Examining Equal Access to Healthcare among Nationals and Expatriates: Evidence from Qatar’s World Health Survey

Abstract

BACKGROUND: Previous research has examined equity in access to healthcare in the Middle East and North Africa (MENA) region by income and other socioeconomic factors. However, we have identified no study that examined whether access to healthcare systems differs between nationals and their expatriate counterparts in the region. AIMS AND OBJECTIVES: The primary purpose of this paper is to examine equity in access to healthcare among national and expatriate populations in Qatar, an oil- and gas-producing country where expatriates constitute a significant proportion of the total population. METHODS: The equity in access to healthcare among national and expatriate populations was examined using the World Health Survey 2006, adapted for the Qatari context. Utilization of public healthcare facilities was assessed using self-reported measures of inpatient and outpatient utilization. A set of self-reported health, and socio-demographic variables were defined, including nationality, age, marital status, size f household, education, profession, self-perception of health status and language. Bivariate and multivariate analyses were used to assess the association between nationality status and health utilization of public facilities.RESULTS: 4,360 respondents (2,154 Qatari and 2,206 expatriate respondents) were included in the analyses, 48.3% of whom were male. Qatari nationals reported a higher prevalence of all chronic diseases and accessed inpatient and outpatient care more often than expatriates during the 12 months prior to the survey (13.7% nationals and 9.3% expatriates received inpatient care; 39.7% nationals and 34.9% expatriates received outpatient care). Bivariate analysis showed that national were significantly more likely to access inpatient care, overall and by chronic disease subgroups; the same was true for the outpatient care, except for those with chronic diseases where no difference was found. Multivariate analyses showed no significant difference in access to inpatient or outpatient healthcare services, except for the expatriates with chronic diseases who have higher utilization rates. CONCLUSIONS: Access to the public healthcare system in Qatar is not statistically different between national and expatriate populations.