The effects of citizenship status on service utilization and general satisfaction with healthcare: a cross-cultural study.
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.


METHODS
A cross-sectional survey conducted in 2012.


METHODS
A household survey in the State of Qatar in the Arab Gulf.


METHODS
A nationally representative sample of 2750 citizens and noncitizens aged 18 years and older.


RESULTS
General satisfaction status with Qatar's healthcare system.


METHODS
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.
Social and Economic Survey Research Institute, Qatar University, Doha, Qatar.
Salma M
SM
Khaled
Social and Economic Survey Research Institute, Qatar University, Doha, Qatar.
Bethany
B
Shockley
Social and Economic Survey Research Institute, Qatar University, Doha, Qatar.
Hanan F
HF
Abdul Rahim
D000293:Adolescent; D000328:Adult; D003431:Cross-Cultural Comparison; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011780:Qatar; D011795:Surveys and Questionnaires
Qatari citizens; White-Collar migrants; expectation-based satisfaction; experience-based satisfaction; general satisfaction; health insurance; healthcare utilization; inpatient; normative expectations.; outpatient