Trends and inequalities in health system satisfaction: results from the latest nationally representative surveys in...

Health system satisfaction is an important but understudied indicator of health system performance. It has far-reaching implications for sustainability but has been widely understudied particularly for non-European settings. Qatar represents a growing international experience of rapid development requiring steadfast system funding and reorganisation. After decades of unprecedented immigration and nearly free health care, Qatar sought to expand the system by 2016, reorganise it by 2022, and accelerate private funding and health system outcomes by 2030.

The aim of this study is to conduct a comprehensive assessment of health system satisfaction in Qatar, in anticipation of the 2024-2030 health reforms, with a particular emphasis on detailed policy attribution and the formulation of recommendations. The overarching aim of this study is to contribute to the limited body of international literature on health system satisfaction, particularly in non-European contexts, with a focus on specific populations such as migrants, labourers, and labour camp residents.

We analysed the levels of, and individual inequalities in, health system satisfaction in Qatar between 2012 and 2014. Descriptive statistics were employed to assess satisfaction levels, while inequalities were examined using logit analysis. The satisfaction variables encompass the key aspects of health system provision and management, whereas the individual variables are focused on their attributability to Qatar's specific health policy context, including regionally distinct socio-economic groups.

Health system satisfaction levels in Qatar were relatively high in both 2012 and 2014, particularly regarding service provision, though they did not reach exceptionally high levels. Both satisfaction dimensions-provision and management-improved in 2014, with management showing more rapid progress. However, males, Qatari citizens, individuals with chronic disease, labourers, and residents of the largest labour camps were less likely to express satisfaction with the system.

Qatar's satisfaction trends and inequalities between 2012 and 2014 emphasise the significance of both dedicated efforts and effective organisational structures in maintaining high levels of health system satisfaction during periods of rapid development. To ensure continued satisfaction, performance, and sustainability throughout the 2024-2030 reforms, it is essential to address unresolved organisational constraints before eroding dedicated efforts through increased private health funding.