Robin Tiow Heng Tan1, Siti Zaleha Abdul Rasid2,3, Wan Khairuzzaman Wan Ismail4, Janiza Tobechan5, Edwin Tiow Yong Tan6, Alia Natasha Yusof7, Jia Hui Low8. 1. Pharmaceutical Services Division, Melaka State Health Department, Ministry of Health, Melaka, Malaysia. robintan1632@gmail.com. 2. Azman Hashim International Business School, Universiti Teknologi Malaysia, Kuala Lumpur, Malaysia. 3. University of Business and Technology, Jeddah, Saudi Arabia. 4. Sulaiman AlRajhi School of Business, Sulaiman AlRajhi University, Al Bukayriyah, Saudi Arabia. 5. Melaka General Hospital, Ministry of Health, Melaka, Malaysia. 6. Bukit Katil Clinic, Melaka, Malaysia. 7. Alor Gajah Hospital, Ministry of Health, Melaka, Malaysia. 8. Jasin Hospital, Ministry of Health, Melaka, Malaysia.
Abstract
BACKGROUND: The Malaysian public healthcare system is tax funded, with healthcare costs highly subsidized by the Government. The current health financing is not sustainable to cover all the healthcare resources. Introducing a national health insurance (NHI), a prepayment method, would protect the population from financial hardship by reducing out-of-pocket payment, minimizing the barrier to accessing health and achieving equitable healthcare. Studies on the willingness to pay (WTP) for NHI are available in different contexts; however, little was found in Malaysia. In addition, factors affecting the WTP for NHI have been less researched in the Malaysian context. OBJECTIVE: This study investigates the WTP for NHI and factors influencing it in Melaka, Malaysia. METHOD: Using the contingent valuation method, the researchers distributed a pre-tested self-administered questionnaire to 489 respondents in three leading public hospitals from 1 to 9 November 2019. Multi-stage sampling forms the selection of respondents. Respondents were presented with a hypothetical scenario on NHI and asked whether they would be willing to pay for NHI. Chi-square was used to examine the association between categorical independent variables and WTP for NHI, and binary logistic regression was applied to determine the variables with the most predictive effect towards WTP for NHI. RESULTS: Out of 462 usable responses, 344 respondents (74.5%) were willing to pay for NHI. The majority (51.3%) of the respondents were willing to pay 15 Malaysian Ringgit (3.70 US dollars) or more for the NHI scheme. Chi-square analysis revealed that age, marital status, education level, employment status, chronic diseases, and perception towards NHI were significantly associated with WTP for NHI. Binary regression analysis found that marital status and perception towards NHI have the most predictive effect on respondents' WTP for NHI. CONCLUSION: This study revealed that the majority of the respondents are willing to pay for NHI if implemented in Malaysia. The findings lay a foundation for implementing a future NHI framework in Malaysia and reference future health financing research.
BACKGROUND: The Malaysian public healthcare system is tax funded, with healthcare costs highly subsidized by the Government. The current health financing is not sustainable to cover all the healthcare resources. Introducing a national health insurance (NHI), a prepayment method, would protect the population from financial hardship by reducing out-of-pocket payment, minimizing the barrier to accessing health and achieving equitable healthcare. Studies on the willingness to pay (WTP) for NHI are available in different contexts; however, little was found in Malaysia. In addition, factors affecting the WTP for NHI have been less researched in the Malaysian context. OBJECTIVE: This study investigates the WTP for NHI and factors influencing it in Melaka, Malaysia. METHOD: Using the contingent valuation method, the researchers distributed a pre-tested self-administered questionnaire to 489 respondents in three leading public hospitals from 1 to 9 November 2019. Multi-stage sampling forms the selection of respondents. Respondents were presented with a hypothetical scenario on NHI and asked whether they would be willing to pay for NHI. Chi-square was used to examine the association between categorical independent variables and WTP for NHI, and binary logistic regression was applied to determine the variables with the most predictive effect towards WTP for NHI. RESULTS: Out of 462 usable responses, 344 respondents (74.5%) were willing to pay for NHI. The majority (51.3%) of the respondents were willing to pay 15 Malaysian Ringgit (3.70 US dollars) or more for the NHI scheme. Chi-square analysis revealed that age, marital status, education level, employment status, chronic diseases, and perception towards NHI were significantly associated with WTP for NHI. Binary regression analysis found that marital status and perception towards NHI have the most predictive effect on respondents' WTP for NHI. CONCLUSION: This study revealed that the majority of the respondents are willing to pay for NHI if implemented in Malaysia. The findings lay a foundation for implementing a future NHI framework in Malaysia and reference future health financing research.
Authors: Jens-Oliver Bock; André Hajek; Hermann Brenner; Kai-Uwe Saum; Herbert Matschinger; Walter Emil Haefeli; Ben Schöttker; Renate Quinzler; Dirk Heider; Hans-Helmut König Journal: Health Serv Res Date: 2016-06-20 Impact factor: 3.402