Introduction
The Health system that is currently in place in the emirate of Abu Dhabi has undergone several changes since 2007 for the purpose of overcoming some shortcomings and optimizing the system for better efficiency. As a result, the current health system employed in Abu Dhabi is designed and maintained carefully to preserve the effectiveness and quality of healthcare services provided in the area. Moreover, the reform of the health system that inflicted some significant changes was implemented to achieve several goals such as the improvement of service quality, the expansion of access to healthcare, and the increased affordability of the services (Koornneef, Robben, Seiari, & Al Siksek, 2012).
Before the initiation of the reform, the professionals who are in charge of its implementation have carried out substantial and thorough research to provide the planned changes with a solid foundation and plan. The focus of this paper is a discussion of the effects of two elements of the ongoing health system reform with the help of specific examples of health system building blocks.
Health System Reform Elements and Building Blocks
The reform of the health system in Abu Dhabi is comprised of three major elements – enhanced competition between health service providers, centralized regulation, and mandatory health insurance (Koornneef et al., 2012). Using these three goals as the key elements for the improvement of the quality of health system, the Abu Dhabi health leaders aim at the establishment of a high level of excellence combined with positive patient experience, and a client-centered form of organization of service provision and allocation.
At the same time, the World Health Organization (2017) outlined a list of building blocks of a successful health system. These blocks represent six core aspects that need to be properly organized for the creation of an effectively performing health system. The six building blocks named by the WHO are financing, leadership and governance, healthcare workforce, service delivery, health information systems, and access to essential medications and resources (Lazarus & France, 2014).
From the list of these building blocks, it is possible to see that they represent all of the essential elements of health systems and as a result, their performance indicators can serve as a valid reflection of changes in health systems enforced with the help of reforms.
Health Reform Effects in Service Delivery via Enhanced Competition
The health system reform under review has created a wide range of positive impacts on the quality of care provided by healthcare service agencies and facilities in Abu Dhabi. In particular, since the initiation of the reform, the area has seen a significant increase in quantity and reach of service providing organizations. Specifically, it is reported that due to the expansion of the healthcare market the number of beds available for Abu Dhabi inpatients rose by as many as 21% within just a few years between 2009 and 2013 (“Abu Dhabi boosting the quality of health care,” 2017). This a good example of how the reform helped the health system accomplish a higher level of effectiveness using establishing the availability of healthcare resources and services to patients.
In fact, the growth and expansion of the Abi Dhabi health system are also reflected in public health results and statistics. For example, according to the healthcare reports, the decrease in infant mortality comprised about 70% compared to the rates registered before the implementation of the reform (“Abu Dhabi boosting the quality of health care,” 2017). Besides, to assess the changes in the quality of care that occurred over the last several years, the Health Authority – Abu Dhabi (HAAD), the major regulatory agency to which the entire system is to report, carried out impartial research that included over 38000 of respondents.
The findings of this research showed that the general rate of patient satisfaction was about 80% (“Abu Dhabi boosting the quality of health care,” 2017). At the same time, many respondents also noted that further improvement was required in such areas of care as quality, communication, and promptness. It is important to emphasize that the increase in quality of care was majorly achieved using the maximization of the number of competitors in the industry (Oxford Business Group, 2016). This change helped create a more densely populated market of services that is capable of serving to a larger base of consumers, address more public health problems, and thus minimize their rates.
Health Reform Effects in Affordability and Leadership via the Centralized Regulation
As it was mentioned previously, Health Authority – Abu Dhabi that is also known as HAAD served as the main regulatory agency in charge of the health system of the area. One of the most important goals of the reform under discussion was to achieve a higher level of cost-effectiveness of the health system using the optimization of its performance and operations. The establishment of mandatory health insurance was one of the steps towards the accomplishment of this goal. The benefits of this change were seen in the establishment of a more sustainable health system that allowed meeting the consumer’s goals more accurately (“Abu Dhabi seeks costs savings on health spending,” 2016).
HAAD presents a unified leadership for the entire health system. This clear vertical form of leadership helped create a more orderly and clear structure and can provide a consistent and detailed plan for the system to follow (Olarte-Ulherr, 2014). As soon as the Abu Dhabi health system entered its new phase powered and driven by the reforms, the role of a unified leader was to monitor the changes and their effects and introduce new initiatives to regulate and coordinate the performance.
The major effect of this approach was the significant improvement of public health statistics in many areas such as emergencies, injuries, suicide, and traffic accidents; also, the statistics in chronic and genetic diseases, as well as mental health, saw significant improvement (Olarte-Ulherr, 2014). As a result, it can be stated that a centralized regulatory system introduced by the reform added to the consolidated effort of the change and powered its effectiveness in many areas.
The Effects of Insurance Reform on Access to Care through Quality of Care and Affordability
Doctor Maha Taysir Barakat is the Director-General of the Health Authority in Abu Dhabi; according to her expert opinion, the main objective of the latest insurance reform implemented in the area is to change the culture of relations and communication between doctors and patients (Webster, 2017).
In particular, the health system reform is designed to provide patients with a higher level of confidence in the diagnoses and the offered medical opinion. In that way, the need for the second and third opinions that used to be available under the insurance coverage will no longer arise. Practically, it became clear to the experts such as Dr. Barakat that patients used to habitually request more opinions and visit more doctors because of being unsure of the prescriptions they were given.
Regarding the quality of care provided by medical professionals, as well as their adherence to the standards of practice, the reform will ensure a more serious control over the performance of healthcare practitioners via real-time records that will be accessed directly by the HAAD members (Webster, 2017). In addition to the higher-level scrutiny to medical practice and care delivery, the reform also cut insurance coverage for the services of private hospitals when used by the citizens covered under the Thiqa plan. Practically, using the services of private hospitals, Thiqa plan patients will have to pay 20 percent of their cost from the pocket (Carvalho, 2017).
This change resulted in the outflow of patients from private hospitals and their inflow in government hospitals thus damaging the businesses of the former and causing the organizations that own private hospitals to start lobbying the Abu Dhabi government to reevaluate and, possibly, reverse the change.
Conclusion
The health system reform that took place in the emirate of Abu Dhabi was majorly successful in a variety of aspects and managed to achieve such goals as the optimization of the system, the maximization of its effectiveness, the establishment of a sustainable industry, alongside some cost-saving practices. Due to the main elements of the reform under discussion, the key building blocks of the health system saw significant improvement leading to the overall benefits of healthcare providing organizations as well as consumers of healthcare services.
References
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