Health Care Utilization and Out-of-Pocket Payments among Elderly with Cognitive Frailty in Malaysia

Abstract

Background: Cognitive frailty (CF) as a potential risk factor for dementia, functional disability, poor quality of life, and mortality. The aim of this study was to explore the health care-related utilization and out-of-pocket (OOP) expenditures, sociodemographic characteristics, and comorbidities among elderly Malaysians with CF. Methods: A cross-sectional study targeting elderly Malaysian aged ≥65 years was conducted. The study included all participants of the fourth phase of the Malaysian representative Long-Term-Research-Grant-Scheme Towards-Useful-Aging (LRGS-TUA) community-based study. A structured and validated interview questionnaire was used. Results: In total, 1006 elderly were interviewed, with a 66.18% response rate. Only 730 respondents met the inclusion criteria. Of the eligible respondents, the CF prevalence was 4.5%. Around 60.6% of the participants with CF had utilized outpatient care at government clinics within the past 6 months. The estimated mean total OOP payments for CF during the past 6 months was 84 Malaysian Ringgit (RM) (SD 96.0). Conclusions: CF among elderly Malaysians is within the internationally recognized range of prevalence. The OOP payments for seeking health care among CF elderly are not different from that of other elderly categories. There is a high possibility of underutilization of the health care services of CF cases while they are still needy.

Cost effectiveness of quadrivalent influenza vaccines in the elderly population of Malaysia

“…In this study, we calculated the patient’s and caregiver’s productivity losses based on the duration of hospitalization and outpatient visits from the Casemix database and expert input 2 . According to a current study conducted in Malaysia, 16% of the elderly aged over 65 years are currently employed 27 . Therefore, the estimation of absenteeism due to workdays lost as well as productivity loss due to pre-mature death for the elderly population was included to reflect the societal perspective.…”

“…The estimated average daily productivity (USD 39.72) was calculated based on Malaysia’s gross domestic product (GDP) per capita in 2020 26 , based on the assumption of 40 working hours per week or 8 working hours per day. Employment rates among the elderly were referenced from a recent study done in Malaysia 27 while rates among their caregivers were based on the Department of Statistics Malaysia reports 28 . We estimated the costs of lost productivity of their caregivers due to hospitalization and disability in this population.…”