Alnaif Mohammed S
Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, PO Box 10219, Riyadh 11433, Kingdom of Saudi Arabia.
Saudi Med J. 2006 May;27(5):693-9.
To assess physicians views on health insurance and its implication on the health care system.
We carried out a cross-sectional study in 2 major hospitals in Riyadh, Kingdom of Saudi Arabia. Data were collected from January to December 2002 through self-administered questionnaires that were distributed to a total sample of 400 physicians. The instrument consisted of 28 items that focused on assessing physicians' perception towards health insurance and its effect on health services. We performed a descriptive statistics and analysis of variance using the Statistical Package for Social Sciences.
Overall, 151 physicians (38%) completed the survey. This study clearly shows that access to health care services is a major concern; more than 94% of the respondents agree that everyone in the Kingdom should have access to healthcare services. Respondents also agree that health insurance will improve access to healthcare services for all citizens. Physicians also believed that health insurance would lead to more regulations and utilization review of services, create more competition between healthcare providers, and create new jobs in the healthcare sector. Saudi physicians reported a higher mean score for 11 items with significant p-values as compared with non-Saudi physicians.
Physicians in this survey believed that accessibility is a major policy concern, and that health insurance will have a positive effect on access to the health care system. Yet, accessibility is an illusive term with many aspects that go beyond the identification of need for health care to the actual delivery of health care services and the organizational structures to match the needs of society. Cooperation as a national health system should be built on collaborative efforts rather than market competition in itself. It has been suggested that markets are stronger in the role of delivery than in the financing of health care, that markets tend to promote more expenditure on technological innovation rather than producing the most desired set of social outcomes. Cooperative health insurance can be an answer to the current problems facing the health care system in the Kingdom of Saudi Arabia as long as it remains cooperative rather than competitive.
评估医生对医疗保险及其对医疗保健系统影响的看法。
我们在沙特阿拉伯王国利雅得的两家主要医院开展了一项横断面研究。2002年1月至12月期间,通过自行填写的问卷收集数据,共向400名医生发放问卷。该问卷包含28个项目,重点在于评估医生对医疗保险的认知及其对医疗服务的影响。我们使用社会科学统计软件包进行描述性统计和方差分析。
总体而言,151名医生(38%)完成了调查。这项研究清楚地表明,获得医疗保健服务是一个主要问题;超过94%的受访者认为沙特王国的每个人都应能获得医疗保健服务。受访者还一致认为医疗保险将改善所有公民获得医疗保健服务的机会。医生们还认为医疗保险将导致对服务的更多监管和使用审查,在医疗服务提供者之间创造更多竞争,并在医疗保健部门创造新的就业机会。与非沙特医生相比,沙特医生在11个项目上的平均得分更高,p值具有显著性。
本次调查中的医生认为可及性是一项主要的政策关注点,且医疗保险将对获得医疗保健系统产生积极影响。然而,可及性是一个难以捉摸的术语,它有许多方面,不仅涉及对医疗保健需求的认定,还包括实际提供医疗保健服务以及与社会需求相匹配的组织结构。作为国家医疗保健系统,合作应建立在协作努力而非市场竞争本身的基础上。有人认为,市场在医疗保健服务提供方面的作用比在融资方面更强,市场往往会促使在技术创新上支出更多,而不是产生最理想的一系列社会成果。只要保持合作而非竞争,合作性医疗保险可以成为沙特阿拉伯王国医疗保健系统当前面临问题的一个解决方案。