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医生对保险状况对沙特阿拉伯临床决策影响的看法。

Physicians' Perspectives on the Impact of Insurance Status on Clinical Decision-Making in Saudi Arabia.

作者信息

Alotaibi Abdullah A, Alotaibi Khalid A, Almutairi Ahmad N, Alsaab Anas

机构信息

Family Medicine, Manzil Healthcare Services, Riyadh, SAU.

Internal Medicine, King Abdulaziz Medical City Riyadh, Riyadh, SAU.

出版信息

Cureus. 2024 Feb 7;16(2):e53756. doi: 10.7759/cureus.53756. eCollection 2024 Feb.

Abstract

Background The decision-making process in clinical practice depends heavily on collaboration and information sharing. Physicians' decision-making processes are profoundly influenced by the patient's insurance status, which warrants focused investigation. Hence, this study aimed to investigate how physicians perceive the influence of insurance status on treatment options and medical interventions and to explore the extent to which physicians discuss insurance-related considerations with patients during the shared decision-making process. Methodology This was a cross-sectional exploratory study conducted in various healthcare facilities all over Saudi Arabia. The electronic questionnaire was the primary tool for data collection. Data were then coded, entered, and analyzed using both descriptive and inferential statistical methods. Results The study involved 430 physicians, primarily male (= 230, 53.5%), aged 31-40 years (= 215, 50%), and mostly non-Saudi (= 285, 66.3%). Medical officers constituted the majority of the study population (= 258, 60%), with one to five years of experience (= 187, 43.5%), and engaged in private practice (= 230, 70%). Concerning insurance, 287 (66.7%) physicians considered patient's insurance when discussing treatment options, while 318 (74%) physicians discussed the financial implications of different treatment options with the patients. Regarding outcomes, 373 (86.7%) physicians believed that insurance status affected patient outcomes and treatment modalities. Significant factors, such as age between 31 and 40 years ( < 0.001), over 10 years of clinical experience ( = 0.002), engagement in both governmental and private practice ( = 0.012), and being a medical officer ( = 0.005), demonstrated a high impact on the insurance status influencing clinical decision-making. Overall, recognizing the influence of insurance on decision-making is crucial for equitable healthcare. Conclusions More than half of the physicians demonstrated high scores indicating the impact of insurance status on the clinical decision-making process. This impact was influenced by specific physician parameters such as age, experience, specialty, and type of practice. Moreover, the financial situation and insurance status of the patients significantly affected treatment and patient outcomes.

摘要

背景 临床实践中的决策过程在很大程度上依赖于协作和信息共享。医生的决策过程受到患者保险状况的深刻影响,这值得重点研究。因此,本研究旨在调查医生如何看待保险状况对治疗选择和医疗干预的影响,并探讨医生在共同决策过程中与患者讨论保险相关考虑因素的程度。

方法 这是一项在沙特阿拉伯各地不同医疗机构开展的横断面探索性研究。电子问卷是数据收集的主要工具。然后使用描述性和推断性统计方法对数据进行编码、录入和分析。

结果 该研究涉及430名医生,主要为男性(=230人,53.5%),年龄在31至40岁之间(=215人,50%),且大多不是沙特人(=285人,66.3%)。医务人员占研究人群的大多数(=258人,60%),有1至5年工作经验(=187人,43.5%),并从事私人执业(=230人,70%)。关于保险,287名(66.7%)医生在讨论治疗选择时会考虑患者的保险情况,而318名(74%)医生会与患者讨论不同治疗选择的财务影响。关于结果,373名(86.7%)医生认为保险状况会影响患者的治疗结果和治疗方式。年龄在31至40岁之间(<0.001)、临床经验超过10年(=0.002)、同时从事政府和私人执业(=0.012)以及身为医务人员(=0.005)等重要因素,对影响临床决策的保险状况显示出很大影响。总体而言,认识到保险对决策的影响对于公平的医疗保健至关重要。

结论 超过一半的医生得分较高,表明保险状况对临床决策过程有影响。这种影响受到年龄、经验、专业和执业类型等特定医生参数的影响。此外,患者的财务状况和保险状况显著影响治疗和患者的治疗结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79f6/10921445/2f52f0949724/cureus-0016-00000053756-i01.jpg

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