x Abu Dhabi, UAEWednesday 26 July 2017

Surge in numbers at trauma centre

A payment scheme for treatment at Dubai Hospital has diverted low-income patients to Rashid Hospital, inundating the facility, officials say.

DUBAI // A new scheme for urgent care treatment at Dubai Hospital has diverted low-income patients to Rashid Hospital, inundating the facility, officials said. The trauma centre at Rashid, the city's largest, has witnessed a 40 per cent spike in admissions over the past month, mainly because the policy change at Dubai Hospital has led to people paying Dh200 for some treatments that were previously free.

"We are getting around 100 more patients every day because they do not want to pay for treatment at Dubai Hospital," said a senior doctor at Rashid, speaking on condition of anonymity. "They cannot afford to pay, so will either go without treatment or come to us. We are operating above capacity." The trauma centre, one of the largest in the Middle East, now treats up to 100 more patients a day - amounting to about 350 admissions daily.

On Wednesday, the hospital in Oud Metha, admitted just under 500 patients to the emergency room, many of them suffering from heat exhaustion and other complaints. Dubai Hospital would not comment on why it introduced the new charges. Triage in government hospital emergency departments is based on five priority levels: Triage level 1 is a life threatening case such as a heart attack; triage level 5 is a non-emergency case that does not require same day treatment.

Previously at Dubai Hospital, patients in triage levels 1 to 4 were treated free of charge at both Dubai and Rashid hospitals. Starting last month Dubai Hospital, in Deira, began charging for treatment at triage level 4, including treatment for such injuries as broken bones, abrasions, eye injuries and sprains common to construction workers Non-emergency patients are now directed to a walk-in clinic nearby, where consultations cost up to Dh200 (US$55), with further charges for treatment.

Construction workers, who frequently suffer injuries requiring emergency room treatment, have been most directly affected by the change, hospital officials said. Dr Abdul Razzaq al Madani, director of Dubai Hospital, said patients whose cases did not count as emergencies were being redirected to the walk-in clinic, where consultation fees do apply. He said the changes would ensure non-emergency patients did not needlessly spend time waiting for treatment.

For an expatriate, a consultation costs Dh100 with a valid health card from the Dubai Health Authority (formerly the Department of Health and Medical Services). Without a card, the charge is Dh200. "All the emergency cases are still seen, as it was before," Dr al Madani said. "The only thing is that cases that are non-emergency cases are directed to the walk-in clinic rather than taking time at the emergency room."

Without health insurance, most construction workers only receive emergency treatment free at public hospitals. A health card gives the holder benefits such as lower consultation fees and prices for medicines, though diagnostic tests such as x-rays and blood tests are still charged the full price. The cards cost between Dh100 and Dh300 for expatriates, depending on age, but a senior doctor at Rashid Hospital estimated that less than five per cent of labourers had them.

"If the charges were introduced here, there would be hundreds of patients who couldn't afford to be seen at all. The labourers cannot afford to pay Dh200, and then for treatment," the doctor said. At Rashid Hospital, consultations and same-day non-emergency treatment are free, but patients must pay for follow-up treatment and outpatient appointments. The hospital did not specify whether it would be following the example of Dubai Hospital and introducing its own fee scheme.

Government hospitals in Abu Dhabi have similar payment structures but in 2006 the Health Authority-Abu Dhabi introduced mandatory health insurance covering most residents in the emirate. @Email:munderwood@thenational.ae * with additional reporting by Praveen Menon