The Impact of Key Factors on Internal Audit Performance:Evidence from Saudi Arabia’s Healthcare Sector
DOI:
https://doi.org/10.14419/agzhhh17Keywords:
Internal Audit, Government Units in KSA, Saudi Vision 2030, and the Health Sector.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
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.
Alshamrani, S. (2024). Determinants of internal audit quality in government agencies. International Journal of Accounting Research, 12(2), 77–95.
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.
Cheung, M. W.-L. (2024). Advances in structural equation modelling: Best practices for measurement and mediation. Behavior Research Methods, 56, 312–333.
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.
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.
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.
Goodwin-Groen, P., & Weisman, E. (2020). Governance and accountability in public sector health institutions. Global Health Governance Journal, 14(1), 1–12.
Greapca, E. (2024). Management support and audit function performance: Evidence from public institutions. Public Organization Review, 24(2), 345–362.
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.
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.
Hazaea, S., Al-Matari, E., & Almashaqbeh, I. (2024). Internal audit effectiveness and governance reforms in developing countries. Cogent Business & Management, 11(1), Article 2378002.
Henseler, J. (2023). Composite-based SEM for theory development in management research. Management Research Review, 46(4), 789–805.
Karagiorgos, T., Poutos, E., & Maras, V. (2025). Leadership support, organizational controls, and internal audit performance. Managerial Auditing Journal, 40(1), 55–78.
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.
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.
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.
Pereira, C., Santos, L., & Silva, M. (2024). Audit quality, organizational trust, and performance in public healthcare. Health Policy Open, 7, Article 100097.
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.
Yoon, S., & Kim, J. (2021). Service quality and e-audit integration in public institutions. Journal of Public Sector Management, 34(3), 289–305.
Downloads
Published
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal''s published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
