Alnakhi Wafa K, Segal Jodi B, Frick Kevin D, Hussin Altijani, Ahmed Saifuddin, Morlock Laura
1Department of Health Policy and Management Bloomberg School of Public Health, Baltimore, USA.
2School of Medicine Johns Hopkins University, Baltimore, USA.
Trop Dis Travel Med Vaccines. 2019 Jul 2;5:10. doi: 10.1186/s40794-019-0086-8. eCollection 2019.
Each year, the Dubai Health Authority (DHA) spends millions of dollars to cover the costs of United Arab Emirates (UAE) nationals seeking healthcare overseas. Patients may travel overseas to seek an array of treatments. It is important to analyze the number of trips and treatment destinations for patients travelling overseas to provide baseline information for the DHA to improve polices and strategies related to overseas treatment for UAE nationals.
Administrative data were obtained from the DHA for UAE nationals who sought medical treatment overseas during 2009-2016. We examined the number of trips and treatment destinations by medical specialty, age, gender, years of travel and travel seasons. Multinomial logistic and negative binomial regression models were used to assess the relationships of the treatment destinations and number of trips, respectively, with the key variables of interest.
The study included data from 6557 UAE nationals. The top three treatment destinations were Germany (46%), the UK (19%) and Thailand (14%). The most common medical specialties were orthopedic surgery (13%), oncology (13%) and neurosurgery (10%). Oncology had the highest expected number of trips adjusted for a number of covariates (IRR 1.34, 95% CI: 1.24-1.44). Regarding destination variation, patients had a lower relative risk ratio of seeking healthcare in Germany in the winter (RRR 0.68, 95% CI: 0.57-0.80). Endocrinology was the most common medical specialty sought in the UK (RRR 3.36, 95% CI: 2.01-5.60).
This is the first study to systematically examine the current practice of medical treatment overseas among UAE nationals. The results demonstrate that treatment destinations, medical specialties for which treatment was sought, age, gender and travel season are significant factors in understanding overseas travel for medical care. The study can guide the DHA in collecting more data for further research that may lead to policy-relevant information about sending patients to the best-quality treatment choices at an optimal cost.
每年,迪拜卫生局(DHA)花费数百万美元用于支付阿拉伯联合酋长国(UAE)国民在海外寻求医疗服务的费用。患者可能会前往海外寻求一系列治疗。分析海外就医患者的出行次数和治疗目的地很重要,以便为DHA提供基线信息,以改进与阿联酋国民海外治疗相关的政策和策略。
从DHA获取了2009年至2016年期间在海外就医的阿联酋国民的行政数据。我们按医学专科、年龄、性别、出行年份和出行季节检查了出行次数和治疗目的地。分别使用多项逻辑回归和负二项回归模型来评估治疗目的地和出行次数与感兴趣的关键变量之间的关系。
该研究纳入了6557名阿联酋国民的数据。排名前三的治疗目的地是德国(46%)、英国(19%)和泰国(14%)。最常见的医学专科是骨科手术(13%)、肿瘤学(13%)和神经外科(10%)。在调整了多个协变量后,肿瘤学的预期出行次数最高(发病率比值比1.34,95%置信区间:1.24 - 1.44)。关于目的地差异,患者在冬季前往德国寻求医疗服务的相对风险比更低(相对风险比0.68,95%置信区间:0.57 - 0.80)。内分泌学是在英国寻求治疗的最常见医学专科(相对风险比3.36,95%置信区间:2.01 - 5.60)。
这是第一项系统研究阿联酋国民当前海外就医情况的研究。结果表明,治疗目的地、寻求治疗的医学专科、年龄、性别和出行季节是理解海外就医出行的重要因素。该研究可为DHA指导收集更多数据以进行进一步研究提供帮助,这可能会得出有关以最佳成本将患者送往最优质治疗选择的与政策相关的信息。