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

Healthcare Financing in Saudi Arabia: A Comprehensive Review

Saudi Vision 2030 is a game-changer for all aspects of the economy, including healthcare. This article provides a comprehensive overview of healthcare financing in the Kingdom of Saudi Arabia (KSA). It identifies key healthcare financing challenges that must be addressed to achieve the initiative's envisioned health system goals. The review also examines and demonstrates how healthcare funds in the KSA are allocated among different healthcare services, to offer a perspective on resource use efficiency at various healthcare levels. This research used a mixed-method design which includes a literature review and secondary data analysis. A literature review was conducted aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. The secondary data were gathered from the reports and websites of government agencies, international organizations, and non-governmental organizations. Despite implementing significant reforms in its healthcare system, the share of private healthcare expenditure in total healthcare spending has seen only marginal growth. The current healthcare financing system appears insufficient to adequately support the chronically ill and the poor. There is a significant imbalance in the allocation of government budgets between hospitals and primary care, with four-fifths of financial resources directed towards hospital services. The Ministry of Health's budget allocation prioritizes personnel compensation, potentially reducing the available budget for medicines and other essential healthcare supplies. Ongoing reforms in the health sector, including privatization, public-private partnership initiatives, and the government's commitment to developing a robust primary healthcare network, are expected to play a significant role in controlling rapidly increasing public healthcare expenditures in Saudi Arabia.

Potential and Risks Behind the National Transformation Program in Saudi Arabia

Saudi Arabia guarantees citizens the right to receive medical care and treatment during emergencies or sickness and aging. However, with the consistent increase in expenditure and inability to provide access, the transformation was an unavoidable action. Therefore, this paper aims to address the potential and risks behind the National Transformation Program (NTP) in Saudi Arabia through the lens of the Value Transformation Framework. Multiple research databases (PubMed, Web of Science, UpToDate, Google Scholar, and Summon) were searched between 2016 and 2024. Relevant articles were selected by scanning the title and abstract, yielding 34 references after the screening, exclusion, and inclusion criteria were met. Citation software was used to identify additional sources as analysis proceeded, in accordance with the hermeneutic approach in mapping and classification. The most cited concerns were the sustainability and workforce of the healthcare system. In terms of care delivery, the literature was extensive. In contrast, insufficient studies have been conducted on infrastructure and people. Furthermore, limited information is available on how to assess the transformation, which remains an unaddressed research question. NTP could meet several hurdles. However, through the measurement, assessment phases, and development tracking, success could be achieved.

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

Objectives

To explore and understand KSA's fundamental healthcare system reform, the potential changes and challenges, and their impacts on major stakeholders.

Methodology

To gain in-depth insights into healthcare leaders' perspectives regarding healthcare system reform in KSA, a qualitative research approach was used. Ten participants from diverse backgrounds were selected, representing various sectors in KSA: private, public, executive, consulting, and regulatory. This study was conducted between august 2022 and June 2023.

Findings

The findings revealed four key themes that shed light on healthcare system transformation in KSA and its effects: healthcare system reform, the impact of corporatization/privatization on healthcare providers, the impact of corporatization/privatization on health insurance, and the impact of corporatization/privatization on the workforce. Furthermore, the findings indicated that the ongoing transformation of the public sector toward privatization in KSA faces various challenges that affect most, if not all, stakeholders in the sector. However, the private sector possesses several strengths that can aid in addressing the challenges associated with the rapid transformation of the system. These strengths include familiarity with the market, robust financial management, extensive experience in coding and billing payers and insurance companies, efficient decision-making processes, flexibility, and maturity.

Conclusion

The study facilitated comprehensive insights into the transformation of KSA's healthcare system and the public sector's shift toward corporatization/privatization. The sector must enhance its capabilities by establishing specialized units and recruiting talent. Further studies are also needed to gain a deeper understanding of the obstacles hindering the transformation.

Advantages and Challenges of Implementation and Strategies for Health Insurance in Saudi Arabia: A Systemic Review

The Saudi Vision 2030 emphasizes the need for health insurance in terms of both economic growth and lowering government healthcare costs. Recently, the Saudi Ministry of Health has requested the private sector to contribute more to health spending through alternative financing and delivery systems, specifically health insurance. The main purpose of this review is to systematically review the benefits and issues of the implementation approach for health insurance in Saudi Arabia. Three electronic databases were used to conduct the systematic search for articles published in 2018 or after as this is a recent review of the last 5 years articles. Articles were considered if they matched the following criteria: Saudi articles concentrating on health insurance in Saudi Arabia, with a particular emphasis on issues, problems, barriers, and challenges related to insurance in Saudi Arabia. Of the many references identified in the initial search, 13 studies were identified that met the inclusion criteria. The included studies clearly highlighted, explained the current financial methods of the healthcare system in Saudi Arabia, and evaluated Cooperative Health Insurance's potential contribution to the healthcare system's success in achieving the Saudi Vision 2030 goals, as well as the benefits and disadvantages of health insurance. This review exemplifies the need for implementation of health insurance in Saudi Arabia to improve economic growth, and to improve efficiency and quality of care. Many of the issues were identified in this review could be addressed by a strong healthcare infrastructure. The Council of Cooperative Health Insurance and Saudi Arabian Monetary Agency should keep monitoring medical services and collaborating toward enhancing Saudi Arabia's health insurance.

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

BACKGROUND

The medical workforce plays a pivotal role in advancing human health, particularly within the healthcare system of Saudi Arabia. While government-employed healthcare providers form the central structure of the system and offer free healthcare services, the private healthcare sector is also witnessing significant growth. In parallel, the field of child neurology has experienced notable transformations in recent years, with continued expansion. This expansion brings forth a range of challenges for both current and future pediatric neurologists, necessitating careful consideration and proactive measures to address them.

AIM OF THE STUDY

To investigate and analyze the current characteristics of the workforce, with a specific focus on their employment status and related data.

METHODS

This is a cross-sectional analysis, using a survey to assess the distribution of pediatric neurologists in Saudi Arabia (SA). The final analytical sample included 82 subjects, working in 13 regions in SA. A descriptive analysis was used to address the study question.

RESULTS

The survey received responses from a total of 82 pediatric neurologists in Saudi Arabia (response rate 55%), with 38 (46%) being men and 44 (54%) being women. The mean age was 33 ± 1.225 years. The majority of participants practiced in major cities such as Riyadh and Jeddah. Nearly 50% of pediatric neurologists experienced some form of delay in obtaining their first job, ranging from 1 to 36 months.

CONCLUSION

The landscape of the pediatric neurology workforce is currently witnessing noteworthy demographic shifts. With the majority of practitioners concentrated in major cities, there is an ongoing demand for qualified professionals in peripheral areas. This study describes the real-life challenges faced by pediatric neurologists, particularly the delay in securing employment after graduation, and underscores the critical importance of addressing these persistent issues along the journey of pediatric neurology.