The Role of Health Insurance in Improving Health Services Use by Thais and Ethnic Minority Migrants

Jian, Hu

doi:10.1177/1010539509351183

Cited by 18 publications

(14 citation statements)

References 10 publications

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“…The role of employers in access to health insurance, particularly for minorities, cannot be underestimated, as has been asserted by others. 25 , 26 Our findings are in agreement with other research reporting that minority workers in large companies have better knowledge of their health insurance benefits compared with those working in small companies. 27 This finding can be explained by the fact that people obtain their knowledge about health insurance benefits from their employers as a first source, 28 and larger employers have better methods of informing their employees about these benefits.…”

Section: Discussionsupporting

confidence: 91%

Knowledge of health insurance benefits among male expatriates in Saudi Arabia

Alkhamis

2017

SMJ

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Objectives:To measure expatriates’ knowledge of health insurance benefits with respect to outpatient, inpatient, prescription drug, and dental services, and to link this knowledge to sociodemographic and employment characteristic.Methods:Cross-sectional, face-to-face interviews were conducted from March 2015 to February 2016 with a stratified random sample of 3,398 male insured expatriate workers in the private sector of Riyadh, Kingdom of Saudi Arabia. Descriptive analysis, one-way ANOVA, and linear regression were used to interpret data. Data on knowledge of health insurance benefits was compiled by adding the scores of the 4 service category items (outpatient, inpatient, prescription drug, and dental services) to those of the 5 objective knowledge items on copayments.Results:More than 87% of the participants reported knowledge on their health insurance benefits coverage for outpatient, 62% for the inpatient, 86% for the prescription drug and 62% for the dental services. However, 7.5% knew the correct copayments for general practitioner, 64% for the outpatient (inclusive), 13% for the inpatient visits, 15% for the prescription drugs and 9.6% for the dental care. Most personal and job characteristics had associations with knowledge measures. A total of 55% of the overall knowledge variance was explained by the independent variables (R2=0.55), suggesting that other factors also influence knowledge.Conclusion:Expatriates’ knowledge of their health insurance benefits is very limited, which indicates the importance of developing a policy for increasing this knowledge among expatriates in Saudi Arabia.

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Section: Discussionsupporting

confidence: 91%

Knowledge of health insurance benefits among male expatriates in Saudi Arabia

Alkhamis

2017

SMJ

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“…Our findings are supported by another study, which suggests some employers pay insurers ‘under the table’ to renew employees’ Iqamas when in fact the employees do not have health insurance [23]. This finding supports evidence that employers might play a major role in the provision of health insurance for minorities in Asia [45, 57]. The source of this behaviour could either be the employer as indicated or the employees who buy their visas from their sponsors (i.e.…”

Section: Discussionsupporting

confidence: 89%

“…As shown by studies from other countries, small sized companies are less likely to provide health insurance to their workers [45, 49, 57, 58]. The same applies in Saudi Arabia.…”

Section: Discussionmentioning

confidence: 88%

“…The uninsured population spans all age groups, but younger adults (19–25 years) represent 30% of the uninsured, this could be because they usually begin their careers in positions offering relatively low incomes. Saudi Arabia is similar to other countries, where the risk of being on a low income means that not only is the employer more likely to offer a job without health insurance but also that the premium is unlikely to be shared [43–45]. …”

Section: Discussionmentioning

confidence: 99%

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The personal and workplace characteristics of uninsured expatriate males in Saudi Arabia

Alkhamis

Cosgrove

Mohamed

et al. 2017

BMC Health Serv Res

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BackgroundA major concern by the health decision makers in Gulf Cooperative Council (GCC) countries is the burden of financing healthcare. While other GCC countries have been examining different options, Saudi Arabia has endeavoured to reform its private healthcare system and control expatriate access to government resources through the provision of Compulsory Employment-Based Health Insurance (CEBHI). The objective of this research was to investigate, in a natural setting, the characteristics of uninsured expatriates based on their personal and workplace characteristics.MethodsUsing a cross-sectional survey, data were collected from a sample of 4,575 male expatriate employees using a multi-stage stratified cluster sampling technique. Descriptive statistics were used to summarize all variables, and the dependent variable was tabulated by access to health insurance and tested using Chi-square. Logistic analysis was performed, guided by the conceptual model.ResultsOf survey respondents, 30% were either uninsured or not yet enrolled in a health insurance scheme, 79.4% of these uninsured expatriates did not have valid reasons for being uninsured, with Iqama renewal accounting for 20.6% of the uninsured. The study found both personal and workplace characteristics were important factors influencing health insurance status. Compared with single expatriates, married expatriates (accompanied by their families) are 30% less likely to be uninsured. Moreover, workers occupying technical jobs requiring high school level of education or above were two-thirds more likely to be insured compared to unskilled workers. With regard to firm size, respondents employed in large companies (more than 50 employees) are more likely to be insured compared to those employed in small companies (less than ten employees). In relation to business type, the study found that compared to workers from the agricultural sector, industrial/manufacturing, construction and trading sectors, workers were, respectively, 76%, 85%, and 60% less likely to be uninsured.ConclusionAlthough the CEBHI is mandatory, this study found that the characteristics of uninsured expatriates, in respect of their personal and workplace characteristics have similarities with the uninsured from other private employment-sponsored health insurance schemes. Other factors influencing access to health insurance, besides employee and workplace characteristics, include the development and extent of the country’s insurance industry.

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“…Finally, the role of employers in increasing their expatriate employees’ access to health care is very important, as supported by studies from different contexts [ 37 ], whether by increasing their knowledge of health insurance benefits [ 10 ] or by increasing their access to health insurance [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

The association between insured male expatriates’ knowledge of health insurance benefits and lack of access to health care in Saudi Arabia

Alkhamis¹

2018

BMC Public Health

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BackgroundInsufficient 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.MethodsA 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.ResultsDescriptive 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.ConclusionsOur results confirmed that low perceived knowledge of health insurance in expatriates was associated with less access to health care.

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The Role of Health Insurance in Improving Health Services Use by Thais and Ethnic Minority Migrants

Cited by 18 publications

References 10 publications

Knowledge of health insurance benefits among male expatriates in Saudi Arabia

Knowledge of health insurance benefits among male expatriates in Saudi Arabia

The personal and workplace characteristics of uninsured expatriate males in Saudi Arabia

The association between insured male expatriates’ knowledge of health insurance benefits and lack of access to health care in Saudi Arabia

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