The Impact of Key Factors on Internal Audit Performance:‎Evidence from Saudi Arabia’s ‎Healthcare Sector

  • Authors

    • Esam Ali Alghamdi Graduate School of Management, Management and Science University, Malaysia
    • Aza Azlina Md Kassim Graduate School of Management, Management and Science University, Malaysia
    https://doi.org/10.14419/agzhhh17

    Received date: December 11, 2025

    Accepted date: January 16, 2026

    Published date: January 23, 2026

  • Use about five keywords or phrases in alphabetical order, separated by Semicolon

  • Abstract

    This study investigates how auditors’ competency, e-audit practices, and management ‎support influence internal audit performance in Saudi Arabia’s healthcare sector, ‎operating within the structural transformation of Vision 2030. The research additionally ‎assesses the mediating role of audit quality and the moderating effect of risk ‎management. Structural Equation Modeling (SEM) was utilized to assess direct, indirect, ‎and moderated pathways using data from 80 public healthcare facilities in Riyadh. The ‎findings show that internal audit performance is greatly improved by all three important ‎factors, with audit quality acting as a potent mediator. In order to improve audit ‎governance in healthcare systems undergoing national reform, the study offers theoretical, ‎empirical, and practical insights‎.

  • References

    1. Alghamdi, A., & Kassim, A. (2025). Digital transformation and audit effectiveness in public sector organizations. Journal of Public Administration Research and Theory, 35(1), 112–128. https://doi.org/10.4102/aosis.2025.BK479.03.
    2. Alshamrani, S. (2024). Determinants of internal audit quality in government agencies. International Journal of Accounting Research, 12(2), 77–95.
    3. Arena, M., & Azzone, G. (2009). Identifying organizational drivers of internal audit effectiveness. International Journal of Auditing, 13(1), 43–60. https://doi.org/10.1111/j.1099-1123.2008.00392.x.
    4. Cheung, M. W.-L. (2024). Advances in structural equation modelling: Best practices for measurement and mediation. Behavior Research Methods, 56, 312–333.
    5. Dellai, M., Omri, M. A., & Omri, A. (2016). Factors affecting the internal audit effectiveness in Tunisian organizations. Research Journal of Fi-nance and Accounting, 7(16), 208–221.
    6. El Beshlawy, H., & Ardroumli, S. (2021). Board dynamics and decision making in turbulent times. Corporate Governance and Organizational Be-havior Review, 5, 57–58. https://doi.org/10.22495/cgobrv5i1p6.
    7. Endaya, K., & Hanefah, M. (2016). Internal audit effectiveness: An approach to develop the theoretical framework. Research Journal of Finance and Accounting, 7(10), 23–30.
    8. Goodwin-Groen, P., & Weisman, E. (2020). Governance and accountability in public sector health institutions. Global Health Governance Journal, 14(1), 1–12.
    9. Greapca, E. (2024). Management support and audit function performance: Evidence from public institutions. Public Organization Review, 24(2), 345–362.
    10. Hailemariam, S. (2023). Determinants of internal audit effectiveness in the public sector: Case study in selected Ethiopian public sector offices [Doctoral dissertation, Jimma University]. Jimma University Repository.
    11. Hair, J. F., Hult, G. T. M., Ringle, C. M., & Sarstedt, M. (2022). A primer on partial least squares structural equation modeling (PLS-SEM) (3rd ed.). SAGE Publications. https://doi.org/10.1007/978-3-030-80519-7.
    12. Hazaea, S., Al-Matari, E., & Almashaqbeh, I. (2024). Internal audit effectiveness and governance reforms in developing countries. Cogent Business & Management, 11(1), Article 2378002.
    13. Henseler, J. (2023). Composite-based SEM for theory development in management research. Management Research Review, 46(4), 789–805.
    14. Karagiorgos, T., Poutos, E., & Maras, V. (2025). Leadership support, organizational controls, and internal audit performance. Managerial Auditing Journal, 40(1), 55–78.
    15. Lutfi, A., Idris, K., & Mohd-Shamsudin, F. (2023). Internal audit practices and governance mechanisms in public-sector healthcare. BMC Health Services Research, 23, Article 1152.
    16. Mujalli, A. (2024). The role of e-audit systems in enhancing audit productivity and reliability. Electronic Journal of Information Systems Evaluation, 27(1), 45–58.
    17. Novatiani, R., Putri, D., & Ramadhani, S. (2024). Auditor competence, fraud detection, and audit quality. Journal of Accounting and Organiza-tional Change, 20(2), 233–252.
    18. Pereira, C., Santos, L., & Silva, M. (2024). Audit quality, organizational trust, and performance in public healthcare. Health Policy Open, 7, Article 100097.
    19. Teoh, A. P. (2017). Risk management implementation and its impact on firm performance: Evidence from Malaysian firms. International Journal of Economics and Management, 11(1), 221–235.
    20. Yoon, S., & Kim, J. (2021). Service quality and e-audit integration in public institutions. Journal of Public Sector Management, 34(3), 289–305.

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  • How to Cite

    Alghamdi, E. A. ., & Kassim, A. A. M. . (2026). The Impact of Key Factors on Internal Audit Performance:‎Evidence from Saudi Arabia’s ‎Healthcare Sector. International Journal of Accounting and Economics Studies, 13(1), 316-323. https://doi.org/10.14419/agzhhh17