1
|
Sayuti M, Sukeri S. Assessing progress towards Sustainable Development Goal 3.8.2 and determinants of catastrophic health expenditures in Malaysia. PLoS One 2022; 17:e0264422. [PMID: 35213626 PMCID: PMC8880746 DOI: 10.1371/journal.pone.0264422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 02/10/2022] [Indexed: 12/04/2022] Open
Abstract
The Sustainable Development Goal 3.8.2 is an indicator to track a country’s progress toward universal health coverage on the financial protection against catastrophic health expenditure (CHE). The purpose of this study is to determine the proportion of households with catastrophic health expenditure, and its associated factors among Malaysian households. A secondary data analysis was performed using the Household Expenditure Survey 2015/2016. The inclusion criterion was Malaysian households with some health spending in the past 12 months before the date of the survey. Catastrophic health expenditure was defined as out-of-pocket health expenditures exceeding 10% of the total household consumption. The study included a total of 13015 households. The proportion of households with CHE in the sample was 2.8%. Female-led households (AdjOR 1.6; CI 1.25, 2.03; p-value <0.001), households in rural areas (AdjOR 1.29; 95% CI 1.04, 1.61; p-value = 0.022), small household size (AdjOR 2.4; 95% CI 1.81, 3.18; p-value <0.001) and heads of household under 60 years old (AdjOR2.34; 95% CI 1.81, 3.18; p-value <0.001) were significantly associated with CHE. Although the proportion of Malaysian households affected by CHE is small, it is increasing in comparison to previous findings. This is concerning because it may jeopardise efforts to achieve universal health coverage by 2030. To ensure financial protection and access to care, a health financing policy that includes safety net measures for households at risk of CHE is required.
Collapse
Affiliation(s)
- Muaz Sayuti
- Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia
| | - Surianti Sukeri
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
- * E-mail:
| |
Collapse
|
2
|
Jan S, Laba TL, Essue BM, Gheorghe A, Muhunthan J, Engelgau M, Mahal A, Griffiths U, McIntyre D, Meng Q, Nugent R, Atun R. Action to address the household economic burden of non-communicable diseases. Lancet 2018; 391:2047-2058. [PMID: 29627161 DOI: 10.1016/s0140-6736(18)30323-4] [Citation(s) in RCA: 143] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 09/04/2017] [Accepted: 01/19/2018] [Indexed: 01/05/2023]
Abstract
The economic burden on households of non-communicable diseases (NCDs), including cardiovascular diseases, cancer, respiratory diseases, and diabetes, poses major challenges to global poverty alleviation efforts. For patients with NCDs, being uninsured is associated with 2-7-fold higher odds of catastrophic levels of out-of-pocket costs; however, the protection offered by health insurance is often incomplete. To enable coverage of the predictable and long-term costs of treatment, national programmes to extend financial protection should be based on schemes that entail compulsory enrolment or be financed through taxation. Priority should be given to eliminating financial barriers to the uptake of and adherence to interventions that are cost-effective and are designed to help the poor. In concert with programmes to strengthen national health systems and governance arrangements, comprehensive financial protection against the growing burden of NCDs is crucial in meeting the UN's Sustainable Development Goals.
Collapse
Affiliation(s)
- Stephen Jan
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia; School of Public Health, University of Sydney, Sydney, NSW, Australia.
| | - Tracey-Lea Laba
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia; School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Beverley M Essue
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia; School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Adrian Gheorghe
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Janani Muhunthan
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia; School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Michael Engelgau
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Ajay Mahal
- Nossal Institute for Global Health, University of Melbourne, VIC, Australia
| | - Ulla Griffiths
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Diane McIntyre
- Health Economics Unit, University of Cape Town, Cape Town, South Africa
| | - Qingyue Meng
- China Center for Health Development Studies, Peking University, China
| | - Rachel Nugent
- Research Triangle Institute International, Seattle, WA, USA
| | - Rifat Atun
- Department of Global Health and Population, Harvard School of Public Health, Harvard University, Cambridge, MA, USA
| |
Collapse
|