Assessment of Beneficiaries’ Satisfaction with Access to Health Care and Barriers within the Health Delivery System in Saudi Arabia

Abstract

Introduction: Health care system navigation and communication with the providers are the barriers to health care access. Recently, a new health care model with the provider’s reform mechanism was introduced in Saudi Arabia. The national goal of financial reform is to provide Saudi nationals, residents, and visitors with timely access to health care. This study aimed to assess the long-term beneficiaries’ satisfaction with access to health care and explore the influencing factors and barriers, including cost and communication with the providers and probable solutions. Methods: In this cross-sectional self-administered online survey, we used the validated “6A,” namely, affordability, acceptability, adequacy, accessibility, availability, and awareness (30 items) of perceived access to health care questionnaire. The primary outcome variable was the overall satisfaction with access to health care among the long-term beneficiaries and caregivers. Demographic variables were used as predictors of the level of satisfaction. Results: A total of 118 health care long-term beneficiaries completed the questionnaires. The mean age of the participants was 49 years. Most participants were beneficiaries from the Ministry of Health (n = 62; 52.5%). Only 42 participants (35.6%) reported a high level of satisfaction. Low satisfaction level was mainly reported by non-Saudi, retired males living in big cities. Similarly, those who paid the health care services in cash reported a significantly low level of satisfaction. Moreover, the level of satisfaction was significantly associated with insurance coverage. Discussion: The first application of the “6A” perceived access to health care questionnaire in Saudi Arabia identified that 35.6% were poorly satisfied with access to health care. However, the rate is lower than that reported in six European countries, which ranged from 53% to 55%. Since after 4 years of health reform, payment methods for health services were identified as a significant predictor of variation in the mean scores of accesses to health care. Further national-level studies exploring access to health care are needed on long-term beneficiaries who are retired and those who live in rural and remote areas. In future health sector reform and health system research, addressing unaffordable to pay services is required.