Health Statistics 2011

Health Authority Abu Dhabi Reliable Excellence in Healthcare

www.haad.ae/statistics

www.haad.ae/statistics-xl

Updated 4 October 2012

Contents

Overview Vision 2 Achieving our vision… the journey so far 3 Statistical highlights 4 Public Health highlights 5 Investor highlights 6 Benchmarks 7

Population Population various breakdowns 9 Births and Deaths 12 Leading causes of death 13 Injury deaths 15 Communicable diseases 16 Health status 17 Diabetes Mellitus 19 Diabetes Indicators 21 Diabetes cost 22 Cancer 23

Episodes and activities Episodes various analyses 26 Activities by type 29 Procedures 30 Drugs 31

Note The data presented have been prepared to the best of our knowledge at time of release. Although effort has been invested to creating consistency and coherence, this should be considered work in progress. Feedback on content and layout are welcome.

New

Providers Provider overview 33 Clinical performance 34 Labour productivity 35 Hospital patient satisfaction 36 Hospitals 38 Hospital inpatient profile 39 Centers and Clinics 40 Beds including critical care 41 Blood bank 43 Market structure 44

Claims Claims 47 Claims by provider 48 Claim activities by provider 49

Payers Payer members 51 Payer claims 52

Financing Enhanced plans premiums 54 Enhanced plans limits 55 Enhanced plans benefits 56

1

Person

Provider Payer

Stable Vision

• The health system finances itself through a mandatory health insurance for all AD residents.

• The financial system should be flexible in order to manage for change over time and the degree of subsidy should be managed as efficiently as possible.

• In the Emirate of Abu Dhabi, everyone has access to healthcare and freedom to choose their provider.

• A system encompassing the full spectrum of health - protecting, promoting, sustaining and restoring services across the territory of the Emirate.

• Providers are independent and predominantly private.

• An open system for all certified providers of health services delivers World-class quality care and outcomes in compliance with the highest international standards.

Quality driven by ambitious improvement

targets set by the regulatory authority of the

Emirate and reflected in the regularly monitored

and published key performance indicators of

the system.

2

Achieving our Vision … the journey so far

3

In 2006 we first defined a vision for Abu Dhabi’s health system with the mission to Ensure Reliable Excellence in Healthcare. This vision has guided major reforms and continues to inform daily decisions in healthcare. The Health Authority Abu Dhabi (HAAD) was created to track and steer progress towards realizing the vision and, to measure returns on investments for a healthy society. HAAD regulates all healthcare actors – public/private, provider/payer/professionals – by licensing, setting clear and simple rules, e.g., minimum standards for facilities, and ensuring compliance. HAAD doesn’t itself own, build or manage healthcare facilities, treat patients, pay for treatment (insurers and other payers do), or pay the private sector to partner. SEHA (Arabic for ‘health’) is the public provider; it owns and develops existing public healthcare facilities, including partnerships with several renowned overseas operators to manage its facilities. In 2012 HAAD plans to lead a major review of the health system, and the role of HAAD, providers and payers.

Everyone has access to healthcare via mandatory health insurance. In 2006 Abu Dhabi began giving all expatriates health insurance and, by linking it to resident permits, guaranteed access to healthcare – a first in the region. In 2008 Nationals received Thiqa health insurance, providing free access to care in both private and public sector and the freedom to choose their provider.

World-class quality care and outcomes with Quality regularly monitored and published. We have invested heavily in a common, routine and confidential way to share information about the conditions patients have and the treatments they receive. In support of improving quality, HAAD has been standardising clinical care and service standards across the health sector through HAAD standards tailored to the health system of Abu Dhabi; and that in 2012, Abu Dhabi Health Regulations (Policy Manuals) will be published and implemented sector wide. We are also working with local doctors and international experts to develop measures that tell us if patients are getting the right treatments and outcomes, e.g., is a patient’s diabetes well-controlled after receiving treatment?

Full spectrum of health services. Our model of care sets out services which are appropriate, convenient and well co-ordinated around patient needs.

Prevention. We want to try to prevent diseases from occurring at the onset so we work with a range of stakeholders, e.g., Municipalities on tobacco control, schools on healthy eating and exercise, Police on road safety, and employers on workplace health promotion.

Screening for health risks. When Nationals were screened for various health risk factors in a programme called ‘Weqaya’ (Arabic for ‘protection’) it showed that 71% had at least one CVD risk factor; many were unaware thus unable to seek care, and risk factors are projected to increase. Community-based services help

patients manage their chronic conditions, like diabetes, on a daily basis. For instance, the Imperial College London Diabetes Centre offers integrated consultation, diagnostic and pharmacy services to diabetics. Another creative solution is to treat patients, particularly those who are frail, in their homes as the Sama Abu Dhabi Home Health Care group is now doing.

Specialty care. Competition for patients is helping create new services, increased convenience and efficiency for existing services, and generally reduced waiting times. Examples include: international experts flying in to provide services otherwise not available; SKMC’s pediatric kidney transplantation service; Tawam and Lifeline providing mobile breast cancer screening services; and the Corniche Hospital opening a conveniently located Women’s Health Centre. Patients also have greater choice as private facilities offer services previously only available at SEHA, such as Al Noor Hospital’s dialysis service and cancer treatments at the Gulf International Cancer Centre.

Hospital care. The desire is to treat patients outside hospitals wherever possible. however, to account for population increase, 7 new private facilities have opened in the last 5 years. In addition, 93 private clinics and 12 SEHA clinics have opened with more planned, in both private and public sectors. The challenge is to manage potential over-supply in some areas and to ensure the hospitals operate with both quality and cost comparable with international benchmarks.

Ambulance services. Good hospitals are worthless if patients can’t get there. The Police provide emergency ambulance services and are planning to privatize them. HAAD is working with them to develop a more integrated service that responds to a wider range of health emergencies – by road or air.

Predominantly private providers. Based on positive experience both locally and regionally, we would like private operators to provide most healthcare as well as add any required new capacity. Private facilities generally build and operate more efficiently than public, and are also generally more responsive to HAAD quality audits. Patients feel at least equally satisfied in private facilities – and, we will be monitoring how they perform on robust clinical indicators.

A Flexible and efficient financial system. We want to pay providers for the patients they actually treat and the quality of that treatment as well as limit direct subsidies to SEHA. The DRG system introduced in 2010 rewards quality: it pays hospitals on the basis of how sick patients are, not how long they stay or how many doctors they see. Insurers are also set to pay a bonus for high quality care. In 2012 we intend to improve the system by taking accurate account of providers

costs in setting prices for healthcare delivery.

Statistical highlights

Note * An Episode is an inpatient Encounter or a set of outpatient Encounters linked to the same clinical case based on the patient (identified by insurance member ID), Episode Clinician – the clinician responsible for consultation, and principal diagnosis.

Population

Providers Payers Claims

Financing Episodes*

• 2.4m residents, 18% Nationals • Median age 19 for Nationals and

31 for Expatriates • 32,084 births and 2’902 deaths

• 11.4 million Episodes* – 1.1% inpatient (130,219) – 39% by Nationals – 51% by hospitals

• 4’900 physicians, 10’504 nurses and 5’222 allied health professionals & pharmacists in 1’353 licensed facilities including: – 34 hospitals (3’659 beds) – 759 centers and clinics – 427 pharmacies

38 licensed insurers compete for members

There are more insurance contracts (2.8m) than residents

• 15 Million claims processed • 99.1 % of claims for outpatients

4

Public health highlights • Population One in five residents are Nationals, of whom two

thirds are under 30 and half under 199. Expatriates are overwhelmingly male and of Asian origin and predominantly aged between 20 and 409. A significant share are employed in construction and accommodated in labour camps. The introduction of mandatory health insurance in 2007 provided all residents in Abu Dhabi access to high quality care. Residence status is generally contingent on being employed, so there are very few expatriated retirement age or unemployed. The population has been growing rapidly in previous years, with, a likely temporary decline in 2009.

• Birth Fertility rates – the main driver of growth for Nationals – has declined for over 30 years11,12. The UAE’s Total Fertility Rate has declined from 4.4 to 2.3 per woman between 1990 and 2007. Declining birth rates are attributed to urbanisation, delayed marriage, changing attitudes about family size, and increased education and work opportunities for women.

• Death Mortality rates have also declined steadily12 over the past years. Infant mortality is now comparable with other developed countries7 and the WHO has reported a decrease in the under 5 mortality rate from 15 to 7 per 1’000 live births between 1990 and 2009 across the UAE. In 2011, the diseases of Circulatory System caused the highest number of deaths, accounting for 37.5% of all death cases registered in the Abu Dhabi Emirate. External Causes of morbidity and mortality and Neoplasms are the second and third highest causes of death13,14.

• Injuries Abu Dhabi has one of the highest rates of injuries resulting from Road traffic accidents. They account for 11% of all deaths and are the leading cause of death amongst young males13-15. Speeding fines, free provision of child seats, and traffic safety education programs are some of the actions being

taken by government agencies. Occupational injuries are now covered by health insurance.

• Non-Communicable diseases The Emirate has high rates of chronic diseases related to life style such as obesity, diabetes, and cardiovascular diseases. Cardiovascular diseases accounted for over a quarter of deaths in 2011. Adult Nationals were screened for cardiovascular risk factors in 2008 as a condition for enrollment in Thiqa insurance. Early analysis of results of this screening showed obesity rates of 33% for males and 38% for females and high proportions of people at risk of diabetes and hypertension among UAE nationals over 1517. Without major changes, these rates are set to increase further as the young population ages. Individuals thought to be at high risk of cardiovascular disease are being followed up.

• Cancer caused 14% of all deaths in the Emirate in 2011. Lymphoid, Haematopoietic and related tissue cancers are the dominant cancers in Abu Dhabi. Late detection of breast cancer leads to significant increases in mortality. Female adult Nationals aged 40-69 are being screened for breast cancer as part of their Thiqa insurance renewal. Education and awareness campaigns have increased screening rates for all nationalities.

• Communicable diseases Rates of childhood communicable diseases are very low, due to immunization programs targeting children aged <5 years16. Expatriates are screened for communicable diseases before acquiring residence status16.

• Respiratory infections are the second most common non-life threatening condition in the Emirate after “signs, symptoms and ill-defined”, accounting for 13.6% of Episodes across all healthcare facilities27. Respiratory infections mostly impact workforce productivity and quality of life.

5

Investor highlights • Population The population is concentrated on or nearby Abu

Dhabi islandC23. Areas of growth in the short to medium term are expected to be just off the island (Mohammed Bin Zayed City, Capital district, Shamkha and the islands adjacent to Abu Dhabi island) and Al Ain city. At the end of 2011 there were 0.42m National Thiqa members, 1.3m Basic members and 1.0 m Enhanced members51.

• Demand Aggressive growth in demand is expected for services relating to lifestyle related diseases, e.g. diabetes and cardiovascular disease, and cancer with larger volume increases in outpatient settingsC26.

• Supply There has been 3% growth in the number of physiciansC9 and 11.8% growth of facilities*C9. By 2021 it is estimated that up to 3,200 additional doctors and 5,900 nurses will be required. If churn remains at the 2011 level, this requires annual recruitment of some 1,500 doctors and 1,600 nursesC25. Physician productivity indicates however, there are reserves within existing facilities36. High demand projectionsC25 also indicate that in 2021 demand for inpatient services may require up to 1,600 additional beds beyond the current 3,659 beds38. However, investors hold 42 Preliminary hospital licenses which signals significant future capacity to meet this demandC22.

• Capacity gaps Waiting times have been reduced across most specialties. There is a critical capacity gap in Intensive & Critical Care medicine and overall gaps remain in Emergency medicine, Neonatology, Cardiology, Psychiatry, Pediatrics, Oncology and Obstetrics & GynaecologyC9. Significant new capacity is however anticipated in pediatrics and obstetrics/gynaecologyC22. Overall bed occupancy rates vary by facility, but have significantly decreased in aggregate38 Indicating reduced efficiency. Bed occupancy in ICU, NICU, PICU, CICU, CCU and Isolation was consistently over the optimal 75% during 201142.

• Reimbursement HAAD sets prices for the Basic product uniformly. Providers negotiate prices with Payers for Enhanced plans, generally as a multiple of Basic product rates. Thiqa rates are equivalent to Daman’s most generous Enhanced plan. Prices have been weighted towards outpatient care. DRGs were introduced for the Basic product in 2010, were voluntarily applied for Thiqa in 2011, and will be applied for Enhanced during 2012. 2012 will see more outpatient payments based on Evaluation and Management codes, thereby changed to reflect the severity of the patient’s condition not the grade of doctor seen.

• Provider market Government-subsidised SEHA hospitals provided care in 65% of all inpatient Episodes and 40% of all hospital outpatients (2% increase from 2010)26. The largest independent groups are Al Noor (who hold 21% of the hospital outpatient market) and NMC38. Off the island, health services are concentrated in larger facilities38,41. International providers have come to Abu Dhabi, generally on the basis of a management service agreement, such as the Cleveland Clinic for SKMC and Johns Hopkins for Tawam.

• Payer market Overall, the competitive Enhanced health insurance market has increased to almost 1.05m members. Over 50% of this market is held by three payers – Daman (31.8%), ADNIC Insurance (14.4%) and Al Dhafra (7.0%)51. Daman also administers Thiqa and Basic product. Claims per member have risen from 4.58 in 2009 to 5.44 in 201147. On average payers take 47 days to remit AED1 claimed52. This has improved from 55 in 2010. Oman, Al Khazna and Alliance had the lowest time to remit, less than 40 days52.

6 Note* Percentage growth needs to be interpreted with caution, due to the fact of having some services within SEHA facilities holding a separate license

Benchmarks

Notes Bed ratio calculations were adjusted, as the population in Abu Dhabi is young and is not expected to need to go to hospital as frequently as other older population. To enable a fair comparison the bed ratio was adjusted by mapping the population age structure of Abu Dhabi to that of Germany, using German resource consumption profiles.

Life expectancy 2010 for Abu Dhabi Emirate, 2009 for others.

Sources WHO Statistical Information System/World Health Statistics 2010, Public health department, HAAD population estimates, SCAD, and Health Statistics Analysis 7

8

5

7

3

21

9

12

13

4

12

8.7

USA

UK

UAE

Singapore

Saudi Arabia

Qatar

Oman

Kuwait

Germany

Bahrain

Abu Dhabi

Under - 5 mortality rate / 1'000 live birth

26.7

27.4

19.3

18.3

9.4

27.6

19

17.9

35.3

14.4

20.4

Physicians /10'000 population

98.2

103

40.9

59

21

73.7

41.1

45.5

108.2

37.3

43.6

Nurses / 10'000 population

3.1

3.4

1.9

3.1

2.2

1.4

1.9

1.8

8.2

1.9

2.5

Beds / 1'000 population

1

0.5

4.1

1.9

2.4

8.7

1.9

3.5

0

2.2

5.5

USA

UK

UAE

Singapore

Saudi Arabia

Qatar

Oman

Kuwait

Germany

Bahrain

Abu Dhabi

Population growth, 1999-2009

7

5

7

2

18

7

9

11

3

9

6.4

Infant mortality rate / 1'000 live birth

76

78

77

79

69

78

72

78

78

73

74.9

Life expectancy at birth (years), Males

81

82

79

84

75

79

77

79

83

76

77

Females

Population

Providers Payers Claims

Financing Episodes

8

Population by age, gender and nationality

Note HAAD and SCAD are collaborating to align figures with official SCAD estimates; Estimates presented here differ and are for internal HAAD use only

Source SCAD population estimates for Nationals, additional HAAD assumptions and analysis based on raw insurance data 9

Age band National Expatriate

All Male Female Total Male Female Total

0-4 160'829 35'863 32'288 68'151 48'370 44'308 92'678

National 05-09 128'277 31'831 28'633 60'464 34'995 32'818 67'813

Expatriate 10-14 101'567 26'014 23'050 49'064 26'920 25'583 52'503

15-19 91'899 23'734 21'547 45'281 24'685 21'933 46'618

20-24 259'246 20'819 20'061 40'880 172'359 46'007 218'366

25-29 461'689 19'509 20'890 40'399 342'290 79'000 421'290

30-34 379'538 16'742 18'798 35'540 276'901 67'097 343'998

35-39 274'694 11'345 13'696 25'041 200'887 48'766 249'653

40-44 210'301 7'637 9'493 17'130 158'188 34'983 193'171

45-49 138'765 5'734 7'198 12'932 101'726 24'107 125'833

50-54 99'206 4'359 5'859 10'218 71'262 17'726 88'988

55-59 62'891 3'815 4'810 8'625 42'364 11'902 54'266

60-64 26'681 3'215 3'246 6'461 14'490 5'730 20'220

65-69 11'525 2'522 2'182 4'704 4'027 2'794 6'821

70-74 6'909 2'028 1'761 3'789 1512 1608 3'120

75-79 3'798 1'194 978 2'172 707 919 1626

80-84 2'430 760 704 1'464 376 590 966

85+ 2'155 714 756 1'470 252 433 685

Total 2'422'400 217'835 215'950 433'785 1'522'311 466'304 1'988'615

110,000 10,000 90,000 190,000 290,000

0-4

05-09

10-14

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80-84

85+

♂ Male♀ Female

Population by region and nationality

Note HAAD and SCAD are collaborating to align figures with official SCAD estimates; Estimates presented here differ and are for internal HAAD use only

Source SCAD population estimates for Nationals, additional HAAD assumptions and analysis based on raw insurance data 10

Region National Expatriate Total

Abu Dhabi 228'228 1'560'966 1'789'194

Al Ain 177'117 307'590 484'707

Western 28'440 120'059 148'499

Total 433'785 1'988'615 2'422'400

52.6%

78.5%

40.8%

15.5%

6.6% 6.0%

National Expatriate

Abu Dhabi Al Ain Western

19.2%

36.5%

12.8%

80.8%

63.5%

87.2%

National Expatriate

Births and Deaths 2011

Note Rates = crude birth and death rates calculation are based on internal HAAD population estimates (per 1000) other rates based on crude births (per 1000); Total 2011 births include 9 Non-Hospital and 277 Outside UAE deliveries, 2010 still births as of 2009, HAAD and SCAD are collaborating to align with official SCAD data

Source Birth and Death notifications; Health Statistics Analysis 11

Total By Region Rates By Nationality and gender

Number % Number National Expatriate NA

20

10

20

11

Nat

ion

al

Mal

es

Ab

u

Dh

abi

East

ern

Wes

tern

Tota

l

Ab

u

Dh

abi

East

ern

Wes

tern

Mal

e

Fem

ale

NA

Mal

e

Fem

ale

NA

Mal

e

Fem

ale

NA

Live births 29'528 32'084 46% 51% 19'312 11'397 1'089 13.2 10.8 23.5 7.3 7'428 7'208 8'864 8'534 26 24

Deaths 2'879 2'902 32% 72% 1'642 952 227 1.2 0.9 2.0 1.5 571 368 1 1502 454 2 2 2

Still births 182 68 44% 35% 57 8 3 2.1 3.0 0.7 2.8 8 9 13 15 12 8 1 2

Neonatal mortality 133 127 45% 61% 102 21 4 4.0 5.3 1.8 3.7 32 25 45 24

Infant mortality 235 205 42% 56% 157 40 5 6.4 8.1 3.5 4.6 44 43 70 47

Child mortality (1-4) 60 75 51% 55% 47 22 3 2.3 2.4 1.9 2.8 22 16 19 18

Death by age group % % %

0-6 days 95 99 46% 62% 82 13 4 3% 5% 1% 2% 25 21 35 17 1

7-27 days 38 28 39% 61% 20 8 1% 1% 1% 0% 7 4 10 7

28-364 days 102 78 38% 47% 55 19 1 3% 3% 2% 0% 12 18 25 23

1-4 60 75 51% 55% 47 22 3 3% 3% 2% 1% 22 16 19 18

5-9 42 24 54% 71% 11 9 2 1% 1% 1% 1% 11 2 6 5

10-14 17 25 48% 40% 15 6 1 1% 1% 1% 0% 7 5 3 10

15-19 46 45 67% 82% 26 14 1 2% 2% 1% 0% 27 3 10 5

20-24 129 152 29% 88% 81 34 31 5% 5% 4% 14% 37 7 97 11

25-29 186 193 11% 89% 115 45 29 7% 7% 5% 13% 16 5 156 16

30-34 184 176 10% 85% 95 53 27 6% 6% 6% 12% 12 6 137 20 1

35-39 180 182 15% 80% 95 62 22 6% 6% 7% 10% 16 11 130 24 1

40-44 206 200 16% 85% 112 58 27 7% 7% 6% 12% 21 10 148 21

45-49 187 188 16% 81% 111 57 16 6% 7% 6% 7% 21 9 132 26

50-54 229 229 15% 84% 126 80 18 8% 8% 8% 8% 25 10 168 26

55-59 215 245 22% 80% 136 86 17 8% 8% 9% 7% 31 22 164 27 1

60-64 193 184 35% 68% 100 73 4 6% 6% 8% 2% 40 24 86 33 1

65-69 142 166 45% 63% 97 57 4 6% 6% 6% 2% 46 28 59 33

70-74 158 170 54% 59% 88 69 3 6% 5% 7% 1% 54 37 46 33

75-79 153 142 61% 54% 85 49 6 5% 5% 5% 3% 47 39 30 26

80-84 136 125 60% 39% 64 57 1 4% 4% 6% 0% 36 39 13 36 1

85+ 179 176 63% 49% 81 81 10 6% 5% 9% 4% 58 52 1 28 37

NA 2

Births and deaths time series

Note Rates based on internal HAAD population estimates; HAAD and SCAD are collaborating to align with official SCAD data

Presented data include cases where nationality is not available.

Source MOH statistics, Preventive Medicine Department annual reports, Public Health and Policy; Health Statistics analysis

Births

Deaths

12

0.0

1.0

2.0

3.0

4.0

19

85

19

86

19

87

19

88

19

89

19

90

19

91

19

92

19

93

19

94

19

95

19

96

19

97

19

98

19

99

20

00

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

08

20

09

20

10

20

11

0

10

20

30

40

50 National

Expatriate

Aggregate

Year Total National Rate Expatriate Rate % Nationals

1985 18'874 6'376 46.9 12'498 29.1 34%

1986 19'700 6'328 45.2 13'372 30.3 32%

1987 20'667 6'400 43.8 14'267 30.7 31%

1988 22'113 6'668 43.3 15'445 31.6 30%

1989 21'686 6'647 41.0 15'039 29.2 31%

1990 21'750 6'652 39.1 15'098 27.9 31%

1991 20'246 6'729 37.8 13'517 23.7 33%

1992 20'456 7'202 38.3 13'254 22.1 35%

1993 20'410 7'928 40.4 12'482 19.8 39%

1994 21'505 8'060 39.1 13'445 20.2 37%

1995 20'425 8'261 37.1 12'164 16.9 40%

1996 20'095 8'697 38.1 11'398 15.4 43%

1997 20'017 8'917 37.2 11'100 14.3 45%

1998 20'348 8'435 33.5 11'913 14.5 41%

1999 21'303 8'948 33.9 12'355 14.3 42%

2000 23'525 9'783 35.2 13'742 15.1 42%

2001 23'974 10'349 34.9 13'625 15.6 43%

2002 24'317 10'714 34.5 13'603 15.1 44%

2003 24'990 11'279 34.6 13'711 14.7 45%

2004 26'215 12'021 35.2 14'194 14.7 46%

2005 27'112 12'254 35.3 14'858 15.8 45%

2006 25'738 12'165 33.8 13'573 10.9 47%

2007 27'002 12'857 34.7 14'145 10.7 48%

2008 28'456 13'040 32.4 15'416 8.9 46%

2009 29'044 13,479 31.1 15,565 7.8 46%

2010 29'502 13,635 31.4 15,867 8.0 46%

2011 32'034 14,636 33.7 17,398 8.7 46%

Year Total National Rate Expatriate Rate % Nationals

1985 1'275 520 3.8 755 1.8 41%

1986 1'356 492 3.5 864 2.0 36%

1987 1'444 528 3.6 916 2.0 37%

1988 1'480 551 3.6 929 1.9 37%

1989 1'561 571 3.5 990 1.9 37%

1990 1'628 572 3.4 1'056 1.9 35%

1991 1'774 652 3.7 1'122 2.0 37%

1992 1'829 690 3.7 1'139 1.9 38%

1993 1'946 689 3.5 1'257 2.0 35%

1994 1'963 614 3.0 1'349 2.0 31%

1995 2'166 722 3.2 1'444 2.0 33%

1996 2'050 723 3.2 1'327 1.8 35%

1997 2'105 708 3.0 1'397 1.8 34%

1998 2'098 758 3.0 1'340 1.6 36%

1999 2'206 792 3.0 1'414 1.6 36%

2000 2'250 822 3.0 1'428 1.6 37%

2001 2'574 928 3.1 1'646 1.9 36%

2002 2'612 849 2.7 1'763 2.0 33%

2003 2'493 913 2.8 1'580 1.7 37%

2004 2'489 887 2.6 1'602 1.7 36%

2005 2'443 820 2.4 1'623 1.7 34%

2006 2'380 821 2.2 1'559 1.5 34%

2007 2'750 990 2.6 1'760 1.5 36%

2008 2'949 981 2.4 1'947 1.1 33%

2009 2'973 983 2.3 1'990 1.0 33%

2010 2'855 967 2.2 1'888 0.9 34%

2011 2'898 940 2.2 1,958 1.0 32%

Leading causes of death

Note Causes of death classified according to WHO ICD-10

Source Death notifications; Health Statistics Analysis 13

Injury, poisoning and certain other consequences of external causes

3%

Congenital malformations,

deformations and chromosomal abnormalities

2%

Diseases of the circulatory system

38%

External causes of morbidity

17%

Neoplasms16%

Other causes21%

Endocrine, nutritional and

metabolic diseases3%

Causes 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001

Diseases of the circulatory system 1'089 762 707 697 506 378 424 413 624 778 622

External causes of morbidity 481 202 632 464

Injury, poisoning and certain other

consequences of external causes100 385 57 85

Neoplasms 461 461 397 360 370 315 294 298 276 289 252

Endocrine, nutritional and metabolic diseases 98 194 210 79 201 130 133 126 103 73 65

Congenital malformations, deformations and

chromosomal abnormalities72 144 199 120 177 131 156 146 152 199 190

Other 601 731 715 1'144 867 993 874 943 763 664 845

Total 2'902 2'879 2'917 2'949 2'742 2'450 2'446 2'489 2'492 2'617 2'574

614 600621 503 565 563 574

Leading causes of death

Note Classification according to ICD 10

Source Death notifications; Health Statistics Analysis 14

National Expatriate NA

By gender By age group By gender By age group By gender By age group

Causes of death Cases ♂ ♀ NA 0-1 1-15 15-30 30-45 45-60 60+ ♂ ♀ NA 0-1 1-15 15-30 30-45 45-60 60+ ♂ ♀ 0-1 30-45 60+

Total Death 2'902 571 368 1 87 63 95 76 118 501 1'502 454 2 117 61 295 480 544 461 2 2 1 2 1

Diseases of the circulatory system 1'089 193 140 4 9 21 21 37 241 648 105 1 8 6 88 185 298 169 1 1 1 1

External causes of morbidity 481 82 22 3 23 50 13 6 9 338 39 2 17 148 147 48 15

Neoplasms 461 93 63 1 6 2 20 36 91 175 130 9 11 46 101 138

Diseases of the respiratory system 124 40 22 1 4 2 3 6 48 36 25 3 2 3 10 14 29

Symptoms, signs and abnormal clinical and laboratory

findings, not elsewhere classified117 20 18 4 3 5 4 4 18 47 30 3 2 6 27 14 25 1 1 1 1

Injury, poisoning and certain other consequences of

external causes100 15 7 1 2 10 5 4 65 13 1 2 28 32 14 1

Endocrine, nutritional and metabolic diseases 98 27 16 1 2 7 33 37 18 1 3 2 7 16 26

Certain conditions originating in the perinatal period 87 23 14 37 28 22 50

Certain infectious and parasitic diseases 81 18 12 2 2 1 3 22 38 13 2 2 3 6 16 22

Congenital malformations, deformations and

chromosomal abnormalities72 14 18 24 6 1 1 21 19 30 7 1 2

Diseases of the digestive system 62 13 9 2 5 7 8 22 17 1 4 3 2 4 8 19

Diseases of the genitourinary system 42 12 11 1 5 17 13 6 2 4 13

Diseases of the nervous system 36 10 5 1 6 1 1 2 4 13 8 4 5 6 5 1

Diseases of the blood and blood-forming organs and

certain disorders involving the immune mechanism17 6 3 1 2 1 5 5 3 2 2 1 2 1

Diseases of the musculoskeletal system and connective

tissue14 3 4 1 1 1 4 6 1 2 4 1

Diseases of the skin and subcutaneous tissue 2 1 1 1 1

Pregnancy, childbirth and the puerperium 1 1 1

Diseases of the ear and mastoid process 1 1 1

Diseases of the eye and adnexa 1 1 1

Mental, Behavioral and Neurodevelopmental disorders 1 1 1

NA 15 2 4 6 7 2 7 2

Injury deaths

Source HAAD Death notification data complemented by investigation into the causes of injury using medical records and police reports - Public Health and Policy; Health Statistics Analysis 15

% Change Cases % National

2010-11 2011 2010 2009 2008 2007 2011 2010 2009 2008 2007

Total -3% 537 551 680 623 621

Road Traffic Injury -6% 330 350 430 422 427 25% 27% 27% 28% 28%

Occupational Injury -5% 71 75 82 68 66 1% 3% 4% 3% 5%

Suicide 12% 47 42 51 66 39 2% 0% 0% 2% 3%

Home 90% 40 21 57 34 10 25% 33% 23% 24% 20%

Occupational RTI -54% 12 26 26 8 34 0% 4% 0% 13% 6%

Drowning -29% 10 14 13 13 22 30% 7% 31% 38% 36%

Other 17% 27 23 21 12 23 22% 13% 24% 25% 39%

Road Traffic Injury62%

Occupational Injury13%

Suicide9%

Home7%

Other5%

Occupational RTI2%Drowning

2%

27 31 159 124 90 46 11 3 4

65

17

13

6

4

11

2

0.130.13

0.28

0.20

0.25 0.26

0.37

0.28

0.22

0.00

0.05

0.10

0.15

0.20

0.25

0.30

0.35

0.40

0

20

40

60

80

100

120

140

160

180

200

0-09 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+

Male

Female

Rate per 1000

Communicable diseases

Note Preventable: Diseases preventable by vaccination, Screened: Adult expatriates are screened on application or renewal of residence visa

Source HAAD infectious diseases notification data 2011 BI report - Public Health and Policy; Health Statistics Analysis 16

Total National Expatriate NA

Disease 2010 2011 0-14 15-34 35-54 55-64 65+ 0-14 15-34 35-54 55-64 65+ 0-14

n Chickenpox 7'429 11'768 4282 441 54 8 1 3288 2922 744 23 3 2

Malaria 1'415 2'731 2 72 1'734 823 98 2

n n Viral Hepatitis B 711 673 4 108 68 15 7 6 222 205 30 8

Viral Hepatitis C 668 580 1 20 24 21 13 6 160 242 75 18

Scabies 654 585 23 33 11 2 3 60 306 128 16 3

Other Food Poisoning 471 667 197 64 8 2 114 181 94 7

n Pulmonary Tuberculosis 450 383 1 15 7 3 4 5 210 111 22 5

Typhoid Fever 335 394 11 10 9 3 2 44 199 112 3 1

Other STD 318 243 1 62 36 2 1 3 66 63 9

n Seasonal Influenza 248 282 59 56 10 4 6 57 41 41 7 1

n Mumps 221 194 61 8 2 67 35 20 1

n Viral Hepatitis A 193 138 30 11 1 52 38 5 1

Extra Pulmonary Tuberculosis 175 183 1 8 6 2 3 5 119 34 4 1

Scarlet Fever 105 239 139 95 4 1

n Whooping Cough 73 39 31 8

Gonorrhoea 62 42 17 1 16 7 1

n Syphilis 62 99 1 8 7 2 1 29 46 5

Giardia Lambia 55 82 8 2 1 2 12 38 15 2 2

Brucellosis 52 75 15 8 10 2 3 3 19 15

n Measles 50 49 12 1 16 19 1

Viral Meningitis 36 37 7 1 11 11 6 1

Other Viral Hepatitis 26 1 1

n Rubella 22 42 3 1 5 30 3

Acute Flaccid Paralysis 11 15 5 9 1

Acute Encephalitis 10 10 1 1 2 1 4 1

n Tetanus 1 3 3

Other 315 741 79 124 54 5 7 170 156 124 15 6 1

Scre

en

ed

Pre

ven

tab

le

Selected cardiovascular indicators overview

Source 1Preliminary analysis of Weqaya sample of 112’301 UAE Nationals in the Emirate screened in 2008-9, Public Health and Policy; Definitions:

Obesity: body-mass index ≥ 30; Hypertension: systolic blood pressure ≥ 140 mm Hg or diastolic blood pressure > 90 mm Hg; High lipids: LDL >4.1 mmol/l or HDL <1 mmol/l; Diabetes: HbA1c ≥ 6.1%; Smoking: at least one cigarette per day, 1 cigar/pipe per week or one shisha per month

2Preliminary analysis of Weqaya sample1, Public Health and Policy; Indicators used in correlation analysis: Obesity: body-mass index; Hypertension: systolic blood pressure; High lipids: LDL; Diabetes: HbA1c; Smoking: self-reported consumption

3Extrapolation based on a survey of 76,070 residents in the Emirate in 2005; Definitions: High lipids: self-reported history of high cholesterol and/or total serum cholesterol >200 mg/dl; Hypertension: self-reported history of hypertension, and/or systolic blood pressure ≥ 140 mm Hg or diastolic blood pressure > 90 mm Hg; Obesity: body-mass index > 30; Diabetes: self-reported diabetes or fasting glucose over 126 mg/dl; where only random glucose was available, diabetes status was imputed using a logistic model; Smoking: self-reported smoking; UAE University and Health Statistics analysis

Preliminary

17

Tota

l

Mal

e

Fem

ale

Ob

esit

y

Hyp

erte

nsi

on

Dia

bet

es

Hig

h li

pid

s

Smo

kin

g

Tota

l

Mal

e

Fem

ale

Obesity 36% 33% 38% 20% 17% 32%

Hypertension 17% 24% 12% 35% 33% 41%

Diabetes 21% 22% 20% 18% 18% 18%

High lipids 36% 50% 26% 18% 19% 15%

Smoking 11% 24% 0.8% 25% 29% 6.6%

National1 Correlation2 Expatriate3

Less More

likely likelyPeople who are obese are more likely to have high blood pressure, high lipids and diabetes, but are as likely to be smokers as those who aren't obese

Selected cardiovascular indicators by age group and gender Preliminary

Source 1 Preliminary analysis of Weqaya sample of 112’301 UAE Nationals in the Emirate screened in 2008-9, Public Health and Policy; Definitions:

Obesity: body-mass index ≥ 30; Hypertension: systolic blood pressure ≥ 140 mm Hg or diastolic blood pressure > 90 mm Hg; High lipids: LDL >4.1 mmol/l or HDL <1 mmol/l; Diabetes: HbA1c ≥ 6.1%; Smoking: at least one cigarette per day, 1 cigar/pipe per week or one shisha per month

2 Extrapolation based on a survey of 76,070 residents in the Emirate in 2005; Definitions: High lipids: self-reported history of high cholesterol and/or total serum cholesterol >200 mg/dl; Hypertension: self-reported history of hypertension, and/or systolic blood pressure ≥ 140 mm Hg or diastolic blood pressure > 90 mm Hg; Obesity: body-mass index > 30; Diabetes: self-reported diabetes or fasting glucose over 126 mg/dl; where only random glucose was available, diabetes status was imputed using a logistic model; Smoking: self-reported smoking; Physical exercise: self-reported physical exercise; UAE University and Health Statistics analysis

Female Male

Nationality Indicator 20-29 30-39 40-49 50-59 60-69 70-79 80+ 20-29 30-39 40-49 50-59 60-69 70-79 80+

National Obesity 25% 41% 57% 65% 55% 45% 37% 29% 37% 37% 36% 30% 25% 23%

High lipids 20% 26% 34% 37% 38% 36% 35% 44% 56% 57% 55% 49% 51% 50%

Hypertension 5% 8% 18% 34% 44% 50% 47% 18% 20% 28% 42% 47% 49% 46%

Diabetes 8% 14% 34% 57% 61% 59% 57% 8% 17% 34% 55% 64% 62% 50%

Smoking 1% 1% 1% 1% 1% 0% 0% 27% 27% 22% 17% 10% 7% 7%

Heart disease 0% 1% 3% 8% 11% 14% 13% 1% 1% 3% 7% 12% 14% 14%

Stroke 0% 1% 2% 4% 5% 6% 6% 1% 1% 1% 3% 5% 6% 6%

Physical exercise 25% 27% 25% 20% 13% 5% 6% 43% 40% 35% 33% 27% 19% 24%

Expatriate Obesity 21% 32% 42% 51% 49% 30% 67% 12% 18% 21% 23% 30% 21% 18%

High lipids 29% 37% 61% 66% 60% N/A N/A 16% 37% 48% 52% 52% 51% 50%

Hypertension 3% 9% 28% 45% 65% 61% 58% 9% 16% 30% 46% 58% 53% 33%

Diabetes 5% 13% 32% 46% 61% 44% 33% 5% 15% 35% 46% 53% 47% 33%

Smoking 6% 7% 9% 6% 5% 10% 0% 33% 29% 25% 21% 21% 14% 21%

Physical exercise 21% 23% 27% 29% 23% 9% 8% 32% 31% 34% 37% 36% 24% 36%

2

1

18

Note Risk of diabetes is defined as HbA1c ≥ 6.1%

Source Preliminary analysis of Weqaya sample of 112’301 UAE Nationals in the Emirate screened in 2008-9, Health Statistics`

Prevalence of Diabetes Mellitus by age group

19

23%

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

0%

10%

20%

30%

40%

50%

60%

70%

20-29 30-39 40-49 50-59 60-69 70-79 80+

% At risk of diabetes

Average

Population

Notes Diabetics is number of members who had an Encounter with diagnosis of diabetes. Well controlled diabetes is a measure of diabetics whose latest HbA1c<7%. Moderate and well controlled diabetics are those whose latest HbA1c<7.5%.Poorly controlled diabetics are those whose latest HbA1c>9%. Related care indicators apply to diabetics only and indicate ≥1 test per member per annum. Rates shown are rates within breakdown category. Indicator definitions are available at https://www.shafafiya.org

Source KEH Episodes with Encounter start date 1 January – 31 December 2011 as at 5 April 2012 20

Diabetes performance

Notes Green indicates better than average (previous page) indicator values, red indicates otherwise

Indicator definitions are available at https://www.shafafiya.org.

Source KEH Episodes with Encounter start date 1 January – 31 December 2011 as at 5 April 2012 21

Diabetes indicators, top providers

Episodes

with

diabetics

Well

controlled

diabetics

Diabetics w

HbA1c

observatio

n & latest

HbA1c<7%

QI

Moderate

& well

controlled

diabetics

Diabetics w

HbA1c

observatio

n & latest

HbA1c<7.5

% QI

Poorly

controlled

diabetics

Diabetics w

HbA1c

observatio

n & latest

HbA1c>9%

QI

Annual

HbA1c test

Annual

lipid profile

test

Annual

renal test

Annual eye

exam

Target direction:

SKMC 58'506 47.4% 64.6% 54.8% 74.7% 20.5% 27.9% 79.0% 63.2% 79.0% 94.1%

Tawam 52'647 41.7% 58.7% 49.6% 69.9% 21.5% 30.4% 78.8% 58.4% 70.9% 93.0%

Imperial College London Diabetes Centre 51'435 56.8% 61.8% 68.3% 74.4% 33.0% 35.9% 96.2% 87.3% 95.4% 86.3%

Al Ahalia 36'815 31.4% 61.7% 36.1% 71.0% 14.4% 28.3% 60.9% 53.1% 66.4% 95.6%

Al Noor 29'231 47.5% 67.6% 54.2% 77.2% 18.3% 26.1% 78.0% 62.1% 85.6% 95.2%

N M C Specialty 27'785 40.4% 64.7% 47.0% 75.4% 15.9% 25.4% 72.5% 60.3% 82.0% 85.4%

Al Noor - Al Ain 26'806 39.3% 56.1% 47.5% 67.8% 23.4% 33.4% 75.3% 58.1% 80.5% 92.2%

Al Mafraq 22'504 43.4% 61.1% 51.0% 71.8% 21.3% 30.0% 79.9% 60.5% 83.6% 95.9%

Al Ain 21'534 36.0% 55.9% 44.1% 68.4% 19.9% 30.9% 73.7% 57.8% 73.6% 90.9%

Life Line 16'666 37.3% 66.9% 42.7% 76.5% 13.5% 24.1% 65.1% 58.3% 75.8% 92.9%

Al Noor - Airport Road 16'318 50.3% 68.3% 57.2% 77.6% 20.1% 27.3% 80.9% 64.4% 88.0% 96.6%

N M C Specialty - Al Ain 14'636 36.5% 58.4% 44.0% 70.5% 18.3% 29.3% 69.4% 58.3% 78.3% 89.3%

Al Jahili 13'001 43.2% 58.8% 51.4% 69.9% 22.3% 30.3% 81.5% 58.6% 71.4% 95.2%

Al Rahba 11'370 46.7% 65.6% 53.8% 75.5% 20.1% 28.2% 78.4% 59.1% 75.6% 94.0%

Taha Medical Centre 11'123 24.2% 63.2% 31.0% 80.8% 5.7% 14.9% 44.0% 59.2% 68.7% 96.1%

Gulf Diagnostic Center 10'310 48.9% 73.0% 55.1% 82.3% 14.2% 21.2% 75.7% 63.4% 85.0% 95.7%

Al Salama 9'473 45.8% 67.3% 51.6% 75.9% 17.6% 26.0% 76.0% 59.9% 82.2% 97.1%

Oasis 9'361 39.1% 59.4% 46.6% 70.7% 19.6% 29.7% 73.8% 53.2% 72.6% 91.0%

Al Ameen Medical Centre 7'877 32.1% 55.4% 38.2% 65.9% 17.7% 30.5% 63.1% 36.9% 56.8% 93.9%

Madinat Zayed 7'815 42.7% 58.9% 50.0% 68.9% 24.5% 33.7% 81.5% 62.9% 86.0% 96.4%

Medical Services Administration Of Abu Dhabi Police Ghq7'124 52.9% 74.6% 58.1% 82.1% 19.1% 26.9% 78.7% 59.6% 83.6% 98.7%

Al Musaffah Al Alhli Medical Centre 6'730 28.2% 53.4% 33.5% 63.4% 18.6% 35.1% 61.5% 52.8% 61.5% 96.9%

Life Line Hospital Al Musafah 6'714 33.7% 58.2% 39.1% 67.5% 18.0% 31.1% 67.3% 56.3% 74.1% 94.5%

Al Kamal Medicdal Poly Clinics- L L C 6'490 28.4% 65.7% 32.1% 74.2% 9.8% 22.7% 49.0% 49.5% 63.8% 92.7%

Modern Center 6'407 16.1% 50.0% 21.7% 67.3% 8.7% 27.0% 34.4% 43.9% 56.3% 96.9%

National 6'013 31.7% 63.6% 37.2% 74.6% 11.7% 23.6% 59.4% 55.7% 65.8% 92.9%

Al Khabisi Clinic 5'704 38.2% 56.1% 46.1% 67.7% 20.5% 30.1% 78.0% 60.1% 75.8% 91.8%

Neima 5'506 41.6% 59.5% 49.8% 71.1% 20.3% 29.0% 78.6% 57.3% 65.8% 97.3%

Specilaized Uneversity Medical Centre 4'616 47.9% 54.9% 73.9% 84.6% 17.7% 20.3% 89.0% 76.2% 58.7% 88.4%

Golden Sand Medical Centre 4'593 36.2% 58.5% 41.9% 67.7% 18.6% 30.0% 68.5% 58.8% 77.8% 97.6%

Notes: Activity Net represents claimed amount

* Excludes mandatory 50% co-pay for drugs for Thiqa patients in non-SEHA facilities

Source KEH Episodes with Encounter start date 1 January – 31 December 2011 as at 5 April 2012 22

Diabetes cost

Cost contribution by Activi ty Type

Drugs Procedures DRG Suppl ies Services

Total 100.0% 749'322 9.6 1'307 136 38% 35% 16% 5% 6%

Thiqa 62.2% 261'917 12.7 2'326 183 35% 35% 19% 7% 4%

Imperia l Col lege London Diabetes Centre 22.7% 42'081 29.5 5'285 179 39%* 51% 0% 8% 2%

SKMC 11.0% 42'349 13.0 2'545 195 33% 22% 31% 9% 5%

Tawam 9.8% 45'355 9.1 2'119 234 30% 19% 39% 6% 6%

Al Mafraq 3.1% 12'814 11.1 2'363 212 36% 12% 44% 5% 3%

Al Ain 2.1% 7'579 12.0 2'657 222 22% 14% 49% 5% 10%

Other 13.5% 111'739 8.0 1'187 148 36%* 37% 15% 5% 7%

Enhanced 24.9% 219'800 8.9 1'107 125 53% 37% 1% 3% 6%

Imperia l Col lege London Diabetes Centre 2.9% 8'854 23.2 3'198 138 48% 46% 0% 3% 3%

Al Noor 2.5% 16'588 9.5 1'468 154 51% 37% 2% 4% 6%

N M C Specia l ty 2.4% 19'409 8.4 1'208 144 59% 29% 3% 3% 6%

SKMC 1.2% 5'401 11.1 2'226 200 35% 45% 5% 6% 9%

Al Noor - Al Ain 1.0% 6'436 11.6 1'497 130 51% 40% 1% 4% 4%

Other 14.9% 163'112 7.9 892 113 55% 36% 1% 2% 6%

Basic 12.9% 268'095 7.2 472 66 22% 36% 35% 1% 6%

SKMC 2.0% 10'794 17.9 1'770 99 9% 14% 65% 1% 11%

Al Mafraq 1.2% 6'781 9.4 1'674 177 10% 11% 72% 0% 7%

Al Ain 1.1% 9'422 8.6 1'095 127 12% 20% 58% 1% 9%

Al Noor - Al Ain 0.9% 17'612 9.2 481 52 28% 50% 14% 0% 8%

Al Noor 0.6% 10'389 8.2 591 72 27% 46% 22% 0% 5%

Other 7.1% 213'097 6.3 334 53 29% 45% 21% 1% 4%

Average

Activi ty Net

(AED)Activi ty Net Episodes

Activi ties

per Episode

Activi ty Net

per Episode

(AED)

Cancer death cases

23

By site

Note Data need to be interpreted with caution, due to undercounting and ambiguity about the overall population (denominator)

Source Death Notifications, Health Statistics Analysis

Cancer death cases Rate per 100'000 population

Total Male Female Male Female

403 229 174 13.2 25.5

National 137 79 58 36.3 26.9

Expatriate 266 150 116 9.9 24.9

Stomach

Pancreas

Breast

25.1%

2.5%

4.2%

4.2%

5.5%

6.9%

8.9%

8.9%

10.4%

11.4%

11.7%

Other

Cervix uteri

Brain, nervous system

Lymphoma

Stomach

Pancreas

Leukaemia

Liver and intrahepatic bile ducts

Trachea, bronchus and lung

Colorectum

Breast

All

23.1%

3.1%

3.1%

5.2%

5.7%

6.1%

7.9%

8.7%

10.9%

11.4%

14.8%

Other

Bladder

Prostate

Lymphoma

Stomach

Brain, nervous system

Pancreas

Leukaemia

Liver and intrahepatic bile ducts

Colorectum

Trachea, bronchus and lung

Male

18.4%

2.9%

2.9%

4.6%

5.2%

5.7%

5.7%

6.3%

9.2%

11.5%

27.0%

Other

Ovary

Lymphoma

Trachea, bronchus and lung

Stomach

Pancreas

Cervix uteri

Liver and intrahepatic bile ducts

Leukaemia

Colorectum

Breast

Female

National34%

Expatriate66%

By nationality

Male57%

Female43%

By gender

Cancer death cases by age group

Note Data need to be interpreted with caution, due to undercounting and ambiguity about the overall population (denominator)

Source Death Notifications, Health Statistics Analysis 24

Age %National %Female

0-4 60% 20%

5-9 33% 0%

10-14 33% 67%

15-19 0% 0%

20-24 50% 25%

25-29 0% 0%

30-34 40% 40%

35-39 32% 77%

40-44 27% 64%

45-49 26% 57%

50-54 20% 37%

55-59 34% 36%

60-64 35% 33%

65-69 31% 42%

70-74 35% 42%

75-79 48% 19%

80-84 58% 69%

85+ 41% 35%

53

6

24 5

15

22 22

35 35

53 52

48

31

21

26

17

0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.1 0.1 0.3 0.4 0.8 1.94.2 4.5 5.5

10.77.9

0-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80-8

4

85

+

Cases Rate per 1000

Population

Providers Payers Claims

Financing Episodes

25

Episodes by type, setting and nationality

Notes An Episode is an inpatient Encounter or a set of outpatient Encounters linked to the same clinical case based on the patient (identified by insurance member ID), Episode Clinician – the clinician responsible for consultation, and principal diagnosis. Episodes are attributed to facility types according to Episode Clinician facility as per clinician licensing database. Non-SEHA ER Episodes are underrepresented because of miscoding of ER Encounter types as outpatient.

* Estimate based on Encounters reported in 2010 eClaims end Encounter/Episode ratios

Source Cube 2011; Health Statistics Analysis 26

2011 SEHA 2010* SEHA*

Total 11'361'157 37% 10'998'469 34%

Hospital 5'774'551 40% 5'954'723 38%

Inpatient 130'219 65% 136'725 63%

ER 45'138 94% 36'576 95%

National 21'216 97% 18'311 98%

Expatriate 21'232 92% 17'469 95%

N/A 2'690 76% 796 22%

Non-ER 85'081 49% 100'149 51%

National 28'894 67% 40'878 75%

Expatriate 40'135 41% 43'793 45%

N/A 16'052 39% 15'478 4%

Outpatient 5'644'332 40% 5'817'998 38%

ER 655'394 97% 575'654 95%

National 354'837 99% 321'781 96%

Expatriate 297'177 96% 251'751 93%

N/A 3'380 61% 2'123 61%

Non-ER 4'988'938 32% 5'242'343 31%

National 1'647'896 57% 1'875'221 53%

Expatriate 2'907'096 22% 3'000'493 21%

N/A 433'946 2% 366'629 2%

Center 5'049'446 38% 4'528'463 31%

National 2'269'165 63% 1'974'079 54%

Expatriate 2'497'339 19% 2'340'605 15%

N/A 282'941 1% 213'779 1%

Clinic 537'160 2% 515'283 1%

National 103'564 7% 107'613 2%

Expatriate 394'009 0% 380'371 0%

N/A 39'588 0% 27'298 0%

Outpatient

ExpatriateHospital

Center National

N/AER ClinicInpatient

Setting Provider Nationality

Episodes by diagnosis group, % of volume

Source Cube 2011; Health Statistics analysis; diagnosis groups based on WHO classification of diagnoses ICD 9 27

Outpatient Inpatient

Total Non-ER ER Non-ER ER

% of Total Episodes 100 93.1 5.2 1.0 0.7

Signs, symptoms and ill-defined 19.5 19.3 22.5 24.1 17.0

Respiratory infections 13.6 13.5 18.7 4.2 6.1

Musculoskeletal diseases 8.3 8.6 6.3 3.1 2.0

Digestive diseases 6.6 6.5 6.9 7.9 7.6

Endocrine disorders 6.0 6.1 2.1 7.9 9.9

Respiratory diseases 5.8 5.8 5.6 5.4 5.4

Cardiovascular diseases 5.0 5.1 3.3 6.1 8.4

Genitourinary diseases 4.6 4.6 4.2 5.1 4.6

Skin diseases 4.6 4.7 2.7 1.6 2.0

Diabetes mellitus 4.1 4.2 2.4 3.2 5.3

Sense organ diseases 4.0 4.2 2.4 1.1 1.2

Injuries 3.7 3.2 13.2 3.2 5.8

Infectious and parasitic diseases 3.6 3.7 2.0 3.0 4.6

Oral conditions 2.8 3.0 0.9 0.4 0.4

Nutritional deficiencies 2.7 2.8 0.5 2.9 2.9

Neuropsychiatric conditions 2.2 2.1 2.2 2.7 4.3

Maternal and Perinatal conditions 2.1 1.9 2.8 15.0 9.2

Cancer 0.5 0.5 0.3 1.9 1.4

Congenital anomalies 0.3 0.2 0.2 1.2 1.0

RTA 0.1 0.0 0.8 0.2 1.0

100.0 100.0 100.0 100.0 100.0

Episodes by diagnosis group, % of value

Source Cube 2011; Health Statistics analysis; diagnosis groups based on WHO classification of diagnoses ICD 9 28

Total Outpatient Inpatient

100.0% 70.3% 29.7%

Break down Break down

Services Procedures Drugs Supplies DRG Services Procedures Drugs Supplies

% of Total value 100 100 8.3 59.0 30.6 2.3 100 47.2 15.2 29.1 6.1 2.6

Signs, symptoms and ill-defined 17.0 17.5 1.9 12.1 3.0 0.5 15.5 8.6 1.7 3.7 1.3 0.2

Diabetes mellitus 8.6 11.6 0.4 4.6 6.0 0.6 1.2 0.7 0.1 0.2 0.2 0.0

Respiratory infections 7.8 9.0 1.4 3.8 3.7 0.0 5.0 2.5 0.8 1.2 0.5 0.0

Cardiovascular diseases 7.4 6.4 0.4 2.7 3.1 0.2 10.0 5.7 1.2 2.1 0.3 0.7

Musculoskeletal diseases 7.3 8.2 0.6 5.1 2.4 0.1 5.3 1.4 0.4 2.7 0.4 0.3

Maternal and Perinatal conditions 6.1 2.7 0.2 2.1 0.3 0.0 14.3 7.8 1.9 4.3 0.2 0.1

Digestive diseases 5.5 4.3 0.4 2.3 1.6 0.0 8.4 3.8 0.8 3.3 0.4 0.2

Genitourinary diseases 5.5 5.6 0.5 3.8 1.2 0.1 5.2 1.6 0.5 2.8 0.2 0.1

Oral conditions 5.0 6.9 0.0 6.7 0.2 0.0 0.5 0.1 0.1 0.3 0.0 0.0

Respiratory diseases 4.9 4.1 0.4 1.7 1.8 0.1 6.9 2.6 2.2 1.7 0.3 0.1

Endocrine disorders 4.4 4.9 0.3 2.7 1.9 0.1 3.2 1.5 0.5 0.6 0.4 0.2

Injuries 4.3 2.8 0.3 2.1 0.5 0.0 7.9 4.2 0.9 2.5 0.2 0.2

Neuropsychiatric conditions 3.4 3.0 0.2 1.6 1.0 0.3 4.4 1.0 2.5 0.6 0.2 0.1

Infectious and parasitic diseases 3.1 3.1 0.3 1.6 1.1 0.0 3.1 2.0 0.6 0.4 0.1 0.0

Skin diseases 3.1 3.7 0.5 1.9 1.3 0.0 1.5 0.6 0.2 0.3 0.4 0.0

Sense organ diseases 3.0 3.2 0.5 2.0 0.6 0.2 2.5 0.4 0.3 1.3 0.4 0.2

Cancer 2.0 1.5 0.0 0.9 0.4 0.0 3.3 1.7 0.3 0.7 0.6 0.0

Nutritional deficiencies 1.0 1.4 0.1 0.9 0.3 0.0 0.2 0.1 0.0 0.1 0.0 0.0

Congenital anomalies 0.8 0.4 0.0 0.3 0.0 0.1 1.8 1.0 0.3 0.3 0.0 0.0

RTA 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Activities by type, % of value

* Dark area indicates proportion of outpatient

Note Not all drugs have been mapped to the appropriate ATC code http://en.wikipedia.org/wiki/ATC_code_A02 ; HCPCS CMS Hospital Outpatient Payment system includes 90% unclassified drugs.

Source Cube 2011; Health statistics analysis 29

CPT 100% OP*

Pathology & Laboratory 47.3%

Evaluation & Management 16.1%

Diagnostic Ultrasound 7.6%

Radiology 7.4%

Musculoskeletal 3.4%

Digestive System 3.4%

Maternity Care & Delivery 2.7%

Integumentary 2.4%

Respiratory System 1.7%

Eye & Ocular Adnexa 1.7%

Urinary System 1.6%

Nuclear Medicine 1.1%

Cardiovascular System .8%

Female Genital System .6%

Radiation Oncology .6%

Auditory System .5%

Male Genital System .4%

Nervous System .4%

Other CPT .3%

Breast Mammography .2%

0.0%

Service 100% OP*

Consultation Specialist 25.2%

Perdiem - Long Term Stay 15.6%

Consultation Consultant 14.1%

Consultation GP 12.8%

Room and Board: First Class Room 7.5%

Observation or Treatment room 5.1%

Perdiem - Haemodialysis (HD) 3.3%

Generic code for yet undefined services 2.6%

Outlier Payment 2.5%

Room and Board: Shared Room 2.4%

Per diem Intensive - Care Unit (ICU) 2.0%

Perdiem - Day Stay (Day care) 1.9%

Per diem N-ICU 1.7%

Per diem Inpatient 1.1%

Operating Room and Services .5%

Per diem - Special-Care Baby Unit (SCBU) .4%

Room and Board: Private Room Deluxe or better .3%

Comprehensive screening evaluation and management .2%

Perdiem - PICU - Daily Rate (Day 1 to 7) .2%

Room and Board: Ward .2%

Perdiem - Non-Medical Escort .2%

Perdiem - New-born Nursery - Daily Rate (Day 1 to 3) .1%

Perdiem - SCU - Daily Rate (Day 1 to 3) .1%

Perdiem - Room Rate difference .1%

Delivery Room .0%

Other services .1%

CPT46%

Drug23%

DRG14%

Service10%

Dental5%

HCPCS2%

Drug 100% OP*

Alimentary tract and metabolism 22.9%

Cardiovascular system 16.1%

Antiinfectives for systemic use 15.3%

Antineoplastic and immunomodulating agents 10.8%

Respiratory system 8.8%

Blood and blood forming organs 5.9%

Musculo-skeletal system 5.9%

Nervous system 5.6%

Dermatologicals 2.5%

Genito-urinary system and sex hormones 2.1%

Sensory organs 1.8%

Systemic hormonal preparations, excluding sex hormones and insulins 1.3%

Various .7%

Antiparasitic products, insecticides and repellents .2%

0.0%

DRG 100% OP*

Newborns & Other Neonates 16.7%

Diseases & Disorders Of The Respiratory System 16.3%

Childbirth 11.5%

Diseases & Disorders Of The Circulatory System 10.5%

Diseases & Disorders Of The Digestive System 8.9%

Diseases & Disorders Of The Musculoskeletal System & Connective Tissue6.7%

Diseases & Disorders Of The Female Reproductive System 4.2%

Diseases & Disorders Of The Nervous System 4.1%

Diseases & Disorders Of The Ear, Nose, Mouth & Throat 3.5%

Diseases & Disorders Of The Urinary Tract 2.9%

Diseases & Disorders Of The Skin, Subcutaneous Tissue & Breast 2.6%

Diseases & Disorders Of The Hepatobiliary System & Pancreas 2.3%

Diseases & Disorders Of The Endocrine, Nutritional & Metabolic Systems 2.0%

Infectious & Parasitic Diseases Of Systemic Or Unspecified Sites 1.9%

Diseases & Disorders Of The Myeloproliferative System & Poorly Differentiated Neoplasms1.4%

Diseases & Disorders Of Blood, Blood Forming Organs, Immunological System1.4%

Mental Diseases & Disorders .8%

Diseases & Disorders Of The Male Reproductive System .7%

Injuries, Poisonings & Toxic Effects Of Drugs .6%

Diseases & Disorders Of The Eye .6%

Other DRG .4%

0.0%

Dental 100% OP*

Restoration 35.3%

Diagnostic 11.7%

Oralmaxillo 10.3%

Adjunctivegeneral 9.8%

Endodontics 9.3%

Orthodontics 9.0%

Prevention 7.1%

Fixedprostho 3.5%

Periodontics 2.9%

Removableprostho 1.1%

Procedures by diagnosis group, % of value

* Dark area in pie charts represents share of top 5 procedures within total value of diagnosis group

Note Procedures: CPT excluding E&M codes

Data should be interpreted with caution, particularly for categories with low counts

Source Cube 2011; Health Statistics analysis; diagnosis groups based on WHO classification of diagnoses ICD 9 30

Diagnosis group 100 Top 5* 1st 2nd 3rd 4th 5th

Signs, symptoms and ill-defined 20 Complete Cbc W/Auto Diff Wbc (3.8%) Ob Us >/= 14 Wks, Sngl Fetus (2.8%) Echo Exam Of Heart (2.7%) Ob Us, Detailed, Sngl Fetus (2.3%) Us Exam, Abdom, Complete (2.3%)

Oral conditions 10 Two Surfaces (5.6%) One Surface (5.5%)Crown, Porcelain/Ceramic/Polymer

Glass + L (5.4%)Three Surfaces (4.6%) Class I Malocclusion + L (4.2%)

Musculoskeletal diseases 9 Knee Arthroscopy/Surgery (10.3%) Mri Lumbar Spine W/O Dye (8.4%) Therapeutic Exercises (5.0%) Mri Neck Spine W/O Dye (3.7%) Mri Jnt Of Lwr Extre W/O Dye (3.7%)

Genitourinary diseases 7 Us Exam, Pelvic, Complete (6.6%) Fragmenting Of Kidney Stone (6.2%) Transvaginal Us, Non-Ob (5.6%) Hemodialysis, One Evaluation (4.1%) Us Exam Abdo Back Wall, Comp (3.9%)

Diabetes mellitus 7 Lipid Panel (8.7%) Assay Of Parathormone (7.9%) Glycosylated Hemoglobin Test (7.8%) Assay Of Vitamin D (7.6%) Eye Exam With Photos (3.0%)

Maternal and Perinatal conditions 6 Cesarean Delivery Only (16.4%) Obstetrical Care (16.4%) Ob Us >/= 14 Wks, Sngl Fetus (9.4%) Ob Us, Detailed, Sngl Fetus (6.3%) Ob Us < 14 Wks, Single Fetus (6.0%)

Digestive diseases 5 Upper Gi Endoscopy, Biopsy (6.8%) Laparoscopic Cholecystectomy (5.6%) Us Exam, Abdom, Complete (4.8%) Laparoscopy, Appendectomy (4.6%) Colonoscopy And Biopsy (3.7%)

Cardiovascular diseases 5 Echo Exam Of Heart (9.0%) Cath Placement, Angiography (4.8%) Lipid Panel (4.6%) Extremity Study (3.1%) Cardiovascular Stress Test (3.0%)

Injuries 4 Repair Superficial Wound(S) (9.2%) Knee Arthroscopy/Surgery (8.3%) Mri Jnt Of Lwr Extre W/O Dye (5.3%) Remove Foreign Body From Eye (3.2%) Layer Closure Of Wound(S) (2.3%)

Endocrine disorders 4 Lipid Panel (6.8%) Assay Thyroid Stim Hormone (6.1%) Assay Of Vitamin D (5.7%) Free Assay (Ft-3) (3.9%) Assay Of Free Thyroxine (3.6%)

Respiratory infections 4 Nasal Endoscopy, Dx (9.2%) Ther/Proph/Diag Inj, Sc/Im (7.5%) Airway Inhalation Treatment (7.0%) Complete Cbc W/Auto Diff Wbc (6.0%) Chest X-Ray (4.0%)

Sense organ diseases 3 Cataract Surg W/Iol, 1 Stage (13.7%) Treatment Of Retinal Lesion (6.4%) Remove Impacted Ear Wax (5.6%) Ophth Dx Imaging Post Seg (5.6%) Eye Service Or Procedure (4.6%)

Respiratory diseases 3 Nasal Endoscopy, Dx (14.6%) Airway Inhalation Treatment (7.2%) Remove Tonsils And Adenoids (6.3%) Ct Maxillofacial W/O Dye (5.1%) Repair Of Nasal Septum (4.7%)

Neuropsychiatric conditions 3 Psytx, Off, 20-30 Min W/E&M (7.2%) Speech/Hearing Therapy (5.6%) Psy Dx Interview (5.4%) Motor Nerve Conduction Test (4.8%) Medication Management (4.0%)

Skin diseases 2 Drainage Of Skin Abscess (16.0%) Photochemotherapy With Uv-B (4.1%) Complete Cbc W/Auto Diff Wbc (3.1%) Destruct B9 Lesion, 1-14 (3.0%) Ther/Proph/Diag Inj, Sc/Im (2.7%)

Infectious and parasitic diseases 2 Destruct B9 Lesion, 1-14 (6.5%) Transvaginal Us, Non-Ob (5.5%) Us Exam, Pelvic, Complete (4.5%) Complete Cbc W/Auto Diff Wbc (3.5%) Culture, Bacteria, Other (2.3%)

Cancer 2 Pet Image W/Ct, Full Body (18.0%) Pet Image W/Ct, Skull-Thigh (10.6%) Radiation Tx Delivery, Imrt (3.7%) Tissue Exam By Pathologist (2.6%) Ct Abdomen W/Dye (2.2%)

Nutritional deficiencies 1 Assay Of Vitamin D (14.3%) Assay Of Parathormone (5.6%) Assay Of Ferritin (5.3%) Assay Thyroid Stim Hormone (4.6%) Complete Cbc W/Auto Diff Wbc (4.6%)

Congenital anomalies 1 Echo Transthoracic (16.7%) Suspension Of Testis (5.7%) Reconstruction Of Urethra (2.4%) Echo Exam Of Heart (2.3%) Therapeutic Exercises (2.3%)

RTA Speech/Hearing Evaluation (31.2%) Ct Head/Brain W/O Dye (9.7%) Ct Neck Spine W/O Dye (9.3%) Ct Lumbar Spine W/O Dye (8.7%) Therapeutic Exercises (5.6%)

Drugs by diagnosis group, % of value

* Dark area in pie charts represents share of top 5 drugs within total value of diagnosis group Note Data should be interpreted with caution, particularly for categories with low counts Source Cube 2011; Health Statistics analysis; diagnosis groups based on WHO classification of diagnoses ICD 9 31

Diagnosis group 100 Top 5* 1st 2nd 3rd 4th 5th

Diabetes mellitus 18 Lipitor (10.2%) Janumet (7.9%) Januvia (5.1%) Lantus Solostar (4.7%) Crestor (4.5%)

Respiratory infections 12 Augmentin (10.5%) Rocephin (4.8%) Zinnat (4.4%) Omnicef (3.4%) Klacid (2.8%)

Signs, symptoms and ill-defined 11 Herceptin (6.8%) Norditropin (2.5%) Lipitor (2.2%) Nexium (1.8%) Glivec (1.8%)

Cardiovascular diseases 10 Lipitor (11.9%) Plavix (7.2%) Crestor (5.1%) Norvasc (4.1%) Exforge (2.7%)

Musculoskeletal diseases 8 Humira (12.2%) Celebrex (9.0%) Arcoxia (6.7%) Lyrica (4.4%) Voltaren (4.0%)

Endocrine disorders 6 Lipitor (10.9%) Kogenate Fs (9.7%) Ceprotin (8.4%) Crestor (6.7%) Exjade (4.4%)

Respiratory diseases 6 Singulair (10.3%) Seretide Diskus (7.1%) Symbicort Turbuhler (5.6%) Singulair Paediatric (4.0%) Pulmicort (4.0%)

Digestive diseases 5 Nexium (11.9%) Pantozol (7.1%) Humira (5.6%) Pariet (4.1%) Remicade (3.3%)

Skin diseases 5 Humira (15.2%) Remicade (10.0%) Roaccutane (5.3%) Enbrel (5.2%) Augmentin (3.3%)

Genitourinary diseases 4 Gonal - F (9.2%) Ciprobay (6.2%) Arnasep (4.3%) Tavanic (3.8%) Xatral Xl (3.5%)

Infectious and parasitic diseases 4 Lamisil (4.8%) Baraclude (4.7%) Pegasys (3.9%) Zovirax (3.7%) Peg-Intron (2.9%)

Neuropsychiatric conditions 3 Keppra (9.4%) Avonex (6.6%) Rebif (5.7%) Zyprexa Velotab (4.3%) Seroquel (4.2%)

Sense organ diseases 2 Lucentis (18.9%) Cosopt (4.6%) Zaditen (2.7%) Travatan (2.7%) Augmentin (2.6%)

Cancer 2 Glivec (12.5%) Herceptin (10.2%) Revlimid (8.2%) Sprycel (4.7%) Neulastim (3.7%)

Injuries 2 Augmentin (6.4%) Celebrex (5.8%) Voltaren (5.1%) Arcoxia (4.1%) Zinnat (2.4%)

Maternal and Perinatal conditions 1 Duphaston (7.4%) Clexane (7.0%) Promise Nunal (4.0%) Synagis (3.9%) Augmentin (2.8%)

Nutritional deficiencies 1 D-Forte (8.1%) Lipitor (4.0%) Humira (3.5%) One-Alpha (2.7%) Nexium (2.4%)

Oral conditions 1 Augmentin (37.9%) Brufen (4.6%) Cataflam (3.2%) Amoxil (2.6%) Metrolag (2.0%)

Congenital anomalies Tracleer (13.2%) Ventolin (12.8%) Norditropin (8.6%) Synagis (7.6%) Human Albumin (2.6%)

RTA Celebrex (24.3%) Lyrica (14.8%) Augmentin (6.6%) Brufen (5.5%) Zinnat (5.3%)

Population

Providers Payers Claims

Financing Episodes

32

Providers

Notes Definitions of categories as per Health Facilities Licensing criteria, see www.haad.ae Seven Day Surgery Hospitals considered as Centers as per Health Facilities Licensing Criteria changes, One hospital was licensed by December 30, 2010. Behavioral Science Pavillion and Rehabilitation Center considered as part of SKMC as they are under SKMC management Liwa licensed as a hospital but doesn't have inpatients, therefore classified as a Center Al Ain Military Hospital added to the Eastern region Non-SEHA hospitals, not licensed by HAAD, but they do operate in Eastern region with about 130 bed capacity

Source Clinicians licensing database; facility licensing database 33

Facilities Clinicians

Total SEHA Abu Dhabi Eastern Western Total Physicians SEHA Dentists SEHANurses&

MidwifesSEHA

AHP&

PharmacistsSEHA

Total 1'354 12% 934 362 58 21'490 4'900 47% 864 25% 10'504 60% 5'222 52%

Hospital 35 34% 19 10 6 13'016 3305 60% 167 32% 7477 73% 2067 77%

Centers (various) 494 13% 348 124 22 4'479 1'265 26% 608 26% 1'504 39% 1'102 39%

Center 151 39% 98 40 13 3'176 951 34% 296 54% 1207 48% 722 54%

Polyclinic 216 0% 159 52 5 968 277 312 282 97

Diagnostic 21 29% 12 6 3 143 35 26% 9 78% 99 40%

Rehabilitation 106 1% 79 26 1 192 2 6 184 3%

Clinic 265 1% 180 81 4 417 118 3% 79 207 7% 13

Pharmacy 427 16% 277 127 23 1'628 1'628

Store 67 4% 60 7 105 105 3%

Other 66 14% 50 13 3 1'845 212 3% 10 30% 1316 24% 307 2%

Breakdown by Nationality & Gender

National Male 241 39% 34 44% 11 9% 37 70%Female 380 77% 71 59% 112 63% 261 75%

Expatriate Male 2'958 44% 480 20% 2'047 45% 2'338 45%

Growth rate (CAGR 2007 - 11) Female 1'319 47% 279 23% 8'331 64% 2'583 55%

2011 2010 2009 2008 2007 CAGR NA Male 1 100%

Hospital 35 33 39 37 33 1.5 Female 2 100% 2 50% 3 100%

Centers (various) 494 429 365 386 389 6.2 Breakdown by Region

Clinic 265 239 207 196 188 9.0 Abu Dhabi 3'176 37% 586 20% 6'975 54% 3'451 42%

Pharmacy 427 408 405 369 358 4.5 Al Ain 1'457 64% 246 31% 3'028 73% 1'490 69%

Store 67 60 61 62 63 1.6 Western 267 78% 32 72% 501 78% 281 83%

Centers (various)

36%

Pharmacy31%

Clinic20%

Store5%

Other5%

Hospital3%

Notes Performance is reported for Episodes with HAAD licensed clinicians. Performance is not shown for all categories of healthcare professionals or healthcare facilities. Rates shown are rates within breakdown category. Indicator definitions are available at https://www.shafafiya.org

Source KEH Episodes with Encounter start date 1 January – 31 December 2011 as at 5 April 2012 34

Clinical performance

Target

direction Indicator 2011

Change

2010-11 Public Private Hospital Center Polyclinic Clinic Consultant Specialist GP

Specialist

Dentist

GP

Dentist

Episodes Hypertensive w treatment 51 % -4 % 49% 52% 48% 58% 49% 50% 55% 48% 52% 22% 36%

Thiqa episodes Obese w Lifestyle or drug treatment 2 % -4 % 3% 0% 1% 6% 6% 0% 3% 1% 4% 0% 0%

Episodes w Diabetics HbA1c>7% w/o Medication 11 % +4 % 18% 8% 17% 5% 8% 7% 5% 13% 12% 33% 13%

Episodes w Diabetics HbA1c>9% w/o Medication 11 % +4 % 16% 9% 16% 6% 7% 9% 5% 12% 13% 50% 20%

Episodes w Diabetics HbA1c>9% w/o Treatment 10 % +3 % 15% 8% 15% 6% 7% 9% 5% 12% 13% 50% 20%

Episodes w Diabetics w Microalbuminuria w/o ACE/ARB 95 % -3 % 91% 96% 93% 97% 98% 95% 97% 94% 96% 100%

Episodes w Common Cold w Antibiotics 38 % +1 % 18% 43% 38% 31% 50% 41% 47% 39% 37% 64% 45%

Routine dental extraction w complication 1 % -0 % 1% 1% 1% 1% 1% 0% 0% 0% 0% 1% 1%

Labour productivity

Notes * Episode Clinician facility Productivity is defined as adjusted Episodes per clinician per day. To account for the higher resource need of inpatients, inpatient Episodes are multiplied by ratio

of the average value (ClaimNet) of an Inpatient Episode versus an Outpatient Episode. To reflect clinical complexity inpatient Episodes are then adjusted by the difference of case mix index of each individual hospital from Abu Dhabi average. SEHA hospitals Episodes are underestimated due to certain SEHA clinical obligations such as public events medical preparation. Tawam hospital provides rotating staff to Al Wagan which effects both hospitals’ productivity.

Source Cube 2011; HAAD licensing database; Health Statistics analysis

Indicative

35

Tawam

Al Mafraq

SKMC

Al Ain

Al Corniche

Al Rahba

Madinat Zayed

Ghayathi Al Mirfa

Al Silla

Al Wagan

Delma

Al NoorOasis

NMC Specialty

Al Noor - Al Ain

Al Ahalia

Al Noor - Airport Road

Al Salama

Life Line

Dar Al Shifaa

Emirates International

Emirates French

Al Reef Internaional

Gulf Diagnostic Center

Al Raha

Specialized Medical Care

NMC Specialty - Al Ain National

Al Rewaise

Seha

Other

Life Line Hospital Al Musafah

Epis

od

es p

er d

oct

or

per

day

Episodes per nurse per day3.1

6.82011 Average

≈

≈

Productivity Episodes (000)

Hospital* Do

cto

r

Nu

rse

Inp

atie

nt

Ou

tpat

ien

t

Tota

l,

We

igh

ted

Al Ahalia 16.1 18.1 4.4 468.3 541.8

Al Noor - Al Ain 11.1 5.8 4.2 339.0 399.6

Al Salama 10.6 6.4 3.3 174.7 221.0

Dar Al Shifaa 10.4 9.1 .8 125.3 136.4

Al Wagan 10.2 6.2 .7 52.8 63.6

Oasis 9.9 3.9 4.1 111.8 173.3

Al Noor 9.8 7.5 6.5 476.6 578.6

Al Noor - Airport Road 9.5 5.7 6.2 356.4 484.3

National 8.4 5.1 .2 59.1 61.6

N M C Specialty - Al Ain 8.3 4.2 3.1 192.9 246.0

Life Line 8.0 5.6 2.6 186.5 223.5

N M C Specialty 7.6 4.0 5.1 343.3 448.9

Gulf Diagnostic Center 7.5 14.5 1.0 220.5 233.7

Emirates International 7.4 10.0 1.6 95.3 113.2

Tawam 7.2 2.4 16.8 516.5 936.9

Al Corniche 7.1 1.9 14.9 92.7 328.7

SKMC 6.9 1.7 11.9 541.8 894.9

Specialized Medical Care 6.8 9.5 .6 63.4 69.5

Life Line Hospital Al Musafah 6.7 5.0 .7 85.2 85.2

Al Rahba 6.3 2.1 7.4 125.9 253.0

Al Reef Internaional 5.9 1.8 .0 10.3 10.8

Al Ain 5.8 2.1 14.5 325.7 582.6

Al Mafraq 5.5 1.9 11.7 322.6 571.6

Emirates French 5.3 3.2 .5 34.3 40.5

Ghayathi 5.2 3.4 .9 47.3 61.2

Al Mirfa 4.7 2.1 .4 28.7 34.6

Al Sil la 4.6 2.8 .6 33.2 40.5

Madinat Zayed 4.5 2.6 3.8 124.7 184.7

Al Raha 4.4 8.5 .1 45.0 46.6

Delma 3.9 3.5 .4 21.6 27.1

Al Rewaise 2.1 1.0 .3 15.4 19.4

Total/Average 6.8 3.1 129.4 5,636.5 8,113.1

Hospital patient satisfaction, inpatient indicators

36 Note Overall facility rating is based on a single question in the patient satisfaction questionnaire; Source: GRMC Advisory Services, 2010

Seven Day Surgery Hospitals considered as Centers as per Health Facilities Licensing Criteria changes.

Hospital patient satisfaction, outpatient indicators

37 Note Overall facility rating is based on a single question in the patient satisfaction questionnaire; Source: GRMC Advisory Services, 2010

Seven Day Surgery Hospitals considered as Centers as per Health Facilities Licensing Criteria changes.

Hospitals

Notes * Totals include data for SKMC Rehabilitation Center and Behavioral Science Pavilion as of 31st December 11; Episodes are attributed to facilities according to Episode Clinician facility as per clinician licensing database

Source Hospital submissions, Operation Center, Clinician Licensing Database

38

Episodes*, 000's Staff Beds Indicators Ambulances

Region Hospital Inpatient Outpatient

ER Non-ER ER Non-ERTotal 45.1 85.1 655.4 4'988.9 17.8 3'305 167 7'477 2'067 4'904 3'659 598 107 21 106

SEHA 42.2 41.8 637.2 1'596.2 12.8 1'966 54 5'328 1'569 3'889 2'415 442 54 13 56

Eastern Tawam 6.2 10.6 181.0 335.5 2'861 443 5 1'096 358 959 435 82 20 2 73% 6.9 8

Abu Dhabi Al Mafraq 6.0 5.7 59.8 262.8 1'643 314 3 821 256 249 360 59 8 2 60% 6.7 6

Abu Dhabi SKMC 7.5 4.4 120.3 421.5 3'645 470 17 1'434 461 1263 552 138 10 4 70% 11.9 13

Eastern Al Ain 8.4 6.1 127.9 197.8 1'859 305 2 791 223 538 387 56 6 2 71% 6.9 5

Western Madinat Zayed 2.3 1.6 34.4 90.3 457 99 13 197 70 78 148 21 30% 4.2 6

Abu Dhabi Al Corniche 4.8 10.1 13.6 79.1 1'109 127 478 60 444 285 50 8 3 55% 3.8 2

Abu Dhabi Al Rahba 5.8 1.6 58.5 67.4 731 106 4 329 78 214 119 36 2 82% 4.9 4

Western Ghayathi .2 .7 12.6 34.7 132 30 2 49 18 33 28 61% 6.8 4

Eastern Al Wagan .7 .0 7.3 45.6 91 15 2 28 5 41 15 40% 3.1

Western Al Si l la .1 .5 5.8 27.4 94 22 2 39 10 21 36 11% 2.6 3

Western Al Mirfa .2 .2 9.6 19.1 114 18 2 45 18 31 28 21% 5.1 3

Western Delma .2 .2 6.4 15.2 70 17 2 21 12 18 22 5% 0.9 2

Military .0 .0 .1 .4 254 149 31 37 37 NA 314 35 18 1 NA

Abu Dhabi Zayed Mi l i tary .0 .0 .1 .4 254 149 31 37 37 NA 314 35 18 1 41% NA NA

Eastern Al Ain Mi l i tary NA NA NA NA NA NA NA NA NA NA NA NA NA

Other 2.9 43.0 18.1 3,390.1 4742 1184 82 2018 443 1015 735 121 35 7 50

Abu Dhabi Al Noor .1 6.5 .0 476.6 454 153 9 212 80 95 22 3 42% 2.2 1

Abu Dhabi Al Ahal ia .0 4.4 1.3 467.0 225 88 4 82 21 30 40 8 78% 2.5 2

Abu Dhabi Al Noor - Ai rport Road .2 6.0 .7 355.7 429 132 8 231 58 106 30 6 2 43% 2.7 2

Abu Dhabi N M C Specia l ty 1.1 4.0 .6 342.7 870 141 21 305 55 348 92 11 5 62% 4.1 9

Eastern Al Noor - Al Ain .0 4.2 .0 339.0 345 96 3 190 45 11 50 10 1 36% 1.6 4

Abu Dhabi Gul f Diagnostic Center .1 .9 .4 220.1 358 80 5 44 23 206 8 0% 2

Eastern N M C Specia l ty - Al Ain .6 2.5 .6 192.3 266 75 6 160 23 2 30 4 3 37% 1.3

Abu Dhabi Li fe Line .0 2.5 1.2 185.3 237 75 2 110 25 25 25 7 2 60% 2.1 8

Abu Dhabi Al Sa lama .2 3.1 8.7 165.9 168 54 3 94 17 19 2 21% 0.4 7

Eastern Oas is .0 4.1 1.9 109.9 420 48 123 24 225 52 14 75% 3.5 1

Abu Dhabi Dar Al Shi faa .0 .8 .7 124.5 100 33 3 41 11 12 17 2 2 1 12% 0.9 4

Eastern Emirates International .1 1.5 1.2 94.1 93 42 31 10 10 25 7 6 16% 0.9 1

Abu Dhabi Li fe Line Hospita l Al Musafah L.L.C. .2 .5 .2 85.0 96 33 2 47 14 36

Abu Dhabi Emirates French .0 .5 .0 34.3 163 19 2 35 4 103 11 2 2 1 9% 0.8 1

Abu Dhabi Al Reef Internaional .0 .0 .0 10.2 33 5 16 1 11 21 2 0% 6

Abu Dhabi Al Raha .0 .1 .2 44.7 54 24 5 15 2 8 11 2 9% 2.8

Eastern Specia l i zed Medica l Care .0 .6 .0 63.3 73 24 4 20 6 19 23 2 1 3 4% 0.6 1

Abu Dhabi National .0 .2 .0 59.1 66 18 2 33 8 5 20 0% 1

Western Al Rewaise .0 .3 .0 15.4 87 23 2 54 8

Eastern Al Ain Cromwel l Women & Chi ldrens Hospita l .0 .2 .3 4.7 121 17 1 96 7 25

Abu Dhabi Provi ta International Medica l Center Llc .3 .0 .0 .1 84 4 79 1 29

Bed

Occ

up

ancy

ALO

S

Den

tist

s

Tota

l

Ad

min

istr

atio

n

Bed

Cap

acit

y

Cri

tica

l Bed

s

VIP

Ro

yal

Ph

ysic

ian

s

Nu

rses

& M

idw

ifes

AH

P &

Ph

arm

acis

ts

Hospital inpatient profile by value

* Dark area in pie chart represents share of top 5 Diagnosis groups within the total value of provider’s services

Source Cube 2011; Health Statistics analysis; diagnosis groups based on WHO classification of diagnoses ICD 9 39

Diagnosis group 100 Top 5* 1st 2nd 3rd 4th 5th

Tawam 18 Signs, Symptoms And Ill-Defined (20.9%) Maternal And Perinatal Conditions (14.5%) Cardiovascular Diseases (8.9%) Injuries (7.6%) Cancer (7.1%)

SKMC 14 Cardiovascular Diseases (21.1%) Injuries (8.8%) Infectious And Parasitic Diseases (8.4%) Congenital Anomalies (8.2%) Respiratory Diseases (6.4%)

Al Mafraq 10 Signs, Symptoms And Ill-Defined (18.0%) Injuries (17.4%) Cardiovascular Diseases (16.1%) Maternal And Perinatal Conditions (11.1%) Digestive Diseases (6.9%)

Al Ain 9 Maternal And Perinatal Conditions (17.7%) Injuries (12.6%) Digestive Diseases (10.7%) Cardiovascular Diseases (10.1%) Signs, Symptoms And Ill-Defined (9.7%)

Al Corniche 7 Maternal And Perinatal Conditions (54.7%) Signs, Symptoms And Ill-Defined (43.4%) Genitourinary Diseases (1.2%) Cancer (0.4%) Congenital Anomalies (0.1%)

Al Noor - Airport Road 6 Maternal And Perinatal Conditions (26.0%) Cardiovascular Diseases (20.9%) Digestive Diseases (11.4%) Respiratory Diseases (8.3%) Musculoskeletal Diseases (6.2%)

Al Rahba 4 Signs, Symptoms And Ill-Defined (27.4%) Maternal And Perinatal Conditions (25.2%) Injuries (8.6%) Digestive Diseases (7.1%) Respiratory Infections (6.8%)

N M C Specialty 4 Cardiovascular Diseases (22.4%) Digestive Diseases (15.7%) Maternal And Perinatal Conditions (11.0%) Musculoskeletal Diseases (8.9%) Signs, Symptoms And Ill-Defined (8.7%)

Al Noor 4 Maternal And Perinatal Conditions (32.4%) Digestive Diseases (14.2%) Endocrine Disorders (8.7%) Signs, Symptoms And Ill-Defined (8.0%) Cardiovascular Diseases (7.3%)

Provita International Medical Center Llc 4 Respiratory Diseases (52.8%) Neuropsychiatric Conditions (19.1%) Signs, Symptoms And Ill-Defined (6.7%) Cardiovascular Diseases (5.9%) Endocrine Disorders (4.9%)

Al Ahalia 3 Digestive Diseases (25.8%) Cardiovascular Diseases (21.8%) Genitourinary Diseases (16.5%) Maternal And Perinatal Conditions (10.4%) Injuries (5.1%)

Al Noor - Al Ain 2 Maternal And Perinatal Conditions (15.9%) Digestive Diseases (15.5%) Musculoskeletal Diseases (12.6%) Cardiovascular Diseases (11.8%) Respiratory Diseases (8.4%)

Oasis 2 Maternal And Perinatal Conditions (63.3%) Signs, Symptoms And Ill-Defined (16.3%) Respiratory Infections (5.3%) Digestive Diseases (5.3%) Genitourinary Diseases (2.9%)

Life Line 2 Digestive Diseases (23.2%) Maternal And Perinatal Conditions (22.2%) Cardiovascular Diseases (13.8%) Signs, Symptoms And Ill-Defined (9.4%) Genitourinary Diseases (9.3%)

Madinat Zayed 2 Maternal And Perinatal Conditions (15.6%) Signs, Symptoms And Ill-Defined (13.4%) Digestive Diseases (13.1%) Injuries (12.5%) Cardiovascular Diseases (9.7%)

N M C Specialty - Al Ain 2 Digestive Diseases (18.7%) Cardiovascular Diseases (16.4%) Musculoskeletal Diseases (15.6%) Maternal And Perinatal Conditions (10.7%) Genitourinary Diseases (10.0%)

Al Salama 2 Respiratory Infections (16.7%) Digestive Diseases (14.5%) Injuries (12.3%) Musculoskeletal Diseases (11.7%) Respiratory Diseases (8.8%)

Abu Dhabi Rehabilitation Center 1 Neuropsychiatric Conditions (87.2%) Congenital Anomalies (5.4%) Genitourinary Diseases (2.6%) Injuries (2.3%) Cardiovascular Diseases (1.5%)

Emirates International 1 Endocrine Disorders (31.7%) Digestive Diseases (17.3%) Maternal And Perinatal Conditions (12.4%) Respiratory Diseases (10.7%) Cardiovascular Diseases (6.0%)

Behavioral Sciences Pavilion 1 Neuropsychiatric Conditions (98.5%) Signs, Symptoms And Ill-Defined (0.7%) Maternal And Perinatal Conditions (0.3%) Digestive Diseases (0.3%) Cancer (0.1%)

Gulf Diagnostic Center Genitourinary Diseases (21.7%) Respiratory Diseases (21.4%) Digestive Diseases (13.6%) Cardiovascular Diseases (8.3%) Respiratory Infections (8.3%)

Ghayathi Cardiovascular Diseases (17.2%) Respiratory Infections (16.4%) Digestive Diseases (16.3%) Maternal And Perinatal Conditions (11.4%) Neuropsychiatric Conditions (9.4%)

Dar Al Shifaa Maternal And Perinatal Conditions (38.2%) Digestive Diseases (22.1%) Respiratory Diseases (9.8%) Genitourinary Diseases (5.2%) Cardiovascular Diseases (5.1%)

Emirates French Respiratory Diseases (63.4%) Maternal And Perinatal Conditions (24.1%) Genitourinary Diseases (3.9%) Cancer (3.3%) Injuries (1.5%)

Al Wagan Respiratory Infections (55.6%) Digestive Diseases (13.8%) Respiratory Diseases (8.7%) Signs, Symptoms And Ill-Defined (5.7%) Infectious And Parasitic Diseases (5.0%)

Life Line Hospital Al Musafah Digestive Diseases (28.9%) Respiratory Diseases (18.5%) Respiratory Infections (9.2%) Cardiovascular Diseases (7.6%) Signs, Symptoms And Ill-Defined (6.5%)

Specialized Medical Care Genitourinary Diseases (30.9%) Respiratory Diseases (15.7%) Maternal And Perinatal Conditions (12.6%) Respiratory Infections (11.9%) Digestive Diseases (9.2%)

Al Silla Maternal And Perinatal Conditions (21.5%) Digestive Diseases (16.2%) Respiratory Infections (15.7%) Cardiovascular Diseases (14.8%) Neuropsychiatric Conditions (6.4%)

Al Mirfa Maternal And Perinatal Conditions (30.7%) Respiratory Infections (15.4%) Digestive Diseases (14.2%) Signs, Symptoms And Ill-Defined (8.4%) Respiratory Diseases (6.3%)

Al Rewaise Maternal And Perinatal Conditions (35.7%) Digestive Diseases (19.6%) Cardiovascular Diseases (15.3%) Signs, Symptoms And Ill-Defined (8.8%) Respiratory Infections (8.3%)

Delma Maternal And Perinatal Conditions (15.6%) Digestive Diseases (15.6%) Cardiovascular Diseases (12.7%) Injuries (8.1%) Respiratory Infections (7.9%)

Al Raha Sense Organ Diseases (19.0%) Maternal And Perinatal Conditions (14.9%) Respiratory Diseases (13.9%) Genitourinary Diseases (13.3%) Digestive Diseases (9.2%)

National Digestive Diseases (42.7%) Musculoskeletal Diseases (12.9%) Cardiovascular Diseases (11.8%) Injuries (5.2%) Respiratory Diseases (5.1%)

Al Reef Internaional Digestive Diseases (49.0%) Cardiovascular Diseases (9.8%) Genitourinary Diseases (9.5%) Signs, Symptoms And Ill-Defined (8.8%) Skin Diseases (7.5%)

Al Ain Cromwell Women & Children Hospital Maternal And Perinatal Conditions (89.9%) Congenital Anomalies (4.0%) Digestive Diseases (2.4%) Respiratory Infections (1.8%) Signs, Symptoms And Ill-Defined (1.2%)

Region Facility

Episodes

(best

estimate) Ph

ysic

ian

s

De

nti

sts

Nu

rse

s

AH

P

Total 1'922'236 335 160 600 426

Abu Dhabi Baniyas 167'299 9 2 3 8

Khalifa A 101'775 25 7 37 25

Shahama 81'212 19 5 27 17

Al Bateen 80'385 6 0 9 1

Abu Dhabi City Dental Center 62'834 * 0 27 8 10

Bain Al Gesreen 55'853 * 19 5 37 18

Al Zafarana 43'761 3 0 8 0

Samha 38'554 10 5 17 9

Disease Prevention And Screening Center 37'235 * 16 0 15 50

Al Khaleej 34'445 3 0 8 0

Al Khalidiya Urgent Care 34'407 6 0 20 0

Al Mafraq Dental Center 17'937 0 29 0 27

Al Zafra Dental Center 15'592 0 5 5 10

Disease Prevention And Screening Center - Mussafah 13'963 * 6 0 7 21

Al Khatim 12'235 6 2 11 4

Airport 9'309 * 4 0 14 0

Seha Dialysis Services – Sheikh Khalifa Medical City 5'740 0 0 13 0

Seha Dialysis Services – Al Rahba Hospital 2'355 0 0 15 0

Other 150'100 * 8 3 18 13

Al Ain Neima 122'294 18 4 22 8

Al Jahili 105'447 21 0 29 10

Al Yahar 72'314 9 3 22 3

Al Masoudi Primary Health Care Center 71'375 10 1 14 1

Mezyed 65'150 13 3 18 6

Muweiji 61'157 13 8 21 19

Al Maqam 55'693 10 3 18 6

Al Khabisi Clinic 53'989 13 0 16 2

Tawam Dental Center 33'261 0 39 0 65

Hili 33'099 6 1 10 2

Niyadat 32'746 7 1 14 6

Al Qua'A 29'632 6 2 12 3

Oud Al Toba Primary Health Care Center 28'805 6 0 13 3

Blood Bank Center 27'094 * 1 0 0 13

Zakher 22'311 7 0 11 0

Al Hayer 20'464 6 1 11 0

Swaihan 15'655 5 1 11 1

Remah 13'963 5 0 9 2

Al Khazna 8'585 3 1 9 0

Tawam Ivf Center 4'654 * 2 0 6 13

Disease Prevention And Screening Center-Alain 3'857 8 0 13 26

Other 18'900 * 5 0 11 5

Western Liwa Hospital 25'599 * 9 2 17 4

Al Dhafra Family Medicine Center 23'664 8 0 17 5

Other 7'536 * 4 0 4 10

Region Facility

Episodes

(best

estimate) Ph

ysic

ian

s

De

nti

sts

Nu

rse

s

AH

P

Total 3'664'370 1'058 533 1'122 5

Abu Dhabi Medical Services Administration Of Abu Dhabi Police Ghq 108'323 92 21 167

Al Noor Hospital Clinics - Al Mussaffah 94'620 7 0 10 0

Al Musaffah Al Alhli Medical Centre 89'325 14 1 10

Imperial College London Diabetes Centre 73'898 38 0 30

Adnoc Medical Center 72'143 * 21 10 25

New National Medical Centre 66'275 16 1 20

Prince Specialized Medical Centre 58'180 * 21 4 28

Dr. Ahmed Hassan Fikri Medical Centre 48'726 10 1 3

Al Amal Medical Centre 43'204 7 1 8

Ibn Al Nafis Medical Centre 39'482 15 2 6

Al Noor Hospital Speciality Clinics- Al Musafah 37'235 * 14 2 7

Amrita Midical Centre 33'648 14 5 9

Taha Medical Centre 33'222 9 6 6

Al Mafraq Medical Centre 32'233 7 2 3

Al Kamal Medicdal Poly Clinics- L L C 31'418 7 3 4

Advance Cure Diagnostic Centre L.L.C 29'720 19 1 8

Exeter Medical Center 27'926 * 12 0 2

Home Health Medical Centre L.L.C 25'927 8 1 5

Cosmesurge Emarites Hospital For One Day Surgery 25'895 25 3 27

Nadia Medical Center L.L.C 24'506 9 1 4

Al Musaffah Al Alhli Medical Centre - Branch 23'412 5 0 7

Adco Medical Centre 23'272 * 10 0 9

Al Hendawy Medical Centre 23'204 10 0 4

Golden Sand Medical Centre 21'113 5 1 5

Capital Medical Centre For Health Screening - L.L.C 20'945 * 9 0 9

Magrabi Specialized Hospital 20'287 10 0 6

Consultant Medical Centre 19'525 7 0 6

American European Medical Center 17'589 9 1 13

Etihad Airways Polyclinic 16'290 * 7 0 9

Al Hikma Medical Centre 16'290 * 0 7 4

Seha Emirates One Day Surgery Centerllc 16'290 * 7 0 5

Almazroui Hospital One Day Surgery 15'614 14 1 4

Ruwais Housing Medical Center 14'224 5 2 17

Al Rafa Medical Center L.L.C 13'380 7 1 8

Prime Medical Center 11'255 12 1 9

Oxford Medical Center 6'899 5 3 3

Al Rawdah German Medical Center - L L C 5'083 10 0 7

Al Bustan Medical Center 4'977 4 4 6

American Crescent Health Care Centre 4'023 5 1 5

Abu Dhabi Knee And Sports Medicine Center 3'327 5 0 15

National Petroleum Construction Company Medical Center 1'738 2 0 13

Canadian Medical Center Llc 1'513 0 1 13

Other 1'476'145 * 356 283 359 5

Al Ain Al Sultan Advanced Medical Clinics 51'065 10 3 1

Mubarak Medical Center 26'611 7 1 4

Dr. Khalid Aljamal Medical Center 12'179 4 3 4

Al Madar Medical Center - Branch 9'762 5 6 12

The Specialist Diabetes Treatment & Research Centre (Imperial College Diabetes Centre) Llc - Branch3'975 2 0 14

Cosmesurge & Emirates Hospital For One Day Surgery Polyclinic L L C. Al Ain Branch1'843 3 1 7

Uae University Clinics - Tawam Clinic 954 2 0 19

Other 584'634 * 119 141 116

Western Al- Noor Hospital Clinics - Madinat Zayed 61'380 7 0 4

Alnoor Hospital Speciality Clinics Llc Madinet Zayed Branch 34'908 * 14 1 5

Other 104'758 * 16 6 18

Centres & Clinics

Notes List of Non-SEHA facilities with more than 10 clinicians, some centers’ Episodes were reported under the managing hospital

* Includes estimates based on the number of clinicians and average productivity

Source Cube 2011; Professionals licensing database; Extrapolation and Facility submissions

SEHA Other

40

Critical care bed capacity

Source Operation Center as of 31st December 2011 41

Bed occupancy

Notes *All Burns beds are shown in green and are provided by SEHA. For the duration of 2010 and 2011 the occupancy in PICU Private was 0%. Optimal occupancy is 85% for normal beds and 75% for critical care beds. Source HAAD Operation Center 42

CICU

Jan Apr Jul Oct

SCBU

0%

25%

50%

75%

100%

Jan Apr Jul Oct

Isolation & Burns*0%

25%

50%

75%

100%ICU PICU

NICU

Jan Apr Jul Oct

CCU/Medical Stepdown

0%

25%

50%

75%

100%Normal Ward

CCU

Occupancy above optimal level

Seha 2011 Private 2011

Average 2011 Average 2010

Blood Bank Donors

Source Abu Dhabi Blood Bank, Health Statistics Analysis 43

Year 2011 2010 2009 2008 2007 2006

Donors 27'094 25'850 24'758 21'834 19'461 16'737

National 3'794 4'240 4'116 3'832 3'311 2'664

Expatriate 23'300 21'610 20'642 18'002 16'150 14'073

Units donated 27'094 25'850 24'758 22'379 19'849 17'129

O + 10'141 9'441 8'960  8'314 7'242 6'396

A + 6'704 6'620 1'430 5'840 5'263 4'548

B + 5'740 5'423 6'421 4'294 4'040 3'396

AB + 1'767 1'727 705 1'302 1'074 857

O - 1'310 1'274 5'130 1'346 1'101 953

A - 706 711 483 667 587 501

B - 575 521 1'493 501 426 381

AB - 151 133 136 115 116 97

2'664 3'311 3'832 4'116 4'240 3'794

14'07316'150

18'00220'642 21'610 23'300

2006 2007 2008 2009 2010 2011

National Expatriate

Inpatient market by value

* Dark area in pie chart represents share of top 5 providers within the total value of diagnosis group

Source Cube 2011; Health Statistics analysis; diagnosis groups based on WHO classification of diagnoses ICD 9 44

Diagnosis group 100 Top 5* 1st 2nd 3rd 4th 5th

Maternal and Perinatal conditions 17 Al Corniche (22.4%) Tawam (14.4%) Al Ain (9.1%) Al Noor - Airport Road (8.6%) Al Noor (7.9%)

Signs, symptoms and ill-defined 14 Tawam (26.2%) Al Corniche (22.3%) Al Mafraq (12.3%) Al Rahba (8.7%) Al Ain (6.3%)

Cardiovascular diseases 12 SKMC (23.7%) Tawam (13.2%) Al Mafraq (13.0%) Al Noor - Airport Road (10.2%) N M C Specialty (8.1%)

Digestive diseases 9 Al Ain (11.1%) Tawam (9.7%) SKMC (9.6%) Al Ahalia (8.2%) N M C Specialty (7.6%)

Injuries 8 Al Mafraq (21.0%) Tawam (16.8%) SKMC (14.8%) Al Ain (14.4%)Abu Dhabi Knee And Sports

Medicine Center (4.9%)

Respiratory diseases 7Provita International Medical

Center Llc (26.0%)Tawam (14.4%) SKMC (11.3%) Al Ain (9.7%) Al Noor - Airport Road (6.3%)

Musculoskeletal diseases 5Abu Dhabi Knee And Sports

Medicine Center (34.4%)SKMC (12.1%) Tawam (7.2%) N M C Specialty (6.9%) Al Noor - Airport Road (6.5%)

Neuropsychiatric conditions 5Abu Dhabi Rehabilitation

Center (22.5%)Tawam (17.3%) SKMC (15.7%)

Provita International Medical

Center Llc (14.2%)

Behavioral Sciences Pavilion

(10.9%)

Respiratory infections 4 Tawam (19.4%) SKMC (13.9%) Al Ain (11.0%) N M C Specialty (7.4%) Al Mafraq (7.3%)

Genitourinary diseases 4 Tawam (16.1%) Al Ahalia (11.0%) SKMC (9.1%) Al Mafraq (7.0%) Al Noor (6.9%)

Infectious and parasitic diseases 4 SKMC (29.7%) Tawam (18.7%) Al Mafraq (11.3%) Al Ain (10.7%) Al Rahba (5.0%)

Endocrine disorders 3 Tawam (26.9%) SKMC (20.7%) Al Noor (10.8%) Al Noor - Airport Road (8.3%) Emirates International (5.4%)

Cancer 3 Tawam (38.5%) SKMC (25.4%) Al Mafraq (10.2%) Al Ain (7.6%) N M C Specialty (2.8%)

Congenital anomalies 2 SKMC (51.8%) Tawam (12.9%)Provita International Medical

Center Llc (8.1%)Al Noor - Airport Road (6.9%) Al Ain (6.3%)

Diabetes mellitus 1 Tawam (21.0%) SKMC (19.3%) Al Mafraq (15.4%) Al Ain (13.2%) Al Rahba (9.9%)

Skin diseases 1 SKMC (17.6%) Al Ain (12.4%) Al Mafraq (11.8%) Tawam (11.7%) Al Ahalia (5.6%)

Sense organ diseases 1 SKMC (26.6%) Al Mafraq (24.8%) Al Ain (14.3%) Tawam (6.8%) Al Raha (3.2%)

Oral conditions SKMC (39.0%) Tawam (19.2%) Al Mafraq (16.2%) Al Rahba (4.2%) Al Ain (2.8%)

Nutritional deficiencies SKMC (24.7%) Tawam (24.2%) Al Mafraq (9.9%) Al Ain (7.9%) Al Noor - Airport Road (5.1%)

RTA Al Rewaise (100.0%)

Outpatient market by value

* Dark area in pie chart represents share of top 5 providers within the total value of diagnosis group

Source Cube 2011; Health Statistics analysis; diagnosis groups based on WHO classification of diagnoses ICD 9 45

Diagnosis group 100Top

5*1st 2nd 3rd 4th 5th

Signs, symptoms and ill-defined 18 Tawam (16.6%) Al Noor (6.2%) SKMC (6.1%) Al Noor - Airport Road (5.2%) Al Noor - Al Ain (3.8%)

Diabetes mellitus 11Imperial College London Diabetes

Centre (41.0%)SKMC (5.9%) Tawam (5.3%) N M C Specialty (2.9%) Al Noor (2.7%)

Respiratory infections 9 Al Noor (7.6%) Al Noor - Airport Road (5.0%) N M C Specialty (4.5%) Tawam (2.9%) Al Noor - Al Ain (2.9%)

Musculoskeletal diseases 8 SKMC (9.3%) Al Noor (7.3%) Tawam (6.4%) Al Noor - Airport Road (5.4%) N M C Specialty (5.3%)

Oral conditions 6 Tawam Dental Center (14.0%) Al Mafraq Dental Center (7.0%) Abu Dhabi Dental Clinic (5.6%) Bain Al Gesreen (3.4%) Madinat Zayed (2.8%)

Cardiovascular diseases 6 SKMC (12.2%) Al Noor (6.9%) Tawam (6.1%) Al Noor - Airport Road (5.2%) N M C Specialty (4.8%)

Genitourinary diseases 6 Tawam (13.1%) SKMC (9.3%) Al Noor (6.6%) Al Noor - Airport Road (5.2%) N M C Specialty (3.9%)

Endocrine disorders 5 SKMC (17.0%)Imperial College London Diabetes

Centre (13.3%)Tawam (10.1%) Al Noor (4.8%) Gulf Diagnostic Center (4.2%)

Digestive diseases 5 Tawam (7.4%) Al Noor - Airport Road (6.6%) Al Noor (6.0%) SKMC (5.8%) Gulf Diagnostic Center (5.7%)

Respiratory diseases 4 Al Noor (8.7%) SKMC (6.3%) Al Noor - Airport Road (6.1%) Tawam (5.3%) Gulf Diagnostic Center (3.2%)

Sense organ diseases 4 Al Noor (10.9%)Samaya Specialized Center -Ssc-

Laser & Day Care Surgery Llc (9.9%)SKMC (7.6%) Magrabi Specialized Hospital (6.9%) N M C Specialty (6.4%)

Skin diseases 4 Al Noor - Airport Road (9.0%) SKMC (8.2%) Al Noor (6.4%) Tawam (5.4%) Al Mafraq (5.2%)

Injuries 3 Tawam (7.3%) SKMC (7.2%) Al Noor - Airport Road (6.4%) N M C Specialty (6.2%) Al Ain (6.1%)

Neuropsychiatric conditions 3 SKMC (19.1%) Tawam (14.1%) Behavioral Sciences Pavilion (12.4%) Al Ain (7.2%) Al Mafraq (6.2%)

Infectious and parasitic diseases 3 Al Noor (10.5%) Tawam (8.2%) Al Noor - Airport Road (5.4%) SKMC (4.6%) Gulf Diagnostic Center (4.3%)

Maternal and Perinatal conditions 3 Al Noor (12.8%) Tawam (11.0%) Al Corniche (9.4%) Al Noor - Airport Road (8.7%) Al Noor - Al Ain (3.6%)

Cancer 2 SKMC (19.2%) Al Mafraq (18.9%)Gulf International Cancer Center

(17.7%)Tawam (17.7%)

Tawam Molecular Imaging Centre

(8.5%)

Nutritional deficiencies 1Imperial College London Diabetes

Centre (19.9%)SKMC (9.7%) Gulf Diagnostic Center (6.1%) Al Bateen (3.8%) Al Noor (3.8%)

Congenital anomalies SKMC (41.3%) Tawam (20.6%) Al Noor - Airport Road (6.6%) Al Mafraq (5.4%) Al Noor (3.9%)

RTA Step Home Health Care Centre (56.5%)Al Mafraq (29.6%) N M C Specialty - Al Ain (4.4%) Al Ahalia (2.0%) N M C Specialty (1.7%)

Population

Providers Payers Claims

Financing Episodes

46

Claims

Notes (1) Average for population is set to 100% to allow comparison across inpatient and outpatient utilisation

(2) Average Claim Net per Claim, represents claimed amount

Source Cube 2011; Health Statistics analysis 47

■ Outpatient

■ Inpatient

Claims per member per year, standardised(1)

Average

ClaimNet

(AED) Claims (000)(2) Claims per member

2011 2011 2010 2009 2011 2010 2009

Inpatient 10'861 131 166 146 0.05 0.06 0.06

InpatientBasic 9'006 38 35 25 0.03 0.03 0.03

InpatientEnhanced 9'380 35 55 50 0.03 0.05 0.05

InpatientThiqa 12'939 59 76 71 0.13 0.18 0.18

Outpatient 300 15'197 12'918 10'443 5.39 4.84 4.52

OutpatientBasic 154 4'138 2'928 2'107 3.1 2.4 2.3

OutpatientEnhanced 342 4'860 4'146 3'932 4.6 4.0 4.0

OutpatientThiqa 364 6'199 5'844 4'404 14.0 13.8 11.2

Total 390 15'328 13'084 10'589 5.44 4.90 4.58 62%

70%

285%

58%

86%

260%

Basic

Enhanced

Thiqa

Utilisation for Population (100%)

Claims by provider

Notes (1) Claim Net represents claimed amount. Data relates to providers licensed by HAAD. Market Share break down represents proportion of the total

(2) Activity to Submission represents average number of days to submit AED 1 from Activity Start Date to first Claim Submission Date, weighted by Activity Net

(3) Submission to Remittance represents average number of days to remit AED 1 from first Claim submission date to first Remittance Advice submission date, weighted by Activity Net

* Imperial College London Diabetes Centre, Provita International Medical Centre and Abu Dhabi Knee And Sports Medicine Center are specialised facilities that provide non-standard mix of services,

which explains high average Claim Net

SEHA facilities receive Government subsidy in addition to insurance Claims payments

Source Cube 2011; Health Statistics analysis 48

Market Share Inpatient Outpatient Activity to Submission (2) Submission to Remittance (3)

Facility Claim Net (AED) (1) Basic Enhanced Thiqa Basic Enhanced Thiqa Basic Enhanced Thiqa Basic Enhanced Thiqa

Total 5,982 Million 9'006 9'380 12'939 154 342 364 40 45 41 38 46 50

Tawam 10.9% 15'552 16'522 14'962 261 662 555 56 53 52 38 37 50

SKMC 8.2% 16'271 15'617 22'531 202 509 674 41 36 36 41 40 49

Al Noor 5.2% 7'614 10'113 11'712 317 612 586 32 40 32 37 50 47

Al Noor - Airport Road 4.8% 9'208 12'545 10'887 386 601 664 35 41 31 69 63

Al Mafraq 4.8% 11'374 9'575 12'349 192 457 411 54 56 53 38 40 48

Imperial College London Diabetes Centre 4.7% 2'439* 1'884* 3'434* 47 54 53 39 42 53

Al Ain 4.5% 8'359 7'145 12'182 166 294 312 49 52 49 35 40 50

N M C Specialty 3.1% 9'626 9'466 8'014 287 365 354 35 54 35 39 45 46

Al Noor - Al Ain 3.0% 6'535 9'735 10'776 334 524 524 30 33 30 70

Al Corniche 2.3% 6'301 8'856 7'925 110 186 203 45 56 47 36 39 48

Gulf Diagnostic Center 1.9% 10'412 7'945 6'778 230 404 466 26 36 24 36 46 47

Al Rahba 1.9% 7'649 5'123 9'621 90 197 233 53 55 53 36 43 49

Life Line 1.8% 6'488 8'913 11'712 259 445 676 28 46 26 36 46 48

Al Salama 1.6% 5'525 6'664 5'962 194 453 378 31 43 29 39 48 47

Al Ahalia 1.6% 6'383 6'688 1'592 148 192 272 51 62 48 39 40 50

N M C Specialty - Al Ain 1.3% 7'481 9'979 5'624 251 337 324 37 47 35 53

Oasis 1.2% 5'185 7'385 6'153 262 402 406 26 36 25 36 47 49

Madinat Zayed 1.1% 6'949 4'737 9'380 97 178 214 26 26 27 37 40 51

Baniyas 0.9% 87 160 184 58 57 57 38 37 48

Provita International Medical Center 0.8% 201'160* 42 47

Dar Al Shifaa 0.7% 6'708 6'973 5'887 214 344 304 38 53 33 38 44 46

Emirates International 0.7% 5'224 5'272 6'983 344 350 303 38 43 38 37 51 49

Medical Services Administration Of Abu Dhabi Police Ghq0.6% 313 367 354 52 78 59 55 49 59

Tawam Dental Center 0.6% 655 446 667 39 46

Specialized Medical Care 0.6% 4'529 5'368 5'155 394 469 434 59 61 57 35 41 48

Khalifa A 0.6% 70 143 200 22 22 21 35 36 48

Al Bateen 0.6% 125 246 282 21 23 25 35 37 48

Al Noor Hospital Clinics - Al Mussaffah 0.5% 293 348 353 28 40 28 23

Life Line Hospital Al Musafah 0.5% 5'822 4'143 6'453 208 294 286 45 67 43 40 42 54

Abu Dhabi Knee And Sports Medicine Center 0.4% 29'253* 32'958* 48'657* 225 228 274 37 48 43 31 36 49

Other 28.6% 5'490 6'401 9'795 100 255 241 36 43 33 39 45 49

Average Claim Net (AED) Claims processing (days)

Claim activities by provider

49

Notes: (1) Excludes mandatory 50% co-pay for drugs and dental procedure for Thiqa patients in non-SEHA facilities

* Provita International Medical Centre provides specialised long-term care service, and Abu Dhabi Knee And Sports Medicine Center claims all services related to an orthopedic surgical

procedure as a lump sum, which explains low number of activities and high average Activity Net

SEHA facilities receive Government subsidy in addition to health insurance Claims funding

Source Cube 2011; Health Statistics analysis

Inpatient Outpatient

Faci l i ty

Activi tiesper Cla im DRG Procedures

(1)Drugs

(1)Services Suppl ies

Activi tiesper Cla im Procedures

(1)Drugs

(1)Services Suppl ies

Tawam 38 366 80% 7% 2% 10% 0% 2.2 228 52% 34% 8% 7%

SKMC 100 170 76% 9% 3% 11% 1% 2.0 251 46% 38% 7% 10%

Al Noor 22 443 24% 46% 4% 18% 8% 4.9 107 69% 22% 10% 0%

Al Noor - Ai rport Road 37 301 27% 40% 4% 19% 9% 6.1 95 78% 11% 11% 0%

Al Mafraq 28 364 90% 4% 1% 5% 0% 2.0 161 40% 49% 6% 5%

Imperia l Col lege London Diabetes Centre 18.3 160 57% 35% 3% 6%

Al Ain 28 310 84% 6% 2% 8% 0% 2.0 119 54% 26% 16% 3%

N M C Specia l ty 41 218 24% 49% 4% 14% 9% 3.5 96 65% 24% 11% 1%

Al Noor - Al Ain 20 410 44% 35% 2% 11% 8% 5.5 77 79% 8% 13% 0%

Al Corniche 24 301 81% 11% 1% 8% 0% 2.1 86 79% 10% 10% 1%

Gulf Diagnostic Center 10 765 13% 69% 3% 12% 3% 3.3 117 73% 17% 10% 0%

Al Rahba 24 335 87% 4% 2% 8% 0% 1.8 99 59% 28% 11% 2%

Life Line 18 437 20% 50% 5% 22% 3% 4.7 79 69% 22% 9% 0%

Al Sa lama 28 222 17% 52% 6% 22% 4% 4.4 76 58% 33% 9% 0%

Al Ahal ia 20 314 36% 46% 4% 10% 4% 2.4 65 81% 1% 18% 0%

N M C Specia l ty - Al Ain 25 324 41% 39% 3% 9% 9% 3.5 87 73% 13% 13% 1%

Oas is 21 272 32% 40% 2% 25% 1% 4.3 77 67% 21% 12% 1%

Madinat Zayed 17 421 83% 7% 1% 9% 0% 1.8 83 67% 22% 9% 2%

Baniyas 2.1 71 53% 36% 10% 2%

Provita International Medica l Center 1 197'804* 100% 0%

Dar Al Shi faa 12 549 11% 56% 2% 26% 5% 3.5 86 67% 20% 13% 0%

Emirates International 15 407 1% 60% 5% 24% 10% 4.5 70 64% 22% 14% 0%

Medica l Services Adminis tration Of Abu Dhabi Pol ice Ghq 4.8 70 44% 46% 10% 0%

Tawam Dental Center 2.3 259 99% 1% 0%

Specia l i zed Medica l Care 16 317 24% 48% 5% 19% 4% 4.8 88 72% 18% 10% 0%

Khal i fa A 1.9 85 72% 19% 9% 0%

Al Bateen 2.4 103 48% 42% 11% 0%

Al Noor Hospita l Cl inics - Al Mussaffah 5.7 56 81% 10% 9% 0%

Life Line Hospita l Al Musafah 17 301 46% 30% 5% 18% 0% 4.7 51 71% 20% 9% 0%

Abu Dhabi Knee And Sports Medicine Center 1 24'635* 99% 1% 1.5 149 66% 34% 0%

Other 31 323 59% 20% 2% 16% 2% 2.7 73 59% 30% 9% 2%

AverageActivi ty Net

(AED)

AverageActivi ty Net

(AED)

Population

Providers Payers Claims

Financing Episodes

50

Payer members

Note Market share applies to Enhanced products

* Premium per Member Per Annum, Thiqa value is based on ClaimNet x 1.1 as a proxy for Premium

Source Cube 2011; Health Statistics analysis 51

Members

Market Share 2011 2010 2009 2008

Change

2010-11

Contracts

2011

PPMPA*

2011

Total 2'818'958 2'671'391 2'312'569 2'260'749 147'567 2'843'849 2'371

Thiqa 442'261 422'239 394'618 383'795 20'022 454'118

Basic 1'322'804 1'204'418 936'207 944'344 118'386 1'326'663 602

Total Enhanced 100.0% 1'053'893 1'044'734 981'744 932'610 9'159 1'063'068 3'019

Daman 31.8% 335'593 299'089 301'447 304'649 36'504 341'729 4'746

ADNIC 14.4% 151'247 151'654 90'190 97'058 -407 151'247 3'761

Al Dhafra 7.0% 73'549 12'590 957 14'087 60'959 73'561 775

Oman 6.7% 70'101 171'478 205'690 155'735 -101'377 70'130 2'195

Al Buhaira 6.0% 63'263 49'838 51'215 25'083 13'425 63'265 839

Al Wathba 5.3% 56'059 48'038 41'583 8'021 56'059 1'714

Green Crescent 4.6% 48'591 70'881 21'341 -22'290 48'591 2'571

EIC 3.0% 32'083 17'721 15'167 26'517 14'362 32'083 2'246

ArabOrient 2.8% 29'997 26'742 1'524 24'337 3'255 30'051 1'814

Abu Dhabi Takaful 2.2% 22'988 1'131 21'857 22'988 2'609

AXA 2.1% 22'449 886 3'537 3'044 21'563 22'461 3'672

Al Hilal Takaful 2.1% 21'723 11'075 5'003 10'648 21'727 1'249

Methaq Takaful 1.9% 20'523 17'002 3'521 20'523 928

Al Sagr 1.7% 17'710 27'661 94'758 17'710 17'710 1'275

Qatar 1.2% 12'304 6'305 9'332 10'381 5'999 12'304 2'283

Al Khazna 1.1% 11'167 78'147 137'648 90'229 -66'980 11'283 1'046

RAK 0.9% 9'508 10'508 11'368 8'827 -1'000 9'508 2'667

ALICO 0.9% 9'239 10'384 1'030 6'431 -1'145 12'036 3'782

Lebanese 0.6% 6'457 7'044 3'596 1'437 -587 6'457 789

Al Fujairah 0.5% 5'269 4'099 36 2'112 1'170 5'269 1'061

Aman 0.5% 4'764 286 258 916 4'478 4'764 1'977

Al Ain Ahlia 0.4% 4'269 24'419 23'857 4'707 -20'150 4'269 2'831

Al-Ittihad 0.4% 3'781 3'781 3'781 2'478

United 0.3% 3'403 825 3'645 1'887 2'578 3'403 2'372

Sharjah 0.3% 3'299 3'299 3'299 744

Saudi Arabian 0.3% 3'057 2'445 469 3'057 3'062 3'993

NoorTakaful 0.2% 1'801 2'094 47 -293 1'801 3'135

Arabia 0.2% 1'662 1'076 443 49 586 1'663 2'693

Arabian Scandinavian 0.1% 1'332 29 1 4'489 1'303 1'332 1'265

Union 0.1% 1'269 1'269 1'273 2'151

Insurance House - PSC 0.1% 1'216 1'216 1'216 2'297

Royal and Sun Alliance 0.1% 1'216 1'381 781 9 -165 1'216 5'347

NGI 0.1% 937 2'798 627 792 -1'861 940 3'216

Salama 0.1% 745 622 1'726 926 123 745 3'371

Alliance 0.1% 588 14'822 881 40'960 -14'234 588 3'648

Dubai Insurance Co. 0.0% 383 383 383 1'168

Takaful Emarat 0.0% 328 1'600 16'222 12'721 -1'272 328 1'823

Dubai National 0.0% 23 23 23 2'246

Thiqa16%

Basic47%

Enhanced37%

Volume

Thiqa62%

Basic8%

Enhanced30%

Value

ClaimNet (1) 2011 2010 2009 2008

Change

10-11

Days to Remit

2011 (2)ClaimNet per

Claim 2011

Claims per

Member 2011

Total 15'432'738 13'084'009 10'589'348 3'987'923 2'348'729 47 390 5.4

Thiqa 6'080'751 5'920'296 4'475'578 160'455 50 482 13.7

Basic 4'015'083 2'932'545 2'132'354 1'319'825 1'082'538 38 234 3.0

Total Enhanced 100.0% 5'336'904 4'200'514 3'996'092 2'668'098 1'136'390 46 403 5.1

Daman 37.7% 2'010'955 1'993'114 1'656'879 1'287'361 17'841 40 444 6.0

ADNIC 21.7% 1'160'175 733'321 42'914 32'814 426'854 62 452 7.7

Oman 7.3% 391'019 432'316 806'221 523'760 -41'297 26 363 5.6

Green Crescent 5.5% 292'777 146'809 67'127 145'968 383 6.0

Al Wathba 3.5% 188'644 173'397 89'700 15'247 76 276 3.4

Al Buhaira 4.6% 243'697 127'519 84'053 55'499 116'178 49 198 3.9

EIC 2.2% 117'510 66'261 69'999 72'802 51'249 344 3.7

ArabOrient 1.6% 83'302 47'022 366'736 134'390 36'280 58 484 2.8

ALICO 1.3% 69'589 38'332 124'824 47'742 31'257 75 425 7.5

Al Ain Ahlia 1.6% 85'622 98'489 72'831 6'326 -12'867 326 20

Al Khazna 1.7% 91'765 111'181 79'801 101'078 -19'416 35 300 8.2

Abu Dhabi Takaful 1.4% 72'257 51'659 49'146 47'599 20'598 354 3.1

Qatar 1.1% 60'996 34'359 14'480 36'874 26'637 361 5.0

Saudi Arabian 0.6% 34'163 17'463 677 3'557 16'700 121 640 11.2

Al Hilal Takaful 1.4% 74'364 42'363 32'001 47 260 3.4

AXA 0.8% 45'121 2 14'450 45'119 422 2.0

Methaq Takaful 1.2% 63'518 12'224 196 51'294 126 267 3.1

RAK 0.8% 43'065 40'256 40'102 29'291 2'809 327 372 4.5

Al Sagr 0.7% 38'935 2'014 323'149 267'491 36'921 134 352 2.2

Al Dhafra 0.9% 45'464 31'453 32'106 45'464 245 0.6

Arabia 0.3% 16'223 8'936 1'369 1'015 7'287 380 438 9.8

NGI 0.3% 17'098 1'474 2'590 2'215 15'624 407 18.2

United 0.2% 11'204 60 16'439 2'867 11'144 145 459 3.3

NoorTakaful 0.2% 11'584 7'750 1'366 3'834 77 386 6.4

Sharjah 0.2% 11'196 11'196 330 3.4

Dubai Insurance Co. 0.2% 8'458 8'458 64 418 22

Lebanese 0.2% 10'413 4'950 6'404 4'483 5'463 274 1.6

Aman 0.2% 9'374 158 1'841 9'216 58 304 2.0

Al Fujairah 0.1% 6'406 1'680 7'145 3'635 4'726 103 346 1.2

Royal and Sun Alliance 0.1% 4'479 3'656 1'297 823 485 3.7

Al-Ittihad 0.1% 4'377 4'377 346 1.2

Salama 0.1% 3'353 3'055 1'017 4'702 298 230 326 4.5

Takaful Emarat 0.0% 1'888 487 1'401 40 512 5.8

Union 0.1% 2'764 2'764 341 2.2

Alliance 0.0% 1'674 172 18'245 1'502 37 542 2.8

Insurance House - PSC 0.0% 1'912 1'912 227 1.6

Arabian Scandinavian 0.0% 1'543 5 2'597 1'538 179 1.2

Dubai National 0.0% 20 20 544 0.9

Thiqa

39%

Basic26%

Enhanced35%

Volume

Thiqa

49%

Basic

15%

Enhanced36%

Value

Payer claims

Notes (1) Market share calculation applies to Enhanced products; Claim Net represents claimed amount

(2) Days to Remit is measured as “average number of days to submit AED 1 from first Claim Submission Date to first Remittance Date”, using the following mathematical formulae: Σ t xt / Σ xt;

{x} being the series denoted as Claim Net at duration t

(3) Claim Net per Claim

Source Cube 2011; Health Statistics analysis 52

Population

Providers Payers Claims

Financing Episodes

53

Note 39,105 contracts have gross premium < 601 AED, inconsistent with the definition of GrossPremium on https://www.shafafiya.org

Source KEH and Products Search Engine Database; Strategy Analysis

Enhanced plans premiums

54

Number of Contracts

Ave

rage

Gro

ss P

rem

ium

601-999 AED, 260,000

1000 - 1999 AED, 155,000

2000 - 2999 AED, 202,000

3000 - 3999 AED, 131,000

4000-4999 AED,

104,000

5000+AED,

168,000

7,993

4,383

3,413

2,504

1,469

685

Note About 26% of the enhanced plans contracts are excluded due to non compliance with reporting of benefits information

Source KEH and Products Search Engine Database; Strategy Analysis

Enhanced plans limits

55

Benefit Level

Basic Product

Better than Basic Product

Me

mb

er %

0 (44%)

20 (2%)70 (2%)

80 (36%)

100 (16%)

% Cover Outside Network

Other Emirates

Emergency, 1%

+ Other Emirates

In/Outpatient, 27%

+ International, 58%

+ Home Country,

14%

GeographicCoverage

.25, 30%

.30, 24%

.50, 18%

.40, 1%

1.00, 12%

1.50, 2%2.50, 2%5.00, 1%

Other, 10%

Annual LimitAED millions

Enhanced plans benefits

56

Note Benefits are not mutually exclusive, a plan may have more than one of the listed benefits. About 26% of the enhanced plans contracts are excluded due to non compliance with reporting of benefits information

Source KEH and Products Search Engine Database; Strategy Analysis

* Some enhanced products include more than one of the listed benefits.

0%

0%

1%

2%

3%

4%

6%

8%

10%

11%

15%

16%

26%

76%

77%

Genetic Disorders

Cosmetic treatment

Dietician

Infertility

Preventive care

Rehabilitation

Chiropractic

Congenital Disorders

Home Nursing

Ophthalmology

Psychiatry

Alternative Medicine

Dental

Miscellaneous Enhanced Clinical & Non Clinical

Any Clinical Service > Basic Level

Member Count

Capacity Masterplan

August 2012

Contents

Model Abu Dhabi’s model of care C3 Model of care How health services are currently used, what’s wrong? C4 Model of care what’s new C5 Abu Dhabi working definition of ‘World Class’ healthcare C6 HAAD will regulate to drive Quality, Access and Cost-Efficiency C7 Plan* Current service balance C9 Service capacity balance by specialty C10 Capacity gaps by sub-specialty C11 Service capacity balance by location C12 Planning for healthcare services C13 Improving capacity management through regulating clinical service lines C14 List of Abu Dhabi clinical service lines C15 Centralised, Regional and Standard services, by % total Abu Dhabi DRG volumes C16 Current and projected demand, by Episodes and beds C17

Projected demand by Abu Dhabi planning region C18 Projected demand by Abu Dhabi planning region, by number of beds C19 Assumptions Health facility Locations C21 Supply projections C22 Population density C23 Population growth, scenarios C24 Demand projections C25 Demand projections based on WHO disease classification C26 Demand projections for doctors by specialty C27 Recommendations Planning Recommendations Summary C29 Facility recommendations for developers, investors, and healthcare Providers C30 Service recommendations for investors and developers C31 Recommendation for allocation of land and service provision C32 Access requirements C33 Case example C34

*Detailed plans for specific locations and services are available on https://www.shafafiya.org

Note The data presented have been prepared to the best of our knowledge at time of release. Although effort has been invested to creating consistency and coherence, this should be considered work in progress. Feedback on content and layout are welcome.

C1

Model Planning

Assumptions Recommendations

DRAFT

Patient self-care

Model of care How health services should be used

Source Institute of Medicine 2001 Crossing the Quality Chasm, Bodenheimer et al 2002 JAMA, Department of Health UK 2001 Reforming Emergency Care, Picker Institute, Strategy analysis 11

Remote support

Preventative

Screening

Check-up

Disease management

Non-emergency/elective

Outpatient Clinic

Elective Admission

Emergency

Ambulance

Emergency Admission .

Triage

Urgent Care Centre

ER

Including diagnostics

Population growth, scenarios

Note HAAD and SCAD are collaborating to align figures with official SCAD estimates; Estimates presented here are for internal HAAD use only

Projections for Nationals are rounded to the nearest 2.5% variance between high and low, and those for Expatriates at 5%.

Source SCAD population estimates; additional HAAD assumptions and analysis based on raw insurance data` 73

As at 31 December 2010 Draft

Population growth, Scenarios

National Expatriate

Year Low High

2011 411'200 1'945'000 2'045'000

2012 416'150 1'970'000 2'190'000

2013 422'200 2'060'000 2'350'000

2014 429'400 2'130'000 2'505'000

2015 437'800 2'175'000 2'675'000

2016 445'800 2'250'000 2'850'000

2017 453'600 2'310'000 3'045'000

2018 460'500 2'360'000 3'240'000

2019 467'600 2'400'000 3'400'000

2020 473'600 2'475'000 3'575'000

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Po

pu

lati

on

(m

illi

on

s)

High

Low

DRAFT

For planning purposes, land must be available for hospitals, clinics and ambulance stations to serve anticipated population as per the following guidelines:

Land requirements Guidelines for urban planners

Notes 1Transient population includes staff and other non-residential visitors 2Clinics collectively refers to Clinics, Centers and Polyclinics3Appropriate facilities for co-location with Clinics include Hospitals, Ambulance Stations, Mosques, Neighbourhood Commercial Centres, Sport Facilities, Community/Cultural Centres, Pharmacies, Schools and Post Offices, 4Clinic GFA may be provided within larger commercial centre with adequate transport options and shared parking5 If residential population is less than 60,000 or transient population is less than 180,000, land provision for a hospital facility needs to be made on a site-based analysis which considers the accesibility of existing hospital facilities6Optimal hospital size is 200-600 beds7Appropriate facilities for co-location with Ambulance Stations include Clinics, Hospitals, Civil Defense Stations, Police Stations and Municipal Offices

Source HAAD Health Facility Community Guidelines 2009, Strategy analysis 5

Population (000’s people)

Land provision options Parking(spaces)

Minimum service requirement

Estimated Resources

Residential Transient1 Land area(m2 000’s)

Co-location GFA4

(m2 000’s)

Clinics2 4-5 12-15 6 ? 3 2.5 25 •Primary care•Pharmacy services (on-site or within 10 min walk)•Laboratory service

2 Physicians

8-12 24-36 7 ? 3 3 30 4-6 Physicians

12-30 36-90 8.5 ? 3 3.5 35 7-14 Physicians

30-40 90-120 12 ? 3 4.5 45 15-20 Physicians

Hospitals5 60-80 180-240 80 n/a n/a 3/bed •Emergency services•Laboratory services•Radiology services•Stand-alone building

180-240 Beds6

90-110 270-330 100 n/a n/a 3/bed 270-330 beds6

Ambulance Stations

10-16 30-48 3 ? 7 n/a 10 •Ambulance service (land /air) 1 Ambulance

16-40 48-120 4 ? 7 n/a 15 •Ambulance service (land /air) 2 Ambulances

OR OR OR

Capacity Masterplan

Note: Abu Dhabi and Al Gharbia populations based on SCAD 2005 census. Al Ain population based on 2008 UPC estimate.

Source: Population: SCAD, UPC 2030 plans. Clinicians and Facilities: Licensing database. Planned Facilities ; SEHA, UPC 2030 plans, HAAD Planning analysis.

Capacity Gap

Severe

Moderate

None

Population Facilities Clinicians Ratios 2030 Plan growth 2030 requirements 2030 planned Projects under way

Region District Gap now Type Tota

l

% N

atio

nal

Nat

ion

als

Tota

l

Ho

spit

als

Cli

nic

s

Ne

arb

y

ho

spit

al

Do

cto

rs

Nu

rse

s

De

nti

sts

Oth

er

Fac

ilit

ies

/10

00

0

Do

cto

rs

/10

00

Nu

rse

s

/10

00

Population Growth

Ho

spit

als

req

uir

ed

Cli

nic

req

uir

ed

Ho

spit

als

Cli

nic

s

Ho

spit

als

Cli

nic

s

20

30

Po

pu

lati

on

Abu Dhabi Desert Villages Rural 28,480 #NAME? 10,963 None 81,520 1 110,000

Al Falah Rural 4,028 #NAME? 1,996 None 95,972 1 1 100,000

Ghantoot District Rural 2,478 #NAME? - None 97,522 1 100,000

Abu Dhabi Island Urban 313,809 #NAME? 44,004 229 13 182 2,529 3,878 430 1,284 6.2 8.1 12.4 111,191 425,000

CBD/Financial Centre Urban 174,625 #NAME? 14,141 124 5 86 1,131 1,663 241 539 5.2 6.5 9.5 15,375 1 190,000

Musaffah Urban 141,268 #NAME? 2,256 36 31 161 194 21 68 2.2 1.1 1.4 (41,268) 1 1 3 100,000

Bani Yas Rural 47,245 #NAME? 27,267 43 37 162 106 57 73 7.8 3.4 2.2 22,755 4 70,000

Al Shahama Rural 37,831 #NAME? 16,361 10 10 45 47 14 24 2.6 1.2 1.2 72,169 1 1 1 110,000

Shamkhah Rural 15,839 #NAME? 10,674 None 1 114,161 1 130,000

Al Rahba Rural 15,315 #NAME? 13,038 1 1 132 325 5 89 0.7 8.6 21.2 94,685 1 110,000

New Port City Rural 11,740 #NAME? 4,565 None 1 138,260 2 150,000

Capital District South Urban 9,247 #NAME? 33 None 1 45,753 1 1 55,000

Bain Al Jesrain Urban 7,694 #NAME? 4,927 3 3 33 42 10 17 3.9 4.3 5.5 17,306 1 1 25,000

Khalifa City A Urban 5,317 #NAME? 2,703 11 1 10 78 74 17 75 20.7 14.7 13.9 64,683 1 1 6 70,000

Grand Mosque District Urban 5,257 #NAME? 1,837 None 1 114,743 1 1 120,000

Inner Islands Urban 2,804 #NAME? 480 1 2 4 3.6 0.7 1.4 17,196 1 20,000

Capital District North Urban 2,371 #NAME? 2,121 2 1 1 426 792 36 302 8.4 179.7 334.0 67,629 1 3 70,000

Al Mina Urban 1,070 #NAME? 53 7 4 87 103 25 62 37.4 81.3 96.3 98,930 100,000

Al Raha Urban 827 #NAME? 397 2 1 1 41 42 9 12 49.6 50.8 119,173 1 120,000

Yas Island Urban 776 #NAME? 1 None 99,224 100,000

Mohamed Bin Zayed City Urban 328 #NAME? 95 2 2 1 2 4 2 3.0 6.1 49,672 1 1 4 50,000

Saadiyat Urban 122 #NAME? None 119,878 - 120,000

Airport District Urban 98 #NAME? 32 6 4 8 11 5 11 81.6 112.2 49,902 1 50,000

Lulu Island Urban 75 #NAME? None 19,925 1 20,000

Capital District Urban #NAME? None 240,000 2 240,000

Mohamed Bin Zayed Centre Urban #NAME? None 80,000 1 80,000

South Hudayriat Island Rural #NAME? None 100,000 1 100,000

Marina Village Urban #NAME? 3 2 1 3 6 5,000 5,000

Al Suwwah Urban #NAME? None 30,000 1 1 30,000

Al Reem Urban #NAME? None 200,000 200,000

Al Ain Umm Ghaffa Rural 8,851 #NAME? 5,873 None 3,049 1 1 11,900

Nahel Rural 5,196 #NAME? 2,377 None 4,804 1 1 10,000

Industrial City Rural 48,803 #NAME? 18 8 5 14 5 1 5 1.0 0.3 0.1 30,937 1 1 79,740

Al Salamat/Al Yaher Urban 37,544 #NAME? 23,400 1 1 1 3 1 6 0.3 0.1 0.0 36,456 1 1 2 74,000

Al Dhahra Rural 4,958 #NAME? 715 None 1,042 1 1 6,000

Abu Krayyah Rural 4,108 #NAME? 655 None 892 1 1 5,000

Al Saad Rural 3,829 #NAME? 702 None 1,171 1 1 5,000

Al Araad Rural 3,791 #NAME? 139 None 209 1 4,000

Abu Samra Rural 1,942 #NAME? 286 None 558 1 2,500

Al Ain City Urban 343,002 #NAME? 100,298 186 7 148 1,733 2,864 318 968 4.5 5.1 8.3 364,298 3 8 707,300

Al Quaa Rural 12,512 #NAME? 4,912 1 1 8 13 1 3 0.8 0.6 1.0 10,488 1 1 23,000

Al Wagan Rural 11,865 #NAME? 3,330 1 1 17 29 1 4 0.8 1.4 2.4 18,135 1 1 1 30,000

Al Hayer Rural 11,484 #NAME? 2,570 3 3 25 34 4 3 2.6 2.2 3.0 20,516 1 2 32,000

Al Dhaher Rural 10,641 #NAME? 7,325 1 1 13 20 3 4 0.9 1.2 1.9 3,709 1 1 14,350

Remah Rural 8,187 #NAME? 683 1 1 6 9 2 1.2 0.7 1.1 1,313 1 1 9,500

Sweihan Rural 7,880 #NAME? 713 1 1 8 11 1 1 1.3 1.0 1.4 32,120 1 2 40,000

Al Khazna Rural 7,350 #NAME? 1,071 2 2 4 13 1 2.7 0.5 1.8 1,650 1 1 9,000

Mezyad Rural 6,407 #NAME? 3,809 None 1 1,993 1 1 8,400

Al Shwaib Rural 3,260 #NAME? 1,546 1 1 3 4 3.1 0.9 1.2 2,240 1 1 5,500

Al Fagah Rural 2,089 #NAME? 378 1 1 3 3 4.8 1.4 1.4 1,411 1 3,500

Western Liwa Rural 20,000 #NAME? 661 5 1 1 8 17 5 32 1.0 0.4 0.9 45,000 1 65,000

Madinat Zayed Rural 29,000 #NAME? 6,785 16 2 11 175 256 23 107 4.5 6.0 8.8 11,000 1 1 40,000

Ruwais Rural 16,000 #NAME? 1,270 4 1 3 50 100 7 14 2.5 3.1 6.3 114,000 1 130,000

Mirfa Rural 15,000 #NAME? 3,676 4 1 3 32 61 3 17 2.7 2.1 4.1 60,000 75,000

Ghayathi Rural 8,000 #NAME? 3,898 6 1 5 38 63 5 18 7.5 4.8 7.9 7,000 1 15,000

Sila'a Rural 5,000 #NAME? - 1 1 22 39 2 10 2.0 4.4 7.8 65,000 70,000

Delma Island Rural 5,000 #NAME? 2,139 1 1 23 25 2 10 2.0 4.6 5.0 5,000 1 10,000

C2

• Healthcare in Abu Dhabi faces growing demand for services arising from an expanding populationC12,C24 that has a deteriorating health statusC26. The current population is young and has a high rate of chronic diseases that is set to increase as it ages. The current model of care in Abu Dhabi does not adequately support self care or prevention –screening programmes and diagnostic services are not integrated into care plans. Also, patients have undirected access to services and specialty care which leads to inappropriate use and, in turn, over-supply of servicesC4. In response HAAD is developing integrated care pathways and further developing its Weqaya screening programme. It has issued a new RFP for the provision of Weqaya data services.

• Historically, Abu Dhabi has had a relatively limited supply of healthcare services, particularly hospital beds, which led to investment in infrastructure3. Achieving world-class quality care, however, is about much more than new buildingsC6. Before embarking on large-scale projects which affect community healthcare services long-term, it is important to be clear on what type of healthcare is appropriate for the evolving communities and population of Abu Dhabi in the 21st century.

• Abu Dhabi’s model of care (see page C5) describes how healthcare should look in future and is based on robust international experience**. The focus is on empowering patients. As a first step, pro-active check-ups and convenient routine follow-up should help prevent disease. When there is a condition, patients should be supported to care for themselves, where appropriate – given the growing burden of chronic disease the reality is that most such care is already managed by patients (and their families) themselves. This should be supported by targeted home care and the integrated use of telemedicine*. This has been shown to improve quality, and improve access in rural areas. Patients will clearly still have reactive access to appropriate ‘elective’ and emergency care, but this should be streamlined and optimised from the patient’s perspective through an emphasis on early clinical triage. Diagnostics, for instance, should be available everywhere to enable one-stop-treatment. In order to promote the use of home care and telemedicine HAAD has developed new “At Home” and telemedicine standards.

• Making such ambitious changes to our healthcare system will requires countless small decisions on what to do and what not to do. HAAD’s quantitative definition of world-class quality careC6 helps clarify how trade-offs should be made in delivering health services and transitioning to the new model of care. HAAD is facilitating these changes through the adoption of payment incentives, introduction of care pathways and streamlining of licensing processes in accordance with the intended service structureC9.

Abu Dhabi’s model of care

*A randomised controlled trial of child psychiatric assessment conducted by videoconferencing. Alford, R et al (2000) . ** Impact of home care on hospital days: a meta analysis. Hughes, SL et al (1997)

C3

Diagnostics

Inpatient Outpatient

Model of care How health services are currently used, what’s wrong?

Hospital admission

Open access1

Primary care centre/ clinic

Hospital ER

Specialist

Hospital specialist

Screening

Laboratory and radiology

Ambulance

Notes 1Access to Seha hospital specialists is only via referral from Seha Centres/Clinics and ER departments. Some Seha Hospital ER departments also direct non-emergency patients to adjacent ‘Urgent care’ centres Source Strategy analysis

Patient access to services is not streamed: leading to over-servicing, over-

supply and inappropriate service use

There are no systems in place

to support patient self-care and

management of chronic disease

Screening programmes are

not (yet) fully aligned to prevent and treat chronic

conditions

Diagnostic services are not optimally

integrated into treatment paths

C4

Patient self-care

Desired model of care what’s new?

Source Institute of Medicine 2001 Crossing the Quality Chasm, Bodenheimer et al 2002 JAMA, Department of Health UK 2001 Reforming Emergency Care, Picker Institute, Strategy analysis

Remote support

Preventive

Screening

Check-up

Disease management

Non-emergency/elective

Outpatient Clinic

Elective Admission

Emergency

Ambulance

Emergency Admission .

Triage

Urgent Care Centre

ER

Including diagnostics

C5

Abu Dhabi working definition of ‘World Class’ healthcare

1 Includes Insurance premiums, Thiqa payments, as well as funded mandates and capital, but not loss transfers . Government determines budgets for Basic and Thiqa, while Employers determine effective budgets for Enhanced, while Individuals can choose to add discretionary spending on health

2 This refers to Cost limits/Prices; Funded mandates to follow the same logic and price levels as insurance-based system 3 Exceptions to market pricing are ‘Specialised services’ provided by certified Providers for which HAAD sets a uniform base rate; ‘non-market DRGs’ only provided by SEHA at that time, where HAAD sets Gap=0 and

Marginal=100% 4 Providers may be outside Abu Dhabi, but within the UAE if travel/accommodation are covered and Provider complies with HAAD standards

Quality • Health system

– Health performance indicators reviewed by Clinical Quality Panel, e.g., % of well-controlled diabetics

– Citizen satisfaction with health system • Pathway

– Pathway performance indicators reviewed by Clinical Quality Panel, e.g., Diabetics with regular HbA1c tests

• Provider – Provider performance indicators reviewed by

Clinical Quality Panel – Patient satisfaction from standardised survey

conducted by HAAD • Service level, such as Hotel services, e.g., 10 beds

per ward for Basic, 2 per room most Enhanced, single room for Thiqa

• Intervention/Investigation level beyond a guideline-determined floor, e.g., it may be indicated to do 2 standard ultrasound scans per pregnancy, but an Enhanced/Thiqa plan may cover more scans or higher specification scans

• Clinician experience, such as qualification level/years of experience of a clinician, e.g., Thiqa has preferential access to Consultants; Basic may have more junior Doctors, as long as Clinicians act within their respective privileges

Access • Network size

– Inpatients: >1 inpatient Provider per 250,000 population for Regional secondary and simple tertiary care services and 1-2 Provider(s) for complex tertiary care4

– Critical care bed occupancy [<90%] – Outpatients: primary care within [30

minutes]; specialist outpatient care at least in Abu Dhabi or Al Ain, unless tertiary specialty

• Waiting time – Emergency: [Ambulance arrival <20

mins; Waiting time in ER <4 hours] – Elective: [<3 months in all cases] – Ambulatory: [<1 month in all cases]

• Schedule of Benefits – Authorization requirement – Exclusions (Dental, Mental health) – Member incentives

Assume no material changes in the short

run for Basic/Enhanced which are equilibrating, while there is still quite some movement on the structure of Thiqa benefits, including member incentives

Cost2

•Reimbursement – Market prices as a principle within a price

corridor 1-3x HAAD’s Basic product2 – Pay for Quality premium based on

Provider quality (expected to be up to 10%)

– Reimbursement structure is fixed – Reflects severity: DRGs for inpatients and

E and M logic for outpatients •Capital

– 6 Million AED/bed [US average] – 23,000 AED/m2 [US average]

• Premium+Subsidy per member1 in AED as Health systems are designed to revenue – Basic 1’950 ~Thailand – Enhanced 3’400 ~Turkey – Thiqa 16’000 ~England

Assumptions for evolving reimbursement – ‘Pay for Health’ pilots for Thiqa (short-term) – Tendering process a la Medicare to set Lab rates for Basic product (short-term) – Introduce capitation elements for outpatients, e.g., primary care in the medium term

Absolute target

Target varies by plan

Absolute targets must be met by all plans (including Basic), while improvements are paid for by differential budget

© Health Authority Abu Dhabi 2011 C6

In addition to developing the model of care and planning for healthcare need, HAAD will:

1. Promote the use of homecare, telemedicine and screening programmes by creating necessary pre-requisites in terms of financing (schedule of benefits), reimbursement (payment codes) and licensing/accreditation, and then aligning HAAD’s licensing, care standards and quality audit practices accordingly. For instance, homecare reimbursement has been enabled recently, screening in the Weqaya and Visa programmes are being aligned, while telemedicine financing and reimbursement will be clarified.

2. Create/continue taskforces for key planning areas with the mandate to align financing, reimbursement, licensing and quality audit to address capacity gaps and ensure care is integrated across the Emirate:

— 2 key specialties: Emergency services and Mental Health

— Rural Transformation – to address the specific healthcare challenges faced by rural communities of Abu Dhabi, including guidelines for serving communities of <4,000 residents, e.g., using clinician rotations, mobile clinics, homecare and telemedicine to improve access

3. Designation of Centralised and Regional services. Allocation of Centralised and Regional services to specific facilities will ensure that concentration of clinical experience can lead to improved clinical outcomes for patients, and the more efficient use of resources. Quality, Access and Cost outcomes will be reviewed regularly and Provider designation updated in light of these reviews.

4. Prioritise licensing of healthcare professionals where there are acute shortages. Intensive and Critical Care, Emergency Medicine, Neonatology, Cardiology and Psychiatry, as well as rural areas in general

5. Maturing and strengthening licensing standards and procedures, e.g., by streamlining processes and supporting clinical training and privileging within the Professional Qualification Requirements (PQR).

HAAD will regulate to drive Quality, Access and Cost-Efficiency

C7

Model Planning

Assumptions Recommendations

DRAFT

Patient self-care

Model of care How health services should be used

Source Institute of Medicine 2001 Crossing the Quality Chasm, Bodenheimer et al 2002 JAMA, Department of Health UK 2001 Reforming Emergency Care, Picker Institute, Strategy analysis 11

Remote support

Preventative

Screening

Check-up

Disease management

Non-emergency/elective

Outpatient Clinic

Elective Admission

Emergency

Ambulance

Emergency Admission .

Triage

Urgent Care Centre

ER

Including diagnostics

Population growth, scenarios

Note HAAD and SCAD are collaborating to align figures with official SCAD estimates; Estimates presented here are for internal HAAD use only

Projections for Nationals are rounded to the nearest 2.5% variance between high and low, and those for Expatriates at 5%.

Source SCAD population estimates; additional HAAD assumptions and analysis based on raw insurance data` 73

As at 31 December 2010 Draft

Population growth, Scenarios

National Expatriate

Year Low High

2011 411'200 1'945'000 2'045'000

2012 416'150 1'970'000 2'190'000

2013 422'200 2'060'000 2'350'000

2014 429'400 2'130'000 2'505'000

2015 437'800 2'175'000 2'675'000

2016 445'800 2'250'000 2'850'000

2017 453'600 2'310'000 3'045'000

2018 460'500 2'360'000 3'240'000

2019 467'600 2'400'000 3'400'000

2020 473'600 2'475'000 3'575'000

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Po

pu

lati

on

(m

illi

on

s)

High

Low

DRAFT

For planning purposes, land must be available for hospitals, clinics and ambulance stations to serve anticipated population as per the following guidelines:

Land requirements Guidelines for urban planners

Notes 1Transient population includes staff and other non-residential visitors 2Clinics collectively refers to Clinics, Centers and Polyclinics3Appropriate facilities for co-location with Clinics include Hospitals, Ambulance Stations, Mosques, Neighbourhood Commercial Centres, Sport Facilities, Community/Cultural Centres, Pharmacies, Schools and Post Offices, 4Clinic GFA may be provided within larger commercial centre with adequate transport options and shared parking5 If residential population is less than 60,000 or transient population is less than 180,000, land provision for a hospital facility needs to be made on a site-based analysis which considers the accesibility of existing hospital facilities6Optimal hospital size is 200-600 beds7Appropriate facilities for co-location with Ambulance Stations include Clinics, Hospitals, Civil Defense Stations, Police Stations and Municipal Offices

Source HAAD Health Facility Community Guidelines 2009, Strategy analysis 5

Population (000’s people)

Land provision options Parking(spaces)

Minimum service requirement

Estimated Resources

Residential Transient1 Land area(m2 000’s)

Co-location GFA4

(m2 000’s)

Clinics2 4-5 12-15 6 ? 3 2.5 25 •Primary care•Pharmacy services (on-site or within 10 min walk)•Laboratory service

2 Physicians

8-12 24-36 7 ? 3 3 30 4-6 Physicians

12-30 36-90 8.5 ? 3 3.5 35 7-14 Physicians

30-40 90-120 12 ? 3 4.5 45 15-20 Physicians

Hospitals5 60-80 180-240 80 n/a n/a 3/bed •Emergency services•Laboratory services•Radiology services•Stand-alone building

180-240 Beds6

90-110 270-330 100 n/a n/a 3/bed 270-330 beds6

Ambulance Stations

10-16 30-48 3 ? 7 n/a 10 •Ambulance service (land /air) 1 Ambulance

16-40 48-120 4 ? 7 n/a 15 •Ambulance service (land /air) 2 Ambulances

OR OR OR

Capacity Masterplan

Note: Abu Dhabi and Al Gharbia populations based on SCAD 2005 census. Al Ain population based on 2008 UPC estimate.

Source: Population: SCAD, UPC 2030 plans. Clinicians and Facilities: Licensing database. Planned Facilities ; SEHA, UPC 2030 plans, HAAD Planning analysis.

Capacity Gap

Severe

Moderate

None

Population Facilities Clinicians Ratios 2030 Plan growth 2030 requirements 2030 planned Projects under way

Region District Gap now Type Tota

l

% N

atio

nal

Nat

ion

als

Tota

l

Ho

spit

als

Cli

nic

s

Ne

arb

y

ho

spit

al

Do

cto

rs

Nu

rse

s

De

nti

sts

Oth

er

Fac

ilit

ies

/10

00

0

Do

cto

rs

/10

00

Nu

rse

s

/10

00

Population Growth

Ho

spit

als

req

uir

ed

Cli

nic

req

uir

ed

Ho

spit

als

Cli

nic

s

Ho

spit

als

Cli

nic

s

20

30

Po

pu

lati

on

Abu Dhabi Desert Villages Rural 28,480 #NAME? 10,963 None 81,520 1 110,000

Al Falah Rural 4,028 #NAME? 1,996 None 95,972 1 1 100,000

Ghantoot District Rural 2,478 #NAME? - None 97,522 1 100,000

Abu Dhabi Island Urban 313,809 #NAME? 44,004 229 13 182 2,529 3,878 430 1,284 6.2 8.1 12.4 111,191 425,000

CBD/Financial Centre Urban 174,625 #NAME? 14,141 124 5 86 1,131 1,663 241 539 5.2 6.5 9.5 15,375 1 190,000

Musaffah Urban 141,268 #NAME? 2,256 36 31 161 194 21 68 2.2 1.1 1.4 (41,268) 1 1 3 100,000

Bani Yas Rural 47,245 #NAME? 27,267 43 37 162 106 57 73 7.8 3.4 2.2 22,755 4 70,000

Al Shahama Rural 37,831 #NAME? 16,361 10 10 45 47 14 24 2.6 1.2 1.2 72,169 1 1 1 110,000

Shamkhah Rural 15,839 #NAME? 10,674 None 1 114,161 1 130,000

Al Rahba Rural 15,315 #NAME? 13,038 1 1 132 325 5 89 0.7 8.6 21.2 94,685 1 110,000

New Port City Rural 11,740 #NAME? 4,565 None 1 138,260 2 150,000

Capital District South Urban 9,247 #NAME? 33 None 1 45,753 1 1 55,000

Bain Al Jesrain Urban 7,694 #NAME? 4,927 3 3 33 42 10 17 3.9 4.3 5.5 17,306 1 1 25,000

Khalifa City A Urban 5,317 #NAME? 2,703 11 1 10 78 74 17 75 20.7 14.7 13.9 64,683 1 1 6 70,000

Grand Mosque District Urban 5,257 #NAME? 1,837 None 1 114,743 1 1 120,000

Inner Islands Urban 2,804 #NAME? 480 1 2 4 3.6 0.7 1.4 17,196 1 20,000

Capital District North Urban 2,371 #NAME? 2,121 2 1 1 426 792 36 302 8.4 179.7 334.0 67,629 1 3 70,000

Al Mina Urban 1,070 #NAME? 53 7 4 87 103 25 62 37.4 81.3 96.3 98,930 100,000

Al Raha Urban 827 #NAME? 397 2 1 1 41 42 9 12 49.6 50.8 119,173 1 120,000

Yas Island Urban 776 #NAME? 1 None 99,224 100,000

Mohamed Bin Zayed City Urban 328 #NAME? 95 2 2 1 2 4 2 3.0 6.1 49,672 1 1 4 50,000

Saadiyat Urban 122 #NAME? None 119,878 - 120,000

Airport District Urban 98 #NAME? 32 6 4 8 11 5 11 81.6 112.2 49,902 1 50,000

Lulu Island Urban 75 #NAME? None 19,925 1 20,000

Capital District Urban #NAME? None 240,000 2 240,000

Mohamed Bin Zayed Centre Urban #NAME? None 80,000 1 80,000

South Hudayriat Island Rural #NAME? None 100,000 1 100,000

Marina Village Urban #NAME? 3 2 1 3 6 5,000 5,000

Al Suwwah Urban #NAME? None 30,000 1 1 30,000

Al Reem Urban #NAME? None 200,000 200,000

Al Ain Umm Ghaffa Rural 8,851 #NAME? 5,873 None 3,049 1 1 11,900

Nahel Rural 5,196 #NAME? 2,377 None 4,804 1 1 10,000

Industrial City Rural 48,803 #NAME? 18 8 5 14 5 1 5 1.0 0.3 0.1 30,937 1 1 79,740

Al Salamat/Al Yaher Urban 37,544 #NAME? 23,400 1 1 1 3 1 6 0.3 0.1 0.0 36,456 1 1 2 74,000

Al Dhahra Rural 4,958 #NAME? 715 None 1,042 1 1 6,000

Abu Krayyah Rural 4,108 #NAME? 655 None 892 1 1 5,000

Al Saad Rural 3,829 #NAME? 702 None 1,171 1 1 5,000

Al Araad Rural 3,791 #NAME? 139 None 209 1 4,000

Abu Samra Rural 1,942 #NAME? 286 None 558 1 2,500

Al Ain City Urban 343,002 #NAME? 100,298 186 7 148 1,733 2,864 318 968 4.5 5.1 8.3 364,298 3 8 707,300

Al Quaa Rural 12,512 #NAME? 4,912 1 1 8 13 1 3 0.8 0.6 1.0 10,488 1 1 23,000

Al Wagan Rural 11,865 #NAME? 3,330 1 1 17 29 1 4 0.8 1.4 2.4 18,135 1 1 1 30,000

Al Hayer Rural 11,484 #NAME? 2,570 3 3 25 34 4 3 2.6 2.2 3.0 20,516 1 2 32,000

Al Dhaher Rural 10,641 #NAME? 7,325 1 1 13 20 3 4 0.9 1.2 1.9 3,709 1 1 14,350

Remah Rural 8,187 #NAME? 683 1 1 6 9 2 1.2 0.7 1.1 1,313 1 1 9,500

Sweihan Rural 7,880 #NAME? 713 1 1 8 11 1 1 1.3 1.0 1.4 32,120 1 2 40,000

Al Khazna Rural 7,350 #NAME? 1,071 2 2 4 13 1 2.7 0.5 1.8 1,650 1 1 9,000

Mezyad Rural 6,407 #NAME? 3,809 None 1 1,993 1 1 8,400

Al Shwaib Rural 3,260 #NAME? 1,546 1 1 3 4 3.1 0.9 1.2 2,240 1 1 5,500

Al Fagah Rural 2,089 #NAME? 378 1 1 3 3 4.8 1.4 1.4 1,411 1 3,500

Western Liwa Rural 20,000 #NAME? 661 5 1 1 8 17 5 32 1.0 0.4 0.9 45,000 1 65,000

Madinat Zayed Rural 29,000 #NAME? 6,785 16 2 11 175 256 23 107 4.5 6.0 8.8 11,000 1 1 40,000

Ruwais Rural 16,000 #NAME? 1,270 4 1 3 50 100 7 14 2.5 3.1 6.3 114,000 1 130,000

Mirfa Rural 15,000 #NAME? 3,676 4 1 3 32 61 3 17 2.7 2.1 4.1 60,000 75,000

Ghayathi Rural 8,000 #NAME? 3,898 6 1 5 38 63 5 18 7.5 4.8 7.9 7,000 1 15,000

Sila'a Rural 5,000 #NAME? - 1 1 22 39 2 10 2.0 4.4 7.8 65,000 70,000

Delma Island Rural 5,000 #NAME? 2,139 1 1 23 25 2 10 2.0 4.6 5.0 5,000 1 10,000

C8

• To obtain an accurate picture of capacity balance in the Emirate, results from a detailed 2011 survey of 574 Clinicians were synthesised through interviews with Hospital Medical Directors and a number of quantitative sources including IPC data.

• Capacity Gaps Intensive and Critical Care medicine is the most severe capacity gap impacting healthcare services within Abu Dhabi. Severe capacity gaps also exist in Emergency care, NICU, Cardiology and PsychiatryC9. Small reductions in the number of clinicians licensed have occurred in Intensive and Critical Care medicine and Emergency care. Modest increases have occurred in the other specialties facing shortages Neonatology, Cardiology and PsychiatryC10.

• Health challenges. Growth in demand for healthcare services associated with the prevention and treatment of cancer, cardiovascular disease, diabetes, neuropsychiatric conditions is expected to be particularly high. Growth in demand for outpatient services is generally anticipated to be greater than for inpatient servicesC26.

• Growth. The number of clinicians licensed within the emirate has grown by 159 (3%) since the end of 2010 continuing to ensure wider coverage across the range of specialties, 798 new clinician licenses were issued during the same period. The number of facilities offering healthcare has also grown by 96 (6% ) to 1,729C10.

• Waiting times have been reduced across all specialties with the exception of slight increases in waiting times for family medicine and radiology as more facilities offer a broader range of specialtiesC10.

• The private sector has been responsible for the largest proportion (75%) of growth in healthcare capacity, however this growth has been predominantly in areas such as general and internal medicine, alternative medicine and dentistryC10. There has been little or no growth in the specialties where capacity gaps exist with the exception of Obstetrics and Gynecology and Paediatric where further capacity is also expected to be added by new and existing Providers in the futureC22.

• Improving capacity management through regulating clinical service lines. From 2013 HAAD will license clinical services within facilities (by DRG).

• Centralised and Regional services. In order to improve coverage and concentrate clinical expertise (and thus improve quality and cost efficiency) HAAD will designate a limited number of “Regional” services each serving a population of ~250,000 residents. For complex and highly specialised “Centralised” services HAAD will designate 1-2 Abu Dhabi Providers to serve the whole Emirate.

C9

Current service balance

Note Gaps –Sub specialty gaps have been identified such as pediatric Cardio physiology, Pediatric Rheumatology and Hand Surgery by IPC data Medical Board, these gaps mainly reflect in small volume in Abu Dhabi and which are addressed via the IPC Program. Source Gaps: 2011 survey of 575 clinicians; 2012 Interviews with Medical Directors; Planning analysis; Episodes: KEH; Physicians and Facilities: Licensing database; Waiting times: 2011 TPA analysis. Note Growth compares 2011 to 2010.

Service capacity balance by specialty As at 31 December 2011

C10

Capacity Balance

Critical capacity gap

Severe capacity gap

No capacity gap

% private/public capacity

Growth - public private

Growth - public

Waiting times

High

Intermediate

Low

Shorter than 2010

Longer than 2010

Capacity gaps by sub-specialty

C11

Paediatric Ophthalmologist Ortho-Oncologist specialist (Sarcoma)

Paediatric Neuro-ophthalmic Specialist Foot & Ankle specialist

Paediatric Cardiac Electrophysiology Hand, Micro-Constructive hand surgeon

Paediatric Epilepsy Surgical Specialist Dystonia Specialist

Paediatric Upper Arm & Hand Specialist Glaucoma Specialist

Paediatric Spinal Surgery Specialist Congenital heart disease in adult

Paediatric Immunologist Fetal Medicine

Paediatric Neuro-Muscular Specialist Gynaecology Pelvic Floor Specialist

Paediatric Onco-Ophthalmic Movement Disorder Specialist

Paediatric Ortho-Oncology Specialist - Sarcoma Ear Reconstruction Specialist

Paediatric Retina , Cornea & Glaucoma Specialist Micro vascular Plastic Reconstruction

Paediatric Rheumatologist Facial Palsy Plastic Surgery

Specialty

Notes Sub-specialty gaps are subject to dynamic change; Sub-specialty gaps identified based on Medical Board referrals abroad for treatment (under International Patient Care, IPC)

Source IPC 2011 Annual Statistics Report

Subject to regular update

Service capacity balance by location

Source Population: SCAD, 2010 Estimate, UPC 2030 plans. Clinicians and Facilities: Licensing database. Planned Facilities ; SEHA, UPC 2030 plans, HAAD Planning analysis. C12

Capacity Gap

Severe

Moderate

None

Supply

Underserved

Potential over supply

L, M, S Clinic size, Large

Medium, Small

Population Facilities Clinicians Ratios 2030 Plan growth Hospitals Clinics

Region District Gap now Type Tota

l

% N

atio

nal

Nat

ion

als

Tota

l

Ho

spit

als

Cli

nic

s &

Ce

ntr

es

Ne

arb

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ho

spit

al

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Oth

er

Fac

ilit

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/10

00

0

Do

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/10

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Nu

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s

/10

00

Population Growth

ne

ed

un

de

r w

ay

ne

ed

un

de

r w

ay

Am

bu

lan

ce

sta

tio

n

20

30

Po

pu

lati

on

Abu Dhabi Desert Villages Rural 35,489 #NAME? 13,661 2 2 7 12 2 5 0.6 0.2 0.3 74,511 1 1L 1 110,000

Al Falah Rural 5,019 #NAME? 2,487 None 55,408 2L 1 60,427

Ghantoot District Rural 3,088 #NAME? - None 4,802 1 1S 1 7,890

Abu Dhabi Island Urban 391,040 #NAME? 54,834 229 13 182 2,529 3,878 430 1,284 5.0 6.5 9.9 (120,775) 1 270,265

CBD/Financial Centre Urban 217,602 #NAME? 17,621 124 5 86 1,131 1,663 241 539 4.2 5.2 7.6 107,788 1 1L 1 325,390

Musaffah Urban 176,035 #NAME? 2,811 36 31 161 194 21 68 1.8 0.9 1.1 (136,927) 3 39,108

Bani Yas Rural 58,872 #NAME? 27,747 43 37 162 106 57 73 6.3 2.8 1.8 25,578 3 1L 1 84,451

Al Shahama Rural 47,142 #NAME? 20,388 10 10 45 47 14 24 2.1 1.0 1.0 14,868 1 1M 1 1 62,010

Shamkhah Rural 19,737 #NAME? 13,301 None 1 192,544 2 2L 1 1 212,281

Al Rahba Rural 19,084 #NAME? 16,247 1 1 132 325 5 89 0.5 6.9 17.0 (1,909) 17,175

New Port City Rural 14,629 #NAME? 5,688 None 1 8,220 1S 1 22,849

Capital District South Urban 11,523 #NAME? 41 None 1 43,477 1 1L 1 55,000

Bain Al Jesrain Urban 9,588 #NAME? 6,140 3 3 33 42 10 17 3.1 3.4 4.4 33,710 2 1L 1 43,298

Khalifa City A Urban 6,626 #NAME? 3,368 11 1 10 78 74 17 75 16.6 11.8 11.2 73,374 1 3 1M 1 80,000

Grand Mosque District Urban 6,551 #NAME? 2,289 None 1 35,643 1 1L 42,194

Inner Islands Urban 3,494 #NAME? 598 1 2 4 2.9 0.6 1.1 7,656 1S 1 11,151

Capital District North Urban 2,955 #NAME? 2,643 2 1 1 426 792 36 302 6.8 144.2 268.1 75,045 1 1 1M 78,000

Al Mina Urban 1,333 #NAME? 66 7 4 87 103 25 62 30.0 65.2 77.2 65,209 1L 66,543

Al Raha Urban 1,031 #NAME? 495 2 1 1 41 42 9 12 19.4 39.8 40.8 103,669 3L 1 104,699

Yas Island Urban 967 #NAME? 1 None 67,768 2L 1 68,735

Mohamed Bin Zayed City Urban 409 #NAME? 118 2 2 1 2 4 2 2.4 4.9 287,591 2 4 2L 1 1 288,000

Saadiyat Urban 152 #NAME? - None 82,133 2L 1 82,285

Airport District Urban 122 #NAME? 40 6 4 8 11 5 11 65.5 90.1 64,363 1L 1 64,485

Lulu Island Urban 93 #NAME? - None 23,135 1M 1 23,228

Capital District Urban - #NAME? - None 270,106 2 1L 1 270,106

Mohamed Bin Zayed Centre Urban - #NAME? - None 80,000 1 80,000

South Hudayriat Island Rural - #NAME? - None 100,000 1 1L 100,000

Marina Village Urban - #NAME? - 3 2 1 3 6 14,132 1M 1 14,132

Al Suwwah Urban - #NAME? - None 28,907 1 1M 1 28,907

Al Reem Urban - #NAME? - None 169,888 2L 1 169,888

Al Ain Umm Ghaffa Rural 9,250 #NAME? 6,138 None 3,755 1S 1 13,005

Nahel Rural 5,430 #NAME? 2,484 None 4,570 1S 1 10,000

Industrial City Rural 51,004 #NAME? 19 8 5 14 5 1 5 1.0 0.3 0.1 (15,477) 1 35,527

Al Salamat/Al Yaher Urban 39,237 #NAME? 24,455 1 1 1 3 1 6 0.3 0.1 0.0 (21,963) 1 1 1 17,274

Al Dhahra Rural 5,182 #NAME? 747 None 354 1S 5,536

Abu Krayyah Rural 4,293 #NAME? 685 None 1,864 1S 6,157

Al Saad Rural 4,002 #NAME? 734 None (309) 1S 3,692

Al Araad Rural 3,962 #NAME? 145 None (270) 1S 3,692

Abu Samra Rural 2,030 #NAME? 299 None (960) 1,069

Al Ain City Urban 358,472 #NAME? 104,822 186 7 148 1,733 2,864 318 968 4.3 4.8 8.0 348,828 3 5 3L 2 707,300

Al Quaa Rural 13,076 #NAME? 5,134 1 1 8 13 1 3 0.8 0.6 1.0 7,411 1M 1 20,487

Al Wagan Rural 12,400 #NAME? 3,480 1 1 17 29 1 4 0.8 1.4 2.3 13,368 1M 25,768

Al Hayer Rural 12,002 #NAME? 2,686 3 3 25 34 4 3 2.5 2.1 2.8 18,654 1M 1 1 30,656

Al Dhaher Rural 11,121 #NAME? 7,655 1 1 13 20 3 4 0.9 1.2 1.8 6,877 1S 1 17,998

Remah Rural 8,556 #NAME? 714 1 1 6 9 2 1.2 0.7 1.1 3,788 1S 12,344

Sweihan Rural 8,235 #NAME? 745 1 1 8 11 1 1 1.2 1.0 1.3 15,088 1M 1 1 23,323

Al Khazna Rural 7,682 #NAME? 1,119 2 2 4 13 1 2.6 0.5 1.7 2,155 9,837

Mezyad Rural 6,696 #NAME? 3,981 None 1 4,651 1S 11,347

Al Shwaib Rural 3,407 #NAME? 1,616 1 1 3 4 2.9 0.9 1.2 1,248 4,655

Al Fagah Rural 2,183 #NAME? 395 1 1 3 3 4.6 1.4 1.4 32 2,215

Western Liwa Rural 41,256 #NAME? 1,364 5 1 8 17 5 32 0.2 0.2 0.4 23,744 1L 1 65,000

Madinat Zayed Rural 59,821 #NAME? 13,996 16 2 11 175 256 23 107 2.2 2.9 4.3 2,079 1S 1 61,900

Ruwais Rural 33,005 #NAME? 2,620 4 1 3 50 100 7 14 1.2 1.5 3.0 72,995 1 1L 1 106,000

Mirfa Rural 30,942 #NAME? 7,583 4 1 3 32 61 3 17 1.3 1.0 2.0 44,058 1L 75,000

Ghayathi Rural 16,502 #NAME? 8,041 6 1 5 38 63 5 18 3.6 2.3 3.8 28,398 1M 44,900

Sila'a Rural 10,314 #NAME? 0 1 1 22 39 2 10 1.0 2.1 3.8 7,186 1S 17,500

Delma Island Rural 10,314 #NAME? 4,536 1 1 23 25 2 10 1.0 2.2 2.4 (2,014) 8,300

Planning for healthcare services

C13

• Current capacity gaps. Geographic coverage in the Emirate is generally good. There are, however, severe capacity shortfalls in the Desert Villages, Al Falah and Ghantoot districts. In Al Ain region, Umm Ghaffa, Nahel and Al Dhahra are underserved as is Liwa in the western region.C12. During Q4 2012 HAAD seeks to centrally procure for primary care facilities in these locations. Based on HAAD planning RecommendationsC32 moderate gaps exist in other rural locations.

• In rural areas, the key to patient access to high quality healthcare requires innovation in delivering services, not primarily building new facilities. This might include the use of mobile and visiting clinics, and clinical staff on a visiting or rotational basis. In larger settlements of the Western region, the pre-existing hospitals will need to adapt and respond to changing and growing needs, rather than the development of new access points.

• Significant population growth. The Abu Dhabi Urban Planning Council (UPC) 2030 Plan envisages the population of Abu Dhabi Emirate doublingC12.

− In Abu Dhabi region the old core (Abu Dhabi Island and Musaffah) is expected to reduce over time, with aggressive growth ‘off island’ and in rural areas, e.g., Mohammed Bin Zayed, Capital District, Shamkha, and Al Reem Island populations are projected to grow by over 820,000 respectively. Growth in 17 of the 28 districts is projected to exceed 60,000 in each case. Population in the villages along the road stretching east from Bani Yas and west of Al Ain city is anticipated to grow to over 74,000 transforming it from a predominately rural area to an urban corridorC12.

− The Al Ain city population is projected to double by 2030 with more modest growth expected in the surrounding rural areasC12.

− Western region population is projected to almost double to over 378,000 with the biggest growth in Ruwais, Ghayathi, Mirfa, and LiwaC12.

• Significant additional capacity is required to meet growth in demand for healthcare services as the population growsC25 and

ages. In existing developed areas the emphasis is on growing existing facilities to facilitate specialization and scale. Existing development plans are focused on or close to existing population centres:

− Hospitals, clinics and emergency network. According to HAAD recommendations for allocation of land and service provisionC32 the 2030 projected populations would require a maximum of 17 new small-to-medium general hospitals and 56 (31 Large,11 Medium and 14 Small) new clinicsC12 to provide local access to the expanding communities. The actual number required will depend on many factors including the extent to which existing facilities expand or improve efficiency of services. The current ambulance service network will also need to expand to support populations in newly developed and remote areasC12.

− Clinical staff. During 2011 the number of licensed Doctors within grew by 3%C10. Attracting and retaining qualified staff remains a challenge for healthcare services across the emirate, particularly in rural areas. It is estimated that by 2021 up to 3,200 additional doctors and 5,900 nurses will be required, if turnover remains high, this translates into 1,500 doctors and almost 1,600 nurses to be recruited annuallyC25. Clinical training and education of a world class standard must be established locally to build a sustainable healthcare workforce and service supply.

• The risk of potential oversupply of healthcare requires careful management. For example, Khalifa City A currently has 3 provisional hospital projectsC12, despite a projected 2030 population of ‘only’ 80,000C12. Similarly, Al Ain city has 5 provisional hospital projectsC12 with potential demand for 3C12. In contrast to these examples, there are few health facility projects in rural areas of the emirateC22. HAAD guidelines for urban planners and developers aim to ensure building of healthcare facilities occurs when demand exists, not years in anticipationC31.

Source Abu Dhabi Urban Planning Council. http://www.upc.gov.ae/

Improving capacity management through regulating clinical service lines

C14

• Moderate complexity

• Time dependency • Some volume-

based competency • Middle volume • Middle cost

• Non-complex • High volume • Low cost

• Highly specialised • Strong volume

based competency • Low volume • High cost

Description

• Cardiac catheterisation

• Specialist diabetes care

• Basic diabetes care • Family medicine • Preventive

services

• Burn Care • Open Heart

Surgery • Oncology surgery

Examples*

Public and private

Open market

Initially public (subject to review)

Provider(s)

Centralised1

Regional2 (Island/Middle, Eastern

and Western)

Standard

Government subsidised

Non-Government subsidised

1 HAAD will restrict provision of these services to 1-2 facilities 2 HAAD will issue licenses for these services on the basis of 1-5 per 250,000 population Source Categories maintained by HAAD with input from Providers, Payers, and other stakeholders

List of Abu Dhabi clinical service lines

For Planning and Licensing purposes HAAD will designate Centralised, Regional and Standard services (at DRG level) within the following 32 clinical service lines:

C15 Source Categories maintained by HAAD with input from Providers, Payers, and other stakeholders

Burns Gynaecology Orthopaedic

Cardiology - Invasive Haematology Plastic surgery

Cardiology - Medical Immunology and infectious disease Psychiatry

Cardiothoracic surgery Neonatology Rehabilitation

Dentistry Nephrology Respiratory medicine

Dermatology Neurological surgery Rheumatology

Endocrinology Neurology Transplant surgery

ENT Obstetrics Trauma

Gastroenterology Obstetric - Delivery Urology

General medicine Oncology Vascular surgery

General surgery Ophthalmology

Centralised, Regional and Standard services, by % total Abu Dhabi DRG volumes

• Centralised services may only be provided by Providers designated by HAAD to do so (1-2 in Abu Dhabi)

• Regional services may only be offered by Providers designated by HAAD to do so (1-5 per Region, depending on demand and supply factors)

• Standard services may be offered by all HAAD Licensed Providers

• Note: Emergency cases presenting to any HAAD Licensed Facilities should be treated (in accordance with HAAD Regulations. In case the DRG falls under Centralised or Regional service line, the case should be transferred to Providers Licensed for those service lines when clinically appropriate.

C16

Source Categories maintained by HAAD with input from Providers, Payers, and other stakeholders Note Percentage figures are % by volume of all DRGs within each clinical service line; Details to be published on HAAD website (www.haad.ae) 1Trauma Service Line contains only 3 DRGs related to Head Trauma.

# HAAD Service Line Centralised Regional Standard

1 Burns 99.5% 0.5% 0.0%

2 Cardiology - Invasive 5.3% 82.7% 12.0%

3 Cardiology - Medical 3.5% 44.9% 51.6%

4 Cardiothoracic surgery 100.0% 0.0% 0.0%

5 Dentistry 0.0% 0.0% 100.0%

6 Dermatology 0.0% 8.0% 92.0%

7 Endocrinology 0.5% 13.3% 86.2%

8 ENT surgery 0.5% 8.3% 91.3%

9 Gastroenterology 0.0% 1.0% 99.0%

10 General medicine 5.6% 26.6% 67.7%11 General surgery 1.2% 4.7% 94.0%

12 Gynaecology 0.2% 0.0% 99.8%

13 Haematology 3.5% 44.9% 51.6%

14 Immunology and infectious disease 0.4% 0.6% 99.0%

15 Neonatology 4.0% 13.1% 82.9%

16 Nephrology 0.0% 2.8% 97.2%

17 Neurological surgery 40.1% 4.5% 55.5%

18 Neurology 0.0% 34.4% 65.6%

19 Obstetrics 0.0% 13.3% 86.7%

20 Obstetric - Delivery 0.0% 0.0% 100.0%

21 Medical oncology 30.7% 69.3% 0.0%

22 Ophthalmology 0.0% 81.1% 18.9%

23 Orthopaedic 0.6% 13.3% 86.2%

24 Plastic surgery 0.0% 26.8% 73.1%

25 Psychiatric 0.0% 20.8% 79.2%

26 Rehabilitation 0.0% 100.0% 0.0%

27 Respiratory medicine 0.7% 7.9% 91.4%

28 Rheumatology 0.0% 39.6% 60.4%

29 Transplant surgery 100.0% 0.0% 0.0%

30 Trauma1

100.0% 0.0% 0.0%

31 Urology 0.4% 30.5% 69.1%32 Vascular surgery 32.5% 67.5% 0.0%

Current and projected demand, by Episodes and beds

C17

Assumptions Projected bed numbers from 2016 onwards are based on ‘International Average’ ALOS and 75% occupancy for ICU beds. Population growth based on: Abu Dhabi Urban Planning Council 2030 Plan projections, ‘Advantaged’ socio-economic class and with life expectancy >77years. Expatriate utilisation increases from 45% of UAE National utilisation to 55% of UAE National utilisation. Notes Sub Acute beds include: Rehabilitation, Palliative care, Maintenance, Older Persons and Psychogeriatric care; ICU beds exclude Paediatrics, NICU, CCU, etc. Acute Overnight beds exclude day case beds.

Bed Occupancy 2011 Actual 2016 2021 2026 2031Acute Overnight

Episodes122,345 184,102 223,539 276,589 332,040

Acute Overnight Beds Current (58%) 3,289 3,992 5,223 6,769 7,061

Intermediate (70%) 3,308 4,328 5,609 5,850

Target (85%) 2,724 3,564 4,619 4,818

Sub Acute Overnight

EpisodesN/A 3,216 4,233 5,461 6,738

Sub Acute Overnight

Beds224 228 292 299 350

ICU beds 146 175 209 245 281

Emergency Bays N/A 353 420 494 602

Projected demand by Abu Dhabi planning region Number of Regional and Centralised Providers

From 2013 Centralised and Regional services may only be provided by Providers designated by HAAD to do so. HAAD has determined the current and future number of Centralised and Regional facilities:

C18

Note HAAD may limit the number of Regional facilities, for example, where there are low volumes Sources * 2010 population estimates from Statistics Centre – Abu Dhabi (SCAD); ** 2012–2030 projections based on Urban Planning Council (UPC) Plan 2030 Methodology Based on 2010 SCAD current population and UPC Plan 2030 projected population and derived compound annual growth rate 2010–2030

2010* 2012** 2017** 2030**

Abu Dhabi and Middle Region population 1,198,000 1,348,000 1,723,000 2,622,379

Regional Providers (Abu Dhabi and Middle Region) 4 5 7 10

Al Ain (Eastern) Region population 568,000 610,000 715,000 1,002,466

Regional Providers (Al Ain Region) 2 2 3 4

Al Gharbiya (Western) Region population 198,000 217,010 264,526 378,600

Regional Providers (Al Gharbiya Region) 1 1 1 2

Total Regional Facilities in Abu Dhabi 7 8 11 16

Emirate wide 'Centralised' Centers 1 (1-2) (2-3) 4

Projected demand by Abu Dhabi planning region, by number of beds (Acute, Sub Acute and Intensive Care) plus Emergency bays

C19

Assumptions Projected bed numbers from 2016 onwards are based on ‘International Average’ ALOS and 75% occupancy for ICU beds. Population growth based on: Abu Dhabi Urban Planning Council 2030 Plan projections, ‘Advantaged’ socio- economic class and with life expectancy >77years. Expatriate utilisation increases from 45% of UAE National utilisation to 55% of UAE National utilisation. Notes Sub Acute beds include: Rehabilitation, Palliative care, Maintenance, Older Persons and Psychogeriatric care; ICU beds exclude Paediatrics, NICU, CCU, etc. Acute Overnight beds exclude day case beds.

Actual Demand

Region Beds Bed Occupancy 2011 2016 2021 2026 2031

Abu Dhabi & Middle Acute Overnight Current (58%) 1,946 2,146 2,666 3,277 3,967

Intermediate (70%) 1,778 2,209 2,715 3,287

Target (85%) 1,464 1,819 2,236 2,707

Sub acute 224 124 130 161 188

Intensive care 101 90 108 126 143

Emergency bays N/A 187 226 264 303

Al Ain Acute Overnight Current (67%) 1,012 1,153 1,407 1,801 2,213

Intermediate (70%) 1,104 1,347 1,724 2,118

Target (85%) 909 1,109 1,420 1,744

Sub acute N/A 76 94 98 109

Intensive care 41 57 70 79 91

Emergency bays N/A 126 151 181 210

Western Acute Overnight Current (30%) 240 592 717 864 1,031

Intermediate (70%) 254 307 370 442

Target (85%) 209 253 305 364

Sub acute N/A 12 15 18 22

Intensive care 4 12 14 16 18

Emergency bays N/A 26 32 35 40

Model Planning

Assumptions Recommendations

DRAFT

Patient self-care

Model of care How health services should be used

Source Institute of Medicine 2001 Crossing the Quality Chasm, Bodenheimer et al 2002 JAMA, Department of Health UK 2001 Reforming Emergency Care, Picker Institute, Strategy analysis 11

Remote support

Preventative

Screening

Check-up

Disease management

Non-emergency/elective

Outpatient Clinic

Elective Admission

Emergency

Ambulance

Emergency Admission .

Triage

Urgent Care Centre

ER

Including diagnostics

Population growth, scenarios

Note HAAD and SCAD are collaborating to align figures with official SCAD estimates; Estimates presented here are for internal HAAD use only

Projections for Nationals are rounded to the nearest 2.5% variance between high and low, and those for Expatriates at 5%.

Source SCAD population estimates; additional HAAD assumptions and analysis based on raw insurance data` 73

As at 31 December 2010 Draft

Population growth, Scenarios

National Expatriate

Year Low High

2011 411'200 1'945'000 2'045'000

2012 416'150 1'970'000 2'190'000

2013 422'200 2'060'000 2'350'000

2014 429'400 2'130'000 2'505'000

2015 437'800 2'175'000 2'675'000

2016 445'800 2'250'000 2'850'000

2017 453'600 2'310'000 3'045'000

2018 460'500 2'360'000 3'240'000

2019 467'600 2'400'000 3'400'000

2020 473'600 2'475'000 3'575'000

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Po

pu

lati

on

(m

illi

on

s)

High

Low

DRAFT

For planning purposes, land must be available for hospitals, clinics and ambulance stations to serve anticipated population as per the following guidelines:

Land requirements Guidelines for urban planners

Notes 1Transient population includes staff and other non-residential visitors 2Clinics collectively refers to Clinics, Centers and Polyclinics3Appropriate facilities for co-location with Clinics include Hospitals, Ambulance Stations, Mosques, Neighbourhood Commercial Centres, Sport Facilities, Community/Cultural Centres, Pharmacies, Schools and Post Offices, 4Clinic GFA may be provided within larger commercial centre with adequate transport options and shared parking5 If residential population is less than 60,000 or transient population is less than 180,000, land provision for a hospital facility needs to be made on a site-based analysis which considers the accesibility of existing hospital facilities6Optimal hospital size is 200-600 beds7Appropriate facilities for co-location with Ambulance Stations include Clinics, Hospitals, Civil Defense Stations, Police Stations and Municipal Offices

Source HAAD Health Facility Community Guidelines 2009, Strategy analysis 5

Population (000’s people)

Land provision options Parking(spaces)

Minimum service requirement

Estimated Resources

Residential Transient1 Land area(m2 000’s)

Co-location GFA4

(m2 000’s)

Clinics2 4-5 12-15 6 ? 3 2.5 25 •Primary care•Pharmacy services (on-site or within 10 min walk)•Laboratory service

2 Physicians

8-12 24-36 7 ? 3 3 30 4-6 Physicians

12-30 36-90 8.5 ? 3 3.5 35 7-14 Physicians

30-40 90-120 12 ? 3 4.5 45 15-20 Physicians

Hospitals5 60-80 180-240 80 n/a n/a 3/bed •Emergency services•Laboratory services•Radiology services•Stand-alone building

180-240 Beds6

90-110 270-330 100 n/a n/a 3/bed 270-330 beds6

Ambulance Stations

10-16 30-48 3 ? 7 n/a 10 •Ambulance service (land /air) 1 Ambulance

16-40 48-120 4 ? 7 n/a 15 •Ambulance service (land /air) 2 Ambulances

OR OR OR

Capacity Masterplan

Note: Abu Dhabi and Al Gharbia populations based on SCAD 2005 census. Al Ain population based on 2008 UPC estimate.

Source: Population: SCAD, UPC 2030 plans. Clinicians and Facilities: Licensing database. Planned Facilities ; SEHA, UPC 2030 plans, HAAD Planning analysis.

Capacity Gap

Severe

Moderate

None

Population Facilities Clinicians Ratios 2030 Plan growth 2030 requirements 2030 planned Projects under way

Region District Gap now Type Tota

l

% N

atio

nal

Nat

ion

als

Tota

l

Ho

spit

als

Cli

nic

s

Ne

arb

y

ho

spit

al

Do

cto

rs

Nu

rse

s

De

nti

sts

Oth

er

Fac

ilit

ies

/10

00

0

Do

cto

rs

/10

00

Nu

rse

s

/10

00

Population Growth

Ho

spit

als

req

uir

ed

Cli

nic

req

uir

ed

Ho

spit

als

Cli

nic

s

Ho

spit

als

Cli

nic

s

20

30

Po

pu

lati

on

Abu Dhabi Desert Villages Rural 28,480 #NAME? 10,963 None 81,520 1 110,000

Al Falah Rural 4,028 #NAME? 1,996 None 95,972 1 1 100,000

Ghantoot District Rural 2,478 #NAME? - None 97,522 1 100,000

Abu Dhabi Island Urban 313,809 #NAME? 44,004 229 13 182 2,529 3,878 430 1,284 6.2 8.1 12.4 111,191 425,000

CBD/Financial Centre Urban 174,625 #NAME? 14,141 124 5 86 1,131 1,663 241 539 5.2 6.5 9.5 15,375 1 190,000

Musaffah Urban 141,268 #NAME? 2,256 36 31 161 194 21 68 2.2 1.1 1.4 (41,268) 1 1 3 100,000

Bani Yas Rural 47,245 #NAME? 27,267 43 37 162 106 57 73 7.8 3.4 2.2 22,755 4 70,000

Al Shahama Rural 37,831 #NAME? 16,361 10 10 45 47 14 24 2.6 1.2 1.2 72,169 1 1 1 110,000

Shamkhah Rural 15,839 #NAME? 10,674 None 1 114,161 1 130,000

Al Rahba Rural 15,315 #NAME? 13,038 1 1 132 325 5 89 0.7 8.6 21.2 94,685 1 110,000

New Port City Rural 11,740 #NAME? 4,565 None 1 138,260 2 150,000

Capital District South Urban 9,247 #NAME? 33 None 1 45,753 1 1 55,000

Bain Al Jesrain Urban 7,694 #NAME? 4,927 3 3 33 42 10 17 3.9 4.3 5.5 17,306 1 1 25,000

Khalifa City A Urban 5,317 #NAME? 2,703 11 1 10 78 74 17 75 20.7 14.7 13.9 64,683 1 1 6 70,000

Grand Mosque District Urban 5,257 #NAME? 1,837 None 1 114,743 1 1 120,000

Inner Islands Urban 2,804 #NAME? 480 1 2 4 3.6 0.7 1.4 17,196 1 20,000

Capital District North Urban 2,371 #NAME? 2,121 2 1 1 426 792 36 302 8.4 179.7 334.0 67,629 1 3 70,000

Al Mina Urban 1,070 #NAME? 53 7 4 87 103 25 62 37.4 81.3 96.3 98,930 100,000

Al Raha Urban 827 #NAME? 397 2 1 1 41 42 9 12 49.6 50.8 119,173 1 120,000

Yas Island Urban 776 #NAME? 1 None 99,224 100,000

Mohamed Bin Zayed City Urban 328 #NAME? 95 2 2 1 2 4 2 3.0 6.1 49,672 1 1 4 50,000

Saadiyat Urban 122 #NAME? None 119,878 - 120,000

Airport District Urban 98 #NAME? 32 6 4 8 11 5 11 81.6 112.2 49,902 1 50,000

Lulu Island Urban 75 #NAME? None 19,925 1 20,000

Capital District Urban #NAME? None 240,000 2 240,000

Mohamed Bin Zayed Centre Urban #NAME? None 80,000 1 80,000

South Hudayriat Island Rural #NAME? None 100,000 1 100,000

Marina Village Urban #NAME? 3 2 1 3 6 5,000 5,000

Al Suwwah Urban #NAME? None 30,000 1 1 30,000

Al Reem Urban #NAME? None 200,000 200,000

Al Ain Umm Ghaffa Rural 8,851 #NAME? 5,873 None 3,049 1 1 11,900

Nahel Rural 5,196 #NAME? 2,377 None 4,804 1 1 10,000

Industrial City Rural 48,803 #NAME? 18 8 5 14 5 1 5 1.0 0.3 0.1 30,937 1 1 79,740

Al Salamat/Al Yaher Urban 37,544 #NAME? 23,400 1 1 1 3 1 6 0.3 0.1 0.0 36,456 1 1 2 74,000

Al Dhahra Rural 4,958 #NAME? 715 None 1,042 1 1 6,000

Abu Krayyah Rural 4,108 #NAME? 655 None 892 1 1 5,000

Al Saad Rural 3,829 #NAME? 702 None 1,171 1 1 5,000

Al Araad Rural 3,791 #NAME? 139 None 209 1 4,000

Abu Samra Rural 1,942 #NAME? 286 None 558 1 2,500

Al Ain City Urban 343,002 #NAME? 100,298 186 7 148 1,733 2,864 318 968 4.5 5.1 8.3 364,298 3 8 707,300

Al Quaa Rural 12,512 #NAME? 4,912 1 1 8 13 1 3 0.8 0.6 1.0 10,488 1 1 23,000

Al Wagan Rural 11,865 #NAME? 3,330 1 1 17 29 1 4 0.8 1.4 2.4 18,135 1 1 1 30,000

Al Hayer Rural 11,484 #NAME? 2,570 3 3 25 34 4 3 2.6 2.2 3.0 20,516 1 2 32,000

Al Dhaher Rural 10,641 #NAME? 7,325 1 1 13 20 3 4 0.9 1.2 1.9 3,709 1 1 14,350

Remah Rural 8,187 #NAME? 683 1 1 6 9 2 1.2 0.7 1.1 1,313 1 1 9,500

Sweihan Rural 7,880 #NAME? 713 1 1 8 11 1 1 1.3 1.0 1.4 32,120 1 2 40,000

Al Khazna Rural 7,350 #NAME? 1,071 2 2 4 13 1 2.7 0.5 1.8 1,650 1 1 9,000

Mezyad Rural 6,407 #NAME? 3,809 None 1 1,993 1 1 8,400

Al Shwaib Rural 3,260 #NAME? 1,546 1 1 3 4 3.1 0.9 1.2 2,240 1 1 5,500

Al Fagah Rural 2,089 #NAME? 378 1 1 3 3 4.8 1.4 1.4 1,411 1 3,500

Western Liwa Rural 20,000 #NAME? 661 5 1 1 8 17 5 32 1.0 0.4 0.9 45,000 1 65,000

Madinat Zayed Rural 29,000 #NAME? 6,785 16 2 11 175 256 23 107 4.5 6.0 8.8 11,000 1 1 40,000

Ruwais Rural 16,000 #NAME? 1,270 4 1 3 50 100 7 14 2.5 3.1 6.3 114,000 1 130,000

Mirfa Rural 15,000 #NAME? 3,676 4 1 3 32 61 3 17 2.7 2.1 4.1 60,000 75,000

Ghayathi Rural 8,000 #NAME? 3,898 6 1 5 38 63 5 18 7.5 4.8 7.9 7,000 1 15,000

Sila'a Rural 5,000 #NAME? - 1 1 22 39 2 10 2.0 4.4 7.8 65,000 70,000

Delma Island Rural 5,000 #NAME? 2,139 1 1 23 25 2 10 2.0 4.6 5.0 5,000 1 10,000

C20

Center

Clinic

Hospital H

Pharmacy

Health Facility locations

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OBAGI HOSPTAL

Al Reef HospitalNational Hospital

Lifeline Hospital

Al Salama Hospital

Al Ahalia Hospital AL MAZROUI HOSPITAL

AL Corniche Hospital

New Al Noor Hospital

Dar Al Shifa HospitalNMC Specialty Hospital

Shaikh Khalifa Hospital

Zayed Military Hospital

Franco Emirates Hospital

Gulf Diagnostic Center Hospital

C21 Source HAAD Licensing database, GPS survey; not all Center and Clinic locations shown

Supply projections As at 30 March 2012

Source Preliminary licensed facilities, HAAD Licensing and Strategy analysis.

Note *Completion likelihood from Land and Project State List (Maintained by HAAD Health Facility Licensing).

C22

Number of beds

Planned 5,730

Anticipated 4,298

Anticipated by 2013 2,837

Region

Planned

Beds

Completion

likelihood Type

Total 5,730

Abu Dhab - Island 1145

78 5 General Hospital

88 7 Specialized Hospital

141 3 General Hospital

838 3 General Hospital

Abu Dhabi - Near Island 3425

20 3 Specialized Hospital

25 6 General Hospital

30 10 General Hospital

35 3 General Hospital

50 8 General Hospital

52 3 General Hospital

99 2 General Hospital

100 9 General Hospital

100 1 Rehabilition Hospital

100 3 Specialized Hospital

119 7 General Hospital

120 3 General Hospital

125 3 General Hospital

150 3 General Hospital

156 3 Rehabilition Hospital

180 1 General Hospital

200 2 General Hospital

210 5 General Hospital

240 6 General Hospital

250 3 General Hospital

300 7 General Hospital

364 7 General Hospital

400 2 General Hospital

Region

Planned

Beds

Completion

likelihood Type

Abu Dhabi - Not yet allocated/

On or Near Island 828

28 2 General Hospital

31 3 General Hospital

50 2 General Hospital

53 1 Specialized Hospital

54 1 General Hospital

100 10 General Hospital

127 10 General Hospital

150 2 General Hospital

235 1 General Hospital

Al Ain* 228

80 1 General Hospital

50 1 General Hospital

50 1 General Hospital

48 1 Rehabilition Hospital

Western 104

54 1 General Hospital

*50 1 General Hospital

Population density

Source Department of Planning and Economy (2005 Census), Strategy Analysis C23

Population growth, scenarios

Note HAAD and SCAD are collaborating to align figures with official SCAD estimates; Estimates presented here are for internal HAAD use only

Projections for Nationals are rounded to the nearest 2.5% variance between high and low, and those for Expatriates at 5%.

Source 2012 – 2022: SCAD population estimates; additional HAAD assumptions and analysis based on raw insurance data; 2030: UPC 2030 Plan C24

Population growth, scenarios

National Expatriate

Year Low High

2012 445'600 1'966'500 1'989'000

2013 457'200 1'977'500 2'042'000

2014 468'600 1'988'000 2'112'000

2015 479'600 1'997'500 2'187'000

2016 490'500 2'007'000 2'255'500

2017 501'000 2'016'000 2'320'000

2018 511'500 2'024'000 2'381'000

2019 521'500 2'032'000 2'440'000

2020 531'500 2'038'000 2'496'000

2021 541'000 2'044'000 2'551'000

2022 550'500 2'049'000 2'603'0000.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0

2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2030

Po

pu

lati

on

(m

illio

ns)

High

Low

UPC

Demand projections Clinical care volumes (outpatient, inpatient), Beds, Doctors and Nurses

Notes Numbers have been rounded for clarity Assumptions Outpatient weight is 1, Inpatient weight is 10 ALOS remains at the 2011 level of 5.7 in the High scenario and reduces to 5.0 in the Low scenario Bed occupancy remains at the 2011 level of 71% (SEHA figure) in the High scenario and increases to 80% in the Low scenario Outpatients per Doctor remains at the 2011 rate of 2'382 in the High scenario and increases by 10% in the Low scenario. Outpatients per

Nurse remains at the 2011 rate of 1'633 in the High and Low scenarios Churn will remain at the 2011 rate of 17% for Doctors and 11% for Nurses Source HAAD Demand Model 2011, HAAD Licensing Database C25

Additional capacity needs over 10 years

Current 2021 CAGR Absolute Annualised

2011 Low High Low High Low High Low High

Outpatients (m) 11 15 18 3.8 5.6 5 8 .4 .6

Inpatients (000's) 152 205 245 3.1 4.9 53 93 5 7 Including churn

ALOS 5.71 5.00 5.71 -1.3 0.0 0.713- - - -

Occupancy 71% 80% 71% 1.2 0.0 9% 0% - -

Beds 3,700 3,500 5,400 -0.4 4.0 200- 1,700 20- 140 Low High

Doctors 3,500 4,600 5,400 2.7 4.5 1,100 1,900 100 160 800 900

Nurses 7,500 10,800 12,800 3.7 5.5 3,300 5,300 280 410 1,200 1,500

Demand projections based on WHO disease classification

Notes Inpatient Encounters in thousands, Outpatient Encounters in millions Definition CAGR = Compound Annual Growth Rate 2011-2021 Source HAAD Demand Model 2011, Categorization based on WHO classification of diagnoses ICD 9, modified to specify deliveries and RTAs C26

CAGR CAGRLow High Low High

2.7 2.8 0.0 0.0

2.3 3.8 1.3 2.8

7.1 10.8 10.7 14.3

2.4 4.6 4.9 6.5

10.2 15.3 10.9 14.4

3.0 5.1 5.2 7.1

1.1 1.6 3.2 3.5

8.1 10.2 0.6 1.6

1.2 3.2 4.1 5.8

3.2 7.8 5.5 7.7

8.4 9.0 10.7 11.8

1.3 3.2 -0.2 1.4

2.3 4.5 4.6 6.5

0.8 2.6 5.3 7.1

3.6 5.8 12.1 14.8

2.0 4.5 1.7 3.1

0.5 2.4 -0.1 1.6

1.9 3.8 1.3 2.9

0.2 1.8 3.0 4.4

2.8 4.1 4.7 6.4

1.6 2.4 3.8 4.5

1.6 2.8 4.0 5.2

.0

2.0

.5

.6

.0

.6

.3

.3

.6

.6

.2

2.2

1.0

.3

.5

.4

.6

.0

.7

.0

.5

.2

.0

.3

.8

.4

.1

.4

.1

.0

.3

.4

.3

.0

.6

.2

1.0

.1

.0

.0

.2

.0

.2

.1

.0

.4

.5

.2

.0

.2

.0

.0

.2

.2

.1

.4

.3

.1

.4

.1

.1

.0

.1

.0

.1

.0

Outpatients

32

20

8

11

3

8

10

4

7

4

3

6

3

4

3

3

3

3

2

1

1

1

10

5

8

3

6

3

1

5

1

2

4

1

1

0

1

1

0

1

0

0

0

0

1

4

7

3

5

2

1

2

2

3

0

1

1

1

1

1

1

1

0

0

0

0

Deliveries

Signs, symptoms &…

Cardiovascular…

Digestive diseases

Cancer

Genitourinary…

Maternal &…

RTA

Respiratory diseases

Sense organ diseases

Neuropsychiatric…

Respiratory infections

Musculoskeletal…

Endocrine disorders

Diabetes mellitus

Infectious &…

Occupational Injuries

Other Injuries

Skin diseases

Congenital anomalies

Oral conditions

Nutritional…

Inpatients

Demand projections for Doctors by specialty

Notes Demand projections as at 31 Dec 2011. Based on ActivityNet (claimed cost); May include duplicate claims; Total licensed physicians as of 31/12/2011 Source HAAD Demand Model, HAAD Licensing Database, KEH; Strategy analysis C27

General Medicine

Dentistry

Pediatrics

Internal Medicine

Obstetric & Gynecology

General Surgery

Anesthesiology

Radiology

Dermatology & Venerology

Pathology

Family Medicine

Orthopaedic surgery

Ophthalmology

Otolaryngology

Accident & Emergency Medicine

Cardiology

Urology

Psychiatry

Endocrinology & Diabetes Specialists

Gastroenterology

Oral & Maxillofacial surgery

Nephrology

Intensive & Critical care Medicine

Rheumatology

Neurology

Pulmonology

Physical Medicine & Rehabiltation

Cardio/Thoracic surgery

Oncology

Neonatology

Infectious Diesease

Allergy & Immunology

2011 2021 Low 2021 High

2011 2021 Low 2021 High1'756 2'168 3'185

838 1'192 1'825429 459 576337 540 1'060282 433 801282 410 678230 342 606163 242 431147 196 300146 204 342137 214 401135 198 348131 223 465127 143 189

89 109 15882 205 67976 128 26057 147 42041 90 24539 63 12032 46 7132 49 9031 43 7131 58 13127 42 7925 48 11125 30 4223 43 10323 36 6821 36 7518 19 2411 15 26

3 4 65'826 8'176 13'986

General medicine

Dentistry

Pediatrics

Internal Medicine

General Surgery

Obstetric & Gynecology

Anesthesiology

Radiology

Dermatology & Venerology

Pathology

Family Medicine

Orthopaedic surgery

Ophthalmology

Otolaryngology

Accident & Emergency Medicine

Cardiology

Urology

Psychiatry

Endocrinology & Diabetes Specialists

Gastroenterology

Oral & Maxillofacial surgery

Alternative Medicine

Intensive & Critical care Medicine

Nephrology

Rheumatology

Neurology

Pulmonology

Cardio/Thoracic surgery

Physical Medicine & Rehabiltation

Oncology

Neonatology

Infectious Diesease

Allergy & Immunology

Model Planning

Assumptions Recommendations

DRAFT

Patient self-care

Model of care How health services should be used

Source Institute of Medicine 2001 Crossing the Quality Chasm, Bodenheimer et al 2002 JAMA, Department of Health UK 2001 Reforming Emergency Care, Picker Institute, Strategy analysis 11

Remote support

Preventative

Screening

Check-up

Disease management

Non-emergency/elective

Outpatient Clinic

Elective Admission

Emergency

Ambulance

Emergency Admission .

Triage

Urgent Care Centre

ER

Including diagnostics

Population growth, scenarios

Note HAAD and SCAD are collaborating to align figures with official SCAD estimates; Estimates presented here are for internal HAAD use only

Projections for Nationals are rounded to the nearest 2.5% variance between high and low, and those for Expatriates at 5%.

Source SCAD population estimates; additional HAAD assumptions and analysis based on raw insurance data` 73

As at 31 December 2010 Draft

Population growth, Scenarios

National Expatriate

Year Low High

2011 411'200 1'945'000 2'045'000

2012 416'150 1'970'000 2'190'000

2013 422'200 2'060'000 2'350'000

2014 429'400 2'130'000 2'505'000

2015 437'800 2'175'000 2'675'000

2016 445'800 2'250'000 2'850'000

2017 453'600 2'310'000 3'045'000

2018 460'500 2'360'000 3'240'000

2019 467'600 2'400'000 3'400'000

2020 473'600 2'475'000 3'575'000

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Po

pu

lati

on

(m

illi

on

s)

High

Low

DRAFT

For planning purposes, land must be available for hospitals, clinics and ambulance stations to serve anticipated population as per the following guidelines:

Land requirements Guidelines for urban planners

Notes 1Transient population includes staff and other non-residential visitors 2Clinics collectively refers to Clinics, Centers and Polyclinics3Appropriate facilities for co-location with Clinics include Hospitals, Ambulance Stations, Mosques, Neighbourhood Commercial Centres, Sport Facilities, Community/Cultural Centres, Pharmacies, Schools and Post Offices, 4Clinic GFA may be provided within larger commercial centre with adequate transport options and shared parking5 If residential population is less than 60,000 or transient population is less than 180,000, land provision for a hospital facility needs to be made on a site-based analysis which considers the accesibility of existing hospital facilities6Optimal hospital size is 200-600 beds7Appropriate facilities for co-location with Ambulance Stations include Clinics, Hospitals, Civil Defense Stations, Police Stations and Municipal Offices

Source HAAD Health Facility Community Guidelines 2009, Strategy analysis 5

Population (000’s people)

Land provision options Parking(spaces)

Minimum service requirement

Estimated Resources

Residential Transient1 Land area(m2 000’s)

Co-location GFA4

(m2 000’s)

Clinics2 4-5 12-15 6 ? 3 2.5 25 •Primary care•Pharmacy services (on-site or within 10 min walk)•Laboratory service

2 Physicians

8-12 24-36 7 ? 3 3 30 4-6 Physicians

12-30 36-90 8.5 ? 3 3.5 35 7-14 Physicians

30-40 90-120 12 ? 3 4.5 45 15-20 Physicians

Hospitals5 60-80 180-240 80 n/a n/a 3/bed •Emergency services•Laboratory services•Radiology services•Stand-alone building

180-240 Beds6

90-110 270-330 100 n/a n/a 3/bed 270-330 beds6

Ambulance Stations

10-16 30-48 3 ? 7 n/a 10 •Ambulance service (land /air) 1 Ambulance

16-40 48-120 4 ? 7 n/a 15 •Ambulance service (land /air) 2 Ambulances

OR OR OR

Capacity Masterplan

Note: Abu Dhabi and Al Gharbia populations based on SCAD 2005 census. Al Ain population based on 2008 UPC estimate.

Source: Population: SCAD, UPC 2030 plans. Clinicians and Facilities: Licensing database. Planned Facilities ; SEHA, UPC 2030 plans, HAAD Planning analysis.

Capacity Gap

Severe

Moderate

None

Population Facilities Clinicians Ratios 2030 Plan growth 2030 requirements 2030 planned Projects under way

Region District Gap now Type Tota

l

% N

atio

nal

Nat

ion

als

Tota

l

Ho

spit

als

Cli

nic

s

Ne

arb

y

ho

spit

al

Do

cto

rs

Nu

rse

s

De

nti

sts

Oth

er

Fac

ilit

ies

/10

00

0

Do

cto

rs

/10

00

Nu

rse

s

/10

00

Population Growth

Ho

spit

als

req

uir

ed

Cli

nic

req

uir

ed

Ho

spit

als

Cli

nic

s

Ho

spit

als

Cli

nic

s

20

30

Po

pu

lati

on

Abu Dhabi Desert Villages Rural 28,480 #NAME? 10,963 None 81,520 1 110,000

Al Falah Rural 4,028 #NAME? 1,996 None 95,972 1 1 100,000

Ghantoot District Rural 2,478 #NAME? - None 97,522 1 100,000

Abu Dhabi Island Urban 313,809 #NAME? 44,004 229 13 182 2,529 3,878 430 1,284 6.2 8.1 12.4 111,191 425,000

CBD/Financial Centre Urban 174,625 #NAME? 14,141 124 5 86 1,131 1,663 241 539 5.2 6.5 9.5 15,375 1 190,000

Musaffah Urban 141,268 #NAME? 2,256 36 31 161 194 21 68 2.2 1.1 1.4 (41,268) 1 1 3 100,000

Bani Yas Rural 47,245 #NAME? 27,267 43 37 162 106 57 73 7.8 3.4 2.2 22,755 4 70,000

Al Shahama Rural 37,831 #NAME? 16,361 10 10 45 47 14 24 2.6 1.2 1.2 72,169 1 1 1 110,000

Shamkhah Rural 15,839 #NAME? 10,674 None 1 114,161 1 130,000

Al Rahba Rural 15,315 #NAME? 13,038 1 1 132 325 5 89 0.7 8.6 21.2 94,685 1 110,000

New Port City Rural 11,740 #NAME? 4,565 None 1 138,260 2 150,000

Capital District South Urban 9,247 #NAME? 33 None 1 45,753 1 1 55,000

Bain Al Jesrain Urban 7,694 #NAME? 4,927 3 3 33 42 10 17 3.9 4.3 5.5 17,306 1 1 25,000

Khalifa City A Urban 5,317 #NAME? 2,703 11 1 10 78 74 17 75 20.7 14.7 13.9 64,683 1 1 6 70,000

Grand Mosque District Urban 5,257 #NAME? 1,837 None 1 114,743 1 1 120,000

Inner Islands Urban 2,804 #NAME? 480 1 2 4 3.6 0.7 1.4 17,196 1 20,000

Capital District North Urban 2,371 #NAME? 2,121 2 1 1 426 792 36 302 8.4 179.7 334.0 67,629 1 3 70,000

Al Mina Urban 1,070 #NAME? 53 7 4 87 103 25 62 37.4 81.3 96.3 98,930 100,000

Al Raha Urban 827 #NAME? 397 2 1 1 41 42 9 12 49.6 50.8 119,173 1 120,000

Yas Island Urban 776 #NAME? 1 None 99,224 100,000

Mohamed Bin Zayed City Urban 328 #NAME? 95 2 2 1 2 4 2 3.0 6.1 49,672 1 1 4 50,000

Saadiyat Urban 122 #NAME? None 119,878 - 120,000

Airport District Urban 98 #NAME? 32 6 4 8 11 5 11 81.6 112.2 49,902 1 50,000

Lulu Island Urban 75 #NAME? None 19,925 1 20,000

Capital District Urban #NAME? None 240,000 2 240,000

Mohamed Bin Zayed Centre Urban #NAME? None 80,000 1 80,000

South Hudayriat Island Rural #NAME? None 100,000 1 100,000

Marina Village Urban #NAME? 3 2 1 3 6 5,000 5,000

Al Suwwah Urban #NAME? None 30,000 1 1 30,000

Al Reem Urban #NAME? None 200,000 200,000

Al Ain Umm Ghaffa Rural 8,851 #NAME? 5,873 None 3,049 1 1 11,900

Nahel Rural 5,196 #NAME? 2,377 None 4,804 1 1 10,000

Industrial City Rural 48,803 #NAME? 18 8 5 14 5 1 5 1.0 0.3 0.1 30,937 1 1 79,740

Al Salamat/Al Yaher Urban 37,544 #NAME? 23,400 1 1 1 3 1 6 0.3 0.1 0.0 36,456 1 1 2 74,000

Al Dhahra Rural 4,958 #NAME? 715 None 1,042 1 1 6,000

Abu Krayyah Rural 4,108 #NAME? 655 None 892 1 1 5,000

Al Saad Rural 3,829 #NAME? 702 None 1,171 1 1 5,000

Al Araad Rural 3,791 #NAME? 139 None 209 1 4,000

Abu Samra Rural 1,942 #NAME? 286 None 558 1 2,500

Al Ain City Urban 343,002 #NAME? 100,298 186 7 148 1,733 2,864 318 968 4.5 5.1 8.3 364,298 3 8 707,300

Al Quaa Rural 12,512 #NAME? 4,912 1 1 8 13 1 3 0.8 0.6 1.0 10,488 1 1 23,000

Al Wagan Rural 11,865 #NAME? 3,330 1 1 17 29 1 4 0.8 1.4 2.4 18,135 1 1 1 30,000

Al Hayer Rural 11,484 #NAME? 2,570 3 3 25 34 4 3 2.6 2.2 3.0 20,516 1 2 32,000

Al Dhaher Rural 10,641 #NAME? 7,325 1 1 13 20 3 4 0.9 1.2 1.9 3,709 1 1 14,350

Remah Rural 8,187 #NAME? 683 1 1 6 9 2 1.2 0.7 1.1 1,313 1 1 9,500

Sweihan Rural 7,880 #NAME? 713 1 1 8 11 1 1 1.3 1.0 1.4 32,120 1 2 40,000

Al Khazna Rural 7,350 #NAME? 1,071 2 2 4 13 1 2.7 0.5 1.8 1,650 1 1 9,000

Mezyad Rural 6,407 #NAME? 3,809 None 1 1,993 1 1 8,400

Al Shwaib Rural 3,260 #NAME? 1,546 1 1 3 4 3.1 0.9 1.2 2,240 1 1 5,500

Al Fagah Rural 2,089 #NAME? 378 1 1 3 3 4.8 1.4 1.4 1,411 1 3,500

Western Liwa Rural 20,000 #NAME? 661 5 1 1 8 17 5 32 1.0 0.4 0.9 45,000 1 65,000

Madinat Zayed Rural 29,000 #NAME? 6,785 16 2 11 175 256 23 107 4.5 6.0 8.8 11,000 1 1 40,000

Ruwais Rural 16,000 #NAME? 1,270 4 1 3 50 100 7 14 2.5 3.1 6.3 114,000 1 130,000

Mirfa Rural 15,000 #NAME? 3,676 4 1 3 32 61 3 17 2.7 2.1 4.1 60,000 75,000

Ghayathi Rural 8,000 #NAME? 3,898 6 1 5 38 63 5 18 7.5 4.8 7.9 7,000 1 15,000

Sila'a Rural 5,000 #NAME? - 1 1 22 39 2 10 2.0 4.4 7.8 65,000 70,000

Delma Island Rural 5,000 #NAME? 2,139 1 1 23 25 2 10 2.0 4.6 5.0 5,000 1 10,000

C28

Summary

The rapid population growth and development in the Emirate of Abu Dhabi requires careful attention to ensure the availability of suitable healthcare services for the population. This plan accordingly includes guidelines and recommendations for parties who play a key role in ensuring appropriate, quality healthcare services are available to the population in a timely manner:

Urban planners – high level indications of health facility requirements for anticipated populations to ensure that appropriate land is made available for these facilities at the planning phase

Developers – a requirement for healthcare facility developers and operators to be engaged before developments are approved to ensure the new population will have access to appropriate, quality healthcare services in a timely manner

Healthcare investors – to support investors with information regarding health service use, supply and demand and to meet regulatory requirements

Centralised services* – For some clinical services centralisation of patient volumes results in better quality and/or cost-efficiency; such services are typically complex, with low volume. HAAD will designate facilities that will provide such Centralised services.

Regional services* – For certain moderately complex and time-dependent clinical services it is required that these are provided within each Abu Dhabi region. HAAD will limit licenses for such Regional services to 1-5 Providers in each region of Abu Dhabi (based on demand).

Standard services* - The majority of clinical services may be offered by any suitable facility in line with HAAD competency framework (set out in the Abu Dhabi Healthcare Regulations).

Planning recommendations

C29 * Clinical services are specified at the level of DRGs; In emergency situations services designated as Regional or Centralised may be offered by any facility

• Health facility developments must: — Meet HAAD licensing requirements (available at www.haad.ae). — Ensure any designated minimum service requirements set out in the Land

Requirements Guidelines for Urban Planners are met.

• From 2013 Providers intending to provide inpatient services, at DRG level, categorised as Centralised or Regional by HAAD must obtain HAAD approval and (re)licence1 prior to establishing services.

• Additional guidance regarding healthcare capacity and demand projections are available within this document, HAAD’s Health Statistics.

Facility recommendations for developers, investors, and healthcare Providers

1 HAAD is currently amending it’s Licensing process to require submission and approval of all intended services specified at DRG level. C30

• Developers for projects with intended residential populations of 4,000 or more must have engaged a developer and operator for the healthcare facilities within the development

• Developers should notify the Executive Council’s Social Development Sub-Committee of their intended plans (copying UPC) in the context of combining/sharing healthcare facilities with other social infrastructure, e.g., community centers

• Services must be designed and operated in accordance with the Abu Dhabi Healthcare Regulations (available at www.haad.ae)

Service recommendations for investors and developers

C31

For planning purposes, land must be available for hospitals, clinics and ambulance stations to serve anticipated population as per the following guidelines:

Notes 1Transient population includes staff and other non-residential visitors 2Clinics collectively refers to Clinics, Centers and Polyclinics 3Clinics may be co-located with other facilities including Mosques, Neighbourhood Commercial Centres, Sport Facilities, Community/Cultural Centres, Pharmacies, Schools and Post Offices. Ambulance Stations may be co-located with other facilities including Hospitals, Civil Defense Stations, Police Stations and Municipal Offices Where facilities are co-located, adequate transport options and shared parking must be made available.

4 If residential population is less than 60,000 or transient population is less than 180,000, land provision for a hospital facility needs to be made on a site-based analysis which considers the accessibility of existing hospital facilities 5Optimal hospital size is 200-600 beds 6GFA Ground Floor Area Source Strategy analysis C32

Population (000’s people)

Land provision options (m2 000’s)

Parking (spaces)

Minimum service requirement

Estimated Resources

Residential Transient1 Land area Co-located GFA3,6

Clinics2 4-5 12-15 6 2.5 25 •Primary care •Pharmacy services (on-site or within 10 min walk) •Laboratory service

2 Physicians

8-12 24-36 7 3 30 4-6 Physicians

12-30 36-90 8.5 3.5 35 7-14 Physicians

30-40 90-120 12 4.5 45 15-20 Physicians

Ambulance Stations

10-16 30-48 3 1.5 10 •Ambulance service (land /air) 1 Ambulance

16-40 48-120 4 2 15 •Ambulance service (land /air) 2 Ambulances

Hospitals4 60-90 180-270 40 n/a 3/bed •Emergency services •Laboratory services •Radiology services •Stand-alone building

180-270 Beds5

90-110 270-330 80 n/a 3/bed 270-330 beds5

OR OR

Recommendation for allocation of land and service provision

Healthcare services should be provided to meet the following access requirements in relation to routine/elective services and emergency services:

Access requirements

Note Alternative solutions such as air ambulance should be utilised to achieve emergency service access requirements in rural and/or densely populated urban areas

Source Department of Health UK, Strategy analysis

Routine/Elective Emergency services

Urban Primary care services within 20 minutes drive at maximum speed of 60 kph

Ambulance access within 15 minutes, if via land driving at maximum speed of 60 kph

Rural Primary care services within 20 minutes drive at maximum speed of 120 kph

Ambulance access within 19 minutes, if via land driving at maximum speed of 120 kph

C33

Facilities

Population served (000’s)

Land to be provided (m2 000’s)

1 5

1 10 50 5.5 GFA +12 Land plot

1 35

1 12 50 2 GFA + 3 Land plot

1 38

Development is for less than 60k residents, site analysis indicates that Al Rahba Hospital located nearby thus no need to provide hospital facility within development

Case example (planning recommendations)

Source Strategy analysis

Population (000’s people)

Land provision options (m2 000’s)

Residential Transient1 Land area Co-located GFA3

Clinics2 4-5 12-15 6 2.5

8-12 24-36 7 3

12-30 36-90 8.5 3.5

30-40 90-120 12 4.5

Ambulance Stations

10-16 30-48 3 1.5

16-40 48-120 4 2

Hospitals4 60-80 180-240 80 n/a

90-110 270-330 100 n/a

OR OR

Villa and associated community facilities and retail development located adjacent to Al Rahba

Anticipated residential population of 50,000 residents and transient (visitor) population expected to be less than 2,000

C34