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  1. Ng CW
    Citation: Ng CW. Universal Health Coverage Assessment Malaysia. Kuala Lumpur: Global Network for Health Equity (GNHE); 2015
    Matched MeSH terms: Healthcare Financing
  2. Chua HT, Cheah JC
    BMC Public Health, 2012;12 Suppl 1:S7.
    PMID: 22992444 DOI: 10.1186/1471-2458-12-S1-S7
    One of the challenges to maintain an agenda for universal coverage and equitable health system is to develop effective structuring and management of health financing. Global experiences with different systems of health financing suggests that a strong public role in health financing is essential for health systems to protect the poor and health systems with the strongest state role are likely the more equitable and achieve better aggregate health outcomes. Using Malaysia as a case study, this paper seeks to evaluate the progress and capacity of a middle income country in terms of health financing for universal coverage, and also to highlight some of the key underlying health systems challenges.The WHO Health Financing Strategy for the Asia Pacific Region (2010-2015) was used as the framework to evaluate the Malaysian healthcare financing system in terms of the provision of universal coverage for the population, and the Malaysian National Health Accounts (2008) provided the latest Malaysian data on health spending. Measuring against the four target indicators outlined, Malaysia fared credibly with total health expenditure close to 5% of its GDP (4.75%), out-of-pocket payment below 40% of total health expenditure (30.7%), comprehensive social safety nets for vulnerable populations, and a tax-based financing system that fundamentally poses as a national risk-pooled scheme for the population.Nonetheless, within a holistic systems framework, the financing component interacts synergistically with other health system spheres. In Malaysia, outmigration of public health workers particularly specialist doctors remains an issue and financing strategies critically needs to incorporate a comprehensive workforce compensation strategy to improve the health workforce skill mix. Health expenditure information is systematically collated, but feedback from the private sector remains a challenge. Service delivery-wise, there is a need to enhance financing capacity to expand preventive care, in better managing escalating healthcare costs associated with the increasing trend of non-communicable diseases. In tandem, health financing policies need to infuse the element of cost-effectiveness to better manage the purchasing of new medical supplies and equipment. Ultimately, good governance and leadership are needed to ensure adequate public spending on health and maintain the focus on the attainment of universal coverage, as well as making healthcare financing more accountable to the public, particularly in regards to inefficiencies and better utilisation of public funds and resources.
    Matched MeSH terms: Healthcare Financing*
  3. Thomas S, Beh L, Nordin RB
    J Public Health Afr, 2011 Sep 05;2(2):e23.
    PMID: 28299064 DOI: 10.4081/jphia.2011.e23
    Since 1957, there has been major reorganization of health care services in Malaysia. This article assesses the changes and challenges in health care delivery in Malaysia and how the management in health care processes has evolved over the years including equitable health care and health care financing. The health care service in Malaysia is changing towards wellness service as opposed to illness service. The Malaysian Ministry of Health (MOH), being the main provider of health services, may need to manage and mobilize better health care services by providing better health care financing mechanisms. It is recommended that partnership between public and private sectors with the extension of traditional medicine complementing western medicine in medical therapy continues in the delivery of health care.
    Matched MeSH terms: Healthcare Financing
  4. Mohamad Nasaruddin Mahdzir, Izwan Effendy Zainuddin, Sharifa Ezat Wan Puteh
    Int J Public Health Res, 2012;2(2):177-183.
    MyJurnal
    The relationship between healthcare services and inequalities is more likely when a group that shares a salient identity faces severe inequalities of various kinds. Such inequalities may be catalyzed by economic, social, political or concern cultural status. The objectives of this review are to identify the issues and challenges involve in healthcare inequalities, to compare factors contributes to healthcare inequalities and to purpose suggestions and recommendations for improvement based on issues and challenges between United States and India. Comparing annual year healthcare report, documentation of healthcare institutional, Ministry of Health's report and circular, official institutional website, scientific healthcare journals, articles and reports published in 1994 until 2011 regarding healthcare inequalities between United States and India. Health inequalities in the healthcare system contributed by the different in socioeconomic status and accessibility to the healthcare facility due to high cost of treatment has been common risk 'Catastrophic' factors to the inequalities in both countries. Health financing system and resource allocation that benefit only the upper class social spectrum of the population. Disparities occur due to the imbalance in distribution of wealth, discrimination and change in the world economy. Adapting healthcare system that provides care to all classes of people need improvement as no healthcare system is perfect. This matter must be tackle urgently as it's a matter of national concern.
    Matched MeSH terms: Healthcare Financing
  5. Azzani M, Roslani AC, Su TT
    Malays J Med Sci, 2019 Jan;26(1):15-43.
    PMID: 30914891 DOI: 10.21315/mjms2019.26.1.3
    The World Health Organization estimates that annually 150 million people experience severe (catastrophic) financial difficulties as a result of healthcare payments. Therefore, a systematic review was carried out to identify the determinants of household catastrophic health expenditure (CHE) in low-to high-income countries around the world. Both electronic and manual searches were conducted. The main outcome of interest was the determinants of CHE due to healthcare payments. Thirty eight studies met the inclusion criteria for review. The analysis revealed that household economic status, incidence of hospitalisation, presence of an elderly or disabled household member in the family, and presence of a family member with a chronic illness were the common significant factors associated with household CHE. The crucial finding of the current study is that socioeconomic inequality plays an important role in the incidence of CHE all over the world, where low-income households are at high risk of financial hardship from healthcare payments. This suggests that healthcare financing policies should be revised in order to narrow the gap in socioeconomic inequality and social safety nets should be implemented and strengthened for people who have a high need for health care.
    Matched MeSH terms: Healthcare Financing
  6. Asante A, Price J, Hayen A, Jan S, Wiseman V
    PLoS ONE, 2016;11(4):e0152866.
    PMID: 27064991 DOI: 10.1371/journal.pone.0152866
    INTRODUCTION: Health financing reforms in low- and middle- income countries (LMICs) over the past decades have focused on achieving equity in financing of health care delivery through universal health coverage. Benefit and financing incidence analyses are two analytical methods for comprehensively evaluating how well health systems perform on these objectives. This systematic review assesses progress towards equity in health care financing in LMICs through the use of BIA and FIA.

    METHODS AND FINDINGS: Key electronic databases including Medline, Embase, Scopus, Global Health, CinAHL, EconLit and Business Source Premier were searched. We also searched the grey literature, specifically websites of leading organizations supporting health care in LMICs. Only studies using benefit incidence analysis (BIA) and/or financing incidence analysis (FIA) as explicit methodology were included. A total of 512 records were obtained from the various sources. The full texts of 87 references were assessed against the selection criteria and 24 were judged appropriate for inclusion. Twelve of the 24 studies originated from sub-Saharan Africa, nine from the Asia-Pacific region, two from Latin America and one from the Middle East. The evidence points to a pro-rich distribution of total health care benefits and progressive financing in both sub-Saharan Africa and Asia-Pacific. In the majority of cases, the distribution of benefits at the primary health care level favoured the poor while hospital level services benefit the better-off. A few Asian countries, namely Thailand, Malaysia and Sri Lanka, maintained a pro-poor distribution of health care benefits and progressive financing.

    CONCLUSION: Studies evaluated in this systematic review indicate that health care financing in LMICs benefits the rich more than the poor but the burden of financing also falls more on the rich. There is some evidence that primary health care is pro-poor suggesting a greater investment in such services and removal of barriers to care can enhance equity. The results overall suggest that there are impediments to making health care more accessible to the poor and this must be addressed if universal health coverage is to be a reality.

    Matched MeSH terms: Healthcare Financing*
  7. Aizuddin AN, Aljunid SM
    Ann Glob Health, 2017 11 21;83(3-4):654-660.
    PMID: 29221542 DOI: 10.1016/j.aogh.2017.10.002
    BACKGROUND: Malaysia is no exception to the challenging health care financing phenomenon of globalization.

    OBJECTIVES: The objective of the present study was to assess the ability to pay among Malaysian households as preparation for a future national health financing scheme.

    METHODS: This was a cross-sectional study involving representative samples of 774 households in Peninsular Malaysia.

    FINDINGS: A majority of households were found to have the ability to pay for their health care. Household expenditure on health care per month was between MYR1 and MYR2000 with a mean (standard deviation [SD]) of 73.54 (142.66), or in a percentage of per-month income between 0.05% and 50% with mean (SD) 2.74 (5.20). The final analysis indicated that ability to pay was significantly higher among younger and higher-income households.

    CONCLUSIONS: Sociodemographic and socioeconomic statuses are important eligibility factors to be considered in planning the proposed national health care financing scheme to shield the needed group from catastrophic health expenditures.

    Matched MeSH terms: Healthcare Financing*
  8. Azimatun Noor, A., Mohd Rizal, A.M., Rozital, H., Aljunid, S.M.
    MyJurnal
    Introduction : Limited access to health services, variations in quality of health care and pressure to contain escalation of health care cost are problems in health care systems that are faced by all the societies in the world especially in developing countries. There is an urgent need to conduct a study to assess perception of individual towards health care services in the new planned National Healthcare Financing Scheme.
    Objective : The study objective is to examine the perception towards health care services among the farming community and to assess the willingness to contribute to The New National Health Financing Scheme.
    Methods : A cross sectional study involving farmers in the state of Selangor in Peninsular Malaysia was conducted. A total of 400 farmers as the household head were selected using multistage random sampling method.
    Results : The respondents’ mean score of perception towards public healthcare services were higher than the respondents’ mean score of perceptions towards private healthcare services except for accessibility and convenience aspects. There was no association between willingness to contribute to The New National Healthcare Financing Scheme and perception towards public healthcare services but there was association between willingness to contribute to The New National Healthcare Financing Scheme and perception towards private healthcare services.
    Conclusion : Perception towards healthcare services is an important element in the implementation of The New National Healthcare Financing Scheme as it will determine the willingness of an individual to contribute to it.
    Matched MeSH terms: Healthcare Financing
  9. Aizuddin, A.N., Hoda, R., Rizal, A.M., Yon, R., Al Junid, S.M.
    MyJurnal
    Introduction: In view of high healthcare expenditure, Malaysia also faces problems in healthcare financing. The policy option is to establish a national health financing scheme. However, it is a problem to develop mechanisms to cover social insurance package to more than one third of the population working in informal sector such as farmers. Therefore, there is an urgent need to assess the ability and willingness of the farming community. The main objective was to study the ability and willingness in the farming community to contribute to national healthcare financing scheme.

    Methodology: This a cross sectional study involved 400 farmers in Selangor. A total of 92.3% farmers were able to pay for the healthcare.

    Results: Willingness to contribute to The national healthcare financing scheme were RM2.00 per month.

    Conclusion: The education level influenced the ability to pay while the educational level and per capita income influenced willingness to pay.
    Matched MeSH terms: Healthcare Financing
  10. Rannan-Eliya RP, Anuranga C, Manual A, Sararaks S, Jailani AS, Hamid AJ, et al.
    Health Aff (Millwood), 2016 May 01;35(5):838-46.
    PMID: 27140990 DOI: 10.1377/hlthaff.2015.0863
    Malaysia has made substantial progress in providing access to health care for its citizens and has been more successful than many other countries that are better known as models of universal health coverage. Malaysia's health care coverage and outcomes are now approaching levels achieved by member nations of the Organization for Economic Cooperation and Development. Malaysia's results are achieved through a mix of public services (funded by general revenues) and parallel private services (predominantly financed by out-of-pocket spending). We examined the distributional aspects of health financing and delivery and assessed financial protection in Malaysia's hybrid system. We found that this system has been effective for many decades in equalizing health care use and providing protection from financial risk, despite modest government spending. Our results also indicate that a high out-of-pocket share of total financing is not a consistent proxy for financial protection; greater attention is needed to the absolute level of out-of-pocket spending. Malaysia's hybrid health system presents continuing unresolved policy challenges, but the country's experience nonetheless provides lessons for other emerging economies that want to expand access to health care despite limited fiscal resources.
    Matched MeSH terms: Healthcare Financing*
  11. Sukeri S, Mirzaei M, Jan S
    Int Health, 2017 01;9(1):29-35.
    PMID: 28028130 DOI: 10.1093/inthealth/ihw054
    BACKGROUND: Malaysia is an upper-middle income country with a tax-based health financing system. Health care is relatively affordable, and safety nets are provided for the needy. The objectives of this study were to determine the out-of-pocket health spending, proportion of catastrophic health spending (out-of-pocket spending >40% of non-food expenditure), economic hardship and financial coping strategies among patients with ischaemic heart disease (IHD) in Malaysia under the present health financing system.

    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.

    Matched MeSH terms: Healthcare Financing*
  12. Chee H L, Barraclough S
    ISBN: 978-0-203-96483-5
    Foreword. M K Rajakumar
    Introduction: The transformation of health care in Malaysia. p1. CHEE HENG LENG AND SIMON BARRACLOUGH
    PART I: The state and the private sector in the financing and provision of health care. p17
    1 The growth of corporate health care in Malaysia. p19. CHEE HENG LENG AND SIMON BARRACLOUGH
    2 Regulating Malaysia’s private health care sector. p40. NIK ROSNAH WAN ABDULLAH
    3 Rising health care costs: the contradictory responses of the Malaysian state. p59. PHUA KAI LIT
    4 Malaysian health policy in comparative perspective. p72. M. RAMESH
    5 The welfarist state under duress: global influences and local contingencies in Malaysia. p85. CHAN CHEE KHOON
    6 Equity in Malaysian health care: an analysis of public health expenditures and health care facilities. p102. WEE CHONG HUI AND JOMO K.S.
    PART II: People’s access to health care. p117
    7 Health care for the Orang Asli: consequences of paternalism and non-recognition. p119. COLIN NICHOLAS AND ADELA BAER
    8 Women’s access to health care services in Malaysia. p137. CHEE HENG LENG AND WONG YUT LIN
    9 HIV/AIDS health care policy and practice in Malaysia. p154. HUANG MARY S.L. AND MOHD NASIR MOHD TAIB
    10 Health care and long-term care issues for the elderly. p170. ONG FON SIM
    11 Health care in Sarawak: model of a public system. p187. KHOO KHAY JIN
    Epilogue: Civil society and health care policy in Malaysia. p208. CHEE HENG LENG AND SIMON BARRACLOUGH
    Index
    Matched MeSH terms: Healthcare Financing
  13. Shahar S, Lau H, Puteh SEW, Amara S, Razak NA
    BMC Public Health, 2019 Jun 13;19(Suppl 4):552.
    PMID: 31196021 DOI: 10.1186/s12889-019-6852-8
    The current issue of BMC Public Health presents work by the Consortium of Low Income Population Research (CB40R), highlighting a comprehensive aspect of health, i.e., physical health, mental health, health behaviour and health financing; and also nutrition involving all stages of lifespan of the socioeconomic deprived group in Malaysia.Consortium of B40 Research (CB40R) reposited and harmonised shared, non-identifiable data from epidemiological studies involving low income population (B40) in Malaysia. CB40R also performed joint or mega-analyses using combined, harmonised data sets that yield collated results with enhanced statistical power, more variabilities (study population, geographical regions, ethnicities and sociocultural groups) to better understand the needs, characteristics and issues of B40 groups in Malaysia. It also aimed to develope a system/framework of minimum/standard variables to be collected in research involving B40 in future. For this special issues, members of the consortium have been invited to contribute an original article involving analysis of the health aspects, access to health and nutritional issues of the B40 samples.All the papers in this special issue have successfully highlighted the health and nutritional issues (i.e., non-communicable disease (NCD), inflammatory bowel disease (IBD), knowledge towards sexually transmitted disease (STD), low birth weight, Motoric Cognitive Risk (MCR) syndrome, urinary incontinence), mental health, oral health and inequalities among the low-income group in Malaysia, including the rural population and also the urban poor. The low-income population in Malaysia is also at risk of both under- and over nutrition, of which specific cost effective strategies are indeed needed to improve their quality of life.The low income population in Malaysia is facing various health challenges, particularly related to NCD and poor mental health, nutritional and physical function. There is a need for a sustainable intervention model to tackle the issues. It is also important to highlight that reducing SES disparities in health will require policy initiatives addressing the components of socioeconomic status (income, education, and occupation) as well as the pathways by which these affect health.
    Matched MeSH terms: Healthcare Financing
  14. Myint CY, Pavlova M, Thein KN, Groot W
    PLoS ONE, 2019;14(6):e0217278.
    PMID: 31199815 DOI: 10.1371/journal.pone.0217278
    We systematically review the health-financing mechanisms, revenue rising, pooling, purchasing, and benefits, in the Association of Southeast Asian Nations (ASEAN) and the People's Republic of China, and their impact on universal health coverage (UHC) goals in terms of universal financial protection, utilization/equity and quality. Two kinds of sources are reviewed: 1) academic articles, and 2) countries' health system reports. We synthesize the findings from ASEAN countries and China reporting on studies that are in the scope of our objective, and studies that focus on the system (macro level) rather than treatment/technology specific studies (micro level).The results of our review suggest that the main sources of revenues are direct/indirect taxes and out of pocket payments in all ASEAN countries and China except for Brunei where natural resource revenues are the main source of revenue collection. Brunei, Indonesia, Philippines, Malaysia, and Viet Nam have a single pool for revenue collection constituting a national health insurance. Cambodia, China, Lao, Singapore, and Thailand have implemented multiple pooling systems while Myanmar has no formal arrangement. Capitation, Fee-for-Service, DRGs, Fee schedules, Salary, and Global budget are the methods of purchasing in the studied countries. Each country has its own definition of the basic benefit package which includes the services that are perceived as essential for the population health. Although many studies provide evidence of an increase in financial protection after reforming the health-financing mechanisms in the studied countries, inequity in financial protection continue to exist. Overall, the utilization of health care among the poor has increased as a consequence of the implementation of government subsidized health insurance schemes which target the poor in most of the studied countries. Inappropriate policies and provider payment mechanisms impact on the quality of health care provision. We conclude that the most important factors to attain UHC are to prioritize and include vulnerable groups into the health insurance scheme. Government subsidization for this kind of groups is found to be an effective method to achieve this goal. The higher the percentage of government expenditure on health, the greater the financial protection is. At the same time, there is a need to weigh the financial stability of the health-financing system. A unified health insurance system providing the same benefit package for all, is the most efficient way to attain equitable access to health care. Capacity building for both administrative and health service providers is crucial for sustainable and good quality health care.
    Matched MeSH terms: Healthcare Financing
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