Daman sharpens focus on quality of medical treatment

This new system is widely used in other countries and is known as 'Payments by Results' whereby the performance of each provider is assessed according to predefined standards and procedures that will affect the payment system accordingly.

As of January 2010, all hospitals will need to regularly provide standardised information about the clinical results they achieve and at a later stage, the system will be implanted on clinics, and single physician offices.

Providers of in- and out-patient health services who want to remain or become part of Daman's network will initially be required to submit lists of their ten most frequent medical procedures together with case-by-case data reflecting certain data such as: Patient survival, treatment achievement of intended therapeutic goals, need for in-patient or intensive care hospitalisation, patient development of wound- or systemic-infections, and re-visit rates of patients seeking additional treatment of the same diagnosis within 30 days.

The submission of quality data and results by each provider, will determine the reimbursement rates for rendered services. However, unannounced audits of medical records and intensified patient satisfaction surveys will take place to ensure the reliability of the presented data and support the new approach.

"It is our primary responsibility to ensure quality services and value for money to all our customers. Daman's approach is in line with the Government's long-term vision for the healthcare system and matches current reforms in some of the world's leading healthcare systems,"

commented Khaled Al Qubaisi, Chairman of Daman.

"The new payment-by-results1 focus marks the rapid evolution of the Emirate's healthcare system, of which we are proud to be one of the driving forces," Dr. Michael Bitzer, CEO of Daman added. "Our initial approach to quality assurance focused on verifying that network providers fulfil the fundamental standards of healthcare delivery. However, we will now raise the game to reward hospitals and clinics that achieve excellent treatment results while penalising those that do not fully meet healthcare outcomes expectations."

Daman's initial inspection-based A-B-C rating system has now been stopped whereby the new system - 'Payment by Results'- will be implemented before the end of the year on all network hospitals and at a later stage, on all network clinics and single physicians.

"The Health Authority - Abu Dhabi is inspecting all hospitals and clinics very thoroughly and outstanding facilities are seeking additional independent quality certifications. This will add to our focus on our core business as a specialised health insurer, and will ensure that our members gain access to اproviders that achieve the best results at reasonable prices," Dr. Michael Bitzer added.