Equity in Out-of-Pocket Payments for Healthcare Services: Evidence from Malaysia

Baharin, Mohamed Fakhri Abu; Juni, Muhamad Hanafiah; Manaf, Rosliza Abdul

doi:10.3390/ijerph19084500

Cited by 5 publications

(5 citation statements)

References 33 publications

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“…Out-of-pocket (OOP) health expenditures were also mildly progressive in the same period, with a Kakwani index of 0.010. The national (macro) level expenditure showed that the government subsidized 58.2% of the funding in the public health sector [23,39].…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, Mohamed Fakhri Abu Baharin et al (2022) examined the equity of OOP payments for healthcare in Malaysia, utilizing data from the Household Expenditure Survey (HES) 2014/2015 [23]. This study focuses exclusively on OOP healthcare expenditures and provides an in-depth examination of expenditure categories within this domain.…”

Section: South and Southeast Asia Regionmentioning

confidence: 99%

“…Attributes of the studies encompassed within the review[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35].…”

mentioning

confidence: 99%

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Inequalities in Out-of-Pocket Health Expenditure Measured Using Financing Incidence Analysis (FIA): A Systematic Review

Shaltynov,

Jamedinova,

Semenova

et al. 2024

Healthcare

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Government efforts and reforms in health financing systems in various countries are aimed at achieving universal health coverage. Household spending on healthcare plays a very important role in achieving this goal. The aim of this systematic review was to assess out-of-pocket health expenditure inequalities measured by the FIA across different territories, in the context of achieving UHC by 2030. A comprehensive systematic search was conducted in the PubMed, Scopus, and Web of Science databases to identify original quantitative and mixed-method studies published in the English language between 2016 and 2022. A total of 336 articles were initially identified, and after the screening process, 15 articles were included in the systematic review, following the removal of duplicates and articles not meeting the inclusion criteria. Despite the overall regressivity, insurance systems have generally improved population coverage and reduced inequality in out-of-pocket health expenditures among the employed population, but regional studies highlight the importance of examining the situation at a micro level. The results of the study provide further evidence supporting the notion that healthcare financing systems relying less on public funding and direct tax financing and more on private payments are associated with a higher prevalence of catastrophic health expenditures and demonstrate a more regressive pattern in terms of healthcare financing, highlighting the need for policy interventions to address these inequities. Governments face significant challenges in achieving universal health coverage due to inequalities experienced by financially vulnerable populations, including high out-of-pocket payments for pharmaceutical goods, informal charges, and regional disparities in healthcare financing administration.

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Section: Discussionmentioning

confidence: 99%

Section: South and Southeast Asia Regionmentioning

confidence: 99%

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Inequalities in Out-of-Pocket Health Expenditure Measured Using Financing Incidence Analysis (FIA): A Systematic Review

Shaltynov,

Jamedinova,

Semenova

et al. 2024

Healthcare

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“…This means that the burden of these costs falls disproportionately on vulnerable groups, as OOP payments can be welfare reducing and can lead to financial hardship [ 33 , 34 ]. While previous local study has shown that OOP payments for healthcare in Malaysia are pro-rich [ 35 ], it is unclear how this distribution applies specifically to dental care. To address this issue, it is important to establish stewardship in oral healthcare and to provide quality and efficient oral healthcare services that reduce OOP costs.…”

Section: Discussionmentioning

confidence: 99%

Modelling the national economic burden of non-surgical periodontal management in specialist clinics in Malaysia using a markov model

Anuwar,

Ng,

Safii

et al. 2024

BMC Oral Health

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Background Non-surgical periodontal treatment is the mainstay of periodontal treatment. In Malaysia, the prevalence of periodontal disease is substantial among adults with almost half of them having periodontitis. Therefore, we estimated the economic burden of non-surgical periodontal treatment in specialist clinics in Malaysia. Methods Relevant data from multiple data sources which include national oral health and health surveys, national census, extensive systematic literature reviews, as well as discussion with experts, were used to estimate the economic burden of non-surgical periodontal management in specialist clinics in Malaysia in 2020. This estimation was done from the oral healthcare provider’s perspective in both public and private sectors using an irreducible Markov model of 3-month cycle length over a time horizon of one year. Results In 2020, the national economic burden of non-surgical periodontal treatment during the first year of periodontal management in specialist clinics in Malaysia was MYR 696 million (USD 166 million), ranging from MYR 471 million (USD 112 million) to MYR 922 million (USD 220 million). Of these, a total of MYR 485 million (USD 115 million) and MYR 211 million (USD 50 million) were the direct oral healthcare cost in public and private dental clinics, respectively. Conclusion The findings of this study demonstrated substantial economic burden of non-surgical periodontal management in specialist clinics in Malaysia. Being a life-long disease, these findings highlight the importance of enforcing primary and secondary preventive measures. On the strength and reliability of this economic evidence, this study provides vital information to inform policy- and decision-making regarding the future direction of managing periodontitis in Malaysia.

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“…The public healthcare services in Malaysia are highly subsidized for all Malaysians, with some services requiring citizens to pay out of their pocket [ 25 ]. Despite the nominal fee, the high percentage of unmet financial needs could be related to a disruption in their income [ 23 ], an increment in expenses associated with long-term care for stroke survivors [ 26 ], and financing the entire family [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

The Unmet Needs of Caregiving Skills, Support, Emotions, and Finances of Stroke Caregivers: A Multicenter Study

Mohd Zawawi,

Abd Aziz,

Fisher

et al. 2023

Cureus

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Background Informal stroke caregivers in Malaysia play an important role in supporting stroke survivors following acute care. Nevertheless, there is a lack of available data to inform the sufficiency of help and resources available to address the needs of local stroke caregivers. This study aimed to determine the unmet needs in caregiving skills, support, emotions, and finances as well as the associated factors of stroke caregivers in Malaysia. Methodology This multicenter, cross-sectional study used a self-administered survey developed and validated for the Malaysian population. It was prepared in paper-based and web-based formats, and it was distributed via direct contact with the respondents, post, and email. Respondents were recruited from different sites in Malaysia. In this study, unmet needs were defined as “help that was needed more or was not provided to assist caregivers and address their specific needs.” This article only presents the quantitative data of this study. Data were analyzed using descriptive analysis and logistic regression to determine factors associated with unmet needs. Results Almost all study respondents (91%) reported having unmet needs. Unmet needs ranged from 1 to 10, while the mean unmet needs was 5. The highest unmet need was related to financial support (72.5%), followed by support from professionals to address their own needs (59.2%), skills to care for stroke survivors, i.e., skills in caring for stroke survivors with their daily activities (57.9%), and skills in supporting stroke survivors to perform rehabilitation at home (53.1%). The lowest unmet need was related to support in transporting stroke survivors from place to place (45.3%). Additionally, this study did not identify an association between the reported unmet needs and gender, age, ethnicity, duration of caregiving, and site of participation. Conclusions This study reported a range of unmet needs perceived by stroke caregivers in Malaysia. Further research is warranted to understand the gaps in supporting local stroke caregivers to inform future post-stroke support and services in the country.

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Equity in Out-of-Pocket Payments for Healthcare Services: Evidence from Malaysia

Cited by 5 publications

References 33 publications

Inequalities in Out-of-Pocket Health Expenditure Measured Using Financing Incidence Analysis (FIA): A Systematic Review

Inequalities in Out-of-Pocket Health Expenditure Measured Using Financing Incidence Analysis (FIA): A Systematic Review

Modelling the national economic burden of non-surgical periodontal management in specialist clinics in Malaysia using a markov model

The Unmet Needs of Caregiving Skills, Support, Emotions, and Finances of Stroke Caregivers: A Multicenter Study

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