Direct Access to Dietitian Services in Dubai's Private Ambulatory Care: Multi-Stakeholder Insights and Implications for Chronic Disease Management.

BACKGROUND

Non-communicable diseases (NCDs) such as diabetes and cardiovascular disorders are rising in the UAE, requiring cost-effective, preventive strategies. Nutrition interventions led by dietitians have demonstrated clinical and economic value in managing chronic conditions. However, access to these services remains restricted in Dubai's private ambulatory care due to insurance, referral, and recognition barriers. This study was conducted to assess the perceived value, accessibility, and reform potential of dietitian services in Dubai's private sector, with a specific focus on the feasibility and impact of direct patient access to dietitians without physician referral.

METHODS

A cross-sectional mixed-methods study surveyed four stakeholder groups - physicians (n=22), dietitians (n=35), outpatients (n=43), and insurance professionals (n=21). Quantitative data evaluated service utilization, referral trends, satisfaction, and outcomes, while qualitative responses captured barriers and reform recommendations. Descriptive and thematic analysis methods were used.

RESULTS

Sixty percent of patients accessed dietitians without a physician referral, while 35% were self-referred. Key barriers included lack of insurance coverage (48-65%), referral delays, and undervaluation of dietitians. However, 85% of patients expressed satisfaction, and 78% reported improved health outcomes. Stakeholders recognized direct access as a potential strategy to reduce hospitalizations, lower medication usage, and improve preventive engagement.

CONCLUSION

Direct access to dietitian services offers a viable, evidence-based reform for enhancing chronic disease management and reducing healthcare costs in Dubai's private sector. To unlock these benefits, policy reforms must address insurance coverage, professional integration, and systematic outcome tracking.