MNHA19972015.pdf

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186 237 273 302 284 282 250 327 Total 2,248 2,361 2,552 2,829 3,216 3,323 3,993 4,306 4,542 6,184 6,532 7,531 7,903 8,715 9,739 11,567 11,956 13,845 14,519 TABLE 8.4c: MOH Hospital Expenditure by Sources of Financing, 1997-2015 (Per cent, %) Sources of financing 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Ministry of Health (MOH) 96.39 96.67 96.81 96.88 97.03 96.74 97.07 96.93 96.91 97.50 97.34 97.53 97.00 96.87 96.90 97.54 97.64 98.19 97.75 Non Ministry of Health (MOH) 3.61 3.33 3.19 3.12 2.97 3.26 2.93 3.07 3.09 2.50 2.66 2.47 3.00 3.13 3.10 2.46 2.36 1.81 2.25 Total 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00
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MNHA HEALTH EXPENDITURE REPORT 1997-2015 81 Most often OOP health expenditures are attained through community surveys. However the best approach for this estimation, as used for this report, is through a complex method called the integrative method whereby the gross level of direct spending from consumption, provision and financing perspective is collated followed by a deduction of third party financial reimbursements by various agencies to avoid double counting. The data shown in this chapter includes spending for TCAM as well as spending for health-related education and training which are excluded in all expenditures that are reported under the SHA framework. OOP Health Expenditure = (Gross OOP Expenditure – Third Party Payer Reimbursement) + OOP Expenditure for Education & Training. The 1997-2015 time series data shows that the household OOP health expenditure remains the largest single source of funding in the private sector amounting to an average of 76 per cent of this sector spending which is equivalent to about 30-40 per cent of total health expenditure (Figure 9.1 and Figure 9.2). The OOP health expenditure from 1997 to 2015 has increased from RM2,934 million to RM19,852 million which is an increase from 1.04 per cent GDP to 1.72 per cent GDP (Figure 9.3). Out-of-Pocket Health Expenditure CHAPTER 9
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82 MNHA HEALTH EXPENDITURE REPORT 1997-2015 35% 35% 34% 35% 32% 32% 31% 34% 39% 36% 37% 36% 33% 34% 36% 36% 38% 37% 38% 0% 10% 20% 30% 40% 50% OOP % of TEH FIGURE 9.1: OOP Share of Total Health Expenditure, 1997-2015 (Per cent, %) FIGURE 9.2: OOP Share of Private Sector Health Expenditure, 1997-2015 (Per cent, %) 74% 73% 73% 76% 73% 73% 74% 77% 78% 79% 78% 78% 76% 77% 77% 77% 79% 80% 78% 68% 70% 72% 74% 76% 78% 80% 82% OOP % Private Spending
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MNHA HEALTH EXPENDITURE REPORT 1997-2015 83 FIGURE 9.3: OOP Health Expenditure and per cent GDP, 1997-2015 (RM Million, Per cent %) 2,934 3,098 3,371 4,080 4,101 4,547 5,527 6,556 7,523 8,550 9,484 10,406 10,124 11,885 13,792 14,871 16,545 18,401 19,852 1.04 1.09 1.12 1.14 1.16 1.19 1.32 1.381.38 1.431.43 1.35 1.42 1.45 1.51 1.53 1.62 1.66 1.72 0.00 0.20 0.40 0.60 0.80 1.00 1.20 1.40 1.60 1.80 2.00 - 5,000 10,000 15,000 20,000 25,000 RM Million % GDP OOP Expenditure (RM Million) OOP as % GDP
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84 MNHA HEALTH EXPENDITURE REPORT 1997-2015 This section cross tabulates OOP health expenditure with providers of health care. Health providers are defined as entities that produce and provide health care goods and services, which benefit individuals or population groups. These providers could be either public or private sector providers. The bulk of public sector health care services for patients in this country have always been heavily subsidized by the government, even if the government outsources any of the services to private providers. However under the provision of public sector services there are some components of healthcare services and several products like most prosthesis which are purchased by patients from private providers. When patient seek
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