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Journal of the Bahrain Medical Society. 2022;34(3):37-42. doi:10.26715/jbms.34_3_6.", "url": "https://www.bhmedsoc.com/jbms/view-article.php?Article_Unique_Id=JBMS261", "locator": "HTML 'Methods', 'Results' and 'Limitations' sections.", "period": "observations from 1 July to 30 September 2019; article published 2022", "territory": "Bahrain Defence Force Royal Medical Services emergency department and 18 referring PHC centres", "evidence_mode_candidate": "observed", "verification_source_layer": "research_literature", "coverage_domains": [ "primary_care", "hospital_organization", "referral_design", "observed_referral", "networks", "facility_data", "utilization", "patient_flows" ], "review_requirements": [ "Keep the study's site and time boundary visible and do not infer national pathway rates." ], "source_references": [ { "title": "Review of Patients Referred to the Emergency Department", "citation": "Al Qassim G, Mohammed A, Ghanem H, Musbah E, Alkaabi AK, Al Ghanem S. Review of Patients Referred to the Emergency Department. Journal of the Bahrain Medical Society. 2022;34(3):37-42. doi:10.26715/jbms.34_3_6. https://www.bhmedsoc.com/jbms/view-article.php?Article_Unique_Id=JBMS261", "url": "https://www.bhmedsoc.com/jbms/view-article.php?Article_Unique_Id=JBMS261", "locator": { "locator_type": "html_section_anchor", "sections": [ "Methods", "Results", "Limitations" ], "source_word_anchor": "A total of 1094 official patient referrals", "source_word_count": 7 }, "source_version": { "response_sha256": "37b4865dc57d8c8d836ccfc8f2e8a342f1c5438e2e80548b414be69494162d9a", "detected_media_type": "text/html", "hash_verified": true, "retrieved_at": "2026-08-15" }, "source_projection_id": "country-improvement-source:BHR:ed-referral-study-2019", "display_source_id": "display-source:BHR:cecee486a3262068eb722290", "source_version_id": "display-source-version:83049153d692c229f540cc85" } ], "source_version": { "response_sha256": "37b4865dc57d8c8d836ccfc8f2e8a342f1c5438e2e80548b414be69494162d9a", "detected_media_type": "text/html", "hash_verified": true, "retrieved_at": "2026-08-15" }, "display_source_ids": [ "display-source:BHR:cecee486a3262068eb722290" ], "source_version_ids": [ "display-source-version:83049153d692c229f540cc85" ], "display_claim_ids": [ "display-claim:c1208f6580d6e008ee4bb84e", "display-claim:cce15d446141e34f184fedf2", "display-claim:0e60443b9e7e641bafae97a6", "display-claim:0813b40e5a00730d74bdd1cb" ], "display_evidence_object_id": "display-claim:c1208f6580d6e008ee4bb84e", "display_eligible": true, "canonical_claim": false, "publication_boundary": "source_linked_typed_mapping_visible_for_annotation_not_a_canonical_claim" }, { "mapping_id": "candidate-mapping:BHR:delivery-referrals:phc-capacity-and-referral-context", "country_id": "BHR", "mapping_group": "delivery_and_referrals", "target_view": "delivery", "target_slot": "dated-phc-capacity-registration-and-referral-context", "support_state": "candidate_supported", "mapping_basis": "reported_by_who_phc_profile_with_empirical_referral_context", "source_projection_ids": [ "country-improvement-source:BHR:who-phc-country-profile", "country-improvement-source:BHR:ed-referral-study-2019", "country-improvement-source:BHR:diabetes-resource-utilisation-2019" ], "typed_fields": { "phc_registration": "54.3 percent of patients registered at PHC facilities in 2018", "reported_secondary_referral_rate": "6.27 percent of cases referred to secondary care in the profile's 2018 PHC annual-report source", "phc_to_ed_observation": "18 centres contributed official referrals to one tertiary emergency department in a 2019 study", "dated_network_context": "a 2011 to 2012 diabetes study describes 28 PHC centres with electronic files networked to main hospitals", "denominator_boundary": "the profile's percentage and the study's referral count have different populations and cannot be combined", "currency_boundary": "both sources are dated and do not describe current national capacity" }, "analytical_objects": {}, "title": "Dated PHC registration, referral and emergency-pathway context", "statement": "The WHO profile supplies dated PHC registration and reported secondary-referral indicators, while the emergency-department study gives a facility-specific 2019 pathway count. 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Journal of the Bahrain Medical Society. 2022;34(3):37-42. doi:10.26715/jbms.34_3_6. https://www.bhmedsoc.com/jbms/view-article.php?Article_Unique_Id=JBMS261", "url": "https://www.bhmedsoc.com/jbms/view-article.php?Article_Unique_Id=JBMS261", "locator": { "locator_type": "html_section_anchor", "sections": [ "Methods", "Results", "Limitations" ], "source_word_anchor": "A total of 1094 official patient referrals", "source_word_count": 7 }, "source_version": { "response_sha256": "37b4865dc57d8c8d836ccfc8f2e8a342f1c5438e2e80548b414be69494162d9a", "detected_media_type": "text/html", "hash_verified": true, "retrieved_at": "2026-08-15" }, "source_projection_id": "country-improvement-source:BHR:ed-referral-study-2019", "display_source_id": "display-source:BHR:cecee486a3262068eb722290", "source_version_id": "display-source-version:83049153d692c229f540cc85" }, { "title": "Type 2 diabetes and healthcare resource utilisation in the Kingdom of Bahrain", "citation": "Salman RA, AlSayyad AS, Ludwig C. 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switching", "implementation_boundary": "the webpage's future-oriented language must not be reported as completed implementation" }, "analytical_objects": { "graph_nodes": [ { "node_id": "bhr:beneficiary", "label": "Insurance beneficiary", "family": "community", "display_claim_ids": [ "display-claim:1f5e5c6202b9108d0ddb3737" ], "display_source_ids": [ "display-source:BHR:d9e4859aab85ad4662641e53", "display-source:BHR:f36d3bbddc5d9cfe72b1191a" ], "source_version_ids": [ "display-source-version:baf3ac44ff55aca8fbab3519", "display-source-version:3ffd36d790fb98e30baf05e8" ], "display_evidence_object_id": "display-claim:1f5e5c6202b9108d0ddb3737" }, { "node_id": "bhr:network", "label": "Provider network specified in insurance documents", "family": "purchaser", "display_claim_ids": [ "display-claim:e06180e64a13047ff4d9b178" ], "display_source_ids": [ "display-source:BHR:d9e4859aab85ad4662641e53", "display-source:BHR:f36d3bbddc5d9cfe72b1191a" ], "source_version_ids": [ "display-source-version:baf3ac44ff55aca8fbab3519", "display-source-version:3ffd36d790fb98e30baf05e8" ], "display_evidence_object_id": "display-claim:e06180e64a13047ff4d9b178" }, { "node_id": "bhr:providers-choice", "label": "Health-service providers", "family": "provider", "display_claim_ids": [ "display-claim:78a57fa1cfde66869607ec5d" ], "display_source_ids": [ "display-source:BHR:d9e4859aab85ad4662641e53", "display-source:BHR:f36d3bbddc5d9cfe72b1191a" ], "source_version_ids": [ "display-source-version:baf3ac44ff55aca8fbab3519", "display-source-version:3ffd36d790fb98e30baf05e8" ], "display_evidence_object_id": "display-claim:78a57fa1cfde66869607ec5d" } ], "graph_edges": [ { "source_node_id": "bhr:network", "target_node_id": "bhr:providers-choice", "relationship": "may specify covered provider network", "relationship_family": "purchasing", "display_claim_ids": [ "display-claim:17a074ec0c827b34b31adcde" ], "display_source_ids": [ "display-source:BHR:d9e4859aab85ad4662641e53", "display-source:BHR:f36d3bbddc5d9cfe72b1191a" ], "source_version_ids": [ "display-source-version:baf3ac44ff55aca8fbab3519", "display-source-version:3ffd36d790fb98e30baf05e8" ], "display_evidence_object_id": "display-claim:17a074ec0c827b34b31adcde" }, { "source_node_id": "bhr:beneficiary", "target_node_id": "bhr:providers-choice", "relationship": "provider choice is described as a Sehati aim", "relationship_family": "operations", "display_claim_ids": [ "display-claim:f7f2fd20420796c2211748f6" ], "display_source_ids": [ "display-source:BHR:d9e4859aab85ad4662641e53", "display-source:BHR:f36d3bbddc5d9cfe72b1191a" ], "source_version_ids": [ "display-source-version:baf3ac44ff55aca8fbab3519", "display-source-version:3ffd36d790fb98e30baf05e8" ], "display_evidence_object_id": "display-claim:f7f2fd20420796c2211748f6" } ] }, "title": "Provider-network design and patient-choice boundary", "statement": "Bahrain's health-insurance law provides for provider networks and primary-care registration 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The available evidence does not verify a universal implemented choice rule or network use.", "citation": "Law No. 23 of 2018, Articles 38 and 52; Bahrain National Portal, accessed 15 August 2026.", "url": "https://www.moh.gov.bh/Content/Upload/File/638248457033688553-SEHATI-Law_en.pdf", "locator": "Law 23 physical pages 43 and 59, Articles 38 and 52; Government Healthcare section 'National Health Insurance program'.", "period": "law promulgated 2018 and current portal description accessed 2026-08-15", "territory": "Kingdom of Bahrain", "evidence_mode_candidate": "formal", "verification_source_layer": "official", "coverage_domains": [ "decision_rights", "primary_care", "referral_design", "networks", "patient_flows", "governance", "market_structure", "reform_history" ], "review_requirements": [ "Label provider choice as policy intent until a source verifies rules, implemented networks and actual use." ], "source_references": [ { "title": "Law No. (23) of 2018 Promulgating the Health Insurance Law", "citation": "Kingdom of Bahrain. Law No. (23) of 2018 Promulgating the Health Insurance Law. 2018. https://www.moh.gov.bh/Content/Upload/File/638248457033688553-SEHATI-Law_en.pdf", "url": "https://www.moh.gov.bh/Content/Upload/File/638248457033688553-SEHATI-Law_en.pdf", "locator": { "locator_type": "legal_articles", "articles": [ "Articles 4 to 5", "19", "23 to 24", "38", "52" ], "physical_pdf_pages": [ 8, 9, 25, 29, 43, 59 ], "source_word_anchor": "The Health Insurance Fund", "source_word_count": 4 }, "source_version": { "file_sha256": "a4f2943fab7664aee0d199d5a8977c08ac52fe703ba8ba6b661ef4e86b6d28ab", "response_sha256": "a4f2943fab7664aee0d199d5a8977c08ac52fe703ba8ba6b661ef4e86b6d28ab", "page_count": 77, "detected_media_type": "application/pdf", "hash_verified": true, "retrieved_at": "2026-08-15" }, "source_projection_id": "country-improvement-source:BHR:health-insurance-law-23-2018", "display_source_id": "display-source:BHR:d9e4859aab85ad4662641e53", "source_version_id": "display-source-version:baf3ac44ff55aca8fbab3519" }, { "title": "Healthcare", "citation": "Bahrain National Portal. Healthcare. Accessed 15 August 2026. https://www.bahrain.bh/wps/portal/en/BNP/HereInBahrain/Healthcare/", "url": "https://www.bahrain.bh/wps/portal/en/BNP/HereInBahrain/Healthcare/", "locator": { "locator_type": "html_section_anchor", "sections": [ "Commitment to Quality, Efficiency, and Reliability", "National Health Insurance program" ], "source_word_anchor": "right to choose the service provider", "source_word_count": 7 }, "source_version": { "response_sha256": "aaed023b5dcbc2f5941311971ecdeb0c595f0f137b109d199d3686d51eb6da73", "detected_media_type": "text/html", "hash_verified": true, "retrieved_at": "2026-08-15" }, "source_projection_id": "country-improvement-source:BHR:government-healthcare-page-2026", "display_source_id": "display-source:BHR:f36d3bbddc5d9cfe72b1191a", "source_version_id": "display-source-version:3ffd36d790fb98e30baf05e8" } ], "source_version": { "file_sha256": "a4f2943fab7664aee0d199d5a8977c08ac52fe703ba8ba6b661ef4e86b6d28ab", "response_sha256": 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"source_node_id": "bhr:nhra-field", "target_node_id": "bhr:government-providers", "relationship": "regulates facilities and services", "relationship_family": "regulation", "display_claim_ids": [ "display-claim:8b3a6a2cfe258fb4ba3e0cf1" ], "display_source_ids": [ "display-source:BHR:92602742d5bd36965de0b00a", "display-source:BHR:f36d3bbddc5d9cfe72b1191a", "display-source:BHR:325ed62220001293d7c8a2e8" ], "source_version_ids": [ "display-source-version:0df983521049ccce47db81a5", "display-source-version:3ffd36d790fb98e30baf05e8", "display-source-version:851b07383e4027aa402f2f1c" ], "display_evidence_object_id": "display-claim:8b3a6a2cfe258fb4ba3e0cf1" }, { "source_node_id": "bhr:nhra-field", "target_node_id": "bhr:private-providers", "relationship": "regulates facilities and services", "relationship_family": "regulation", "display_claim_ids": [ "display-claim:304dd0f423a1177533ce0407" ], "display_source_ids": [ "display-source:BHR:92602742d5bd36965de0b00a", 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The evidence supports a mixed regulatory field, while the intended competitive role of Sehati remains distinct from proof of operational contracting or market effects.", "citation": "NHRA Accreditation Policy and Standards 2023-2027, pages 4 to 5; Bahrain National Portal, accessed 15 August 2026; WHO Bahrain Health Systems Profile 2013.", "url": "https://www.nhra.bh/Departments/Accreditation/Policies/MediaHandler/GenericHandler/documents/departments/Accreditation/Accreditation%20Policy%20V2.2.pdf", "locator": "NHRA policy physical pages 4 to 5; Government Healthcare sections on NHRA and Sehati; WHO profile pages 4 to 5.", "period": "NHRA standards 2023 to 2027, portal accessed 2026-08-15 and historical review published 2013", "territory": "Kingdom of Bahrain", "evidence_mode_candidate": "reported", "verification_source_layer": "official", "coverage_domains": [ "actors", "ownership", "primary_care", "hospital_organization", "networks", "governance", "market_structure", "reform_history", "authoritative_review" ], "review_requirements": [ "Do not infer a purchaser-provider relationship, sector share or quality comparison where the sources state only regulatory scope or policy intent." ], "source_references": [ { "title": "National Health Regulatory Authority Accreditation Policy and Standards 2023-2027", "citation": "National Health Regulatory Authority, Bahrain. 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The cited sources establish regulatory design, not the degree of day-to-day autonomy exercised by any hospital or clinic.", "tags": [], "territory": "Governmental and private health-care facilities in Bahrain", "title": "NHRA regulatory authority and autonomy", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.nhra.bh/Departments/Accreditation/Policies/MediaHandler/GenericHandler/documents/departments/Accreditation/Accreditation%20Policy%20V2.2.pdf" }, { "kind": "source_reference", "source": "Law No. (38) for the Year 2009 Establishing the National Health Regulatory Authority", "url": "https://www.nhra.bh/departments/lau/laws%20resolutions/general/MediaHandler/GenericHandler/documents/departments/LAU/General/Gen000_Law_Law%20No.%20%2838%29%20for%202009%20Establishing%20the%20National%20Organization%20for%20the%20Regulation%20of%20Occupations%20and%20Health%20Services_English.pdf" } ] }, { "analytical_mapping": { "mapping_basis": "declared_from_bahraini_law_current_government_description_and_historical_who_review", "mapping_group": "actors_and_functions", "mapping_id": "candidate-mapping:BHR:actors-functions:national-steward-regulator-architecture", "source_projection_ids": [ "country-improvement-source:BHR:nhra-law-38-2009", "country-improvement-source:BHR:health-insurance-law-23-2018", "country-improvement-source:BHR:national-health-plan-2016-2025", "country-improvement-source:BHR:government-healthcare-page-2026", "country-improvement-source:BHR:who-health-systems-profile-2013" ], "support_state": "candidate_supported", "target_slot": "national-steward-regulator-and-insurance-architecture", "target_view": "functions", "typed_fields": { "health_insurance_institution": "Law 23 establishes a Health Insurance Fund with financial and administrative independence under ministerial oversight", "historical_boundary": "the 2013 WHO profile is historical context, not confirmation of current actors", "national_steward": "Supreme Council of Health has formal national health-plan and health-insurance policy roles", "provider_architecture_boundary": "available sources support public and private provider sectors under NHRA regulation, but do not establish a complete current purchaser-provider contract map", "regulator": "NHRA is established as an independent public regulator for health professions and services" } }, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Law No. 38 of 2009, Articles 2 to 3; Law No. 23 of 2018, Articles 4 to 5 and 19; National Health Plan 2016-2025; Bahrain National Portal, accessed 15 August 2026; WHO Bahrain Health Systems Profile 2013.", "country_ids": [ "BHR" ], "coverage_domains": [ "actors", "authoritative_review", "autonomy", "decision_rights", "governance", "government_responsibilities", "market_structure", "ownership", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": null, "institution": null, "locator": { "description": "Law 38 physical pages 2 to 3; Law 23 physical pages 8 to 9 and 25; National Health Plan pages 15 to 18; Government Healthcare sections on NHRA and Sehati; WHO profile pages 4 to 5." }, "material_id": "material:fa2f2ff949537740fee4cfab", "notes": [ "Keep formal establishment, current public description and historical review evidence separate from implementation and contracting assumptions." ], "origin": "candidate-analytical-mappings", "period": "formal instruments from 2009 to 2018, strategic plan 2016 to 2025 and current webpage accessed 2026-08-15", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "3fc2a064d63fa8b860a3d20442cdcc717c5d3b6d5ed11c99455baee6ab511f72", "page_count": 10, "response_sha256": "3fc2a064d63fa8b860a3d20442cdcc717c5d3b6d5ed11c99455baee6ab511f72" }, "statement": "Bahrain's cited formal architecture assigns national stewardship and insurance-policy roles to the Supreme Council of Health, establishes NHRA as a regulator and establishes a Health Insurance Fund. The evidence does not establish a complete current contract map between a purchaser and all public or private providers.", "tags": [], "territory": "Kingdom of Bahrain", "title": "National stewardship, regulation and insurance architecture", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.moh.gov.bh/Content/Upload/File/638248457033688553-SEHATI-Law_en.pdf" }, { "kind": "source_reference", "source": "Law No. (38) for the Year 2009 Establishing the National Health Regulatory Authority", "url": "https://www.nhra.bh/departments/lau/laws%20resolutions/general/MediaHandler/GenericHandler/documents/departments/LAU/General/Gen000_Law_Law%20No.%20%2838%29%20for%202009%20Establishing%20the%20National%20Organization%20for%20the%20Regulation%20of%20Occupations%20and%20Health%20Services_English.pdf" }, { "kind": "source_reference", "source": "National Health Plan 2016-2025", "url": "https://www.bahrain.bh/wps/wcm/connect/ad2159e2-3fa3-49bd-8f12-8b861f92b3b6/National%2BHealth%2BPlan.pdf?CVID=p2LVX-u&MOD=AJPERES" }, { "kind": "source_reference", "source": "Healthcare", "url": "https://www.bahrain.bh/wps/portal/en/BNP/HereInBahrain/Healthcare/" }, { "kind": "source_reference", "source": "Bahrain Health Systems Profile", "url": "https://applications.emro.who.int/docs/Country_profile_2013_EN_15384.pdf" } ] }, { "analytical_mapping": { "mapping_basis": "observed_from_single_tertiary_emergency_department_record_review", "mapping_group": "delivery_and_referrals", "mapping_id": "candidate-mapping:BHR:delivery-referrals:observed-ed-referral-pathway", "source_projection_ids": [ "country-improvement-source:BHR:ed-referral-study-2019" ], "support_state": "candidate_supported", "target_slot": "observed-primary-care-to-emergency-pathway", "target_view": "referrals", "typed_fields": { "observation_window": "1 July to 30 September 2019", "official_referrals": "1,094 official referrals from 18 primary-health-care centres", "post_ed_outcome": "41.5 percent were discharged home without further follow-up and 7.8 percent were admitted", "scope_boundary": "one emergency department and three months cannot estimate national referral performance", "study_setting": "Bahrain Defence Force Royal Medical Services emergency department" } }, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Al Qassim et al. Journal of the Bahrain Medical Society. 2022;34(3):37-42. doi:10.26715/jbms.34_3_6.", "country_ids": [ "BHR" ], "coverage_domains": [ "facility_data", "hospital_organization", "networks", "observed_referral", "patient_flows", "primary_care", "referral_design", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "observed", "excerpt": null, "institution": null, "locator": { "description": "HTML 'Methods', 'Results' and 'Limitations' sections." }, "material_id": "material:23408ccb6bc1573841918b4f", "notes": [ "Keep the study's site and time boundary visible and do not infer national pathway rates." ], "origin": "candidate-analytical-mappings", "period": "observations from 1 July to 30 September 2019; article published 2022", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "research_literature" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "response_sha256": "37b4865dc57d8c8d836ccfc8f2e8a342f1c5438e2e80548b414be69494162d9a" }, "statement": "A retrospective three-month review observed 1,094 official referrals from 18 primary-health-care centres to one tertiary emergency department. This is empirical pathway evidence for that setting, not a national referral-completion, bypass or patient-choice estimate.", "tags": [], "territory": "Bahrain Defence Force Royal Medical Services emergency department and 18 referring PHC centres", "title": "Observed referrals from primary care to one emergency department", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.bhmedsoc.com/jbms/view-article.php?Article_Unique_Id=JBMS261" } ] }, { "analytical_mapping": { "mapping_basis": "declared_from_health_insurance_law_and_current_government_description", "mapping_group": "relationships_and_networks", "mapping_id": "candidate-mapping:BHR:relationships-networks:choice-and-provider-network-boundary", "source_projection_ids": [ "country-improvement-source:BHR:health-insurance-law-23-2018", "country-improvement-source:BHR:government-healthcare-page-2026" ], "support_state": "candidate_supported", "target_slot": "provider-choice-and-network-boundary", "target_view": "public-private", "typed_fields": { "choice_boundary": "no cited source verifies a current universal choice rule, the available provider menu or observed switching", "choice_intent": "the portal says Sehati aims to guarantee a right to choose the service provider", "formal_network_design": "the health-insurance law permits insurance documents to specify a network of health providers", "implementation_boundary": "the webpage's future-oriented language must not be reported as completed implementation", "primary_care_link": "the law provides for registration rules and coordination with other levels of care" } }, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Law No. 23 of 2018, Articles 38 and 52; Bahrain National Portal, accessed 15 August 2026.", "country_ids": [ "BHR" ], "coverage_domains": [ "decision_rights", "governance", "market_structure", "networks", "patient_flows", "primary_care", "referral_design", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": null, "institution": null, "locator": { "description": "Law 23 physical pages 43 and 59, Articles 38 and 52; Government Healthcare section 'National Health Insurance program'." }, "material_id": "material:35bee88de2f5707cc1692387", "notes": [ "Label provider choice as policy intent until a source verifies rules, implemented networks and actual use." ], "origin": "candidate-analytical-mappings", "period": "law promulgated 2018 and current portal description accessed 2026-08-15", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "a4f2943fab7664aee0d199d5a8977c08ac52fe703ba8ba6b661ef4e86b6d28ab", "page_count": 77, "response_sha256": "a4f2943fab7664aee0d199d5a8977c08ac52fe703ba8ba6b661ef4e86b6d28ab" }, "statement": "Bahrain's health-insurance law provides for provider networks and primary-care registration rules, while the current portal frames provider choice as a Sehati objective. The available evidence does not verify a universal implemented choice rule or network use.", "tags": [], "territory": "Kingdom of Bahrain", "title": "Provider-network design and patient-choice boundary", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.moh.gov.bh/Content/Upload/File/638248457033688553-SEHATI-Law_en.pdf" }, { "kind": "source_reference", "source": "Healthcare", "url": "https://www.bahrain.bh/wps/portal/en/BNP/HereInBahrain/Healthcare/" } ] }, { "analytical_mapping": { "mapping_basis": "declared_from_nhra_policy_and_current_government_description", "mapping_group": "relationships_and_networks", "mapping_id": "candidate-mapping:BHR:relationships-networks:public-private-regulatory-field", "source_projection_ids": [ "country-improvement-source:BHR:nhra-accreditation-policy-2023-2027", "country-improvement-source:BHR:government-healthcare-page-2026", "country-improvement-source:BHR:who-health-systems-profile-2013" ], "support_state": "candidate_supported", "target_slot": "public-private-provider-regulation", "target_view": "public-private", "typed_fields": { "historical_context": "WHO's 2013 profile identified stronger public-private partnership as a need", "network_boundary": "available sources do not establish a complete network roster, contracting terms or market shares", "outcome_boundary": "regulatory coverage and policy intent do not measure quality or public-private substitution", "private_sector_role": "the current portal describes a policy aim of private-sector competition under Sehati", "regulatory_relationship": "NHRA describes regulation across governmental and private sectors" } }, "annotation_status": "open", "authors": [], "availability": {}, "citation": "NHRA Accreditation Policy and Standards 2023-2027, pages 4 to 5; Bahrain National Portal, accessed 15 August 2026; WHO Bahrain Health Systems Profile 2013.", "country_ids": [ "BHR" ], "coverage_domains": [ "actors", "authoritative_review", "governance", "hospital_organization", "market_structure", "networks", "ownership", "primary_care", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": null, "institution": null, "locator": { "description": "NHRA policy physical pages 4 to 5; Government Healthcare sections on NHRA and Sehati; WHO profile pages 4 to 5." }, "material_id": "material:1dab7e35f45833281df23d26", "notes": [ "Do not infer a purchaser-provider relationship, sector share or quality comparison where the sources state only regulatory scope or policy intent." ], "origin": "candidate-analytical-mappings", "period": "NHRA standards 2023 to 2027, portal accessed 2026-08-15 and historical review published 2013", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "33775434c1895dcac91088d726c1195c2fc2ae3698a7c323242233e9e29b017c", "page_count": 34, "response_sha256": "33775434c1895dcac91088d726c1195c2fc2ae3698a7c323242233e9e29b017c" }, "statement": "NHRA's policy and the government portal describe regulatory coverage of governmental and private providers. The evidence supports a mixed regulatory field, while the intended competitive role of Sehati remains distinct from proof of operational contracting or market effects.", "tags": [], "territory": "Kingdom of Bahrain", "title": "Public and private providers share a regulatory field", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.nhra.bh/Departments/Accreditation/Policies/MediaHandler/GenericHandler/documents/departments/Accreditation/Accreditation%20Policy%20V2.2.pdf" }, { "kind": "source_reference", "source": "Healthcare", "url": "https://www.bahrain.bh/wps/portal/en/BNP/HereInBahrain/Healthcare/" }, { "kind": "source_reference", "source": "Bahrain Health Systems Profile", "url": "https://applications.emro.who.int/docs/Country_profile_2013_EN_15384.pdf" } ] }, { "analytical_mapping": { "mapping_basis": "declared_from_formal_laws_and_national_plan", "mapping_group": "time_and_reform", "mapping_id": "candidate-mapping:BHR:time-reform:regulation-insurance-and-plan-timeline", "source_projection_ids": [ "country-improvement-source:BHR:nhra-law-38-2009", "country-improvement-source:BHR:national-health-plan-2016-2025", "country-improvement-source:BHR:health-insurance-law-23-2018" ], "support_state": "candidate_supported", "target_slot": "regulation-insurance-and-strategic-plan-timeline", "target_view": "reforms", "typed_fields": { "2009": "Law 38 establishes NHRA as a public regulator with legal personality and financial and administrative independence", "2016": "National Health Plan sets 2016 to 2025 strategic directions including national supervision, integrated services and private-sector investment", "2018": "Law 23 creates formal health-insurance, provider-network, primary-care coordination and health-information provisions", "current_status_boundary": "a post-2025 plan or current legal consolidation was not verified in this wave", "implementation_boundary": "legal and strategic milestones do not demonstrate completion, use or effects" } }, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Law No. 38 of 2009; Supreme Council of Health National Health Plan 2016-2025; Law No. 23 of 2018.", "country_ids": [ "BHR" ], "coverage_domains": [ "actors", "autonomy", "decision_rights", "governance", "government_responsibilities", "hospital_organization", "market_structure", "networks", "primary_care", "referral_design", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": null, "institution": null, "locator": { "description": "Law 38 physical pages 2 to 3; National Health Plan pages 15 to 18 and 34; Law 23 pages 8 to 9, 25, 43 and 59." }, "material_id": "material:5f2ff7789f5904e9e39cb7cb", "notes": [ "Do not convert strategic-plan targets or legal provisions into implementation outcomes." ], "origin": "candidate-analytical-mappings", "period": "2009 to 2025 plan period, with 2018 law phased application", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "3fc2a064d63fa8b860a3d20442cdcc717c5d3b6d5ed11c99455baee6ab511f72", "page_count": 10, "response_sha256": "3fc2a064d63fa8b860a3d20442cdcc717c5d3b6d5ed11c99455baee6ab511f72" }, "statement": "The source-supported timeline records NHRA's legal establishment in 2009, the 2016 to 2025 National Health Plan, and the 2018 Health Insurance Law. These are formal or strategic milestones, not evidence that every related service, network or policy effect was implemented.", "tags": [], "territory": "Kingdom of Bahrain", "title": "Regulation, planning and health-insurance reform timeline", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.nhra.bh/departments/lau/laws%20resolutions/general/MediaHandler/GenericHandler/documents/departments/LAU/General/Gen000_Law_Law%20No.%20%2838%29%20for%202009%20Establishing%20the%20National%20Organization%20for%20the%20Regulation%20of%20Occupations%20and%20Health%20Services_English.pdf" }, { "kind": "source_reference", "source": "National Health Plan 2016-2025", "url": "https://www.bahrain.bh/wps/wcm/connect/ad2159e2-3fa3-49bd-8f12-8b861f92b3b6/National%2BHealth%2BPlan.pdf?CVID=p2LVX-u&MOD=AJPERES" }, { "kind": "source_reference", "source": "Law No. (23) of 2018 Promulgating the Health Insurance Law", "url": "https://www.moh.gov.bh/Content/Upload/File/638248457033688553-SEHATI-Law_en.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "World Health Organization Regional Office for the Eastern Mediterranean. Bahrain Health Systems Profile. Cairo: WHO EMRO; 2013. https://applications.emro.who.int/docs/Country_profile_2013_EN_15384.pdf", "country_ids": [ "BHR" ], "coverage_domains": [ "actors", "authoritative_review", "autonomy", "decision_rights", "facility_data", "governance", "government_responsibilities", "hospital_organization", "market_structure", "networks", "observed_referral", "ownership", "patient_flows", "primary_care", "referral_design", "reform_history", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "functioning high health council", "institution": "World Health Organization Regional Office for the Eastern Mediterranean", "locator": { "locator_type": "pdf_page_set_anchor", "source_word_anchor": "functioning high health council", "source_word_count": 4 }, "material_id": "material:59920881782f3f1ef3b9680d", "notes": [ "Use only as historical review context and do not extrapolate its facility, private-sector or governance descriptions to the current system." ], "origin": "country-evidence-improvement-sources", "period": "health-system profile published 2013 using earlier data", "publication_date": null, "publication_year": 2013, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "review_literature" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "4f2963628b531dbd16d09944060e085680bcfeba9a7077415c22d3ca0982af1c", "page_count": 2, "response_sha256": "4f2963628b531dbd16d09944060e085680bcfeba9a7077415c22d3ca0982af1c" }, "statement": "The WHO profile documents a functioning high health council, family-practice and primary-care strengths, and a stated need for stronger public-private partnership. It is historical system-review context and should not be read as a current institutional map.", "tags": [], "territory": "Kingdom of Bahrain", "title": "Bahrain Health Systems Profile", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://applications.emro.who.int/docs/Country_profile_2013_EN_15384.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "World Health Organization Regional Office for the Eastern Mediterranean. Bahrain PHC Country Profile. 2021. https://www.emro.who.int/images/stories/health-topics/uhc/documents/bahrain_phccp.pdf", "country_ids": [ "BHR" ], "coverage_domains": [ "actors", "facility_data", "governance", "hospital_organization", "networks", "observed_referral", "patient_flows", "primary_care", "referral_design", "reform_history", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "Formal process exists for referrals", "institution": "World Health Organization Regional Office for the Eastern Mediterranean", "locator": { "locator_type": "pdf_page_set_anchor", "source_word_anchor": "Formal process exists for referrals", "source_word_count": 5 }, "material_id": "material:a45d55d4cfd10d07667783c7", "notes": [ "Keep the 2018 registration and referral values dated; the profile does not establish specialist-choice, completion or bypass rates." ], "origin": "country-evidence-improvement-sources", "period": "profile reports mainly 2017 to 2020 source years", "publication_date": null, "publication_year": 2021, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "5646e030c99044da0620158176135e901b8947888743fb98e29839255cf72428", "page_count": 3, "response_sha256": "5646e030c99044da0620158176135e901b8947888743fb98e29839255cf72428" }, "statement": "The WHO profile reports a formal primary-to-secondary referral process, 54.3 percent PHC registration and 6.27 percent of cases referred to secondary care in 2018. These are dated system indicators, not a current national bypass or completion measure.", "tags": [], "territory": "Kingdom of Bahrain primary-health-care system", "title": "Bahrain PHC Country Profile", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.emro.who.int/images/stories/health-topics/uhc/documents/bahrain_phccp.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Bahrain National Portal. Healthcare. 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Its future-oriented language does not verify full implementation.", "tags": [], "territory": "Kingdom of Bahrain", "title": "Healthcare", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.bahrain.bh/wps/portal/en/BNP/HereInBahrain/Healthcare/" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Kingdom of Bahrain. 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Law No. (38) for the Year 2009 Establishing the National Health Regulatory Authority. 2009. https://www.nhra.bh/departments/lau/laws%20resolutions/general/MediaHandler/GenericHandler/documents/departments/LAU/General/Gen000_Law_Law%20No.%20%2838%29%20for%202009%20Establishing%20the%20National%20Organization%20for%20the%20Regulation%20of%20Occupations%20and%20Health%20Services_English.pdf", "country_ids": [ "BHR" ], "coverage_domains": [ "actors", "autonomy", "decision_rights", "governance", "government_responsibilities", "hospital_organization", "market_structure", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "enjoy financial and administrative independence", "institution": "Kingdom of Bahrain", "locator": { "locator_type": "legal_articles", "source_word_anchor": "enjoy financial and administrative independence", "source_word_count": 5 }, "material_id": "material:2609c2bb2f269ec6b8265987", "notes": [ "Confirm amendments and current legal validity before inferring any present operational power beyond the text of this law." ], "origin": "country-evidence-improvement-sources", "period": "law promulgated 2009; current legal validity requires separate legal confirmation", "publication_date": null, "publication_year": 2009, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "3fc2a064d63fa8b860a3d20442cdcc717c5d3b6d5ed11c99455baee6ab511f72", "page_count": 10, "response_sha256": "3fc2a064d63fa8b860a3d20442cdcc717c5d3b6d5ed11c99455baee6ab511f72" }, "statement": "The law establishes the National Health Regulatory Authority as a public body with legal personality and financial and administrative independence, and assigns it regulatory and monitoring functions for health professions and services.", "tags": [], "territory": "Kingdom of Bahrain", "title": "Law No. (38) for the Year 2009 Establishing the National Health Regulatory Authority", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.nhra.bh/departments/lau/laws%20resolutions/general/MediaHandler/GenericHandler/documents/departments/LAU/General/Gen000_Law_Law%20No.%20%2838%29%20for%202009%20Establishing%20the%20National%20Organization%20for%20the%20Regulation%20of%20Occupations%20and%20Health%20Services_English.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Supreme Council of Health, Kingdom of Bahrain. 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Accreditation Policy and Standards 2023-2027. 2023. https://www.nhra.bh/Departments/Accreditation/Policies/MediaHandler/GenericHandler/documents/departments/Accreditation/Accreditation%20Policy%20V2.2.pdf", "country_ids": [ "BHR" ], "coverage_domains": [ "actors", "autonomy", "decision_rights", "governance", "government_responsibilities", "hospital_organization", "market_structure", "networks", "primary_care", "referral_design", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "both in the governmental and private sectors", "institution": "National Health Regulatory Authority, Bahrain", "locator": { "locator_type": "pdf_page_set_anchor", "source_word_anchor": "both in the governmental and private sectors", "source_word_count": 7 }, "material_id": "material:31e5e725fd7a8a2156b41c89", "notes": [ "Do not equate regulatory scope or accreditation standards with measured quality, coordination or compliance." ], "origin": "country-evidence-improvement-sources", "period": "standards 2023 to 2027", "publication_date": null, "publication_year": 2023, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "33775434c1895dcac91088d726c1195c2fc2ae3698a7c323242233e9e29b017c", "page_count": 34, "response_sha256": "33775434c1895dcac91088d726c1195c2fc2ae3698a7c323242233e9e29b017c" }, "statement": "NHRA's accreditation policy describes NHRA as an independent regulator and states that it regulates governmental and private health services, including licensing standards for facilities. The policy documents regulatory scope rather than provider performance.", "tags": [], "territory": "Governmental and private health-care facilities in Bahrain", "title": "National Health Regulatory Authority Accreditation Policy and Standards 2023-2027", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.nhra.bh/Departments/Accreditation/Policies/MediaHandler/GenericHandler/documents/departments/Accreditation/Accreditation%20Policy%20V2.2.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Ministry of Health, Kingdom of Bahrain. Referral Services for Secondary Health. 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It describes the service pathway but does not report referral completion, bypass or utilization rates.", "tags": [], "territory": "Ministry of Health referral services in the Kingdom of Bahrain", "title": "Referral Services for Secondary Health", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.moh.gov.bh/Services/ReferralServices?lang=en" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Al Qassim G, Mohammed A, Ghanem H, Musbah E, Alkaabi AK, Al Ghanem S. Review of Patients Referred to the Emergency Department. Journal of the Bahrain Medical Society. 2022;34(3):37-42. doi:10.26715/jbms.34_3_6. https://www.bhmedsoc.com/jbms/view-article.php?Article_Unique_Id=JBMS261", "country_ids": [ "BHR" ], "coverage_domains": [ "facility_data", "hospital_organization", "networks", "observed_referral", "patient_flows", "primary_care", "referral_design", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "observed", "excerpt": "A total of 1094 official patient referrals", "institution": "Journal of the Bahrain Medical Society", "locator": { "locator_type": "html_section_anchor", "source_word_anchor": "A total of 1094 official patient referrals", "source_word_count": 7 }, "material_id": "material:dfa633d38ab6985c570e9d13", "notes": [ "Retain the single-emergency-department, three-month design and do not generalize its outcomes to all Bahraini referrals." ], "origin": "country-evidence-improvement-sources", "period": "retrospective electronic-record review, 1 July to 30 September 2019", "publication_date": null, "publication_year": 2022, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "research_literature" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "response_sha256": "37b4865dc57d8c8d836ccfc8f2e8a342f1c5438e2e80548b414be69494162d9a" }, "statement": "A three-month record review at one tertiary emergency department recorded 1,094 official referrals from 18 primary-health-care centres. 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