CONTEXT: Malaysia has rapidly expanded Virtual Consultation Services (VCS) in public primary care to improve access and reduce healthcare burden. However, local evidence on patient-incurred cost savings from VCS remains limited.
OBJECTIVES: This study estimated the mean cost saving per patient from virtual consultations compared with physical consultations and examined differences in patient-incurred costs between the two modalities in Malaysian public primary care.
METHODS: A cross-sectional study was conducted from July to October 2025 in 91 government health clinics across East and West Malaysia. Malaysian adults aged ≥18 years who had attended at least one physical and one virtual outpatient follow-up consultation were included. Cost data were collected from the patient's perspective using a structured online proforma. Direct and indirect costs were identified, measured, and valued. Paired t-tests were used to compare mean costs, with Wilcoxon signed-rank tests performed as sensitivity analyses.
RESULTS: A total of 420 participants were included (mean age 37.23 years [SD = 11.04]; 78.3% female). The mean total cost of a physical consultation was RM47.97 (SD = RM60.69), compared with RM0.04 (SD = RM0.69) for a virtual consultation. The mean cost saving per patient was RM47.93 (SD = RM60.64), with a significant mean difference (95% CI: RM42.12-RM53.75; P < 0.001). Travel costs and productivity loss were the main contributors to cost savings.
CONCLUSION: Virtual consultations resulted in substantial patient-level cost savings compared with physical consultations, supporting continued scale-up of VCS in Malaysian public primary care.
* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.