United Arab Emirates: #22 in the 2020 World Index of Healthcare Innovation
The UAE’s two largest emirates have achieved universal coverage. Will the others follow?
Introduction
The United Arab Emirates ranks 22nd in the World Index of Healthcare Innovation, with an overall score of 44.68. UAE scored highest on Fiscal Sustainability (#4, 72.61), owing to its low debt-to-GDP ratio of 19.7%, and its low public spending growth.
UAE’s heterogeneous system performed poorly in Choice (#28, 32.71) and Science & Technology (#29, 22.77), despite efforts by the Emiratis to attract foreign medical investment.
Background
The United Arab Emirates is a confederation of seven emirates—Dubai, Abu Dhabi, Sharjah, Ras al-Khaima, Ajman, Fujairah, and Umm al-Quwain—of which the first three represent 96.5% of the population. The Emirates gained independence from Britain in 1971.
Dubai, the largest emirate, is also the most competitive, with a multitude of hospitals including affiliates of Western institutions. It is also a popular destination for medical tourism from other parts of the region. Dubai has established universal, mandatory health insurance for Dubai residents, while expatriates are required to have private coverage.
In Abu Dhabi, health coverage is primary a government-funded enterprise, again with expatriate workers required to obtain coverage.
Quality
The UAE ranks 24th overall in quality of care. Specifically, the UAE’s health system infrastructure ranked second to last (29 of 31). In a similar bottom quartile of analysis, the UAE’s patient-centered customer service ranked 24th, with a higher composite in identifying and treating measures of preventable disease.
Choice
The UAE struggles to provide quality patient choice. Ranking third from last in the patient choice metric at 28th, this largely stemmed from the affordability of health insurance (29th). While the UAE scored near the median in patients’ ability to choose health care services (16th) and access new technological advances (15th), the high cost of health insurance offsets these positive elements.
Science & Technology
The UAE ranked second to last overall in access and contribution to medical science and technology (29th). Notably, the UAE’s contribution to scientific innovation ranked 29th, and its contribution to medical innovation ranked 27th. Nonetheless, the UAE proved exceptional in its adoption of EHRs in the analysis, ranking 1st in the WIHI analysis.
Fiscal Sustainability
The UAE performed exceptionally in fiscal sustainability, ranking 4th overall. It ranked identical in its debt-to-GDP ratio, primarily due to the UAE’s economic strength. Similarly, its public health spending per capita ranked 5th. Nonetheless, the rising cost of health care costs in the UAE raises reason for concern, as its growth in health care spending over the last decade grew substantially, ranking it 26 of 31 in the WIHI analysis.
