Efficiency and Equity of Healthcare Service of the Al Mafraq Hospital in Abu Dhabi - Case Study Example

Evaluation of healthcare service in terms of effectiveness, efficiency and equity Al Mafraq Hospital Name: Institution: Date: Table of Contents Table of Contents 2 Evaluation of healthcare service in terms of effectiveness, efficiency and equity 4 Introduction 4 Description of the healthcare service and organization 4 Critical evaluation 5 Effectiveness of the service 5 Efficiency of the service 7 Equity of service 9 Policy strategies 11 Conclusion 12 References 14 Executive summary The service of healthcare is the service related to heath provided by an organization like health authority situated in an organization within a particular country not excluding the United Arab Emirates (UAE) particularly the Al Mafraq Hospital in Abu Dhabi. In comparison with other nations worldwide, the UAE standard of health is generally good. On the other hand, the government’s concern is about the services’ cost, shortage of choices available as well as the services’ quality thus promoting efficiency of healthcare services. Health service within the UAE is offered by six dissimilar authorities, five of them being governmental while the sixth is offered by the private organization. Each authority has its own staff and system. Currently health systems function in a setting of rapid economic, social and technological change. Additionally, health systems are also under perpetual inspection by planners, buyers and users of the provided services. The context has evaluated the services of healthcare in terms of effectiveness, efficiency and equity. One of the recommendations is that, so as to achieve the general goals of effective health, it is crucial that the UAE’s Ministry of Health identify a number of important health challenges faced by health development. Evaluation of healthcare service in terms of effectiveness, efficiency and equity Introduction Provision of quality healthcare services is every nation’s objective. This is why some measures need to be considered so as to meet this objective. The UAE targets to enhance the general health and welfare of its people. One of its strategies is to offer care that is patient centered. Medical attention is offered to everyone not considering nationality or residency. The UAE’s health systems are run by both government and private sectors, largely being the government sector. In various parts of the UAE like Abu Dhabi, delivery of health care is going through a considerable transformation. A lot of infectious diseases such as measles, poliomyelitis and malaria that were previously considered endemic in the UAE have been greatly eradicated, at the same time pre and post-natal care meets the standards of the most developed nations in the world (World Health Databook, 2011). With good facilities in the public and private sector, health care services have notably increased. However, challenges still face this sector of service provision. This paper will therefore evaluate the public healthcare services in the UAE in terms of effectiveness, efficiency and equity. Description of the healthcare service and organization The most important aspect of health care within UAE is the fundamental responsibility of the Ministry of Health in changing an inclusive system competent of decreasing the contribution of every institution offering services of health within the nation and directing such effort to creating quality services of health care (World Health Databook, 2011). This should be as good as that of the countries that are most developed. The services should also be available as well as accessible by the UAE’s people. In addition, the Ministry of Health has taken the duty of instituting national standards to regulate the quality and guide provision of health care to meet the needs and aspirations of the beneficiaries. Al Mafraq Hospital is an Abu Dhabi based hospital in UAE that is government oriented. The hospital has a 500 bed capacity and provides tertiary treatment. It is situated 35 kilometers on the southeast of the city. The Ministry of Health launched the hospital in August 1983 with 36 units and departments, which entail for urology, neurology, dermatology, oncology, endocrinology, neurosurgery, neonatology, ophthalmology, and gynecology (Mafraq Hospital, 2012). Critical evaluation The aim of this report is to ascertain whether the service is effective, efficient or equitable in the UAE. Effectiveness of the service The significant rise in the population of UAE is predicted to remain the essential force of demand for healthcare services and goods. Growth in population within the UAE is among the leading globally, majorly as a result of immigration. The population of UAE increased exponentially to approximately 8.26 million from the year 2006 to 2010, an increase of 64.5% within four years (World Health Databook, 2011). Healthcare spending per head is expected not to decrease, controlled by outpatient services, overconsumption patterns and higher awareness. Hospitals like Al Mafraq Hospital, which pride themselves with up to date facilities, are strategically situated to guarantee accessibility. There are nearly 20 clinics and hospitals dispensed all over the Emirate. The hospitals/clinic to patient ratio is approximately 1:78,000. Regardless of the high population in the UAE, the country is putting in efforts to see that its citizens are provided with health care services and facilities. With respect to the 2002 Annual Statistical Report, the UAE has 15 hospitals within urban regions, whose representation is 57.7 percent of the whole number of hospitals within the nation, and 11 hospitals within rural regions, representing 42.3% of the country’s total hospitals (Fried & Gaydos, 2002). The Ministry of Health offers a standard of one centre for each 35 415 of the population. In addition, the Ministry of Health offers countrywide 11 regions for school health, which oversee 642 clinics in schools, preventive medicine has 9 regions, and maternity and child care has 10 regions. The Ministry also offers countrywide 92 dental clinics. With regards to trends of morbidity and mortality, transformation in the provision and effect of health service are mirrored by some key indicators as approximated in 2002: mortality rate of the infants being 8.12, mortality rate of the neonates being 5.5, mortality rate of the under-fives being 10.1 and the ratio of maternal mortality being 0.0 in 2003 (Fried & Gaydos, 2002). The reduced mortality rates are basically as a result of outstanding facilities and services of maternal health as well as attendance of nearly 98% of deliveries by qualified health personnel. The recommended strategies by WHO have been implemented at the Al Mafraq Hospital and these have led to poliomyelitis eradication. Communicable diseases remain a problem to the UAE regardless of the fact that the occurrence of a lot of communicable diseases has reduced sharply in present years (Cother, et al, 2012). The government is still working to eliminate or control such diseases. Congenital abnormalities have been positioned as the fourth key cause of death in present years. According to the data provided by the Ministry of Health strategic plan (2000-2010) in the UAE, the major mortality causes include and not limited to cardiovascular diseases with a percentage of 28.7, road traffic accidents with a percentage of 15, cancers have 8.6 percent, congenital abnormalities have 4.7% while diabetes mellitus has 2-3%. Risk adjustments have been taken into account. For instance, cancer control programmes have been incorporated in various regions within the UAE like in the Al Mafraq Hospital in Abu Dhabi. Some of these programmes include screening program for breast cancer, early detection of prostate cancer, cervical cancer, and colorectal cancer. Health education is also provided in both private and public hospitals thus enhancing the sharing of knowledge in terms of health issues. Effectiveness means getting the correct things done (Aday, 2004). With this regard, the public sector of healthcare services in UAE particularly in Abu Dhabi’s Al Mafraq Hospital is effective since it has implemented the right measures in place that promote the delivery of quality healthcare services. Efficiency of the service Efficient entails getting things done correct. Efficiency optimizes utilization of resources while minimizing resource wastage (Porzsolt & Kaplan, 2006). Efficiency determines whether resources of healthcare are being utilized to obtain the paramount value for money. Healthcare is considered an intermediate product, in that it is a path to the end of enhanced health. Efficiency deals with the connection involving inputs of resource in terms of costs, capital; and either transitional outputs like numbers treated; or final outcomes of health in terms of lives gains (Aday, 2004). Implementing the measure of economic efficiency means that society settles on choices that maximize the outcomes of health obtained from the resources given to healthcare. Existence of inefficiency is when resources may possibly be reallocated in a manner that would raise the health outcomes generated. Productive efficiency means the maximization of outcome of health for a specific cost, or the lessening of cost for a particular outcome (Fottler et al, 2002). An example being, a policy of shifting from screening of maternal age to biochemical screening with respect to Down’s syndrome; biochemical screening executes lesser amniocenteses even though it needs the use of a different resource which is a biochemical testing. Since dissimilar combinations of inputs are being executed, the choice involving interventions is grounded on the relative expenses of these dissimilar inputs. If the amount of the expenses of the latest program of biochemical screening is smaller than or equal to the program of maternal age and the results are similar or better, then it is right to say that the programme that is biochemical is productively efficient in relation to the programme of maternal age. In the setting of healthcare, productive efficiency facilitates evaluation of the comparative worth for money of interventions with directly similar outcomes (Fried & Gaydos, 2002). It is not able to handle the effect of reallocating resources as a wider level, for instance, from elderly care to psychological illness, since the outcomes of health are incommensurate. The allocative efficiency concept considered not merely of the productive efficiency with which resources of healthcare are utilized to generate outcomes of health but as well as the efficiency with which these results are allocated among the society (Kudyba, 2010). Allocative efficiency is obtained when resources are distributed in order to maximize the community’s welfare. With regards to allocative efficiency, every objective competes with one another for implementation. For instance, a question of allocative efficiency can be whether more resources should be allocated to the child injury prevention or improving hospitals and clinics for children who suffer chronic disease like asthma. Allocative efficiency concerns whether to perform something, or the quantity of it to be carried out, instead of how to carry it out. In the healthcare, allocative efficiency is accomplished when there is no possibility of increasing the overall advantages generated by the system of health by redistributing funds between programmes (Kudyba, 2010). This happens where the fraction of marginal advantages to marginal expenses is similar across every programme of healthcare within the system. It is noted that decision makers in various countries not excluding the UAE are increasingly experiencing the challenge of merging rising demand for services of health care with available funds. On the other hand, economists stipulate that the accomplishment of better efficiency from limited resources need to be a major criterion for setting priority. Equity of service Arguably, the objective of general access to health care, as represented in systems of health in almost all developed nations, is to protect equivalent or at least equitable right to use the needed care. Conceptualizing and establishing care access is more difficult a task than it may appear at first. To some extent, this is due to the perception that health care is not homogeneous in its role, for it does rather diverse things for human beings. Additionally, there is disagreement concerning healthcare nature as a social good; for instance, a number of people think healthcare is merely a commodity, to be bought in a market just like other goods; while others argue that it has an exceptional moral significance that differentiates it from a number of other market commodities. In health, equity refers to the equal chance to be healthy, for every population group (Aday, 2004). In health, equity thus means that resources are allocated and processes are planned in ways most expected to shift toward equalizing the health results of underprivileged social clusters with the results of their more privileged counterparts. In terms of social justice, the justice principles target to legalize the conditions of social co-operation. In terms of deliberative justice paradigm, the paradigm concentrates on the significance of involvement of consumer and participation of the community in the planning and implementation of both public and private health programs (MacDonald, 2009). Such involvement encourages empowerment of patient and promotes bridge building involving constituencies, which is considered essential elements for enhancing the quality of healthcare. Every country experiences the question of choice within healthcare. Healthcare resources allocation is without a doubt linked with the distributive justice concept and to the reality of a healthcare right. On the other hand, it is still questioned whether this right ought to include every type of services of healthcare or if it ought to be restricted to chosen types. It then follows that priorities need to be set, choices need to be made, and that healthcare services’ efficiency ought to be maximum. Distributive justice, which the healthcare service in the Al Mafraq Hospital is mainly based on aims at making sure that every person, has access to essential care with respect to the significant ethical principles of solidarity and equity (MacDonald, 2009). Nevertheless, universality entails always choice in efficiency and access in delivery. Allocation of resource is vital in public policy specifically with respect to delivery of quality healthcare services. Al Mafraq Hospital endeavours to provide equity of health services to every citizen in UAE. A descriptive study was carried out in a particular country to evaluate distributive justice with respect to pharmacoeconomics. The findings indicated that the recognition of distributive justice as the latest ethical paradigm for experts indicate that provided the best interest of the client is not compromised, physicians ought to consider the generic drugs use as a suitable measure to enhance the efficiency of healthcare system and thus as a method to promote citizen’s worldwide healthcare access (Rego et al, 2002). Policy strategies The UAE’s health for every strategy relies on the World Health Organization’s (WHO) definition of health which states that health is a state of total social, mental and physical wellbeing, and not just the absence of sickness and diseases (WHO, 2006). In addition, the strategy highlights that enjoyment of the maximum health standard is a fundamental right for every citizen, and that guaranteeing good health for every citizen is important for establishing wellbeing and prosperity. The government of UAE is dedicated to the world affirmation on health which requires that countries confirm their loyalty to the WHO’s constitution, which argues that health is a fundamental human right and an decisive objective for economic and social development and that every country be faithful to reform their systems of health in an appropriate manner and take joint measures against the risks to health and to the welfare of the global community (WHO, 2006). Decentralization is of ancient history, since the UAE is grounded on federalization with extensive sharing of power. In the system of health, the Ministry of Health in UAE considered sharing of power from the perspective of primary health care. A positive feature of decentralization is the rise of excellent health services and the increase of the service beneficiaries’ satisfaction. Public policy concentrates on developing legal and organizational frameworks grounded on best practice, to improve the capabilities of health services in both public and private sectors (Porzsolt & Kaplan, 2006). Additionally, public policy measure will lay down priorities for development of health services in the sector. Through public policy, measures like effectiveness, efficiency and equity of healthcare service can be easily evaluated. Recommendations From the realization of the importance of health, the Ministry of Health, the in charge authority, regulator and chief provider of preventive, promotive and curative care within the UAE has offered and realized outstanding health services for its citizens (WHO, 2006). Regardless of the truth that a lot has been achieved, a number of challenges in the services are still there and need to be addressed. So as to handle these challenges, it is important that the close partnership between WHO and the government of the UAE be made stronger and streamlined, thus enhancing the evaluation of effectiveness, efficiency and equity of healthcare services. Conclusion The paper has evaluated the healthcare services in terms of effectiveness, efficiency and equity in the UAE particularly in Al Mafraq Hospital, Abu Dhabi. The paper has clearly defined the outlined concepts with respect to healthcare services. In an effort to establish whether the public health service in the UAE is effective, efficient or equitable. The findings indicate that the service provided is indeed effective since a number of measures have been implemented to provide excellent healthcare services. In terms of efficiency, it is not easy to measure the efficiency of the service provided, however, with proper allocative and productive efficiency in place, the public health sector is able to be considered as efficient. In terms of equity, the major driver behind equity of health services is resource allocation. With appropriate allocation of healthcare service allocation in Al Mafraq Hospital, the Ministry of Health in UAE is able to pride itself as providers of healthcare in an equitable way thereby increasing accessibility of healthcare services. Public policy is seen to play a significant role in allocation of healthcare services. References World Health Organization, (WHO). (2006). Country Cooperation Strategy for WHO and the United Arab Emirates 2005-2009. Pp 1-43. Cother, H., Oliver, H., & Zainab, S. (June 27, 2012). A profile and approach to chronic disease in Abu Dhabi. Globalization and Health, 8, 1.) Porzsolt, F., & Kaplan, R. M. (2006). Optimizing health: Improving the value of healthcare delivery. New York: Springer. Kudyba, S. (2010). Healthcare informatics: Improving efficiency and productivity. Boca Raton: CRC Press. Fottler, M. D., Ford, R. C., & Heaton, C. P. (2002). Achieving service excellence: Strategies for healthcare. Chicago: Health Administration Press. MacDonald, T. H. (2009). Removing the barriers to global health equity. Oxford: Radcliffe. World Health Databook. (2011). London: Euromonitor Intl. Fried, B., & Gaydos, L. M. (2002). World health systems: Challenges and perspectives. Chicago: Health Administration Press. Rego, G., Brandão, C., Melo, H., & Nunes, R. (January 01, 2002). Distributive justice and the introduction of generic medicines. Health Care Analysis : Hca : Journal of Health Philosophy and Policy, 10, 2, 221-9. Aday, L. A. (2004). Evaluating the healthcare system: Effectiveness, efficiency, and equity. Chicago, Ill: Health Administration Press. Mafraq Hospital. (2012). Retrieved on 14 January, 2013 from http://yp.theemiratesnetwork.com/goto/bjdcj/ Read More