METHODS: A total of 429 respondents diagnosed with urologic cancers (prostate cancer, bladder and renal cancer) from Sarawak General Hospital and Subang Jaya Medical Centre in Malaysia were interviewed using a structured questionnaire. Objective and subjective FT were measured by catastrophic health expenditure (healthcare-cost-to-income ratio greater than 40%) and the Personal Financial Well-being Scale, respectively. HRQoL was measured with the Functional Assessment of Cancer Therapy - General 7 Items scale.
RESULTS: Objective and subjective FT were experienced by 16.1 and 47.3% of the respondents, respectively. Respondents who sought treatment at a private hospital and had out-of-pocket health expenditures were more likely to experience objective FT, after adjustment for covariates. Respondents who were female and had a monthly household income less than MYR 5000 were more likely to experience average to high subjective FT. Greater objective FT (OR = 2.75, 95% CI 1.09-6.95) and subjective FT (OR = 4.68, 95% CI 2.63-8.30) were associated with poor HRQoL.
CONCLUSIONS: The significant association between both objective and subjective FT and HRQoL highlights the importance of reducing FT among urologic cancer patients. Subjective FT was found to have a greater negative impact on HRQoL.
Methods: Cross-sectional data from 62 developing countries were used to run several multivariate linear regressions. R2 was used to compare the powers of MPI with income-poverties (income poverty gaps [IPG] at 1.9 and 3.1 USD) in explaining LE.
Results: Adjusting for controls, both MPI (β =-0.245, P<0.001) and IPG at 3.1 USD (β=-0.135, P=0.044) significantly correlates with LE, but not IPG at 1.9 USD (β=-0.147, P=0.135). MPI explains 12.1% of the variation in LE compared to only 3.2% explained by IPG at 3.1 USD. The effect of MPI on LE is higher on female (β=-0.210, P<0.001) than male (β=-0.177, P<0.001). The relative influence of the deprivation indictors on LE ranks as follows (most to least): Asset ownership, drinking water, cooking fuel, flooring, child school attendance, years of schooling, nutrition, mortality, improved sanitation, and electricity.
Conclusion: Interventions to reduce poverty and improve LE should be guided by MPI, not income poverty indices. Such policies should be female-oriented and prioritized based on the relative influence of the various poverty deprivation indicators on LE.
Methods: This observational study employs secondary data from various official sources of 12 states and one federal territory in Malaysia (2002-2014). Panel data of 78 observations (13 cross-sections at six points in time) were used in multivariate, fixed-effect, regressions to estimate the effects of socioeconomic variables on life expectancy at birth for male, female and both-gender.
Results: Poverty and income significantly determine female, male, and total life expectancies. Unemployment significantly determines female and total life expectancies, but not male. Income inequality and public spending on health (as a percentage of total health spending) do not significantly determine life expectancy. The coefficients of the multivariate regressions suggest that a 1% reduction in poverty, 1% reduction in unemployment, and around USD 23.20 increase in household monthly income prolong total life expectancy at birth by 17.9, 72.0, and 16.3 d, respectively. The magnitudes of the effects of the socioeconomic variables on life expectancy vary somewhat by gender.
Conclusion: Life expectancy in Malaysia is higher than the world average and higher than that in some developing countries in the region. However, it is far lower than the advanced world. Reducing poverty and unemployment and increasing income are three effective channels to enhance longevity.
METHODS: A cross-sectional study was conducted at the National Heart Institute of Malaysia involving 503 patients who were hospitalized during the year prior to the survey.
RESULTS: The mean annual out-of-pocket health spending for IHD was MYR3045 (at the time US$761). Almost 16% (79/503) suffered from catastrophic health spending (out-of-pocket health spending ≥40% of household non-food expenditures), 29.2% (147/503) were unable to pay for medical bills, 25.0% (126/503) withdrew savings to help meet living expenses, 16.5% (83/503) reduced their monthly food consumption, 12.5% (63/503) were unable to pay utility bills and 9.0% (45/503) borrowed money to help meet living expenses.
CONCLUSIONS: Overall, the economic impact of IHD on patients in Malaysia was considerable and the prospect of economic hardship likely to persist over the years due to the long-standing nature of IHD. The findings highlight the need to evaluate the present health financing system in Malaysia and to expand its safety net coverage for vulnerable patients.
METHODS: Through the Association of Southeast Asian Nations Costs in Oncology study, 1490 newly diagnosed cancer patients were followed-up in Malaysia for 1 year. Health-related quality of life was assessed by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and EuroQol-5 (EQ-5D) dimension questionnaires at baseline, 3 and 12 months. Psychological distress was assessed by using Hospital Anxiety and Depression Scale. Data were modeled by using general linear and logistic regressions analyses.
RESULTS: One year after diagnosis, the mean EORTC QLQ-C30 Global Health score of the cancer survivors remained low at 53.0 over 100 (SD 21.4). Fifty-four percent of survivors reported at least moderate levels of anxiety, while 27% had at least moderate levels of depression. Late stage at diagnosis was the strongest predictor of low HRQoL. Increasing age, being married, high-income status, hospital type, presence of comorbidities, and chemotherapy administration were also associated with worse HRQoL. The significant predictors of psychological distress were cancer stage and hospital type.
CONCLUSION: Cancer survivors in this middle-income setting have persistently impaired HRQoL and high levels of psychological distress. Development of a holistic cancer survivorship program addressing wider aspects of well-being is urgently needed in our settings.