ArticleHealth economics review2026
Firm structure, organisational capacity, and employer health insurance provision in Oman: a cross-sectional mediation study.
Article in Health economics review, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmployer mandates are a central mechanism for expanding universal health coverage (UHC). In Oman, the Dhamani platform a national digital health-insurance system mandates private-sector coverage under Capital Market Authority Resolution 78/2019. Full national rollout commenced in 2025, creating an urgent need for pre-implementation employer-readiness evidence.
objectiveTo describe formal employer health-insurance provision rates across Omani private-sector firms, to identify firm structural factors independently associated with provision, and to assess whether organisational resource capacity mediates the firm size-provision relationship.
methodsCross-sectional employer survey (n = 222) conducted prior to full Dhamani enforcement, using stratified purposive sampling by firm size and sector. Multivariable logistic regression (Hosmer-Lemeshow calibration, ROC AUC discrimination, VIF multicollinearity checks, Box-Tidwell linearity test, Firth penalized sensitivity analysis) and bootstrapped mediation analysis (5,000 resamples; bias-corrected 95% CI as primary inferential result) were used.
resultsFormal provision was 36.5% overall (95% CI: 30.2-43.1%), ranging from 10.8% among micro-enterprises to 81.0% among large firms (Cramér's V = 0.573, p < 0.001). Organisational resource capacity was the strongest independent predictor (AOR = 31.51, 95% CI: 11.82-84.01, p < 0.001). The bootstrapped indirect effect of firm size on provision through capacity was 0.413 (bias-corrected 95% CI: 0.189-0.687), representing 30.3% of the total association. Model discrimination was good (ROC AUC = 0.88, 95% CI: 0.83-0.93) and calibration was acceptable (Hosmer-Lemeshow p = 0.45). A post-stratification weighted estimate adjusting for micro-enterprise oversampling was 21.9% (95% CI: 17.0-26.8%). The most common barriers among non-insuring firms were absence of a legal mandate (51.8%) and high premium costs (49.6%).
conclusionsFirm size and organisational resource capacity are strongly associated with formal health-insurance provision. Phased Dhamani enrollment targeting large firms first, premium subsidies, and administrative support for micro- and small enterprises are the evidence-indicated policy responses.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.