在沙特阿拉伯，参保男性侨民对健康保险福利的了解程度与无法获得医疗保健之间的关联。
The association between insured male expatriates' knowledge of health insurance benefits and lack of access to health care in Saudi Arabia.
机构信息
College of Health Sciences, Saudi Electronic University, PO Box 15271, Riyadh, 11444, Saudi Arabia.
出版信息
BMC Public Health. 2018 Mar 15;18(1):354. doi: 10.1186/s12889-018-5293-0.
BACKGROUND
Insufficient knowledge of health insurance benefits could be associated with lack of access to health care, particularly for minority populations. This study aims to assess the association between expatriates' knowledge of health insurance benefits and lack of access to health care.
METHODS
A cross-sectional study design was conducted from March 2015 to February 2016 among 3398 insured male expatriates in Riyadh, Saudi Arabia. The dependent variable was binary and expresses access or lack of access to health care. Independent variables included perceived and validated knowledge of health insurance benefits and other variables. Data were summarized by computing frequencies and percentage of all quantities of variables. To evaluate variations in knowledge, personal and job characteristics with lack of access to health care, the Chi square test was used. Odds ratio (OR) and 95% confidence interval (CI) were recorded for each independent variable. Multiple logistic regression and stepwise logistic regression were performed and adjusted ORs were extracted.
RESULTS
Descriptive analysis showed that 15% of participants lacked access to health care. The majority of these were unskilled laborers, usually with no education (17.5%), who had been working for less than 3 years (28.1%) in Saudi Arabia. A total of 23.3% worked for companies with less than 50 employees and 16.5% earned less than 4500 Saudi Riyals monthly ($1200). Many (20.3%) were young (< 30 years old) or older (17.9% ≥ 56 years old) and had no formal education (24.7%). Nearly half had fair or poor health status (49.5%), were uncomfortable conversing in Arabic (29.7%) or English (16.7%) and lacked previous knowledge of health insurance (18%). For perceived knowledge of health insurance, 55.2% scored 1 or 0 from total of 3. For validated knowledge, 16.9% scored 1 or 0 from total score of 4. Multiple logistic regression analysis showed that only perceived knowledge of health insurance had significant associations with lack of access to health care ((OR) = 0.393, (CI) = 0.335-0.461), but the result was insignificant for validated knowledge. Stepwise logistic regression gave similar findings.
CONCLUSIONS
Our results confirmed that low perceived knowledge of health insurance in expatriates was associated with less access to health care.
背景
对健康保险福利的了解不足可能会导致无法获得医疗保健，尤其是对于少数族裔群体。本研究旨在评估外籍人士对健康保险福利的了解程度与无法获得医疗保健之间的关系。
方法
这是一项在 2015 年 3 月至 2016 年 2 月间进行的横断面研究，研究对象为沙特阿拉伯利雅得的 3398 名参保男性外籍人士。因变量为二分类变量，表示是否能够获得医疗保健。自变量包括感知和验证的健康保险福利知识以及其他变量。通过计算所有变量的频率和百分比来汇总数据。为了评估知识、个人和工作特征与无法获得医疗保健之间的差异，采用了卡方检验。记录了每个自变量的优势比（OR）和 95%置信区间（CI）。进行了多元逻辑回归和逐步逻辑回归，并提取了调整后的 OR。
结果
描述性分析显示，15%的参与者无法获得医疗保健。这些人中的大多数是没有技能的工人，通常没有受过教育（17.5%），在沙特阿拉伯工作不到 3 年（28.1%）。共有 23.3%的人在员工人数少于 50 人的公司工作，16.5%的人每月收入低于 4500 沙特里亚尔（1200 美元）。许多人（20.3%）年龄较小（<30 岁）或较大（17.9%≥56 岁），没有接受过正规教育（24.7%）。近一半的人健康状况一般或较差（49.5%），不擅长用阿拉伯语（29.7%）或英语（16.7%）交流，并且对健康保险缺乏了解（18%）。对于感知到的健康保险知识，55.2%的人在总分 3 分中得分为 1 或 0。对于验证的健康保险知识，16.9%的人在总分 4 分中得分为 1 或 0。多元逻辑回归分析表明，只有感知到的健康保险知识与无法获得医疗保健有显著关联（OR=0.393，95%CI=0.335-0.461），但验证知识的结果并不显著。逐步逻辑回归得出了类似的结果。
结论
我们的结果证实，外籍人士感知到的健康保险知识水平较低与获得医疗保健的机会较少有关。
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