Journal Screenshot

International Journal of Academic Research in Business and Social Sciences

Open Access Journal

ISSN: 2222-6990

Determining Factors Influence Out-of-Pocket Health Expenditure among the Low-Income Group in Malaysia

Rusmawati Said, Norfatihah Isamail, Normaz Wana Ismail

http://dx.doi.org/10.6007/IJARBSS/v10-i10/7740

Open access

A substantial proportion of the population is still struggling to achieve socio-economic and good health, i.e., the low-income groups. The low-income group in Malaysia might bear a higher burden of out-of-pocket health expenditure (OOPHE) and health challenges, mainly related to non-communicable diseases (NCD). The costs are sometimes high enough so that households cannot recuperate them from existing resources and lead them to financial problems. This study analyzed the factors associated with OOPHE among B40 group in Malaysia using nationwide data from the 2015 National Health and Morbidity Survey (NHMS). Ordinary Least Square (OLS) regression analysis is used to study the factors associated with OOPHE. This study suggests that the gender (female) of household, income, T20 income group, tertiary education, unpaid worker, retire, and NCD raises the likelihood of incurring OOPHE. The result for a private employee, self-employed, and insurance status is spending less on OOPHE. Therefore, the results show a clear need for government action to enhanced primary healthcare programs and a focus on achieving Universal Health Coverage. This situation can protect the household from OOPHE financial burden and NCD, exceptionally low-income earners.

Amaya-Lara, J. L. (2016). Catastrophic expenditure due to out-of-pocket health payments and its determinants in Colombian households. International Journal for Equity in Health, 15(1), 1–11. https://doi.org/10.1186/s12939-016-0472-z
Aregbeshola, B. S., & Khan, S. M. (2020). Out-of-pocket healthcare spending and its determinants among households in Nigeria: a national study. Journal of Public Health (Germany), 1–12. https://doi.org/10.1007/s10389-020-01199-x
Arsenijevic, J., Pavlova, M., Rechel, B., & Groot, W. (2016). Catastrophic health care expenditure among older people with chronic diseases in 15 European countries. PLoS ONE, 11(7), 1–18. https://doi.org/10.1371/journal.pone.0157765
Baharin, M. F. A., Juni, M. H., & Manaf, R. A. (2019). Assessing Progressivity of Out-of-Pocket Expenditures for Health Care: Evidence From Households in Malaysia. International Journal of Public Health and Clinical Sciences, 6(3), 187–202. https://doi.org/10.32827/ijphcs.6.3.187
Baird, K. (2016). High Out-of-Pocket Medical Spending among the Poor and Elderly in Nine Developed Countries. Health Services Research, 51(4), 1467–1488. https://doi.org/10.1111/1475-6773.12444
Barasa, E. W., Maina, T., & Ravishankar, N. (2017). Assessing the impoverishing effects and factors associated with the incidence of catastrophic health care payments in Kenya. International Journal for Equity in Health, 16(1), 1–14. https://doi.org/10.1186/s12939-017-0526-x
Chiang, T. L. (1997). Taiwan's 1995 health care reform. Health Policy, 39(3), 225–239. https://doi.org/10.1016/S0168-8510(96)00877-9
Crystal, S., Johnson, R. W., Harman, J., Sambamoorthi, U., & Kumar, R. (2000). Out-of-pocket health care costs among older Americans. Journals of Gerontology - Series B Psychological Sciences and Social Sciences, 55(1), 51–62. https://doi.org/10.1093/geronb/55.1.S51
DOSM. (2019). The Key Findings: Income, Poverty, Inequality, Expenditure, Basic Amenities.
Ebaidalla, E. M., & Ali, M. E. M. (2019). Determinants and impact of household's out-of-pocket healthcare expenditure in Sudan: evidence from urban and rural population. Middle East Development Journal, 11(2), 181–198. https://doi.org/10.1080/17938120.2019.1668163
Galbraith, A. A., Wong, S. T., Kim, S. E., & Newacheck, P. W. (2005). Out-of-pocket financial burden for low-income families with children: Socio-economic disparities and effects of insurance. Health Services Research, 40(6 I), 1722–1736. https://doi.org/10.1111/j.1475-
6773.2005.00421.x
Golinowska, S., & Tambor, M. (2012). Out-of-pocket payments on health in Poland: Size, tendency and willingness to pay. Society and Economy, 34(2), 253–271.
https://doi.org/10.1556/SocEc.34.2012.2.5
Gross, D. J., Alecxih, L., Gibson, M. J., Corea, J., Caplan, C., & Brangan, N. (1999). Out-of-pocket health spending by poor and near-poor elderly Medicare beneficiaries. Health Services Research, 34(1 Pt 2), 241–254.
Grossman, M. (1972). On the Concept of Health Capital and the Demand for Health. Journal of Political Economy, 80(2), 223–255. https://doi.org/10.7312/gros17812-004.
Jayasooria, D. (2016). Towards 2030: Malaysia'S Development Agenda.
Ketsche, P., Adams, E. K., Wallace, S., Kannan, V. D., & Kannan, H. (2011). Lower-income families pay A higher share of income toward national health care spending than higher-income families do. Health Affairs, 30(9), 1637–1646. https://doi.org/10.1377/hlthaff.2010.0712
Koris, R., Nor, N. M., Haron, S. A., Hamid, T. A., Nur, A. M., Shafie, A. A., … Maimaiti, N. (2019). The Cost of Healthcare among Malaysian Community-Dwelling Elderly. Jurnal Ekonomi Malaysia, 53(1), 1–16.
Kumara, A. S., & Samaratunge, R. (2016). Patterns and determinants of out-of-pocket health care expenditure in Sri Lanka: Evidence from household surveys. Health Policy and Planning, 1–14. https://doi.org/10.1093/heapol/czw021
Kwon, E., Park, S., & McBride, T. D. (2018). Health Insurance and Poverty in Trajectories of Out-of-Pocket Expenditure among Low-Income Middle-Aged Adults. Health Services Research, 53(6), 4332–4352. https://doi.org/10.1111/1475-6773.12974
Lu, X., & White, H. (2014). Robustness checks and robustness tests in applied economics. Journal of Econometrics, 178(PART 1), 194–206. https://doi.org/10.1016/j.jeconom.2013.08.016
Mahumud, R. A., Sarker, A. R., Sultana, M., Islam, Z., Khan, J., & Morton, A. (2017). Distribution and determinants of out-of-pocket healthcare expenditures in Bangladesh. Journal of Preventive Medicine and Public Health, 50(2), 91–99. https://doi.org/10.3961/jpmph.16.089
Mamun, S. A. K., Khanam, R., & Rahman, M. M. (2018). The Determinants of Household Out-of-Pocket (OOP) Medical Expenditure in Rural Bangladesh. Applied Health Economics and Health Policy, 16(2), 219–234. https://doi.org/10.1007/s40258-018-0376-8
Manan, M. M., Ali, S. M., Khan, M. A. N., & Jafarian, S. (2015). Estimation of out-of-pocket costs of patients at the Methadone Maintenance therapy clinic in Malaysia. Pakistan Journal of Pharmaceutical Sciences, 28(5), 1705–1711.
McNabb, R., & Said, R. (2013). Trade Openness and Wage Inequality: Evidence for Malaysia. Journal of Development Studies, 49(8), 1118–1132. https://doi.org/10.1080/00220388.2013.794263
Minh, H. Van., Phuong, N. T. K., Saksena, P., James, C. D., & Xu, K. (2013). financial burden of household out-of-pocket health expenditure in VietNam?: Findings from the National Living Standard Survey 2002-2010. Social Science & Medicine, 96, 258–263.
https://doi.org/10.1016/j.socscimed.2012.11.028
MNHA. (2016). Malaysia National Health Accounts, Health Expenditure Report 1997-2014.
NHMS. (2015). National Health & Morbidity Survey, 2015 volume III).
https://doi.org/10.31826/9781463229214-003
O'Brien, R. M. (2007). A Caution Regarding Rules of Thumb for Variance Inflation Factors. Quality & Quantity, 41, 673–690. https://doi.org/10.1007/s11135-006-9018-6
Pallant, J. (2011). SPSS Survival Manual: a step by step guide to data analysis using IBM SPSS. Open University Press.
Pandey, A., Clarke, L., Dandona, L., & Ploubidis, G. B. (2018). Inequity in out-of-pocket payments for hospitalization in India: Evidence from the National Sample Surveys, 1995–2014. Social Science and Medicine, 201(October 2016), 136–147. https://doi.org/10.1016/j.socscimed.2018.01.031
Pannarunothai, S., & Mills, A. (1997). The poor pay more: Health-related inequality in Thailand. Social Science and Medicine, 44(12), 1781–1790. https://doi.org/10.1016/S0277-9536(96)00287-0
PeKaB40. (2020). Skim peduli kesihatan untuk kumpulan B40. Retrieved
https://www.pekab40.com.my/bm
Redzuan, H., Yakob, R., & Isa, Z. (2016). Underinsurance in Malaysia: The application of the Monte Carlo simulation. Jurnal Pengurusan, 47(11), 131-141. http://dx.doi.org/10.17576/pengurusan-2016-47-11
Sarker, A. R., Sultana, M., Ali, N., Akram, R., Sheikh, N., Mahumud, R. A., & Morton, A. (2018). Cost comparison and determinants of out-of-pocket payments on child delivery care in Bangladesh. The International Journal of Health Planning and Management, 1–18. https://doi.org/10.1002/hpm.2615
Sene, L. M., & Cisse, M. (2015). Catastrophic out-of-pocket payments for health and poverty nexus: evidence from Senegal. International Journal of Health Economics and Management, 15(3), 307–328. https://doi.org/10.1007/s10754-015-9170-4
WHO. (2016). World Health Statistics - Monitoring Health for The SDGs. World Health Organization, 1–136. https://doi.org/10.1017/CBO9781107415324.004
Yildirim, J., Yilmaz, E., & Korucu, N. (2011). The determinants of out-of-pocket payments: Evidence from selected hospitals in Ankara, Turkey. Applied Economics Letters, 18(12), 1159–1162. https://doi.org/10.1080/13504851.2010.528351
You, X., & Kobayashi, Y. (2011). Determinants of out-of-pocket health expenditure in China: Analysis using china health and nutrition survey data. Applied Health Economics and Health Policy, 9(1), 39–49. https://doi.org/10.2165/11530730-000000000-00000
Yu, C. P., Whynes, D. K., & Sach, T. H. (2006). Assessing progressivity of out-of-pocket payment: with illustration to Malaysia. International Journal of Health Planning and Management, 21, 193–210. https://doi.org/10.1002/hpm.845
Yunus, N. M., & Said, R. (2016). Do higher levels of qualification lead to higher returns to education: Evidence from Malaysian education sector. International Journal of Economics and Financial Issues, 6(Special issue), 20–26.

In-Text Citation: (Said, Isamail, and Ismail, 2020)
To Cite this Article: Said, R., Isamail, N., and Ismail, N. W. (2020). Determining Factors Influence Out-of-Pocket Health Expenditure among the Low-Income Group in Malaysia. International Journal of Academic Research in Business and Social Sciences. 10(10), 292-311.