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The effects of citizenship status on service utilization and general satisfaction with healthcare: a cross-cultural
Salma M Khaled1, Bethany Shockley1, Hanan F Abdul Rahim1
1Social and Economic Survey Research Institute, Qatar University, Doha, Qatar.
Objective:
To explore the role of citizenship status as a predictor of general satisfaction with healthcare services in Qatar, including potential interaction with utilization and health insurance coverage type.
Design:
A cross-sectional survey conducted in 2012.
Setting:
A household survey in the State of Qatar in the Arab Gulf.
Participants:
A nationally representative sample of 2750 citizens and noncitizens aged 18 years and older.
Main Outcome:
General satisfaction status with Qatar's healthcare system.
Measures:
Citizenship status, healthcare utilization, health insurance type.
Results:
Citizens were significantly less likely to be satisfied with Qatar's healthcare system than noncitizens (odds ratio (OR) = 0.30, P < 0.001). The association between private health insurance and overall satisfaction was not significantly different between citizens and noncitizens (P = 0.19). However, the association between utilization of healthcare services and overall satisfaction was moderated by citizenship (P < 0.001). Among citizens, non-users were less likely to be satisfied than recent users (OR = 1.88, P < 0.05), while the opposite pattern was observed among noncitizens (OR = 0.51, P < 0.05). These patterns persisted even after controlling for potential confounders.
Conclusions:
The study revealed significant population differences in satisfaction between recent users and non-users within citizenship groups. These differences may stem from different expectations with respect to healthcare services. Understanding these expectations may have important policy implications for cross-cultural contexts.
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