United Arab Emirates: #20 in the 2021 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 20th in the World Index of Healthcare Innovation, with an overall score of 45.23. UAE scored highest on Fiscal Sustainability (#8, 65.79), 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, 45.86) and only moderately well in Quality (#24, 46.72) and Science & Technology (#22, 22.53), despite considerable efforts by the Emiratis to attract foreign medical investment.
Overall, the UAE is a study in contrasts. In the wealthy, cosmopolitan emirates of Dubai and Abu Dhabi, UAE health care performs very well, but poorly in the hinterlands. UAE ranked #1 on measures of health IT adoption and COVID-19 pandemic performance, while ranking near the bottom of the Index in several other categories.
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 poorly (27 of 31). The UAE also ranked 27th for patient-centered care. Notably, UAE ranked #1 overall for its COVID-19 preparedness and response, owing to low coronavirus mortality and high vaccination rates.
Choice
The UAE ranked 28th overall on the dimension of Choice, with poor scores for affordability of health insurance (29th) and access to new treatments (28th). The country performed relatively better on the measure of freedom to choose health care services (17th).
Science & Technology
The UAE ranked 22nd overall in Science & Technology, owing to its low 29th-place ranking for scientific discoveries and investment in medical advances. Notably, the UAE ranked first overall for adoption of health information technology.
Fiscal Sustainability
The UAE performed very well in Fiscal Sustainability, ranking 8th overall, aided by its second-place ranking for national solvency, with a debt-to-GDP ratio of only 19.7%. Public health spending in the UAE is low as a share of GDP (8th), owing to the unfinished nature of the country’s health infrastructure, but is rising rapidly as the country develops.
