# Physicians' Perspectives on the Impact of Insurance Status on Clinical Decision-Making in Saudi Arabia

## TL;DR

This study explores how physicians in Saudi Arabia consider patients' insurance status when making clinical decisions and how this affects treatment options and outcomes.

## Contribution

The study provides insights into how insurance status influences physicians' decision-making and patient outcomes in Saudi Arabia.

## Key findings

- Most physicians consider insurance status when discussing treatment options.
- Over 80% of physicians believe insurance status affects patient outcomes and treatment modalities.
- Physician age, experience, and practice type significantly influence how insurance status impacts clinical decisions.

## Abstract

Background

The decision-making process in clinical practice depends heavily on collaboration and information sharing. Physicians' decision-making processes are profoundly influenced by the patient's insurance status, which warrants focused investigation. Hence, this study aimed to investigate how physicians perceive the influence of insurance status on treatment options and medical interventions and to explore the extent to which physicians discuss insurance-related considerations with patients during the shared decision-making process.

Methodology

This was a cross-sectional exploratory study conducted in various healthcare facilities all over Saudi Arabia. The electronic questionnaire was the primary tool for data collection. Data were then coded, entered, and analyzed using both descriptive and inferential statistical methods.

Results

The study involved 430 physicians, primarily male (n = 230, 53.5%), aged 31-40 years (n = 215, 50%), and mostly non-Saudi (n = 285, 66.3%). Medical officers constituted the majority of the study population (n = 258, 60%), with one to five years of experience (n = 187, 43.5%), and engaged in private practice (n = 230, 70%). Concerning insurance, 287 (66.7%) physicians considered patient's insurance when discussing treatment options, while 318 (74%) physicians discussed the financial implications of different treatment options with the patients. Regarding outcomes, 373 (86.7%) physicians believed that insurance status affected patient outcomes and treatment modalities. Significant factors, such as age between 31 and 40 years (P < 0.001), over 10 years of clinical experience (P = 0.002), engagement in both governmental and private practice (P = 0.012), and being a medical officer (P = 0.005), demonstrated a high impact on the insurance status influencing clinical decision-making. Overall, recognizing the influence of insurance on decision-making is crucial for equitable healthcare.

Conclusions

More than half of the physicians demonstrated high scores indicating the impact of insurance status on the clinical decision-making process. This impact was influenced by specific physician parameters such as age, experience, specialty, and type of practice. Moreover, the financial situation and insurance status of the patients significantly affected treatment and patient outcomes.