<p>The Effects of Health Insurance on Health-Seeking Behaviour: Evidence from the Kingdom of Saudi Arabia</p>

Abstract

Background: Saudi Arabia's healthcare sector is growing at a hasty stride; nevertheless, the quality of healthcare consumption remains challenged by the growing caseload in free public health facilities. Insurance could ease this pressure by moving some healthcare demand to private facilities conditional on its ability to enact health-seeking behaviour. These potential effects remain under-investigated. Therefore, the aim of this study was to investigate whether health insurance nudges health-seeking behaviour using data from Saudi Arabia. Materials and Methods: The study used nationally representative secondary data, obtained from the Family Health Survey, conducted in 2018, in Saudi Arabia. Health-seeking behaviour was measured by individual attendance of medical check-up. To account for endogeneity due to non-random selection of individuals into insurance, the analysis employed the inverse propensity weighting and the instrumental variables methods. Results: The results revealed that health insurance leads to increased chances of going for medical check-up. The effects are higher amongst non-Saudi nationals relative to citizens. Furthermore, people who purchase personal health insurance schemes are more likely to go for checks-ups, followed by individuals provided by the private sector and government sector. Finally, the study found that insurance positively nudges hypertension, diabetes, and cholesterol specific medical check-ups. Conclusion:The findings indicated the need for health policy to increase access to health insurance in Saudi Arabia. A notable policy response is the introduction of national health insurance coverage, which has already proven in other countries as an effective measure to attain universal access to improved health. Nevertheless, results from this study highlighted variations in demand for health seeking based on type of insurance with highest returns in personal insurance. Policy should leverage on this behaviour response by introducing insurance packages that share premiums with citizens to incentivise utilisation. The results can also be used to design policy responses to demand for insurance, in the entire Arabian Gulf region, since these countries have similar health financing mechanism with Saudi Arabia.

Economic Analysis of Inequality in Preventive Health Check-Ups Uptake in Saudi Arabia

“…These factors have also been identified as drivers of socioeconomic-related inequality in preventive health check-ups uptake in China (39) and India (40). One potential explanation might be that owing to the long waiting times at public healthcare facilities (41), those with better incomes may be in a position to support themselves to use private healthcare services or purchase health insurance, which has been found to contribute to easy access to the healthcare (18,42). Additionally, those with higher education may be much more aware about the benefits of carrying out preventive health check-ups.…”

“…One study showed that people living in rural areas of Riyadh faced considerable barriers to actively participating in their own healthcare as opposed to urban residents (17). Another study investigated the effect of health insurance on preventive healthcare, which established that the insured are more likely to undertake some medical check-ups (18). Interestingly, studies exploring and decomposing inequalities in preventive healthcare are scarce.…”

Health Insurance and Out-Of-Pocket Expenditure on Health and Medicine: Heterogeneities along Income

“…In practice, the increased demand for expensive healthcare could emerge from health-seeking effects of health insurance combined with opportunistic behavior of providers with asymmetric information (Ying and Chang, 2020). Insurance increases number of medical visits that individuals make to healthcare providers (Al-Hanawi et al, 2020). Healthcare providers use their superior asymmetric information advantage to prescribe medicine that is not covered by the insurance (Bernal et al, 2017).…”

Patient Satisfaction of Ambulatory Care Pharmacy Services

“…There was no statistical difference in all demographic characteristics between the participants of the 2 hospitals. Most of the respondents were Saudi nationals, which was expected because healthcare services are provided through cooperative health insurance regulations and insurance packages and only a small proportion of non-Saudi residents are allowed to receive healthcare services from governmental sectors ( 18 ). Most of the respondents were young adults below 46 years old who agreed to participate in the study, whereas few respondents were elderly.…”