x Abu Dhabi, UAEFriday 19 January 2018

Uniform guidelines can cut health costs in the UAE

In a young health care system like the one in the UAE, patient care guidelines are key to improving care and keeping costs in check.

Standardisation is the hallmark of an efficient health care system. Doctors in different hospitals must be on the same page when it comes to treatments. And patients seeking care deserve a degree of consistency when they move between centres.

But in a relatively young health care system like the one here, patient care guidelines are not always up to snuff. As The National reports today, a lack of clear rules for assessing and treating conditions like diabetes is costing both patients and insurers dearly.

There are two reasons why rectifying this is critical.

The first is quality. As Dr Ayham Refaat of the health care management firm AccuMedPM puts it, the goal is to "eliminate this experience we have when we go to different doctors and receive different feedback". Developing clinical care guidelines is one way to ensure it is.

The other reason is economic; without guidelines it may not be possible to control runaway health care prices.

Health care costs in the UAE are surging, partly due to unnecessary treatments, procedures and medication. According to Dr Refaat's organisation, which conducted research into the clinical care guidelines issue, 9 per cent of insurance claims between 2011 and 2012 were disputed by insurance companies on the grounds that tests and procedures were unnecessary. This amounted to Dh20.4 million worth of services that, at least according to the insurance industry, were not really needed.

Insurance providers have reason to dispute claims, and they do everywhere, not just in the UAE. But when doctors and hospitals do not always use consistent medical guidelines when ordering treatments, resolving these disputes is made more difficult.

Diabetes is a clear example of over-testing. In nearly 26,000 cases studied, researchers found that between two and 12 laboratory tests were requested for the same diagnosis, at a cost of Dh40 to Dh157 each. Only one of four tests is used in the US, considered the gold standard.

Streamlining approaches to patient care would increase transparency between health care providers and insurance companies, and prevent abuse from all ends. And patients will be the first to benefit when care guidelines are made consistent.

If the move helps lower the surging costs of care brought on by unnecessary procedures, everyone will be healthier for it.