Assessing progress towards Sustainable Development Goal 3.8.2 and determinants of catastrophic health expenditures in Malaysia

Abstract

The Sustainable Development Goal 3.8.2 is an indicator to track a country’s progress toward universal health coverage on the financial protection against catastrophic health expenditure (CHE). The purpose of this study is to determine the proportion of households with catastrophic health expenditure, and its associated factors among Malaysian households. A secondary data analysis was performed using the Household Expenditure Survey 2015/2016. The inclusion criterion was Malaysian households with some health spending in the past 12 months before the date of the survey. Catastrophic health expenditure was defined as out-of-pocket health expenditures exceeding 10% of the total household consumption. The study included a total of 13015 households. The proportion of households with CHE in the sample was 2.8%. Female-led households (AdjOR 1.6; CI 1.25, 2.03; p-value <0.001), households in rural areas (AdjOR 1.29; 95% CI 1.04, 1.61; p-value = 0.022), small household size (AdjOR 2.4; 95% CI 1.81, 3.18; p-value <0.001) and heads of household under 60 years old (AdjOR2.34; 95% CI 1.81, 3.18; p-value <0.001) were significantly associated with CHE. Although the proportion of Malaysian households affected by CHE is small, it is increasing in comparison to previous findings. This is concerning because it may jeopardise efforts to achieve universal health coverage by 2030. To ensure financial protection and access to care, a health financing policy that includes safety net measures for households at risk of CHE is required.

Assessing catastrophic health expenditure and impoverishment in adult asthma care: a cross-sectional study of patients attending six public health clinics in Klang District, Malaysia

“…Protecting households against financial hardship has been conceptualised as ensuring financial protection [ 25 ]. Malaysia is committed to delivering the mission of the United Nations Sustainable Development Goals in achieving and sustaining universal health coverage [ 26 ] and this is illustrated by the findings of this study. It provides a free service for those working or retirees from the public sector, while others obtain treatment from public health clinics are heavily subsidised with just needing to pay a very minimal fee [ 26 ].…”

“…Malaysia is committed to delivering the mission of the United Nations Sustainable Development Goals in achieving and sustaining universal health coverage [ 26 ] and this is illustrated by the findings of this study. It provides a free service for those working or retirees from the public sector, while others obtain treatment from public health clinics are heavily subsidised with just needing to pay a very minimal fee [ 26 ]. Asthma is a common chronic respiratory condition in Malaysia, with most patients seeking care at outpatient clinics either at the primary or secondary care level [ 27 ].…”

The economic burden of zoonoticPlasmodium knowlesimalaria on households in Sabah, Malaysia compared to malaria from human-onlyPlasmodiumspecies

“…Alternatively, households may deplete savings, take funding for schooling, sell cash crops or animals or incur other forms of significant debt, collectively contributing to a possible long-term detrimental household debt-cycle [1]. Many of these factors may be further exacerbated if occurring in conjunction with a limited household savings buffer, including a lack of cash flow for those reliant on subsistence farming, for which selling assets such as land or changing agricultural practices to prioritize growing of higher risk cash crops may therefore further jeopardize future household earning potential or stability [27,44]. Households with lower socio-economic status have been found to be at a higher risk of having malaria, [24] indicating the inequitable these households bear.…”

Catastrophic Health Expenditure Among Cancer Patients In National Cancer Institute (NCI), Malaysia And Its Influencing Factors

“…In our literature search, not many studies are available on the association between cancer and CHE, and there were even less studies done in Malaysia to look at this association (16)(17)(18)(19). However, there were also a few studies which have looked into CHE in non-cancer patients in Malaysia such as by Loganathan et al (20), Sukeri et al (21), Zainal et al (22), Sayuti and Sukeri (23), and Samsudin et al (24). A large scale study on cancers involving Malaysia was conducted by the ACTION group, as part of the CHE prevalence study among cancer cases in South East Asia (25).…”