Reform of the Health Insurance Funding Model to Improve the Care of Noncommunicable Diseases Patients in Saudi Arabia

Abstract

Health insurance models are being considered as part of health system reforms in Saudi Arabia. This paper assesses the attributes of health funding models that support better control of non-communicable diseases (NCDs) and perspectives on health insurance as a model from the perspective of patients, clinicians, and managers. The study employed a mixed-methods research design that included quantitative and qualitative data gathering and analysis. Study findings indicated concerns that the current health funding mechanism is financially unsustainable and, as a result, there will be a greater reliance on personal health insurance to support government spending on healthcare. Essential elements of any health insurance model to support effective NCD management identified from a review of the literature and interviews include the following: ensuring continuity of care and equity; funding chronic disease prevention interventions; prioritising primary healthcare; and maintaining the principle of community rating to prevent insurers from discriminating against members. Other desirable attributes for the funding model includes collaboration across primary, secondary, and tertiary care. Healthcare finance reform aimed at adopting and increasing personal health insurance coverage may play a critical role in extending access to healthcare, eliminating health inequities, enhancing population health, and reducing government spending on healthcare if appropriately considered.

Pediatric Neurology Workforce in Saudi Arabia: A 5-Year Update

“…This could be attributed to the current reality of a universal healthcare model adopted in Saudi Arabia which provides free access to health services to all citizens [ 18 ]. However, this finding will likely change in the future, as the country shifts toward privatizing the health sector, thereby increasing the number of health insurance holders [ 19 ]. This issue is of great importance, as studies have identified a correlation between insurance status and health [ 20 ]; this is often reflected in patients in terms of the quality of services provided by their healthcare provider.…”

Key aspects of the Saudi healthcare system reform and the potential impact on the main stakeholders: A qualitative study

“…30 Adopting personal health insurance coverage is seen to improve healthcare accessibility, reduce health inequities, enhance population health, and reduce government healthcare expenditures. 31 …”