Qatar Report




An assessment of
healthcare delivery


 
 Abstract

Aim
To assess health care delivery system in the State of Qatar and audit it according to the Joint Commission International (JCI) standard.

Methods
The data for this retrospective descriptive study were taken from the Annual Health Report of the National Health Authority and Hamad Medical Corporation and various additional sources like World Health Organization reports, Annual Report of Saudi Arabia, and Compendium of Health Statistics, UK. Population per physician, per general practitioner, and per hospital bed, and nurses per physician ratio were calculated.

Results
In 2008, the population per physician in Qatar was 444; the population per general practitioner (GP) was 949; the population per hospital bed was 716; and nurses per physician ratio was 2.6. During the last decade, the population of Qatar has more than doubled, which has resulted in a similar increase in the number of health care providers; moreover, many initiatives launched in cooperation with internationally recognized institutions have greatly improved the quality of the health service. The weighted mean number of visits for 100 population was calculated for the UK and Qatar, taking into consideration the difference in age and sex structure. After comparison with the UK data, population/GP ratio for Qatar should be 1193.

Conclusion
The Qatar health system has improved in the last decade, but there is still the need for more medical workers in primary health care.

Inequitable geographic distribution of health care resources has long been recognized as a worldwide problem (1-9). Sufficient human resources are clearly a prerequisite for adequate health care. In turn, health care is one of the determinants of population health along with socioeconomic, environmental, and behavioral factors(1).

Most surveys show that patients are satisfied with the general practice care they receive, but often perceive that the consultations are too short and that physicians do not use them well(2). Generally, it is not easy to compare specialist and primary care load and performance, since consultations about psychosomatic and behavioral problems last longer than those about other problems( 2). The length of consultations is a frequent patients’ concern. However, it can be used as a marker for quality of consultations in health care assessment(2).

The aim of this study was to examine the provision of health services in the State of Qatar with a special emphasis on primary health care and to compare it with that in other low, medium, and high income countries.

Methods

The data used for this study were taken from the Annual Health Report of the Ministry of Public Health and Hamad Medical Corporation and published in the Annual Health Report 2008(3). This report contains population and vital statistics, leading causes of death, health care expenditures, hospital services, number of medical staff per 100,000 population, hospital beds available per 100,000 population, population per bed, population per pharmacist, population per nurse, and general family health services in Qatar. Additional data were obtained from various sources, including Government Health Statistics, National Health Authority and Annual Health Report 2008(2), Compendium of Health Statistics in UK(4), and World Health Organization Human Resources for Health and Development Estimates of Health Personnel(5-7). Also, Health Statistics for Arabian Gulf States and Western Countries were taken from the World Health Organization Statistics Report(8) and World Bank Report (2004)(9). Results

The State of Qatar is situated on a 160 km-long peninsula on the western coast of the Arabian Gulf. It occupies a total area of 11,493 km2, including the islands. The estimated population in 2008 was 1,448,449 (75.72% men and 24.28% women), 70% of which were expatriates. By wisely using the revenues from oil and gas, Qatar has built a sophisticated social and health infrastructure. The investment in health and social development has resulted in dramatic gains in the health and well-being of the people. The proportion of health expenditure excluding private sector was 3.1% of GDP.


Table 1 shows some selected health indicators and health services in Qatar. In 2008, the population per physician was 444, population per GP was 949, and population per hospital bed was 716. Road traffic accidents and poisoning were ranked as the number one cause of death (22.4%). The infectious disease with the highest incidence rate per 10,000 was chicken pox (39.07%). The population per physician (1:444) was very close to that in the UK (1:417), a representative of economically developed countries.

In the period from 2000-2008, the population of Qatar increased from 578,500 to 1,448,499(3). The increase in population reflected in a greater demand for physicians, which explains the rise in the number of health care providers from 4,707 (1.48 health care providers per 1,000 population) to 11,949 (2.24 health care providers per 1,000 population). In addition to the growing number of health care professionals, numerous new internationally recognized institutions have launched their initiatives in Qatar, thus considerably improving the quality of the health care system in the country. Table 2 shows some selected health services indicators for various low, middle, and high income countries. It is clear that the European countries and the US generally have better population/physician and population/beds ratios than various Arab, Gulf Cooperation Council, and Middle East countries.

Discussion

We estimated the ratios of health services delivery and utilization in Qatar, which was an extremely difficult task due to a lack of reliable data. Underdeveloped nations have a low physician/population ratio – 1:10000 in the Philippines, 1:7143 in Sri Lanka, 1:1667 in Tunisia, and 1:1429 in Pakistan. Oil-rich countries have somewhat higher ratio – 1:667 in Kuwait, 1:714 in Saudi Arabia, 1:769 in Oman, and 1:625 in Bahrain, but still lower than the developed nations – 1:182 in the USA, 1:303 in Germany, and 1:333 in Sweden(8,10). However, the ratios do not always correlate directly with development; Cuba has physician/population ratio 1:439 and Egypt 1:476. We may note that physician/population ratios do not differ among various specialties and cannot accurately show whether there is an overor undersupply of physicians. For example, in the USA it is generally acknowledged that there is an oversupply of surgeons and if these physicians are included in the physician/population ratios, the delivery of general health care seems better than it actually is(8,10).

Various internationally accredited recognized institutions have contributed to the improvement of Qatar’s Health Care System over the last decade. For instance, the Pasteur Institute, Imperial College, the University of Pittsburgh, Weill Cornell Medical College, Heidelberg University Hospital, and Mayo Clinic have all contributed to the improvement of the clinical, laboratory, diagnostic, and research facilities in Qatar. Moreover, the Joint Commission International accreditation which began in 2005, has greatly improved the quality of health care management(11,12).

Longer consultations are associated with better quality of care for patients with chronic conditions; a more recent study from Qatar(2) reported that the consultation length with GP was 6.6 minutes per patient per year (Table 1). This means that in 40 weeks with 6 working days, a primary care physician in Qatar sees 69 patients per shift or 9 per hour. Many studies agree that consultations shorter than 10 minutes do not have a significant effect on health promotion(2). In British general practice, the consultation time averaged 9.4 minutes(4) and in the United States 13 minutes(2).

The number of primary health care workers is still very low in Qatar (8.9%). Over 76% of physicians work in tertiary care and since postgraduate training is not well developed, these are almost entirely in non-training grades (8.9%). In wealthier countries, such as Australia and the UK, this percentage is much higher (43% and 40%, respectively).

It seems that a health service based on the principles of primary health care ought to take into account the parameters which reflect the care given to individuals at the health center level: 1) the population served by a family physician (GP); 2) the number of the primary health care workers and the education and seniority of the primary health care medical workforce. Finally, international Collaboration and JCI accreditation have improved the quality of health care in Qatar in the last decade.

The Authors

Abdulbari Bener and Ahmed Al Mazroei

1 Department of Medical Statistics and Epidemiology, Hamad General Hospital, Hamad Medical Corporation, Weill Cornell Medical College, Doha, State of Qatar

2 Evidence for Population Health Unit, School of Epidemiology and Health Sciences, The University of Manchester, Manchester, United Kingdom

3 Executive Director Facilities Development Division, Hamad Medical Corporation, Doha, State of Qatar

- Correspondence to:

Abdulbari Bener Department of Epidemiology and Medical Statistics Hamad Medical Corporation Weill Cornell Medical College PO Box 3050 Doha, State of Qatar abener@hmc.org.qa

Copyright

This Open Access article was originally published in Croat Med J. 2010 February; 51(1): 85–88. doi: 10.3325/ cmj.2010.51.85 © 2010 by the Croatian Medical Journal. All rights reserved. PMCID: PMC2829183

It is republished here under the Creative Commons Attribution License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

References

1. Dussault G, Dubois CA. Human resources for health policies: a critical component in health policies. Available from: http://www.human-resourceshealth.com/content/1/1/1 . Accessed: January 8, 2010.

2. Bener A, Almarri S, Ali BS, Aljaber K. Do minutes count for health care? Consultation length in general practice. Middle East Journal of Family Medicine. 2007;5:3–8.

3. Annual Health Report. Vital health statistics. Doha: Hamad Medical Corporation; 2008.

4. Yuen P. Office of Health Economics. Compendium of health statistics. 19th ed. London: Radcliffe Medical Press; 2008.

5. Reducing risks, promoting healthy life. World Health Report. Geneva (Switzerland): World Health Organization; 2004.

6. World Health Organization. Human Resources for Health and Development Estimates of health personnel. 2004. Available from: http://www.humanresources-health.com/ Accessed: January 15, 2010.

7. Hongoro C, McPake B. How to bridge the gap in human resources for health. Lancet. 2004;364:1451–6. doi: 10.1016/S0140-6736(04)17229-2. [PubMed] [Cross Ref]

8. World Health Organization. Statistical report. 2004. Available from: http://www.who.int/whr/2004/annex/en/index.html  Accessed: January 15, 2010.

9. World Bank. Report for the year 2004. Available from: http://web.worldbank.org/ external/default/main?entityID=00009034 1_20031007150121&theSitePK=477688 &contentMDK=20283204&menuPK=47 7696&pagePK=64167689&piPK=64167 673. Accessed: January 15, 2010.

10. World Health Organization. World Health Report. 2007. Available from: http://www.who.int/whr/2007/en/index.html. Accessed: January 15, 2010.

11. AMEinfo.com. Hamad Medical Corporation globally recognized. 2007. Available from: http://www.ameinfo.com/108288.html. Accessed: January 17, 2010.

12. Hamad Medical Corporation News Site. JCI Reaccreditation Success for HMC. 2009. Available from: http://www.hmc.org.qa/hmcnewsite/news.aspx?id=613
 

Ebn Sina Medical celebrates 40th anniversary



Since its foundation in 1971, Ebn Sina Medical, branch of Aamal Q.S.C. has maintained a pioneering position in the medical and healthcare sector in Qatar. Ebn Sina Medical specialises in the distribution and marketing of pharmaceuticals, medical equipment, hospital sundries, dental, laboratory and diagnostics as well as skin care, foot care and medicated cosmetics. It represents a considerable number of the world’s leading names in the sector. Ebn Sina’s wholesale activities are carried out through a purpose-built warehouse and distribution centre which is staffed by qualified professionals and equipped with the latest in storage, preparation and distribution systems. On the retail side, Ebn Sina Medical manages a network of six modern pharmacies, two foot care centres and one Bottega Verde shop. All outlets are situated in key locations in Doha offering customers excellent services in all aspects of general health and wellbeing.

“Ebn Sina Medical always considers itself as a strategic partner in developing the health sector of Qatar, following the inspiration from H.H. the Emir’s vision for 2030,” Eman Bader, general manager of Ebn Sina Medical said un reference to company’s participation at Qatar Health 2010 as the main sponsor of the event. Ebn Sina Medical, in cooperation with its partners, presented the most innovative and up-to-date products and technologies. The company introduced different medicines for cancer treatment as well as the latest technology in wound care management which help patients with less pain during dressing change and significantly faster healing. In the radiology sector, Ebn Sina Medical showcased the newest technologies in medical imaging, particularly the future use of cellular and molecular imaging.

In the field of consumer health, Ebn Sina Medical showcased unique oral care products from leading brands like Gum and WaterPik, as well as innovative products like a chair massager and foot invigorator from Scholl.

Skin care lines presented at Qatar Health 2010 included NUXE, Collin, BcomBIO, Tyra and Placentor among others. Ebn Sina Medical is well-known for its selected international brands offering customers a variety of unique product lines.

Qatar Health 2010 was fitting venue and occasion to launch the company’s 40th birthday celebrations. This significant milestone for the organisation is celebrated throughout the year with several activities.

 

Shafallah Medical Genetics Center

Towards the delineation of previously unknown inherited autosomal recessive disorders and the identification of the responsible genes Congenital Malformations and Mendelian Diseases are currently recognised as the principal cause of infant mortality in the United Arab Emirates, and the second leading cause in Bahrain, Kuwait, Oman and Qatar. Mendelian monogenic diseases result from modifications in a single gene occurring in all cells of the body. Though relatively rare, they affect approximately 10/1000 of the population worldwide. It tends to have serious clinical manifestations, high morbidity and early mortality, and primarily affect the paediatric population. The single gene or monogenic diseases can be classified into three main categories; autosomal dominant; autosomal recessive; and X linked. Autosomal recessive diseases are the single largest category of single gene disorders. Recessive diseases occur due to mutation in both gene copies, or alleles. Parents of children with autosomal recessive disorders are almost always carriers. Furthermore, It is noted that an unusually high number of patients with autosomal recessive disorders born to consanguineous parents. A consanguineous marriage is most commonly defined as a union between a couple related as second cousins or closer. In theory, first cousins share 1/8 of all their alleles, and second cousins share 1/32 of all their alleles. Descendants of consanguineous parents inherit half of these common alleles. The assembly of two rare mutated alleles is therefore more frequently observed in descendants from consanguineous parents compared to descendants from unrelated parents. The prevalence of consanguineous marriage in the Middle Eastern countries including Qatar is relatively high. This inevitably leads to an increase in the rate of homozygotes for autosomal recessive genetic disorders.

Several publications on genetic disorders among Arab populations list more than a hundred new genetic syndromes reported over the past two decades. Of these, about 85% syndromes are autosomal recessive. Many of these disorders are yet to be defined. The number of causative genes for autosomal recessive disorders that are yet to be discovered is most likely in the thousands.

One of the current research projects at the Shafallah Medical Genetics Center (SMGC) is the delineation of previously unknown inherited autosomal recessive disorders and the identification of the responsible genes and the genetic variations that contribute to the risk of developing these syndromes, as well as the study of their function. The strategy of choice for identification of these genes is homozygosity mapping in extended consanguineous families, followed by mutation screening of candidate genes. This study is of considerable consequence. It provides the means for the discovery of new and specific tests that will help with carrier identification, counselling, and prenatal or preimplantation diagnosis. Besides its direct scientific significance, this study allows for the establishment of high calibre bench research techniques in laboratories within a Qatari institution. It provides valuable opportunities for capacity building in the fields of disease related human genetics. The study plan allows for the development of scientific and technical skills by providing experience in molecular biology techniques, as well as guidance toward scientific thinking to a group of young trainees, students and technical staff.

 

College of the North Atlantic

College of the North Atlantic – Qatar Celebrates Second Program Accreditation

College of the North Atlantic – Qatar’s School of Health Sciences was recently awarded Provisional Accreditation by the Canadian Council for Accreditation of Pharmacy Programs (CCAPP). This status, the highest accreditation level possible, was granted to the Pharmacy Technician Program and is the first and only International Accreditation awarded by CCAPP.

The two year process culminated with an on-site visit by the Canadian accreditation team in December 2010 after which they provided an overwhelmingly positive verbal report where they stated that CNA-Q’s Pharmacy Technician program could be rated amongst the best in Canada.

This is the second accreditation for the School of Health Sciences in the past six months. In October 2010, the Respiratory Therapy program was accredited by the Council on Accreditation for Respiratory Therapy Education (CoARTE). As with the Pharmacy Technician program, the accreditation is the first international accreditation granted by CoARTE.

“These accreditations attest to many great things going on at CNA-Q. It attests to our facilities and equipment which are second to none; to our industry responsive curriculum and programs; to the dedication and expertise of faculty and staff of CNA-Q; to our great partnerships with private sector partners and of course it attests to the quality of our students,” said Dr. Ken MacLeod, President, College of the North Atlantic – Qatar.

 

University of Calgary – Qatar provides world class training for nurses

The University of Calgary – Qatar has been offering a Bachelor of Nursing Degree programme in Doha for almost five years. It turned out its first batch of nursing degree graduates in 2010, enriching the Qatar healthcare system with 24 highly trained nurses.

There are 111 students presently enrolled at the university, 26 of which are Qatari. Part-time studies and preparatory foundation programmes are being offered with the regular nursing programme and a post diploma bachelor of nursing programme at the Canadian university.

“We’re very pleased with the growth in our student population. It illustrates the popularity and respect the nursing profession is experiencing in Qatar,” said Dr Carolyn Byrne, Dean and CEO, University of Calgary – Qatar.

A part-time Studies Program was started early in 2011. It allows nurses who are working in the healthcare system in Qatar to upgrade their credentials to a nursing degree.

UCQ’s high-tech Clinical Simulation Learning Centre (CSLC) is equipped with some of the most sophisticated teaching resources available world-wide. A family of highfidelity simulators that mimic the anatomical workings of a human body are available to students. Every possible medical scenario from critical and acute care to maternity and newborn assessments is created. The students are able to provide treatment and care without fear of mistakes. It helps build confidence that becomes invaluable in real life. The scenarios are recorded and debriefing sessions are held giving students feedback on their care-giving decisions and technique.

UCQ has received over US$1 million in research funding. Through the generosity of the State of Qatar residents will benefit from the discoveries made in a variety of subjects including breast cancer screening practices of Qatari women, breast feeding practices and strengthening primary healthcare nursing in Qatar.

 Dbsp;DDate of upload: 10th Jul 2011

 

                                  
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