Out-of-Pocket Health Expenditure and Catastrophic Effects: Case of Malaysia
Penggunaan Duit Poket Untuk Perbelanjaan Kesihatan Dan Kesan Catastrophic: Kajian Kes Di Malaysia
Keywords:
Private Health Expenditure, Health Expenditure, Out-of-Pocket, Healthcare Cost, CatastrophicAbstract
The high private health expenditures are also a cause for concern because most of these expenditures are out-of-pocket (OOP) with insurance claims only covering a small segment of the population. More than 94 percent of OOP spending occurred at private facilities. The private hospitals consumed the largest share of OOP. Higher OOP will increase the healthcare cost. Catastrophic OOP payment can lead a household into poverty. To shed some light on the issues above, the aim of this study is to investigate the catastrophic effects of OOP by states in Malaysia. This study used data from the National Health and Morbidity Survey 2015. To evaluate the incidence of catastrophic expenditures, the study used the methodology introduced by the World Health Organisation in 2005. According to World Health Organisation, whenever the health expenditure is equal or exceeding 40 percent of a household non-subsistence income, it is considered catastrophic. Kedah, Malacca and Sarawak are identified as states in Malaysia that faces catastrophic healthcare expenditure. The OOP payments in these three states are relatively higher compared the rest of the states in Malaysia. The government should take a good measure on solving the issue of ballooning of OOP payments, especially in the lower urbanised states. This will solve the problem of catastrophic healthcare expenditure in Malaysia as a whole.
Perbelanjaan kesihatan sektor swasta telah menimbulkan kebimbangan kerana kebanyakan perbelanjaan tersebut adalah daripada duit poket (OOP) dengan tuntutan insuran hanya merangkumi sebahagian kecil daripada populasi. Lebih 94 peratus daripada perbelanjaan OOP berlaku di sektor swasta. Hospital swasta merupakan penyumbang tertinggi dalam OOP. Peningkatan dalam OOP akan meningkatkan lagi perbelanjaan kesihatan. Catastrophic pembayaran OOP boleh menyumbang kepada kemiskinan sesebuah isi rumah. Bagi memberi pencerahan kepada isu ini, objektif kajian ini adalah untuk melihat kesan catastrophic OOP mengikut negeri di Malaysia. Kajian ini telah menggunakan data daripada National Health and Morbidity Survey 2015. Bagi mengkaji insiden perbelanjaan catastrophic, kajian ini telah menggunakan metodologi yang telah diperkenalkan oleh World Health Organisation (WHO) pada tahun 2005.Berdasarkan kepada WHO, apabila perbelanjaan kesihatan adalah bersamaan atau melebihi 40 peratus daripada pendapatan bukan sara hidup, isi rumah dianggap berada dalam keadaan catastrophic. Kedah, Melaka dan Sarawak dikenalpasti sebagai negeri – negeri di Malaysia yang menghadapi catastrophic perbelanjaan kesihatan. Pembayaran OOP bagi 3 negeri tersebut secara relatif adalah tinggi berbanding negeri – negeri lain di Malaysia. Kerajaan seharusnya mengambil pendekatan yang baik bagi menyelesaikan isu pembayaran OOP yang semakin meningkat, terutamanya di negeri yang dikategorikan sebagai negeri kurang membangun. Hal ini dapat menyelesaikan masalah catastrophic perbelanjaan kesihatan di Malaysia secara menyeluruh.
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