52 >50% Y Private General Hospital 52 Planned Y Private Shakbhout City General Hospital 99 Planned Y Private Nursing Home 72 >50% Y Private General Hospital 100 Planned Y Private Mafraq General Hospital 732 >50% 2016 Y Public Mohamed Bin Zayed City General Hospital 37 Planned Y Private General Hospital 50 >50% 2014 Y Private General Hospital 300 Planned Y Private General Hospital 210 Planned Y Private Mussafah General Hospital 100 Planned Y Private General Hospital 35 Planned Y Private General Hospital 100 >50% 2014 Y Private General Hospital 119 >50% 2014 N Private General Hospital 400 Planned N Private Rehabilitation Hospital 140 Planned N Private Rehabilitation Hospital 90 Planned N Private General Hospital 125 Planned N Private General Hospital 50 Planned N Private General Hospital 100 Planned N Private General Hospital 25 Planned N Private General Hospital 150 Planned N Private General Hospital 50 Planned N Private General Hospital 150 Planned N Private General Hospital 150 Planned N Private General Hospital 50 Planned N Private General Hospital 50 Planned N Private General Hospital 72 Planned N Private General Hospital 140 Planned N Private General Hospital 150 Planned N Private General Hospital 100 Planned Y Private General Hospital 100 Planned N Private General Hospital 50 Planned N Private General Hospital 54 Planned N Private Rehabilitation Hospital 140 Planned N Private General Hospital 180 Planned N Private Specialised Hospital 53 Planned N Private General Hospital 100 Planned N Private General Hospital 50 Planned N Private Rehabilitation Hospital 40 Planned N Private General Hospital 300 Planned N Private General Hospital 300 Planned N Private General Hospital 250 Planned N Private General Hospital 235 Planned N Private General Hospital 28 Planned N Private General Hospital 100 Planned N Private Shahama General Hospital 100 >50% Y Private Zaied Militarism City Specialised Hospital 20 Planned Y Private Notes Completion likelihood from Land and Project State List (Maintained by HAAD Health Facility Licensing). Mafraq & Al Ain Hospital existing beds numbers are additional planned beds over and above the existing bed numbers. 76 C30 Source Preliminary licensed facilities, HAAD Licensing and Strategy analysis.
Supply projections Region Eastern Total Total Hospital Beds With Preliminary license No. of Beds For Hospital >50% Construction No. of Beds For Hospital <50% Construction No Construction Status 2289 788 50 1451 Districts Hospital Sub Type No. of Beds Construction Status Completion date Land Public/ Private Al Ain City Specialised Hospital 713 <50% 2019 Y Public General Hospital 50 >50% 2015 Y Private Rehabilitation Hospital 25 >50% 2015 N Private General Hospital 36 Planned Y Private General Hospital 112 Planned Y Private Al Hili General Hospital 30 Planned Y Private General Hospital 100 Planned Y Private Al Jimi General Hospital 100 Planned Y Private Al Khabasi One Day Surgry 6 Planned Y Private Al Towaya General Hospital 54 Planned Y Private General Hospital 100 Planned Y Private Al Yahar General Hospital 60 Planned Y Private Al Jimi General Hospital 30 Planned Y Private Falej Hazza General Hospital 46 Planned Y Private General Hospital 40 Planned Y Private General Hospital 126 Planned N Private General Hospital 50 Planned N Private General Hospital 60 Planned N Private Specialised Hospital 71 Planned N Private Specialised Hospital 70 Planned N Private General Hospital 50 Planned N Private Rehabilitation Hospital 32 Planned N Private General Hospital 50 Planned N Private General Hospital 50 <50% 2015 Y Private General Hospital 96 Planned N Private Rehabilitation Hospital 32 Planned N Private General Hospital 100 Planned Y Private Region Western Total Hospital Beds With Preliminary license No. of Beds For Hospital >50% Construction No. of Beds For Hospital <50% Construction No Construction Status Total 234 0 23 211 Districts Hospital Sub Type No. of Beds Construction Status Completion date Land Public/ Private Gayathi General Hospital 50 Planned Y Public Madinat Zayed General Hospital 54 Planned Y Private Specialized Hospital 23 <50% 2015 N Private General Hospital 50 Planned N Private General Hospital 30 Planned N Private Sila General Hospital 36 Planned 2015 Y Public Notes Completion likelihood from Land and Project State List (Maintained by HAAD Health Facility Licensing). Mafraq & Al Ain Hospital existing beds numbers are additional planned beds over and above the existing bed numbers. 77 C31 Source Preliminary licensed facilities, HAAD Licensing and Strategy analysis.
Inpatient current and projected supply by number of beds (Acute, Subacute and Intensive Care) plus Emergency Bays Provider Bed/Service Type Current Supply Planned Supply 2013 2014 2015 2016 2017 2018 2019 2020 2025 2030 SEHA Total Beds 2,489 2,489 2,516 3,079 3,079 3,079 3,641 3,826 3,876 3,876 Acute Overnight 2,444 2,444 2,471 3,034 3,210 3,210 3,596 3,781 3,831 3,831 Subacute 1 45 45 45 45 45 45 45 45 45 45 Under-supply Potential over-supply Adequate supply Intensive Care Beds 120 120 134 168 202 202 228 228 228 228 Emergency Bays 232 232 232 275 275 275 299 314 314 314 Mubadala Total Beds 80 80 230 330 444 444 444 570 570 570 Acute Overnight 80 80 230 330 444 444 444 570 570 570 Subacute - - - - - - - - - - Intensive Care Beds 3 3 27 39 75 75 75 59 107 107 Emergency Bays - - 16 16 16 16 16 16 16 16 Private Total Beds 1,295 1,814 2,660 2,760 2,860 2,960 3,060 3,160 3,660 4,160 Acute Overnight 1,093 1,612 2,391 2,491 2,573 2,655 2,737 2,819 3,319 3,819 Subacute 202 202 269 269 287 305 323 341 431 521 Intensive Care Beds 60 70 97 124 134 144 154 164 214 264 Emergency Bays 41 41 249 274 299 324 349 374 399 424 Emirate Total Beds 3,864 4,383 5,406 6,169 6,383 6,483 7,145 7,556 8,106 8,606 Acute Overnight 3,617 4,136 5,092 5,855 6,227 6,309 6,777 7,170 7,720 8,220 Subacute 247 247 314 314 332 350 368 386 476 566 Intensive Care Beds 183 193 258 331 411 421 457 451 549 599 Emergency Bays 273 273 497 565 590 615 664 704 729 845 Notes Subacute Beds include: rehabilitation, palliative care, maintenance, older persons and psychogeriatric care but exclude behavioral science beds; Intensive Care Beds are a subset of Acute Overnight Beds and exclude PICU, NICU, CCU, etc.; Acute Overnight beds exclude day case beds. Analysis excludes military beds. Demand projections are subject to further review and change as new reference data & methodology becomes available. 1 Both existing Mafraq and Al Ain hospitals have been identified to be re-used for subacute care, mental health care and isolation facilities once the new SEHA hospitals are operational. These beds are not included in the above supply projections as the exact usage has yet to be determined. 78 C32 Sources Supply projections: Private providers planned supply based on HAAD HFL database; SEHA planned supply based on SEHA communication to HAAD dated 8/10/2014; Mubadala projections based on HAAD HFL database and Mubadala communication to HAAD dated 24/10/2013. Current supply: HAAD Operations Centre Bed Census, HAAD Planning analysis of New Facility Applications (NFAs), SEHA.
Population Facilities Clinicians Ratios 2030 Plan growth 2030 requirements 2030 planned Projects under way Population Growth Region District Gap now Type Abu Dhabi Desert Villages Rural 28,480 #NAME? 10,963 None 81,520 110,000 Al Falah Rural 4,028 #NAME? 1,996 None 95,972 1 1 100,000 Ghantoot District Rural 2,478 #NAME? - None 97,522 1 100,000 Abu Dhabi Island Urban 313,809 #NAME? 44,004 229 13 182 2,529 3,878 430 1,284 6.2 8.1 12.4 111,191 425,000 CBD/Financial Centre Urban 174,625 #NAME? 14,141 124 5 86 1,131 1,663 241 539 5.2 6.5 9.5 15,375 1 190,000 Musaffah Urban 141,268 #NAME? 2,256 36 31 161 194 21 68 2.2 1.1 1.4 (41,268) 1 1 3 100,000 Bani Yas Rural 47,245 #NAME? 27,267 43 37 162 106 57 73 7.8 3.4 2.2 22,755 4 70,000 Al Shahama Rural 37,831 #NAME? 16,361 10 10 45 47 14 24 2.6 1.2 1.2 72,169 1 1 1 110,000 Shamkhah Rural 15,839 #NAME? 10,674 None 1 114,161 130,000 Al Rahba Rural 15,315 #NAME? 13,038 1 1 132 325 5 89 0.7 8.6 21.2 94,685 1 110,000 New Port City Rural 11,740 #NAME? 4,565 None 138,260 2 150,000 Capital District South Urban 9,247 #NAME? 33 None 1 45,753 1 1 55,000 Bain Al Jesrain Urban 7,694 #NAME? 4,927 3 3 33 42 10 17 3.9 4.3 5.5 17,306 1 1 25,000 Khalifa City A Urban 5,317 #NAME? 2,703 11 1 10 78 74 17 75 20.7 14.7 13.9 64,683 1 1 6 70,000 Grand Mosque District Urban 5,257 #NAME? 1,837 None 1 114,743 1 1 120,000 Inner Islands Urban 2,804 #NAME? 480 1 2 4 3.6 0.7 1.4 17,196 1 20,000 Capital District North Urban 2,371 #NAME? 2,121 2 1 1 426 792 36 302 8.4 179.7 334.0 67,629 1 3 70,000 Al Mina Urban 1,070 #NAME? 53 7 4 87 103 25 62 37.4 81.3 96.3 98,930 100,000 Al Raha Urban 827 #NAME? 397 2 1 1 41 42 9 12 49.6 50.8 119,173 1 120,000 Yas Island Urban 776 #NAME? 1 None 99,224 100,000 Mohamed Bin Zayed City Urban 328 #NAME? 95 2 2 1 2 4 2 3.0 6.1 49,672 1 1 4 50,000 Saadiyat Urban 122 #NAME? None 119,878-120,000 Airport District Urban 98 #NAME? 32 6 4 8 11 5 11 81.6 112.2 49,902 50,000 Lulu Island Urban 75 #NAME? None 19,925 1 20,000 Capital District Urban #NAME? None 240,000 2 240,000 Mohamed Bin Zayed Centre Urban #NAME? None 80,000 1 80,000 South Hudayriat Island Rural #NAME? None 100,000 1 100,000 Marina Village Urban #NAME? 3 2 1 3 6 5,000 5,000 Al Suwwah Urban #NAME? None 30,000 1 1 30,000 Al Reem Urban #NAME? None 200,000 200,000 Al Ain Umm Ghaffa Rural 8,851 #NAME? 5,873 None 3,049 11,900 Nahel Rural 5,196 #NAME? 2,377 None 4,804 1 1 10,000 Industrial City Rural 48,803 #NAME? 18 8 5 14 5 1 5 1.0 0.3 0.1 30,937 1 79,740 Al Salamat/Al Yaher Urban 37,544 #NAME? 23,400 1 1 1 3 1 6 0.3 0.1 0.0 36,456 1 1 2 74,000 Al Dhahra Rural 4,958 #NAME? 715 None 1,042 6,000 Abu Krayyah Rural 4,108 #NAME? 655 None 892 1 1 5,000 Al Saad Rural 3,829 #NAME? 702 None 1,171 1 5,000 Al Araad Rural 3,791 #NAME? 139 None 209 1 4,000 Abu Samra Rural 1,942 #NAME? 286 None 558 1 2,500 Al Ain City Urban 343,002 #NAME? 100,298 186 7 148 1,733 2,864 318 968 4.5 5.1 8.3 364,298 3 8 707,300 Al Quaa Rural 12,512 #NAME? 4,912 1 8 13 3 0.8 0.6 1.0 10,488 23,000 Al Wagan Rural 11,865 #NAME? 3,330 1 1 17 29 1 4 0.8 1.4 2.4 18,135 1 1 1 30,000 Al Hayer Rural 11,484 #NAME? 2,570 3 3 25 34 4 3 2.6 2.2 3.0 20,516 2 32,000 Al Dhaher Rural 10,641 #NAME? 7,325 1 1 13 20 3 4 0.9 1.2 1.9 3,709 1 1 14,350 Remah Rural 8,187 #NAME? 683 6 9 2 1.2 0.7 1.1 1,313 1 9,500 Sweihan Rural 7,880 #NAME? 713 1 1 8 11 1 1 1.3 1.0 1.4 32,120 1 2 40,000 Al Khazna Rural 7,350 #NAME? 1,071 2 2 4 13 1 2.7 0.5 1.8 1,650 9,000 Mezyad Rural 6,407 #NAME? 3,809 None 1 1,993 1 1 8,400 Al Shwaib Rural 3,260 #NAME? 1,546 4 3.1 0.9 1.2 2,240 1 5,500 Al Fagah Rural 2,089 #NAME? 378 1 1 3 3 4.8 1.4 1.4 1,411 1 3,500 Western Liwa Rural 20,000 #NAME? 661 5 1 1 8 17 5 32 1.0 0.4 0.9 45,000 65,000 Madinat Zayed Rural 29,000 #NAME? 6,785 16 2 11 175 256 23 107 4.5 6.0 8.8 11,000 1 1 40,000 Ruwais Rural 16,000 #NAME? 1,270 50 100 7 14 2.5 3.1 6.3 114,000 1 130,000 Mirfa Rural 15,000 #NAME? 3,676 4 1 3 32 61 3 17 2.7 2.1 4.1 60,000 75,000 Ghayathi Rural 8,000 #NAME? 3,898 6 5 38 63 5 18 7.5 4.8 7.9 7,000 1 15,000 Sila'a Rural 5,000 #NAME? - 1 1 22 39 2 10 2.0 4.4 7.8 65,000 70,000 Delma Island Rural 5,000 #NAME? 2,139 1 1 23 25 2 10 2.0 4.6 5.0 5,000 1 10,000 Capacity Gap Severe Note: Abu Dhabi and Al Gharbia populations based on SCAD 2005 census. Al Ain population based on 2008 UPC estimate. Moderate Source: Population: SCAD, UPC 2030 plans. Clinicians and Facilities: Licensing database. Planned Facilities ; SEHA, UPC 2030 plans, HAAD Planning analysis. None Model of Care Model of care How health services should be used DRAFT Patient self-care Non-emergency/elective Capacity Gaps Capacity Management Capacity Masterplan Total % National Nationals Total Hospitals Clinics Nearby hospital Doctors Nurses Dentists Other Facilities /10000 Doctors /1000 Nurses /1000 Hospitals required Clinic required Hospitals Clinics Hospitals Clinics 2030 Population Remote support Outpatient Clinic Elective Admission Screening Ambulance Check-up Urgent Care Centre Disease Emergency Triage ER management Admission. Preventative Emergency Including diagnostics Source Institute of Medicine 2001 Crossing the Quality Chasm, Bodenheimer et al 2002 JAMA, Department of Health UK 2001 Reforming Emergency Care, Picker Institute, Strategy analysis 11 Demand & Supply Projections Current and projected demand, by Episodes and beds Acute Overnight Episodes Bed Occupancy 2011 Actual 2016 2021 2026 2031 122,345 184,102 223,539 276,589 332,040 Acute Overnight Beds Current (58%) 3,289 3,992 5,223 6,769 7,061 Sub Acute Overnight Episodes Sub Acute Overnight Beds Intermediate (70%) 3,308 4,328 5,609 5,850 Target (85%) 2,724 3,564 4,619 4,818 N/A 3,216 4,233 5,461 6,738 224 342 438 449 525 ICU beds 146 175 209 245 281 Emergency Bays N/A 789 987 1,182 1,379 Notes :Sub Acute beds include: Rehabilitation, Palliative care, Maintenance, Older Persons and Psychogeriatric care; ICU beds exclude Paediatrics, NICU, CCU, etc. Acute Overnight beds exclude day case beds. Sub acute numbers of beds adjusted Source: TAHPI, Health Facility briefing system, reference data is based on data extracted from the Australian Institute of Health and Welfare, supplemented by data from the USA inpatient sample and UK Hospital Episode Statistics Online (HES) Assumptions Projected bed numbers from 2016 onwards are based on International Average ALOS and 75% occupancy for ICU beds. Population growth based on: Abu Dhabi Urban Planning Council 2030 Plan projections, Advantaged socio-economic class and with life expectancy >77years. Expatriate utilisation increases from 45% of UAE National utilisation to 55% of UAE National utilisation. Sub acute number of beds adjusted to meet international benchmark C17 Assumptions Population (millions) Population growth, scenarios As at 31 December 2010 Draft 4.0 Population growth, Scenarios High 3.5 Low National Expatriate Year Low High 3.0 2011 411'200 1'945'000 2'045'000 2012 416'150 1'970'000 2'190'000 2.5 2013 422'200 2'060'000 2'350'000 2.0 2014 429'400 2'130'000 2'505'000 2015 437'800 2'175'000 2'675'000 1.5 2016 445'800 2'250'000 2'850'000 2017 453'600 2'310'000 3'045'000 1.0 2018 460'500 2'360'000 3'240'000 2019 467'600 2'400'000 3'400'000 0.5 2020 473'600 2'475'000 3'575'000 0.0 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Note HAAD and SCAD are collaborating to align figures with official SCAD estimates; Estimates presented here are for internal HAAD use only Projections for Nationals are rounded to the nearest 2.5% variance between high and low, and those for Expatriates at 5%. Source SCAD population estimates; additional HAAD assumptions and analysis based on raw insurance data` 73 Recommendations Land requirements Guidelines for urban planners DRAFT For planning purposes, land must be available for hospitals, clinics and ambulance stations to serve anticipated population as per the following guidelines: Population (000 s people) Land provision options Residential Transient1 Land area Co-location GFA 4 OR (m 2 000 s) OR OR (m 2 000 s) Parking (spaces) Minimum service requirement Estimated Resources Clinics2 4-5 12-15 6? 3 2.5 25 Primary care 2 Physicians Pharmacy services (on-site or 8-12 24-36 7? 3 within 10 min walk) 3 30 4-6 Physicians Laboratory service 12-30 36-90 8.5 3? 3.5 35 7-14 Physicians 30-40 90-120 12 3? 4.5 45 15-20 Physicians Hospitals5 60-80 180-240 80 n/a n/a 3/bed Emergency services 180-240 Laboratory services Beds 6 Radiology services 90-110 270-330 100 n/a n/a 3/bed 270-330 Stand-alone building beds 6 Ambulance Stations 10-16 30-48 3? 7 n/a 10 Ambulance service (land /air) 1 Ambulance 16-40 48-120 4? 7 n/a 15 Ambulance service (land /air) 2 Ambulances Notes 1 Transient population includes staff and other non-residential visitors 2 Clinics collectively refers to Clinics, Centers and Polyclinics 3 Appropriate facilities for co-location with Clinics include Hospitals, Ambulance Stations, Mosques, Neighbourhood Commercial Centres, Sport Facilities, Community/Cultural Centres, Pharmacies, Schools and Post Offices, 4 Clinic GFA may be provided within larger commercial centre with adequate transport options and shared parking 5 If residential population is less than 60,000 or transient population is less than 180,000, land provision for a hospital facility needs to be made on a site-based analysis which considers the accesibility of existing hospital facilities 6 Optimal hospital size is 200-600 beds 7 Appropriate facilities for co-location with Ambulance Stations include Clinics, Hospitals, Civil Defense Stations, Police Stations and Municipal Offices Source HAAD Health Facility Community Guidelines 2009, Strategy analysis 5 79 C33
Population density 80 C34 Source Department of Planning and Economy (2005 Census), Strategy Analysis.
Population growth, scenarios Population (millions) 5.0 4.5 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0.0 Low High 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Population growth, scenarios National Expatriate Year Low High 2013 491'300 2'117'000 2'233'500 2014 505'600 2'128'500 2'279'500 2015 519'600 2'140'000 2'341'500 2016 533'200 2'150'500 2'407'500 2017 546'500 2'160'500 2'466'500 2018 560'000 2'170'000 2'520'000 2019 572'500 2'179'000 2'570'000 2020 585'000 2'187'000 2'617'000 2021 597'500 2'195'000 2'660'000 2022 609'000 2'201'000 2'701'000 2023 620'500 2'206'000 2'739'000 Note HAAD and SCAD are collaborating to align figures with official SCAD estimates; estimates presented here are for internal HAAD use only. Projections for Nationals are rounded to the nearest 2.5% variance between high and low, and those for Expatriates at 5%. 81 C35 Source 2012 2022: SCAD population estimates; additional HAAD assumptions and analysis based on raw insurance data; 2030: UPC 2030 Plan.
Demand projections Doctors and Nurses Under Process Subject to Change Additional capacity needs 2022 CAGR Absolute Annualised Including churn Low High Low High Low High Low High Low High Doctors not including Dentists 7,100 10,300 2.5 6.4 1,600 4,800 140 350 1,200 1,700 Nurses 17,500 25,400 3.5 7.4 5,100 13,000 430 920 2,000 2,900 Notes These projections present 2 alternative scenarios based on high and low population estimates. Numbers have been rounded for clarity. This page is under process and subject to change. CARG Compound Annual Growth Rate. The actual number needed each year changes is compounded- and this is a mid-period figure. Assumptions Churn (staff turnover) will remain at the 2011 rate of 17% for doctors and 11% for nurses. Source HAAD Demand Model 2012, HAAD Licensing Database. 82 C36
Demand projections based on WHO disease classification 10 20 30 40 50 60 2012 2022 Low 2022 High Deliveries Signs, symptoms & ill-defined Maternal & Perinatal conditions Digestive diseases Cardiovascular diseases Respiratory infections Respiratory diseases Genitourinary diseases Endocrine disorders Infectious & parasitic diseases Occupational Injuries Musculoskeletal diseases Neuropsychiatric conditions Other Injuries Cancer Skin diseases Diabetes mellitus Sense organ diseases Congenital anomalies Oral conditions Nutritional deficiencies RTA Inpatients 3 12 10 7 6 6 5 5 5 4 9-02 1 21 2 10 2 1 0 0 0-20 18 2 1 2 1 1 3 1 3 1 4 1 3 3 4 5 2 4 27 4 5 7 (Thousands) 34 12 3 2 2 10 6 9 28 10 5 CAGR Outpatients CAGR Low High Low High 2.6 3.7 0.0 0.0 2.0 4.6 1.9.3.8 1.5 4.8 1.0 2.0.3.1.0 3.2 4.1 1.5 5.5.6.3.3 4.2 7.3 7.1 15.7.4.5 1.0 9.0 17.1 1.5 4.3.0 1.9.4-0.1 2.1 1.6 5.7.5.3.3 4.3 7.2 2.8 8.6.5.3.4 4.5 8.5 1.1 4.2.3.2.3 5.3 10.1 2.0 5.9.4.1.1 1.8 4.2 1.3 5.4.5.0.1 0.7 3.3 2.3 7.8.9.5.7 4.7 9.1 7.0 11.1.2.2.1 7.7 11.3 2.0 6.1.0 1.4 4.0 7.6 14.2.0.1.1 8.3 15.8-0.1 3.8.6.2.2 3.1 6.0 4.6 12.1.4.9 1.2 11.4 18.8 1.5 9.4.5.3.5 4.9 9.5 3.1 4.9.0 3.9 6.3 1.7 4.9.5.2.2 3.2 5.9 1.8 7.4.2.1.1 4.2 7.6 0.0 0.0.3.1.1 2.9 5.3 (Millions) Definition CAGR = Compound Annual Growth Rate 2012-2022 Notes This page is under process and subject to change. 83 C37 Source HAAD Demand Model 2012, Categorization based on WHO classification of diagnoses ICD 9, modified to specify deliveries and RTAs
Demand projections for doctors by specialty 84 C38
Population Facilities Clinicians Ratios 2030 Plan growth 2030 requirements 2030 planned Projects under way Population Growth Region District Gap now Type Abu Dhabi Desert Villages Rural 28,480 #NAME? 10,963 None 81,520 110,000 Al Falah Rural 4,028 #NAME? 1,996 None 95,972 1 1 100,000 Ghantoot District Rural 2,478 #NAME? - None 97,522 1 100,000 Abu Dhabi Island Urban 313,809 #NAME? 44,004 229 13 182 2,529 3,878 430 1,284 6.2 8.1 12.4 111,191 425,000 CBD/Financial Centre Urban 174,625 #NAME? 14,141 124 5 86 1,131 1,663 241 539 5.2 6.5 9.5 15,375 1 190,000 Musaffah Urban 141,268 #NAME? 2,256 36 31 161 194 21 68 2.2 1.1 1.4 (41,268) 1 1 3 100,000 Bani Yas Rural 47,245 #NAME? 27,267 43 37 162 106 57 73 7.8 3.4 2.2 22,755 4 70,000 Al Shahama Rural 37,831 #NAME? 16,361 10 10 45 47 14 24 2.6 1.2 1.2 72,169 1 1 1 110,000 Shamkhah Rural 15,839 #NAME? 10,674 None 1 114,161 130,000 Al Rahba Rural 15,315 #NAME? 13,038 1 1 132 325 5 89 0.7 8.6 21.2 94,685 1 110,000 New Port City Rural 11,740 #NAME? 4,565 None 138,260 2 150,000 Capital District South Urban 9,247 #NAME? 33 None 1 45,753 1 1 55,000 Bain Al Jesrain Urban 7,694 #NAME? 4,927 3 3 33 42 10 17 3.9 4.3 5.5 17,306 1 1 25,000 Khalifa City A Urban 5,317 #NAME? 2,703 11 1 10 78 74 17 75 20.7 14.7 13.9 64,683 1 1 6 70,000 Grand Mosque District Urban 5,257 #NAME? 1,837 None 1 114,743 1 1 120,000 Inner Islands Urban 2,804 #NAME? 480 1 2 4 3.6 0.7 1.4 17,196 1 20,000 Capital District North Urban 2,371 #NAME? 2,121 2 1 1 426 792 36 302 8.4 179.7 334.0 67,629 1 3 70,000 Al Mina Urban 1,070 #NAME? 53 7 4 87 103 25 62 37.4 81.3 96.3 98,930 100,000 Al Raha Urban 827 #NAME? 397 2 1 1 41 42 9 12 49.6 50.8 119,173 1 120,000 Yas Island Urban 776 #NAME? 1 None 99,224 100,000 Mohamed Bin Zayed City Urban 328 #NAME? 95 2 2 1 2 4 2 3.0 6.1 49,672 1 1 4 50,000 Saadiyat Urban 122 #NAME? None 119,878-120,000 Airport District Urban 98 #NAME? 32 6 4 8 11 5 11 81.6 112.2 49,902 50,000 Lulu Island Urban 75 #NAME? None 19,925 1 20,000 Capital District Urban #NAME? None 240,000 2 240,000 Mohamed Bin Zayed Centre Urban #NAME? None 80,000 1 80,000 South Hudayriat Island Rural #NAME? None 100,000 1 100,000 Marina Village Urban #NAME? 3 2 1 3 6 5,000 5,000 Al Suwwah Urban #NAME? None 30,000 1 1 30,000 Al Reem Urban #NAME? None 200,000 200,000 Al Ain Umm Ghaffa Rural 8,851 #NAME? 5,873 None 3,049 11,900 Nahel Rural 5,196 #NAME? 2,377 None 4,804 1 1 10,000 Industrial City Rural 48,803 #NAME? 18 8 5 14 5 1 5 1.0 0.3 0.1 30,937 1 79,740 Al Salamat/Al Yaher Urban 37,544 #NAME? 23,400 1 1 1 3 1 6 0.3 0.1 0.0 36,456 1 1 2 74,000 Al Dhahra Rural 4,958 #NAME? 715 None 1,042 6,000 Abu Krayyah Rural 4,108 #NAME? 655 None 892 1 1 5,000 Al Saad Rural 3,829 #NAME? 702 None 1,171 1 5,000 Al Araad Rural 3,791 #NAME? 139 None 209 1 4,000 Abu Samra Rural 1,942 #NAME? 286 None 558 1 2,500 Al Ain City Urban 343,002 #NAME? 100,298 186 7 148 1,733 2,864 318 968 4.5 5.1 8.3 364,298 3 8 707,300 Al Quaa Rural 12,512 #NAME? 4,912 1 8 13 3 0.8 0.6 1.0 10,488 23,000 Al Wagan Rural 11,865 #NAME? 3,330 1 1 17 29 1 4 0.8 1.4 2.4 18,135 1 1 1 30,000 Al Hayer Rural 11,484 #NAME? 2,570 3 3 25 34 4 3 2.6 2.2 3.0 20,516 2 32,000 Al Dhaher Rural 10,641 #NAME? 7,325 1 1 13 20 3 4 0.9 1.2 1.9 3,709 1 1 14,350 Remah Rural 8,187 #NAME? 683 6 9 2 1.2 0.7 1.1 1,313 1 9,500 Sweihan Rural 7,880 #NAME? 713 1 1 8 11 1 1 1.3 1.0 1.4 32,120 1 2 40,000 Al Khazna Rural 7,350 #NAME? 1,071 2 2 4 13 1 2.7 0.5 1.8 1,650 9,000 Mezyad Rural 6,407 #NAME? 3,809 None 1 1,993 1 1 8,400 Al Shwaib Rural 3,260 #NAME? 1,546 4 3.1 0.9 1.2 2,240 1 5,500 Al Fagah Rural 2,089 #NAME? 378 1 1 3 3 4.8 1.4 1.4 1,411 1 3,500 Western Liwa Rural 20,000 #NAME? 661 5 1 1 8 17 5 32 1.0 0.4 0.9 45,000 65,000 Madinat Zayed Rural 29,000 #NAME? 6,785 16 2 11 175 256 23 107 4.5 6.0 8.8 11,000 1 1 40,000 Ruwais Rural 16,000 #NAME? 1,270 50 100 7 14 2.5 3.1 6.3 114,000 1 130,000 Mirfa Rural 15,000 #NAME? 3,676 4 1 3 32 61 3 17 2.7 2.1 4.1 60,000 75,000 Ghayathi Rural 8,000 #NAME? 3,898 6 5 38 63 5 18 7.5 4.8 7.9 7,000 1 15,000 Sila'a Rural 5,000 #NAME? - 1 1 22 39 2 10 2.0 4.4 7.8 65,000 70,000 Delma Island Rural 5,000 #NAME? 2,139 1 1 23 25 2 10 2.0 4.6 5.0 5,000 1 10,000 Capacity Gap Severe Note: Abu Dhabi and Al Gharbia populations based on SCAD 2005 census. Al Ain population based on 2008 UPC estimate. Moderate Source: Population: SCAD, UPC 2030 plans. Clinicians and Facilities: Licensing database. Planned Facilities ; SEHA, UPC 2030 plans, HAAD Planning analysis. None Model of Care Model of care How health services should be used DRAFT Patient self-care Non-emergency/elective Capacity Gaps Capacity Management Capacity Masterplan Total % National Nationals Total Hospitals Clinics Nearby hospital Doctors Nurses Dentists Other Facilities /10000 Doctors /1000 Nurses /1000 Hospitals required Clinic required Hospitals Clinics Hospitals Clinics 2030 Population Remote support Outpatient Clinic Elective Admission Screening Ambulance Check-up Urgent Care Centre Disease Emergency Triage ER management Admission. Preventative Emergency Including diagnostics Source Institute of Medicine 2001 Crossing the Quality Chasm, Bodenheimer et al 2002 JAMA, Department of Health UK 2001 Reforming Emergency Care, Picker Institute, Strategy analysis 11 Demand & Supply Projections Current and projected demand, by Episodes and beds Acute Overnight Episodes Bed Occupancy 2011 Actual 2016 2021 2026 2031 122,345 184,102 223,539 276,589 332,040 Acute Overnight Beds Current (58%) 3,289 3,992 5,223 6,769 7,061 Sub Acute Overnight Episodes Sub Acute Overnight Beds Intermediate (70%) 3,308 4,328 5,609 5,850 Target (85%) 2,724 3,564 4,619 4,818 N/A 3,216 4,233 5,461 6,738 224 342 438 449 525 ICU beds 146 175 209 245 281 Emergency Bays N/A 789 987 1,182 1,379 Notes :Sub Acute beds include: Rehabilitation, Palliative care, Maintenance, Older Persons and Psychogeriatric care; ICU beds exclude Paediatrics, NICU, CCU, etc. Acute Overnight beds exclude day case beds. Sub acute numbers of beds adjusted Source: TAHPI, Health Facility briefing system, reference data is based on data extracted from the Australian Institute of Health and Welfare, supplemented by data from the USA inpatient sample and UK Hospital Episode Statistics Online (HES) Assumptions Projected bed numbers from 2016 onwards are based on International Average ALOS and 75% occupancy for ICU beds. Population growth based on: Abu Dhabi Urban Planning Council 2030 Plan projections, Advantaged socio-economic class and with life expectancy >77years. Expatriate utilisation increases from 45% of UAE National utilisation to 55% of UAE National utilisation. Sub acute number of beds adjusted to meet international benchmark C17 Assumptions Population (millions) Population growth, scenarios As at 31 December 2010 Draft 4.0 Population growth, Scenarios High 3.5 Low National Expatriate Year Low High 3.0 2011 411'200 1'945'000 2'045'000 2012 416'150 1'970'000 2'190'000 2.5 2013 422'200 2'060'000 2'350'000 2.0 2014 429'400 2'130'000 2'505'000 2015 437'800 2'175'000 2'675'000 1.5 2016 445'800 2'250'000 2'850'000 2017 453'600 2'310'000 3'045'000 1.0 2018 460'500 2'360'000 3'240'000 2019 467'600 2'400'000 3'400'000 0.5 2020 473'600 2'475'000 3'575'000 0.0 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Note HAAD and SCAD are collaborating to align figures with official SCAD estimates; Estimates presented here are for internal HAAD use only Projections for Nationals are rounded to the nearest 2.5% variance between high and low, and those for Expatriates at 5%. Source SCAD population estimates; additional HAAD assumptions and analysis based on raw insurance data` 73 Recommendations Land requirements Guidelines for urban planners DRAFT For planning purposes, land must be available for hospitals, clinics and ambulance stations to serve anticipated population as per the following guidelines: Population (000 s people) Land provision options Residential Transient1 Land area Co-location GFA 4 OR (m 2 000 s) OR OR (m 2 000 s) Parking (spaces) Minimum service requirement Estimated Resources Clinics2 4-5 12-15 6? 3 2.5 25 Primary care 2 Physicians Pharmacy services (on-site or 8-12 24-36 7? 3 within 10 min walk) 3 30 4-6 Physicians Laboratory service 12-30 36-90 8.5 3? 3.5 35 7-14 Physicians 30-40 90-120 12 3? 4.5 45 15-20 Physicians Hospitals5 60-80 180-240 80 n/a n/a 3/bed Emergency services 180-240 Laboratory services Beds 6 Radiology services 90-110 270-330 100 n/a n/a 3/bed 270-330 Stand-alone building beds 6 Ambulance Stations 10-16 30-48 3? 7 n/a 10 Ambulance service (land /air) 1 Ambulance 16-40 48-120 4? 7 n/a 15 Ambulance service (land /air) 2 Ambulances Notes 1 Transient population includes staff and other non-residential visitors 2 Clinics collectively refers to Clinics, Centers and Polyclinics 3 Appropriate facilities for co-location with Clinics include Hospitals, Ambulance Stations, Mosques, Neighbourhood Commercial Centres, Sport Facilities, Community/Cultural Centres, Pharmacies, Schools and Post Offices, 4 Clinic GFA may be provided within larger commercial centre with adequate transport options and shared parking 5 If residential population is less than 60,000 or transient population is less than 180,000, land provision for a hospital facility needs to be made on a site-based analysis which considers the accesibility of existing hospital facilities 6 Optimal hospital size is 200-600 beds 7 Appropriate facilities for co-location with Ambulance Stations include Clinics, Hospitals, Civil Defense Stations, Police Stations and Municipal Offices Source HAAD Health Facility Community Guidelines 2009, Strategy analysis 5 85 C39
Planning recommendations Summary The rapid population growth and development in the Emirate of Abu Dhabi requires careful attention to ensure the availability of suitable healthcare services for the population. This plan accordingly includes guidelines and recommendations for parties who play a key role in ensuring appropriate, quality healthcare services are available to the population in a timely manner: Urban planners high level indications of health facility requirements for anticipated populations to ensure that appropriate land is made available for these facilities at the planning phase. Developers a requirement for healthcare facility developers and operators to be engaged before developments are approved to ensure the new population will have access to appropriate, quality healthcare services in a timely manner. Healthcare investors to support investors with information regarding health service use, supply and demand and to meet regulatory requirements. Centralised services* For some clinical services centralisation of patient volumes results in better quality and/or cost-efficiency; such services are typically complex, with low volume. HAAD will designate facilities that will provide such Centralised services. Regional services* For certain moderately complex and time-dependent clinical services it is required that these are provided within each Abu Dhabi region. HAAD will limit licenses for such Regional services as detailed on page C27. Standard services* - The majority of clinical services may be offered by any suitable facility in line with HAAD competency framework (set out in the Abu Dhabi Healthcare Regulations). Notes *Clinical services are specified at the level of DRGs; In emergency situations services designated as Regional or Centralised may be offered by any facility. 86 C40
Facility recommendations for developers, investors, and healthcare providers Health facility developments must: Meet HAAD licensing requirements (available at www.haad.ae). Ensure any designated minimum service requirements set out in the Land Requirements Guidelines for Urban Planners are met. From 2013 providers intending to provide inpatient services, at DRG level, categorised as Centralised or Regional by HAAD must obtain HAAD approval and (re)licence 1 prior to establishing services. Additional guidance regarding healthcare capacity and demand projections are available within this document, HAAD s Health Statistics. 1 HAAD has amended its Licensing process to require submission and approval of all intended services specified at DRG level. 87 C41
Service recommendations for investors and developers Developers for projects with intended residential populations in excess of 4,000 (rural) or 6,000 (suburban and urban) must have engaged a developer and operator for the healthcare facilities within the development. Developers should notify the Executive Council s Social Development Sub- Committee of their intended plans (copying UPC) in the context of combining/sharing healthcare facilities with other social infrastructure, e.g., community centres. Services must be designed and operated in accordance with HAAD Regulations (available at www.haad.ae). 88 C42
Requirements for allocation of land and service provision These requirements have been established in partnership with Abu Dhabi Urban Planning Council (UPC) and comprise the healthcare element of the UPC Community Facility Planning Standards. For new residential developments land and facilities must be provided as per the following: Population Land provision options Car parking Facility Type Residential (000 s people) Urban Suburban Rural Transient 1 Minimum Land area Minimum Including if Co-located GFA 3,6 Minimum Land area (m 2 000 s) Urban Suburban Rural Minimum Including if Co-located GFA 3,6 Minimum Land area Minimum Including if Co-located GFA 3,6 (spaces) Minimum service requirement Estimated Resources per facility Clinic 2 (Village) NA NA 4-6 12-15 NA NA NA NA 4 5 25 2 Physicians Primary care Clinic (Small) 6-10 6-10 6-10 24-36 5 3 5 3 5 3 30 4-6 Physicians Clinic (Medium) 12-29 12-29 12-29 36-90 7 3 7 3 7 3 35 Pharmacy services (on-site or within 10 min walk) 7-14 Physicians Clinic (Large) 30-40 30-40 30-40 90-120 10 4 10 4 10 4 45 Laboratory service 15-20 Physicians Hospitals 4 90-110 60-90 180-240 40 NA 40 NA 80 NA 3/bed Emergency services Radiology services 180-270 Beds 5 Laboratory services NA 270-330 50 NA 80 NA NA NA 3/bed Stand-alone building 270-330 Beds 5 Notes 1 Transient population includes staff and other non-residential visitors. 2 Clinics collectively refers to Clinics, Centres and Polyclinics. 3 Clinics may be co-located with other facilities including Mosques, Neighbourhood Commercial Centres, Sport Facilities, Community/Cultural Centres, Pharmacies, Schools and Post Offices. Where facilities are co-located, adequate transport options and shared parking must be made available. 4 Evaluation of the need for provision of a healthcare facility will be carried out on a case by case basis which considers the accessibility of existing and planned facilities close to the new development. 5 Optimal hospital size is 200-600 beds 6 GFA Ground Floor Area. 89 C43 Sources Strategy analysis, UPC Community Facility Planning Standards.
Access requirements Healthcare services should be provided to meet the following access requirements in relation to routine/elective services and emergency services: Urban Rural Routine/Elective Primary care services within 20 minutes drive at maximum speed of 60 km/h Primary care services within 20 minutes drive at maximum speed of 120 km/h Emergency services Ambulance access within 15 minutes, if via land driving at maximum speed of 60 km/h Ambulance access within 19 minutes, if via land driving at maximum speed of 120 km/h Note Source Alternative solutions such as air ambulance should be utilised to achieve emergency service access requirements in rural and/or densely populated urban areas. Department of Health UK, Strategy analysis. 90 C44