Research methodology is “a process of enquiry and investigation into a problem to find a practical solution to the problem and increase in knowledge” (Creswell 2013). Research “is a systematic, methodical and ethical process of inquiry into a problem and its solution” (Creswell 2013). This research aims to make an inquiry into the impact of privatisation of the public health sector in Saudi Arabia. The study seeks to answer the research questions on the impact of privatisation in the delivery of public health services to the people.
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The study seeks to establish the role of compulsory medical insurance to the people and its impact on the government budget and to determine the most suitable balance between privatisation and government spending within the health sector. According to Creswell (2013, p.34), research is based on the spirit of inquiry and the use of logical reasoning, which is based on scientific inquiry to draw unbiased conclusions on the impact of privatisation of the public health services in Saudi Arabia.
The validity of reasoning, which is used in this research, is demonstrated in the procedure that is used to arrive at the results, which can be practically used to solve the problems in the area of privatisation of the public health services in Saudi Arabia. Here, Creswell (2013, p.56) argues that in theory and practice, research methodologies rely on experience, facts, conjecture, and laws, which govern the systematic inquiry. The study will focus on realism, facts, and the collection of different views about privatisation, which involves a large number of respondents to answer the research questions by using both the positivism and the phenomenological order of reasoning (Jannadi 2008).
Typically, the epistemology of the research will draw on the theory that privatisation reduces government expenditure on public health and has been recommended by economists and heath care givers (Feilzer 2010). The research is based on the ‘if-then’ paradigm of arguing that if the government privatises the provision of health-care services, then the cost of offering the services will go down and the quality of services will improve (Feilzer 2010).
Mixed Research Methods
According to Alizadeh (1995, p.45), the critical feature of the mixed research method, which makes it suitable for use in the health-care environment, is that the method provides a clearer comprehension of the connection between privatisation , insurance costs, and the government expenditure in the provision of health-care services to the people.
The solutions and the problems of privatising the health-care system in Saudi Arabia, the formulation of policies, the need to compel people to take insurance cover, the benefits of medical insurance cover, the different types of medical health models provide the basis of this study in Saudi Arabia. The results of the study will enable the researcher to appreciate the benefits of privatisation (Alizadeh 1995).
The mixed research method is a combination of both qualitative and quantitative research paradigms, which seek to gain from the combination of the strengths of each paradigm and to overcome the weaknesses of each of the research methods. The approach is used to gain the best understanding of solutions and answers to the research questions (Feilzer 2010).
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The qualitative and quantitative paradigms seek to establish why the services delivered to people should be privatised, how the privatisation and delivery of services will impact on the delivery of health services to the people. The method enables the researcher to understand the way the government plays its roles in the provision of health-care services. The qualitative paradigm will be used to explore what has not been written about privatisation of the public health services and seeks to listen to what people have to say about the privatisation of health services (Alizadeh 1995).
The qualitative research method will enable the study to understand how the facts about privatisation will contribute to the provision of quality services, the reduction in government expenditure. Typically, the research method will contribute significantly to the sound explanation of the social phenomena of privatisation. This study adopted mixed research methods because of the benefits the method will provide to the government and the private sector (Feilzer 2010).
The study will be both qualitative and quantitative. The qualitative part will be based on the literature review while the quantitative part will be based on data collected using a survey and questionnaires. The quantitative method is applied to determine the correlation between the research variables empirically. The survey will consist of a questionnaire that will be administered to the population, which will be selected through a sampling procedure.
According to Creswell (2013, p.67), the use of survey questionnaires as the most suitable method of data collection enables the respondents to be easily accessed within the target group. The use of those research methods is considered the best because they cannot lead to the disqualification of other alternative explanations, which can be used in the research. The rationale of the sampling procedure gives an unbiased outcome. In the quantitative research survey, the sampling procedure provides valid and reliable results. Therefore, the research methodologies applied in this study are considered the best in attaining the desired results.
Research Design and Data Collection
The Study Design
To explore the success of improving the health care services because of privatisation of public health care, this research study will use empirical and secondary sources of information. The critical elements, which will be considered in the research design, are the participants who should not be influenced to make them feel discriminated or to allow them to bring biasness into the study. This fact implies that the participants are drawn from different sections of the society to answer the question appropriately (Bryman 2012).
In addition to that, the choice of participants falls on the government departments and particularly those who work in the public health sector, the people who benefit from the services offered by the public health service sector, insurance providers, and any other participant who might be regarded as a stakeholder in the provision of the health care services to the people (Bryman 2012). Besides, the study will involve the use of appropriate methods to ensure that it includes every group that benefits from the provision of public health services by the government (Creswell 2013).
The obligatory explorative data will be gathered across the study population, which will be selected through a simple sampling strategy (Bryman 2012). A research technique based on the survey method and an integrated statistical analysis tool will be applied to analyse the data.
Properly designed research questionnaires will be used as the data collection instrument, which will be administered on the respondents. The study will apply both primary and secondary data collection methods while utilising the survey as the main primary data collection tool. A well-designed questionnaire will be administered to the study participants who will be drawn from both the private and public hospitals in Saudi Arabia (Jannadi 2008).
The data collection instruments were designed by bearing in mind that the results could benefit the government and the people, who are the most critical target beneficiaries of the system. In addition to that, it was deemed necessary to ensure that the research results are credible to the community and especially the people, who are the ultimate beneficiaries of the new changes in the health-care service delivery system (Bryman 2012).
To ensure that the research is effective and that the theory and practice underpin the principles of the research, the use of effective communication will be tapped into and the collection of data will form the basis of the avenue for the desired changes in the health-care sector (Bryman 2012).
One of the tools used to collect data to answer the research questions will be the questionnaires. A questionnaire is a tool that provides the research with the ability to collect accurate and reliable data on the target area of study. Here, appropriate questionnaires will be designed depending on the sequence of the steps used in the study to ensure that the data collected is accurate and reliable.
To ensure reliability, the questionnaires will be well designed with questions, which target the right audience, and each question will be correctly formatted and designed to leave no ambiguity in the mind of the respondent. Typically, each step will include defining the required data and information by using the research objectives, which include ascertaining the impact of privatisation of the health sector on the people of Saudi Arabia, the role of compulsory medical insurance on the budgetary allocations of the government and the citizens, and the best balance between privatisation and government spending in the health sector.
The research will use three methods of approach to select the most appropriate respondents to the questionnaire questions to save time and ensure confidentiality of the data, which is collected from the survey. The approach is used to exclude the people who might be a threat to the collection of data because they might show characteristics that are deviant from the rest of the participants. On the other hand, screening questions will be administered to ensure that the right people who are eligible to participate in the study are only admitted into the survey.
Paper questionnaires will be used to collect the data from the respondents because the tool will allow the respondents the right time to answer the questions appropriately. In addition, the Internet will play a critical role in providing the data required for the study because it provides a flexible and easily accessible platform for effective and real time communication. In addition, web based questionnaires make it appropriate for the study to analyse the questions quickly since they can be submitted in an analysable from, without further formatting. Here, data entry errors are easy to avoid, there is a personalised feedback, and are quickly returned for analysis.
The guiding principle of designing and drawing the questions is to keep them simple, clear, straight, and short not to confuse the respondents. In addition, the underpinning principles are to make sure that the questions do not have double negatives. In addition, the questions are designed to avoid ambiguity, leading questions, and any other thing that may distort the meaning and response to the questions.
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In this particular study, all the health service providers are deemed viable. However, only a small number of participants will be selected depending on the frequency with which they have been involved in the provision of health services or participation in health sector reforms in Saudi Arabia (Feilzer 2010). From the total number of the health service providers that will be sampled, seventy hospitals will be selected through the use of the most appropriate technique for simple random sampling strategy, and the research questionnaire will be administered to help in addressing the formulated research questions. The selection process, which is planned to take approximately six months, will be undertaken in the first month of the study.
As one of the most important studies in the public health sector, the information will be collected through administering properly designed research questionnaires, observations alongside conducting well-structured in-depth interviews to the unbiased selected participants namely private hospitals and public hospitals (Feilzer 2010).
The soundly designed research questionnaire will be administered to seventy hospitals including forty public hospitals and thirty privately owned health service providers. Conversely, secondary research data will be acquired from the relevant organisation records and other documents, which contain the information on the privatisation of public health sector. For this particular case, the study intends to trace the success of privatisation of public health sector in terms of improvements in health care services. To prove the appropriateness of the improvements required in the sector, there emerges a need for data collection.
The ontological and epistemological thinking on the use of interviews to collect data is based on the need to gather qualitative data to ensure that the collected data is correctly interpreted (Feilzer 2010). Here, the language plays a significant role in the interaction between the researcher and the respondent. The interview will be conducted on a face to face basis to ensure that the respondent gives answers to the questions that will be posed to them on the spot (Feilzer 2010). The limitations of interviews are that the respondents might give false answers depending on the environment of the interview. The main advantage is that the respondents will be able to seek for the clarification of the questions, which they do not understand.
The disadvantage of questionnaires is that the respondents can easily decide not to answer some questions, which are not clear and cannot be clarified on the spot (Feilzer 2010). To increase the response rate, the respondents will be called and encouraged to respond to the questions on time.
Attitudinal Rating Scale
An attitudinal scale will be used to rate the responses to the questionnaires. The choice of use of the attitudinal scale was deemed appropriate for respondents to give answers to the questions, which are straightforward. It is also possible to use the attitudinal scale to create the response categories and make analysis easy to handle (Feilzer 2010). For the interview, it will be possible for the interviewer to give scores to the responses, which vary between -2 and +2, which are based on interval data.
The data will enable the researcher to calculate the standard deviations and mean for each of the responses from the respondents. To ensure that the responses using the questionnaires are accurate, a Likert scale will be used. It is critical to be aware of the order and the acquiescence effect, central tendency and the pattern answering issues that arise. The approach could enable the responses to avoid the bias that is mostly evident to the left of the self completion scale. In addition, acquiescence, which is the tendency of the respondents to answer “yes” where “no” could be applied will be avoided by placing the negative end of the scale to the left.
The sample size will be selected from the population using the simple sampling technique to ensure that is appropriate for the study because it gives every item an equal chance to participate. The weakness with this method is that it is not appropriate for small population (Feilzer 2010). However, the advantage is that it is not a complex method and that the chosen method is appropriate in this area of study.
Reliability and Validity of Data The researcher will ensure that the data is valid and reliable by designing a questionnaire that is free of errors and the quality of data will be ensured by administering the questionnaires twice, which is based on the test and retest reliability criteria. In addition, the parallel forms reliability and inter-rater reliability will be used to ensure that different judges agree on the assessment decisions, which are made on the data.
On the other hand, it will be critical to ensure the internal validity of the data is kept by testing for average-inter-item reliability and split half reliability by ensuring that the items used in the study agree. On the other hand, the study will ensure that the validity of data is enforced by using different criteria to measure the validity of the data (Feilzer 2010). Those measures of validity include face validity to ensure that the tools including interviews and questionnaires used to collect data will be appropriate for the purpose they are intended to.
Another form of validity is the Construct Validity, which will be used to provide the researcher with the measure that it was intended to evaluate (Feilzer 2010). To ensure construct validity is implemented appropriately, it will be proper to use a panel of experts or a group of skilled people to evaluate the items. The questionnaires and interviews will be subjected to the formative validity test to ensure that the tools can be used to collect the data with the required integrity for the purpose of the research. Because not everything will be tested, the sampling validity technique will be used to collect the study to avoid bias and to prove the validity of the data.
Analysing the Data
The data collected using the questionnaires and the interviews will be assigned numerical values to make it easy for the results to be analysed. The data will be formatted and made appropriate for analysis (Feilzer 2010). Different tools are available, which can be used to analyse the data that will be collected with the help of the most suitable research methods (Feilzer 2010).
Alizadeh, F1995, ‘Interior point methods in semi definite programming with applications to combinatorial optimization’ SIAM Journal on Optimization, vol. 1, no. 5, pp. 13-51.
Bryman, A 2012, Social research methods. Oxford University Press, Oxford.
Creswell, J W, 2013, Research design: Qualitative, quantitative, and mixed methods approaches. Sage, New York.
Feilzer, M Y 2010, ‘Doing mixed methods research pragmatically: Implications for the rediscovery of pragmatism as a research paradigm.” Journal of mixed methods research, vol. 4, no.1, pp. 6-16.
Jannadi, O A 2008, ‘Risks associated with trenching works in Saudi Arabia’, Building and Environment, vol. 4, no. 45, pp. 776-781.