Displaying publications 1 - 20 of 65 in total

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  1. Macalister GH
    Matched MeSH terms: Insurance
  2. Noriszura Ismail, Abdul Aziz Jemain
    This study suggests the regression models of Lognormal, Normal and Gamma for the construction of an insurance scoring system. Comparison between Lognormal, Normal and Gamma regression models were also carried out, and the comparison were centered upon three main elements; fitting procedures, parameter estimates and structure of scores. The main advantage of utilizing a scoring system is that the system may be used by insurers to differentiate between good and bad insureds and thus allowing the profitability of insureds to be predicted.
    Matched MeSH terms: Insurance; Insurance Carriers
  3. Dent J Malaysia Singapore, 1970 Oct;10(2):42-7.
    PMID: 4926400
    Matched MeSH terms: Insurance, Dental
  4. Hegan T
    Med J Malaysia, 2003 Mar;58 Suppl A:141-5.
    PMID: 14556362
    Over the last decade the number of negligence cases brought against doctors, dentists and other healthcare professional has increased significantly in many countries around the world. In addition, the proliferation of the pathways of accountability in many countries means that doctors are feeling undervalued and vulnerable and are therefore seeking assistance and protection more than ever. The effect of a claim or complaint on a doctor can be devastating both personally and professionally. The relationship with the patient is damaged and an increase in defensive practice ultimately causes an increase in healthcare costs. Patient expectations have increased. Patients are more knowledgeable than they were five years ago and the demands on the professions are increasing daily. Unfortunately because of the long delays that are seen between an incident and a claim it is very difficult to predict what reserves are required in the future. We have seen a number of organisations pull out of the business over the last year and it highlights the importance of having an understanding of the needs of the professions and the ability to track trends in litigation in order to set appropriate subscription rates. Doctors and other healthcare professionals require more than just financial protection. They need support from their colleagues and assistance from experienced lawyers in order to help restore their confidence and ensure that they can continue to practice for the benefit of their patients in the future.
    Matched MeSH terms: Insurance, Liability*
  5. Jamal MH, Abdul Aziz AF, Aizuddin AN, Aljunid SM
    Front Public Health, 2022;10:918188.
    PMID: 36388320 DOI: 10.3389/fpubh.2022.918188
    Social health insurance (SHI) is a form of health finance mechanism that had been implemented in many countries to achieve universal health care (UHC). To emulate the successes of SHI in many developed countries, many developing and middle-income countries (MICs) have attempted to follow suit. However, the SHI implementation has problems and obstacles. Many more obstacles were observed despite some successes. This scoping review aimed to study the various developments of SHI globally in its uses, implementation, successes, and obstacles within the last 5 years from 2017 to 2021. Using three databases (i.e., PubMed, EBSCO, and Google Scholar), we reviewed all forms of articles on SHI, including gray literature. The PRISMA-ScR protocol was adapted as the guideline. We used the following search terms: social health insurance, national health insurance, and community health insurance. A total of 57,686 articles were screened, and subsequently, 46 articles were included in the final review. Results showed that the majority of SHI studies were in China and African countries, both of which were actively pursuing SHI programs to achieve UHC. China was still regarded as a developing country. There were also recent experiences from other Asian countries, but only a few from South America. Implementing SHI to achieve UHC was desirable but will need to consider several factors and issues. This was especially the case in developing and MICs. Eventually, full UHC would only be possible with a combination of general taxation and SHI.
    Matched MeSH terms: Insurance, Health*
  6. Paneru DP, Adhikari C, Poudel S, Adhikari LM, Neupane D, Bajracharya J, et al.
    Front Public Health, 2022;10:978732.
    PMID: 36589957 DOI: 10.3389/fpubh.2022.978732
    OBJECTIVE: The Social Health Insurance Program (SHIP) shares a major portion of social security, and is also key to Universal Health Coverage (UHC) and health equity. The Government of Nepal launched SHIP in the Fiscal Year 2015/16 for the first phase in three districts, on the principle of financial risk protection through prepayment and risk pooling in health care. Furthermore, the adoption of the program depends on the stakeholders' behaviors, mainly, the beneficiaries and the providers. Therefore, we aimed to explore and assess their perception and experiences regarding various factors acting on SHIP enrollment and adherence.

    METHODS: A cross-sectional, facility-based, concurrent mixed-methods study was carried out in seven health facilities in the Kailali, Baglung, and Ilam districts of Nepal. A total of 822 beneficiaries, sampled using probability proportional to size (PPS), attending health care institutions, were interviewed using a structured questionnaire for quantitative data. A total of seven focus group discussions (FGDs) and 12 in-depth interviews (IDIs), taken purposefully, were conducted with beneficiaries and service providers, using guidelines, respectively. Quantitative data were entered into Epi-data and analyzed with SPSS, MS-Excel, and Epitools, an online statistical calculator. Manual thematic analysis with predefined themes was carried out for qualitative data. Percentage, frequency, mean, and median were used to describe the variables, and the Chi-square test and binary logistic regression were used to infer the findings. We then combined the qualitative data from beneficiaries' and providers' perceptions, and experiences to explore different aspects of health insurance programs as well as to justify the quantitative findings.

    RESULTS AND PROSPECTS: Of a total of 822 respondents (insured-404, uninsured-418), 370 (45%) were men. Families' median income was USD $65.96 (8.30-290.43). The perception of insurance premiums did not differ between the insured and uninsured groups (p = 0.53). Similarly, service utilization (OR = 220.4; 95% CI, 123.3-393.9) and accessibility (OR = 74.4; 95% CI, 42.5-130.6) were found to have high odds among the insured as compared to the uninsured respondents. Qualitative findings showed that the coverage and service quality were poor. Enrollment was gaining momentum despite nearly a one-tenth (9.1%) dropout rate. Moreover, different aspects, including provider-beneficiary communication, benefit packages, barriers, and ways to go, are discussed. Additionally, we also argue for some alternative health insurance schemes and strategies that may have possible implications in our contexts.

    CONCLUSION: Although enrollment is encouraging, adherence is weak, with a considerable dropout rate and poor renewal. Patient management strategies and insurance education are recommended urgently. Furthermore, some alternate schemes and strategies may be considered.

    Matched MeSH terms: Insurance, Health*
  7. Balqis-Ali NZ, Anis-Syakira J, Fun WH, Sararaks S
    Asia Pac J Public Health, 2021 Nov;33(8):861-869.
    PMID: 33853361 DOI: 10.1177/10105395211000913
    Despite various efforts introduced, private health insurance coverage is still low in Malaysia. The objective of this article is to find the factors associated with not having a private health insurance in Malaysia. We analyze data involving 19 959 respondents from the 2015 National Health Morbidity Survey. In this article, we describe the prevalence of not having health insurance and conducted binary logistic regression to identify determinants of uninsured status. A total of 56.6% of the study population was uninsured. After adjusting for other variables, the likelihood of being uninsured was higher among those aged 50 years and above, females, Malay/other Bumiputra ethnicities, rural, government/semigovernment, self-employed, unpaid workers and retirees, unemployed, lower education level, without home ownership and single/widowed/divorced, daily smoker, underweight body mass index, and current drinker. The likelihood of being uninsured also increased with increasing household size while the inversed trend was seen for household income. A substantial proportion of population in Malaysia did not have private health insurance, and these subgroups have limited preferential choices for provider, facility, and care.
    Matched MeSH terms: Insurance, Health*
  8. Abd Khalim MA, Sukeri S
    PLoS One, 2023;18(1):e0278404.
    PMID: 36649258 DOI: 10.1371/journal.pone.0278404
    Malaysia's subsidised public healthcare system is heavily reliant on government funding. Increasing the uptake of private health insurance (PHI) would alleviate the financial burden on public healthcare facilities caused by high patient loads. The study aimed to determine the uptake of PHI and its associated factors among the East Coast Malaysian populations. A cross-sectional online survey was conducted between February and June 2021. Proportionate stratified sampling was applied to select 1138 participants, and logistic regression was performed to determine the factors associated with PHI uptake. The proportion of the study samples that purchased PHI was 54.3%. Enrolment of private health insurance was associated with working in the public sector (aOR: 6.06, 95% CI: 2.65, 13.88) and private sector (aOR: 6.27, 95% CI: 2.65, 14.85), being self-employed (aOR: 9.23, 95% CI: (3.59, 23.70), being in the middle 40% household income percentile (aOR: 2.74, 95% CI: 1.95, 3.85) and top 20% household income percentile (aOR: 4.42, 95% CI: 2.87, 6.80), and living in urban areas (aOR: 1.31, 95% CI: 1.01, 1.70). Even in the presence of subsidised public healthcare, the high proportion of PHI uptake reflects a demand for private health insurance. The study suggests that PHI should be promoted among those who are employed or self-employed, the middle- and high-income groups, and urban residents. The findings may be beneficial for the government and insurance companies to improve strategies to enhance PHI uptake among these population.
    Matched MeSH terms: Insurance, Health*
  9. Sharifa Ezat Wan Puteh
    MyJurnal
    Many a times, community targeted strategy works in silo and done haphazardly without any long-term planning and impact to the community. This wayward fashion has cost us millions of dollars, lost resources and dimmed motiva-tion. Most of the time, incoherent planning and short-term targets are the motivators. Getting plans into policy is not a task to be taken lightly. Policies that are incoherent, disintegrated with organisational and national plans, will not be taken up as policy papers. Overcoming resistance is another method to ensure smoothness of policy acceptance. This involves enlisting communication with multiple stakeholders and hearing out qualms by community members. Community based insurance is an example. The initial social insurance has been in the agenda for multiple years already. In the past 3 years, this agenda has been sped up by political masterminds and NGOs. The Peka B40 and MySalam have been introduced in the Malaysian healthcare system. It is hoped that these two social health insurance will provide the much needed relief for community in the lower categories.
    Matched MeSH terms: Insurance, Health
  10. Jumadil Saputra, Suhal Kusairi, Nur Azura Sanusi, Yusuf Abdullah
    MyJurnal
    This paper aims to analyze the distinction of premium setting rates by taking into account the risk
    taken by conventional and Family Takaful. This study employed the Net Single and Annual Level
    Premium formula, and the data were analyzed using a numerical simulation. We found that the
    conventional and Takaful insurance systems utilize similar methods in the calculation of insurance
    premium when considering pure risk faced by the participant or insured. However, both systems have
    their own unique characteristics. The conventional and Family Takaful utilize historical data, such as
    mortality rate, expected return rate, expected costs and expected amount of claims. The conventional
    insurance is calculated to mitigate or minimize the risk of the insurance company against an amount of
    claim faced in the future as long as the insurance is enforced until the contract ends. On the other
    hand, the Family Takaful is intended to share fair value among participants in determining
    benevolence through Tabarru premium. Every participant must pay for Tabarru premium to support
    one another so that there is sufficient amount to cover unexpected claims among them and to uphold
    mutual fund as evidence for the sense of mutual co-operation and brotherhood among participants.
    Matched MeSH terms: Insurance
  11. Phua KL
    MyJurnal
    Healthcare costs are rising in Malaysia for various reasons. Thus, some people have responded by purchasing private health insurance to protect against catastrophic illnesses and huge medical bills. In this paper, a comparative analysis of private health insurance plans of dyferent types is done to determine Q' they do provide adequate coverage and adequate protection against heavy financial loss. The results indicate that all of the eight private health insurance plans in this study do not provide adequate coverage and adequate financial protection because of various restrictive terms and conditions.
    Matched MeSH terms: Insurance, Health
  12. Sharifa Ezat WP, Yang Rashidi A, Azimatun Noor A
    Med J Malaysia, 2023 May;78(3):318-328.
    PMID: 37271841
    INTRODUCTION: Private health insurance (PHI) plays an important supplementary role on top of the existing subsidised health financing system to prevent heavy reliance on out-of-pocket (OOP) expenses, especially in diseases with high costly treatment. This study was done to examine the factors associated with PHI usage among cancer patients and its associated influencing factors in Malaysia.

    MATERIALS AND METHODS: This cross-sectional study was conducted in three Malaysian public hospitals using a multilevel sampling technique to recruit 630 respondents. A validated self-developed four-domain questionnaire which includes one domain for health insurance was used to collect the relevant data.

    RESULTS: Approximately 31.7% of the respondents owned PHI. The PHI usage was significantly higher among male respondents (p=0.035), those aged 18-40 years old (p<0.001), Indian and Chinese ethnicities (p=0.002), with tertiary education level (p<0.001), employed (p<0.001), working in the private sector (p<0.001), high household income (T20) (p<0.001), home near to the hospital (p=0.001) and medium household size (p<0.001). The significant predictive factors were age 18-40 years aOR 3.01 (95% CI: 1.67-5.41), age 41-60 years aOR 2.22 (95% CI 1.41-3.49), medium (M40) income aOR 2.90 (95% CI: 1.92-4.39) and high (T20) income aOR 3.86 (95% CI: 1.68-18.91), home near to the hospital aOR 1.68 (95% CI: 1.10-2.55), medium household size aOR 2.20 (95% CI: 1.30-3.72) and female head of household aOR 1.79 (95% CI: 1.01-3.16). The type of cancer treatment, the location of treatment, prior treatment in private healthcare facilities and existence of financial coping mechanisms also were significant factors in determining PHI usage among cancer patients in this study.

    CONCLUSION: Several factors are significantly associated with PHI usage in cancer patients. The outcome of this study can guide policymakers to identify high-risk groups which need supplementary health insurance to bear the cost for their cancer treatment so that a better pre-payment health financing system such as a national health insurance can be formulated to cater for these groups.

    Matched MeSH terms: Insurance, Health*
  13. Esther Omolara A, Jantan A, Abiodun OI, Arshad H, Dada KV, Emmanuel E
    Health Informatics J, 2020 09;26(3):2083-2104.
    PMID: 31957538 DOI: 10.1177/1460458219894479
    Advancements in electronic health record system allow patients to store and selectively share their medical records as needed with doctors. However, privacy concerns represent one of the major threats facing the electronic health record system. For instance, a cybercriminal may use a brute-force attack to authenticate into a patient's account to steal the patient's personal, medical or genetic details. This threat is amplified given that an individual's genetic content is connected to their family, thus leading to security risks for their family members as well. Several cases of patient's data theft have been reported where cybercriminals authenticated into the patient's account, stole the patient's medical data and assumed the identity of the patients. In some cases, the stolen data were used to access the patient's accounts on other platforms and in other cases, to make fraudulent health insurance claims. Several measures have been suggested to address the security issues in electronic health record systems. Nevertheless, we emphasize that current measures proffer security in the short-term. This work studies the feasibility of using a decoy-based system named HoneyDetails in the security of the electronic health record system. HoneyDetails will serve fictitious medical data to the adversary during his hacking attempt to steal the patient's data. However, the adversary will remain oblivious to the deceit due to the realistic structure of the data. Our findings indicate that the proposed system may serve as a potential measure for safeguarding against patient's information theft.
    Matched MeSH terms: Insurance, Health
  14. Rubayah Yakob, Zulkornain Yusop, Alias Radam, Noriszura Ismail
    Sains Malaysiana, 2014;43:1439-1450.
    The objective of this study was to identify the exogenous variables of risk and investment management efficiency by using a two-stage data envelopment analysis (DEA) method. The first stage involves obtaining the efficiency scores of risk and investment management via DEA that requires only the traditional inputs and outputs. In the second stage, the Tobit regression analysis is conducted in which the efficiency score obtained from the first stage is treated as a dependent variable, while the exogenous factors are considered to be independent variables. The exogenous factors consist of operating systems, organizational form, consumer preference and size. The results showed that the mutual company as well as the takaful system demonstrate better risk management performance than their stock and conventional system counterparts. In addition, size is also a significant indicator for risk management efficiency in which the larger insurer/takaful operator exhibits better risk management performance than the smaller one. However, consumer preference is found to be insignificantly correlated with the efficiency of risk management. In contrast, with risk management, organizational form, operating system and size are not indicators of the investment management efficiency, but consumer preference is significantly and positively associated with investment management efficiency.
    Matched MeSH terms: Insurance Carriers
  15. Ng RJ, Choo WY, Ng CW, Hairi NN
    Health Policy Plan, 2024 Mar 12;39(3):268-280.
    PMID: 38300142 DOI: 10.1093/heapol/czae004
    The vital role of healthcare financing in achieving universal health coverage is indisputable. However, most countries, including Malaysia, face challenges in establishing an equitable and sustainable healthcare financing system due to escalating healthcare costs, an ageing population and a growing disease burden. With desirable pre-payment and risk pooling features, private health insurance (PHI) is considered an alternative financing option to reduce out-of-pocket (OOP) medical expenditure. However, ongoing theoretical and empirical debates persist regarding the adequacy of financial risk protection provided by PHI largely because it depends on its role, the benefit design and the regulations in place. Our study aimed to investigate the effect of supplementary PHI on OOP inpatient medical expenditure in Malaysia. Secondary data analysis was conducted using the Malaysian National Health and Morbidity Survey 2019 dataset. A total of 983 respondents with a history of inpatient hospitalization in the past 12 months were included in the study. Instrumental variable analysis using a two-stage residual inclusion was performed to address endogeneity bias, with wealth status and education level as the instrumental variables. Tobit regression model was used in the second stage considering the censored distribution of the outcome variable. Missing data were handled using multiple imputation. About one-fifth of the respondents had PHI. In this study, we found that having PHI significantly increased OOP inpatient medical expenditure in all three marginal effects. Additionally, age, residential location, ethnicity (citizenship), being covered by government guarantee letter, government funding and employer-sponsored health insurance were other significant factors associated with OOP inpatient medical expenditure. Our findings undermine a key justification to advocate PHI uptake among the population, with a need for the Malaysian government to reassess the role of PHI in healthcare financing and reconsider PHI subsidization policy. Regulations should also be strengthened to enhance the financial risk protection provided by PHI.
    Matched MeSH terms: Insurance, Health
  16. Aziz H, Hatah E, Makmor Bakry M, Islahudin F
    Patient Prefer Adherence, 2016;10:837-50.
    PMID: 27313448 DOI: 10.2147/PPA.S103057
    BACKGROUND: A previous systematic review reported that increase in patients' medication cost-sharing reduced patients' adherence to medication. However, a study among patients with medication subsidies who received medication at no cost found that medication nonadherence was also high. To our knowledge, no study has evaluated the influence of different medication payment schemes on patients' medication adherence.
    OBJECTIVE: This study aims to review research reporting the influence of payment schemes and their association with patients' medication adherence behavior.
    METHODS: This study was conducted using systematic review of published articles. Relevant published articles were located through three electronic databases Medline, ProQuest Medical Library, and ScienceDirect since inception to February 2015. Included articles were then reviewed and summarized narratively.
    RESULTS: Of the total of 2,683 articles located, 21 were included in the final analysis. There were four types of medication payment schemes reported in the included studies: 1) out-of-pocket expenditure or copayments; 2) drug coverage or insurance benefit; 3) prescription cap; and 4) medication subsidies. Our review found that patients with "lower self-paying constraint" were more likely to adhere to their medication (adherence rate ranged between 28.5% and 94.3%). Surprisingly, the adherence rate among patients who received medication as fully subsidized was similar (rate between 34% and 84.6%) as that of other payment schemes. The studies that evaluated patients with fully subsidized payment scheme found that the medication adherence was poor among patients with nonsevere illness.
    CONCLUSION: Although medication adherence was improved with the reduction of cost-sharing such as lower copayment, higher drug coverage, and prescription cap, patients with full-medication subsidies payment scheme (received medication at no cost) were also found to have poor adherence to their medication. Future studies comparing factors that may influence patients' adherence to medication among patients who received medication subsidies should be done to develop strategies to overcome medication nonadherence.
    KEYWORDS: drug cost; medication adherence; medication payment scheme
    Matched MeSH terms: Insurance Benefits
  17. Lum MS
    Med J Malaysia, 2000 Aug;55 Suppl B:30-4.
    PMID: 11125518
    Matched MeSH terms: Insurance, Health, Reimbursement
  18. Rajah R, Hassali MAA, Murugiah MK
    Public Health, 2019 Feb;167:8-15.
    PMID: 30544041 DOI: 10.1016/j.puhe.2018.09.028
    OBJECTIVES: Health literacy is increasingly recognized as a public health concern. Most of the literature on health literacy concentrate in the Western countries. Therefore, this study aimed to systematically review and examine the available studies on health literacy in Southeast Asian countries and estimate its prevalence in this region.

    STUDY DESIGN: Systematic review.

    METHODS: A search for relevant articles was carried out using Cumulative Index to Nursing and Allied Health Literature (CINAHL) and MEDLINE (via EBSCOhost), Scopus, Science Direct, PubMed and Google Scholar with multiple search terms. Inclusion criteria comprised articles published in English language and assessing general health literacy. Risk of bias reduced with the involvement of two independent reviewers in the screening of the literature and the quality assessment process.

    RESULTS: A total of 11 studies were included, which only consist of studies from five countries out of 11 making up the Southeast Asian region. The overall prevalence of limited health literacy varied considerably, 1.6%-99.5% with a mean of 55.3% (95% confidence interval [CI]: 35.1%-75.6%). A much higher prevalence was noted in studies conducted in healthcare settings, 67.5% (95% CI: 48.6%-86.3%). The most common factors associated with limited health literacy were education attainment, age, income and socio-economic background. Other factors identified were gender and health behaviours.

    CONCLUSIONS: In summary, despite the little evidence available and existences of high heterogeneity among studies, limited health literacy is still prevalent in Southeast Asian countries. Urgent strategies to improve and promote health literacy in the region are highly warranted. Besides, more studies on health literacy with better quality on the methodology aspect are needed.

    Matched MeSH terms: Insurance Pools
  19. Gafoor AM, Reynu R, Kirubakaran M, Vimal Kumar V, Nik Ritza NM, Tikfun G, et al.
    Med J Malaysia, 2021 03;76(2):229-232.
    PMID: 33742633
    The rise in obesity has fuelled the current debate of its classification as a disease. Contrary to just being a medical condition or a risk factor for other diseases, obesity is a complex disease with multifaceted aetiology as well as its own disabling capacities, pathophysiology, and comorbidities. The problem of obesity in Malaysia is serious and calls for active intervention by all stakeholders ranging from government agencies to insurers and healthcare providers. To aid efforts to curb obesity, this consensus statement for bariatric surgery provides a basis for inclusion and exclusion criteria as well as the types of procedures accepted as the norm in Malaysia. This consensus statement was initiated by the Society of Endoscopic and Laparoscopic Surgeons of Malaysia and was collaborated with representatives from the Ministry of Health Malaysia.
    Matched MeSH terms: Insurance Carriers
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