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1.1 Orígenes de una disciplina y una teoría sobre diseño

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Model of Care

Capacity Gaps

Assumptions

Recommendations

DRAFT

Patient self-care

Model of care How health services shouldbe used

SourceInstitute 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

AdmissionElective

Emergency

Ambulance

Emergency

Admission .

Triage

Urgent Care

Centre

ER

Including diagnostics

Population growth, scenarios

NoteHAAD 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

P

op

u

la

ti

o

n

(m

ill

io

ns)

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 Polyclinics

3Appropriate 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 parking 5 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 facilities

6Optimal hospital size is 200-600 beds

7Appropriate 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

ResidentialTransient

1

Land area

(m

2

000’s)

Co-locationGFA

4

(m

2

000’s)

Clinics

2

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

Hospitals

5

60-80

180-240

80

n/a

n/a

3/bed

•Emergency services

•Laboratory services

•Radiology services

•Stand-alone building

180-240

Beds

6

90-110

270-330

100

n/a

n/a

3/bed

270-330

beds

6

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 growth2030 requirements 2030 plannedProjects under way

RegionDistrict Gap nowType To

tal % N ational Natio nal s To tal Hospi tals ClinicsNearby

hospi talDoctors Nurse sDentists Oth er Fac ilities /1 0000 Doctors /1 000 N urse s /1

000 Population GrowthHospitals required Clinic required

Hospi tals Clinics Hospi tals Clinics 2030 Po pula tion

Abu DhabiDesert Villages Rural 28,480#NAME? 10,963None 81,520 1 110,000 Al Falah Rural 4,028#NAME? 1,996None 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? 10,674None 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? 4,565None 1 138,260 2 150,000 Capital District South Urban 9,247#NAME? 33None 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? 1,837None 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? 1None 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 AinUmm Ghaffa Rural 8,851#NAME? 5,873None 3,049 1 1 11,900 Nahel Rural 5,196#NAME? 2,377None 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 11 3 1 6 0.3 0.1 0.0 36,456 1 1 2 74,000 Al Dhahra Rural 4,958#NAME? 715None 1,042 1 1 6,000 Abu Krayyah Rural 4,108#NAME? 655None 892 1 1 5,000 Al Saad Rural 3,829#NAME? 702None 1,171 1 1 5,000 Al Araad Rural 3,791#NAME? 139None 209 1 4,000 Abu Samra Rural 1,942#NAME? 286None 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 11 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? 3,809None 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 WesternLiwa 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

Capacity

Management

Demand & Supply

Projections

Current and projected demand, by Episodes and beds

C17

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. Sub acute numbers of beds adjusted

Source:TAHPI, Health Facility briefing system, reference data is based on data extracted from the Australian Institute of Health and Welfare, supplemented by data from the USA inpatient sample and UK Hospital Episode Statistics Online (HES)

AssumptionsProjected 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. Sub acute number of beds adjusted to meet international benchmark

Bed Occupancy

2011 Actual

2016

2021

2026

2031

Acute Overnight

Episodes

122,345 184,102 223,539 276,589 332,040

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

Episodes

N/A 3,216 4,233 5,461 6,738

Sub Acute Overnight

Beds

224 342 438 449 525

ICU beds

146 175 209 245 281

Emergency Bays

N/A 789 987 1,182 1,379

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