Alnashmi Maha, Bhuiyan Nuzhat Masud, AlFaham Nour, Salman Ahmad, AlHumaidi Hanadi, Akhtar Nabeel
Health Informatics and Information Management Department, Faculty of Allied Health Sciences, Kuwait University, Jabriya, Kuwait.
Department of Environmental Science and Management, School of Health and Life Sciences, North South University, Bashundhara, Bangladesh.
Clinicoecon Outcomes Res. 2024 Aug 23;16:597-617. doi: 10.2147/CEOR.S469810. eCollection 2024.
In 2014, the Kuwaiti parliament enacted the private health insurance law for Kuwaiti retirees ie, Afya to enhance service quality for retirees through the involvement of the private sector. The study aimed to comprehensively analyze Afya across three crucial dimensions: efficiency, inclusiveness, effectiveness, and service quality; delivery of services throughout the revenue management cycle; and its long-term sustainability in Kuwait.
Conducted between June 2021 and August 2022, the study employed both web-based and hardcopy questionnaires, reaching a response rate of 78.79% from a random sample of 514 Kuwaiti beneficiaries holding Afya insurance cards. Exclusions were made for those who did not receive cards or declined participation, resulting in analysis of 405 completed surveys.
The findings revealed that 95% of participants frequently utilized services from private hospitals, with a corresponding 78.79% satisfaction rate. However, when seeking medical services from government hospitals, respondents often opted to repeat procedures to ensure accurate results and diagnoses. Despite a strong endorsement for enhancing Afya's coverage plan (94%), over half of the respondents suggested a temporary suspension of the scheme to conduct thorough research and alleviate potential financial burdens on the government. Notably, a significant positive correlation (0.578, p < 0.01) was observed between beneficiary satisfaction and their experience with Afya coverage, underscoring the importance of aligning scheme operations with beneficiary needs.
Addressing these disparities and improving access to healthcare services for retirees necessitate a thorough reformation of the Afya scheme. To address these challenges, the study recommends comprehensive reform through evidence-based research, enhanced information exchange mechanisms between public and private sectors, and broader coverage targeting younger demographics. These measures are crucial for ensuring the scheme's efficacy, sustainability, and alignment with the evolving healthcare landscape in Kuwait.
2014年，科威特议会为科威特退休人员颁布了私人医疗保险法，即“阿菲亚”（Afya），以通过私营部门的参与提高退休人员的服务质量。该研究旨在从效率、包容性、有效性和服务质量这三个关键维度全面分析“阿菲亚”；在整个收入管理周期内提供服务的情况；以及其在科威特的长期可持续性。
该研究于2021年6月至2022年8月进行，采用了基于网络和纸质问卷的方式，从514名持有“阿菲亚”保险卡的科威特受益人随机样本中获得了78.79%的回复率。未收到卡或拒绝参与的人员被排除在外，最终对405份完成的调查问卷进行了分析。
研究结果显示，95%的参与者经常使用私立医院的服务，相应的满意度为78.79%。然而，当从公立医院寻求医疗服务时，受访者经常选择重复进行检查以确保结果和诊断准确。尽管对扩大“阿菲亚”的覆盖计划有强烈支持（94%），但超过一半的受访者建议暂时暂停该计划，以便进行全面研究并减轻政府潜在的财政负担。值得注意的是，在受益人满意度与其“阿菲亚”保险覆盖体验之间观察到显著的正相关（0.578，p<0.01），这凸显了使计划运营与受益人需求保持一致的重要性。
解决这些差异并改善退休人员获得医疗服务的机会需要对“阿菲亚”计划进行全面改革。为应对这些挑战，该研究建议通过循证研究进行全面改革，加强公共和私营部门之间的信息交流机制，并针对年轻人群体扩大覆盖范围。这些措施对于确保该计划的有效性、可持续性以及与科威特不断变化的医疗格局相适应至关重要。
