Utilization of Outpatient Services by Elderly in Dubai: Evidence for Policy Makers and its Implication for Health System

Abstract

The purpose of the study is to analyze and describe the patterns of outpatient health services by those aged 65 years and older (elderly) in Dubai. We identified patient characteristics and clinical diagnoses associated with outpatient visits on a national level. Dubai database of utilization of outpatient care visits by elderly in 2012 was obtained. The study is based on analysis of this secondary data collected by DHA and published in the Dubai Health Authority Report in 2012. The information recorded on the database includes patient demographics (age, sex, and nationality), health facility type (private, public), and clinical diagnosis (department or disease category). We then analyzed the patterns and frequency of visits by patient age, sex, nationality, and primary diagnosis in both the private and governmental sectors. Dubai’s annual age-adjusted crude visit rate of 4.4 visits per capita is low compared with an average of 6.3 in Organization for Economic Co-operation and Development (OECD) countries. The nationals visit rate was 8 visits per year compared to 3 for expatriates. In nationals, females have higher visit rate, while males have higher visit rate in expatriates. Females have higher visit rate in the governmental sector (DHA), while there was no significant difference in the visit rate between males and females in the private sector. The annual age-specific visit rate of outpatient services for elderly was about 27.5 visits per capita. The annual age-sex specific visit rate of outpatient services for elderly males was about 30 visits per capita (one visit every 15 days). The annual age-sex specific visit rate of outpatient services for elderly females was about 26 visits annually per capita (one visit every 12 days). The three most frequent principal diagnoses of elderly outpatient visits in private sector were diseases of the respiratory system (14 %), and diseases of the musculoskeletal system (12.6 %) and Endocrine, nutritional, metabolic diseases (11.3 %), respectively. The unclassified signs and symptoms constituted about 12 %. The three most frequent principal diagnoses of elderly outpatient visits in DHA were diseases related to family medicine (37 %); accidents and emergency (10.6 %); and endocrine, nutritional, and physical and medical rehabilitation (10 %), respectively. Elderly group was a small group of high users who consume a disproportionate share of outpatient care services. Although they represent about 0.5 % of the Dubai population, elderly account for approximately 5 % of all outpatient visits. Health promotion and preventive policies to elderly patients with these chronic diseases are urgently needed to address these numbers. Preventive services should focus on endocrine, circulatory, respiratory, and musculoskeletal diseases, which accounted for nearly one-half of the primary diagnoses of elderly outpatient visits. There may be a need to substantially increase in health care resources for geriatric care in the near future and shift towards home care.