Main Organiser

Julius Centre University of Malaya

Co-organiser

Department of Social and Preventive Medicine, Faculty of Medicine, University of Malay

Supported by

University of Malaya

PUBLIC OR PRIVATE? THE UTILIZATION AND FINANCING OF HEALTH SERVICES BY OLDER MALAYSIANS

Author

Sen Tyng, Chai 1 , Tengku Aizan Hamid 1 , Zaiton Ahmad 2 , Rahimah Ibrahim 1

Institution

1 Institute of Gerontology, Universiti Putra Malaysia
2 Faculty of Medicine and Health Sciences, Universiti Putra Malaysia

Abstract

Objectives: This study aims to examine the health services utilization and financing of medical expenses for older Malaysians.

Methods: Data analyzed were part of a larger sample (n = 5,598) from a nationwide cross- sectional survey of four age groups (18-25, 26-39, 40-59 & 60+) in 2009. The enumerator- administered questionnaire included questions on socioeconomic status, health and lifestyle information. A total of 2,128 respondents or 38.2% of the sample had reported being sick at least once in the past six months prior to the interview.

Results: Out of the 660 respondents aged 60 years or over whom had had fallen ill (50.7% of the total elderly sample), almost all (98.3%) sought some form of medical assistance or treatment. A majority (73%) utilized government hospitals and clinics only while 16.5% relied solely on private health care services. 5.3% of the older respondents made use of both public and private medical facilities. Bivariate analysis showed that there is a significant difference in the patterns of utilization by ethnicity (Χ²=56.34, p<0.01), stratum (Χ²=9.49, p<0.05) and household income (Χ²=26.91, p<0.01). Life and medical insurance coverage are limited, and the medical expenses incurred are usually borne by their adult children (63.9%) or by the elderly themselves (29.1%).

Conclusion: The patterns of health services utilization by older persons in Malaysia are mostly affected by socioeconomic and health factors. Detailed data such as out-of-pocket spending, consultation frequency, duration of hospitalization and outpatient waiting time are needed to provide a more accurate estimation of public and private health care costs, access, equity, capacity and efficiency.