Willingness to Pay for National Health Insurance: A Contingent Valuation Study Among Patients Visiting Public Hospitals in Melaka, Malaysia
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 pop...
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| Veröffentlicht in: | Applied health economics and health policy 2022-03, Vol.20 (2), p.255-267 |
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| creator | Tan, Robin Tiow Heng Abdul Rasid, Siti Zaleha Wan Ismail, Wan Khairuzzaman Tobechan, Janiza Tan, Edwin Tiow Yong Yusof, Alia Natasha Low, Jia Hui |
| description | 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. |
| doi_str_mv | 10.1007/s40258-021-00691-z |
| format | Article |
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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.</description><identifier>ISSN: 1175-5652</identifier><identifier>EISSN: 1179-1896</identifier><identifier>DOI: 10.1007/s40258-021-00691-z</identifier><identifier>PMID: 34927225</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Chronic illnesses ; Cross-Sectional Studies ; Employees ; Employment ; Financing, Personal ; Health Administration ; Health care ; Health care expenditures ; Health care industry ; Health care policy ; Health Economics ; Health insurance ; Health services ; Hospitals ; Hospitals, Public ; Humans ; Insurance coverage ; Malaysia ; Marital status ; Medicine ; Medicine & Public Health ; National health insurance ; National Health Programs ; Original Research Article ; Pharmacoeconomics and Health Outcomes ; Political majority ; Population ; Predictions ; Prepayments ; Public finance ; Public Health ; Quality of Life Research ; Questionnaires ; Regression analysis ; Respondents ; Sampling ; Sociodemographics ; Surveys and Questionnaires ; Taxation ; Valuation ; Variables ; Willingness to pay</subject><ispartof>Applied health economics and health policy, 2022-03, Vol.20 (2), p.255-267</ispartof><rights>The Author(s), under exclusive licence to Springer Nature Switzerland AG 2021</rights><rights>2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.</rights><rights>Copyright Springer Nature B.V. Mar 2022</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-da93f70bdb431d27d239f5c26d783ff6903b2b8c98ca619d01190f998d84bcd53</citedby><cites>FETCH-LOGICAL-c408t-da93f70bdb431d27d239f5c26d783ff6903b2b8c98ca619d01190f998d84bcd53</cites><orcidid>0000-0003-3709-0620</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40258-021-00691-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40258-021-00691-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27864,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34927225$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tan, Robin Tiow Heng</creatorcontrib><creatorcontrib>Abdul Rasid, Siti Zaleha</creatorcontrib><creatorcontrib>Wan Ismail, Wan Khairuzzaman</creatorcontrib><creatorcontrib>Tobechan, Janiza</creatorcontrib><creatorcontrib>Tan, Edwin Tiow Yong</creatorcontrib><creatorcontrib>Yusof, Alia Natasha</creatorcontrib><creatorcontrib>Low, Jia Hui</creatorcontrib><title>Willingness to Pay for National Health Insurance: A Contingent Valuation Study Among Patients Visiting Public Hospitals in Melaka, Malaysia</title><title>Applied health economics and health policy</title><addtitle>Appl Health Econ Health Policy</addtitle><addtitle>Appl Health Econ Health Policy</addtitle><description>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.</description><subject>Chronic illnesses</subject><subject>Cross-Sectional Studies</subject><subject>Employees</subject><subject>Employment</subject><subject>Financing, Personal</subject><subject>Health Administration</subject><subject>Health care</subject><subject>Health care expenditures</subject><subject>Health care industry</subject><subject>Health care policy</subject><subject>Health Economics</subject><subject>Health insurance</subject><subject>Health services</subject><subject>Hospitals</subject><subject>Hospitals, Public</subject><subject>Humans</subject><subject>Insurance coverage</subject><subject>Malaysia</subject><subject>Marital status</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>National health insurance</subject><subject>National Health Programs</subject><subject>Original Research Article</subject><subject>Pharmacoeconomics and Health Outcomes</subject><subject>Political majority</subject><subject>Population</subject><subject>Predictions</subject><subject>Prepayments</subject><subject>Public finance</subject><subject>Public Health</subject><subject>Quality of Life Research</subject><subject>Questionnaires</subject><subject>Regression analysis</subject><subject>Respondents</subject><subject>Sampling</subject><subject>Sociodemographics</subject><subject>Surveys and Questionnaires</subject><subject>Taxation</subject><subject>Valuation</subject><subject>Variables</subject><subject>Willingness to 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to Pay for National Health Insurance: A Contingent Valuation Study Among Patients Visiting Public Hospitals in Melaka, Malaysia</title><author>Tan, Robin Tiow Heng ; Abdul Rasid, Siti Zaleha ; Wan Ismail, Wan Khairuzzaman ; Tobechan, Janiza ; Tan, Edwin Tiow Yong ; Yusof, Alia Natasha ; Low, Jia Hui</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-da93f70bdb431d27d239f5c26d783ff6903b2b8c98ca619d01190f998d84bcd53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Chronic illnesses</topic><topic>Cross-Sectional Studies</topic><topic>Employees</topic><topic>Employment</topic><topic>Financing, Personal</topic><topic>Health Administration</topic><topic>Health care</topic><topic>Health care expenditures</topic><topic>Health care industry</topic><topic>Health care policy</topic><topic>Health Economics</topic><topic>Health insurance</topic><topic>Health services</topic><topic>Hospitals</topic><topic>Hospitals, Public</topic><topic>Humans</topic><topic>Insurance coverage</topic><topic>Malaysia</topic><topic>Marital status</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>National health insurance</topic><topic>National Health Programs</topic><topic>Original Research Article</topic><topic>Pharmacoeconomics and Health Outcomes</topic><topic>Political majority</topic><topic>Population</topic><topic>Predictions</topic><topic>Prepayments</topic><topic>Public finance</topic><topic>Public Health</topic><topic>Quality of Life Research</topic><topic>Questionnaires</topic><topic>Regression analysis</topic><topic>Respondents</topic><topic>Sampling</topic><topic>Sociodemographics</topic><topic>Surveys and Questionnaires</topic><topic>Taxation</topic><topic>Valuation</topic><topic>Variables</topic><topic>Willingness to pay</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tan, Robin Tiow Heng</creatorcontrib><creatorcontrib>Abdul Rasid, Siti Zaleha</creatorcontrib><creatorcontrib>Wan Ismail, Wan Khairuzzaman</creatorcontrib><creatorcontrib>Tobechan, Janiza</creatorcontrib><creatorcontrib>Tan, Edwin Tiow Yong</creatorcontrib><creatorcontrib>Yusof, Alia Natasha</creatorcontrib><creatorcontrib>Low, Jia Hui</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>PAIS Index</collection><collection>ABI/INFORM Collection</collection><collection>ABI/INFORM Global (PDF only)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 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Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Applied health economics and health policy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tan, Robin Tiow Heng</au><au>Abdul Rasid, Siti Zaleha</au><au>Wan Ismail, Wan Khairuzzaman</au><au>Tobechan, Janiza</au><au>Tan, Edwin Tiow Yong</au><au>Yusof, Alia Natasha</au><au>Low, Jia Hui</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Willingness to Pay for National Health Insurance: A Contingent Valuation Study Among Patients Visiting Public Hospitals in Melaka, Malaysia</atitle><jtitle>Applied health economics and health policy</jtitle><stitle>Appl Health Econ Health Policy</stitle><addtitle>Appl Health Econ Health Policy</addtitle><date>2022-03-01</date><risdate>2022</risdate><volume>20</volume><issue>2</issue><spage>255</spage><epage>267</epage><pages>255-267</pages><issn>1175-5652</issn><eissn>1179-1896</eissn><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.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>34927225</pmid><doi>10.1007/s40258-021-00691-z</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0003-3709-0620</orcidid></addata></record> |
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| ispartof | Applied health economics and health policy, 2022-03, Vol.20 (2), p.255-267 |
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| subjects | Chronic illnesses Cross-Sectional Studies Employees Employment Financing, Personal Health Administration Health care Health care expenditures Health care industry Health care policy Health Economics Health insurance Health services Hospitals Hospitals, Public Humans Insurance coverage Malaysia Marital status Medicine Medicine & Public Health National health insurance National Health Programs Original Research Article Pharmacoeconomics and Health Outcomes Political majority Population Predictions Prepayments Public finance Public Health Quality of Life Research Questionnaires Regression analysis Respondents Sampling Sociodemographics Surveys and Questionnaires Taxation Valuation Variables Willingness to pay |
| title | Willingness to Pay for National Health Insurance: A Contingent Valuation Study Among Patients Visiting Public Hospitals in Melaka, Malaysia |
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