The Key Factors of Internal Audit Performance in Public Healthcare Facilities in Riyadh, Saudi Arabia

Abstract

Saudi Arabia’s healthcare transformation has increased the importance of internal audit as a governance mechanism for accountability, control, and risk oversight. This study examined how auditors’ competency (AC), e-audit (EA), and management support (MS) relate to internal audit performance (IAP) in public healthcare facilities, with audit quality (AQ) specified as a mediator and risk management (RM) as a moderator. A quantitative cross-sectional survey was conducted in 80 public healthcare facilities in Riyadh, Saudi Arabia. Responses from personnel involved in internal audit, control, risk, and related governance functions were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) in SmartPLS. The reported measurement results indicated strong reliability and convergent validity across the six constructs. The structural model reported positive coefficients from AC, EA, and MS to AQ and IAP, with the largest coefficient to AQ being AC (β = 0.397), followed by MS (β = 0.384) and EA (β = 0.293). AQ had a positive coefficient with IAP (β = 0.297), while the reported indirect coefficients through AQ for AC, EA, and MS were 0.118, 0.087, and 0.114, respectively. The reported RM interaction coefficients were also positive for AC (β = 0.140), EA (β = 0.128), and MS (β = 0.112). Because the manuscript does not report the inferential statistics required to establish path significance, the structural coefficients are interpreted descriptively. The reported pattern suggests that internal audit performance in Riyadh public healthcare is associated with professional capability, digital audit practices, management support, audit quality, and risk governance.