Catastrophic Health Expenditure and its influencing factors in Malaysia

Wp, Sharifa Ezat; Aizuddin, Azimatun Noor; Zainuddin, Zakiah; Manaf, Mohd Rizal Abd; Aljunid, Syed Mohamed

doi:10.1186/1472-6963-12-s1-p2

Cited by 2 publications

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“…Currently, there is scant evidence about the financial risk protection provided by PHI in Malaysia, which is often limited to qualitative studies conducted among cancer patients. Existing studies mainly investigate the factors associated with the purchase of PHI and factors associated with catastrophic health expenditure ( Abu Bakar et al ., 2012 ; Sharifa Ezat et al ., 2012 ; Ellyana et al ., 2020 ; Sukeri and Sayuti, 2020 ; Balqis-Ali et al ., 2021 ). This evaluation is timely and much needed as the government continues encouraging the population to purchase PHI, while efforts are made to revamp the healthcare subsidies to be more targeted.…”

Section: Introductionmentioning

confidence: 99%

Effect of supplementary private health insurance on out-of-pocket inpatient medical expenditure: evidence from Malaysia

Ng,

Choo,

et al. 2024

Health Policy and Planning

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The vital role of healthcare financing in achieving Universal Health Coverage (UHC) is indisputable. However, most countries, including Malaysia, face challenges in establishing an equitable and sustainable healthcare financing system due to escalating healthcare costs, an ageing population, and a growing disease burden. With desirable pre-payment and risk pooling features, private health insurance (PHI) is considered an alternative financing option to reduce out-of-pocket (OOP) medical expenditure. However, ongoing theoretical and empirical debates persist regarding the adequacy of financial risk protection provided by PHI largely because it depends on its role, the benefit design, and the regulations in place. Our study aimed to investigate the effect of supplementary PHI on OOP inpatient medical expenditure in Malaysia. Secondary data analysis was conducted using the Malaysian National Health and Morbidity Survey 2019 dataset. A total of 983 respondents with a history of inpatient hospitalization in the past 12 months were included in the study. Instrumental variable (IV) analysis using a two-stage residual inclusion was performed to address endogeneity bias, with wealth status and education level as the IVs. Tobit regression model was used in the second stage considering the censored distribution of the outcome variable. Missing data was handled using multiple imputation. About one-fifth of the respondents had PHI. In this study, we found that having PHI significantly increased OOP inpatient medical expenditure in all three marginal effects. Additionally, age, residential location, ethnicity(citizenship), being covered by government guarantee letter, government funding, and employer-sponsored health insurance were other significant factors associated with OOP inpatient medical expenditure. Our findings undermine a key justification to advocate PHI uptake among the population, with a need for the Malaysian government to reassess the role of PHI in healthcare financing and reconsider PHI subsidization policy. Regulations should also be strengthened to enhance the financial risk protection provided by PHI.

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Section: Introductionmentioning

confidence: 99%

Effect of supplementary private health insurance on out-of-pocket inpatient medical expenditure: evidence from Malaysia

Ng,

Choo,

et al. 2024

Health Policy and Planning

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“…Catastrophic Health Expenditure (CHE) can be defined as any health expenditure which can threaten the financial capability of a household to maintain its subsistence needs (1). CHE can occur when a household has to pay an amount from out-of-pocket (OOP) for healthcare expenditure, which is higher than a certain threshold level from the household income or expenditure (2).…”

Section: Introductionmentioning

confidence: 99%

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

Wan Puteh,

Abdullah,

Aizuddin

2024

MJMHS

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Introduction: This study looks at the patient’s perspective to determine the Catastrophic Health Expenditure (CHE) level and the possible factors which can be associated with CHE in cancer patients. Methods: This cross sectional study was done in National Cancer Institute, Malaysia with 206 patients sampled using the multilevel sampling method and data collected from interview with patients using a validated questionnaire. The CHE definition used in this study is when the monthly health expenditure exceeds more than 10% of the monthly household income. Results: This study showed a CHE level of 26.2%. CHE was higher in Indian ethnicity (P = 0.017), single marital status (P = 0.019), poverty income (P < 0.001), small household size (P = 0.006) and without Guarantee Letter (GL) (P = 0.002) groups. The significant predicting factors were poverty income aOR 5.60 (95% CI: 2.34 – 13.39), home distance near to hospital aOR 4.12 (95% CI: 1.74 – 9.76), small household size aOR 4.59 (95% CI: 1.07 – 19.72) and lack of Guarantee Letter aOR 3.21 (95% CI: 1.24 – 8.30). Conclusion: The information from this paper can be used by policy makers to formulate better strategies in terms of health financing so that high risk for CHE cancer patients groups can be protected under a better health financing system.

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Catastrophic Health Expenditure and its influencing factors in Malaysia

Cited by 2 publications

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Effect of supplementary private health insurance on out-of-pocket inpatient medical expenditure: evidence from Malaysia

Effect of supplementary private health insurance on out-of-pocket inpatient medical expenditure: evidence from Malaysia

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

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