Discipline of Social & Administrative Pharmacy, Universiti Sains Malaysia, 11800 Penang, Malaysia.
Soc Sci Med. 2013 Nov;96:272-6. doi: 10.1016/j.socscimed.2013.02.045. Epub 2013 Mar 14.
Health care in Malaysia is funded primarily through taxation and is no longer sustainable. One funding option is voluntary community-based health insurance (VCHI), which provides insurance coverage for those who are unable to benefit immediately from either a social or private health insurance plan. This study is performed to assess the willingness of Malaysians to participate in a VCHI plan. A cross-sectional study was performed in the state of Penang between August and mid-September 2009 with 472 randomly selected respondents. The respondents were first asked to select their preferred health financing plan from three plans (out-of-pocket payment, compulsory social health insurance and VCHI). The extent of the household's willingness to pay for the described VCHI plan was later assessed using the contingent valuation method in an ex-ante bidding game approach until the maximum amount they would be willing to pay to obtain such a service was agreed upon. Fifty-four per cent of the participants were female, with a mean age of 34 years (SD = 11.9), the majority of whom had a monthly income of Int$1157-2312. The results indicated that more than 63.1% of the respondents were willing to join and contribute an average of Int$114.38 per month per household towards VCHI. This amount was influenced by ethnicity, educational level, household monthly income, the presence of chronic disease and the presence of private insurance coverage (p < 0.05). In conclusion, our study findings suggest that most Malaysians are willing to join the proposed VCHI and to pay an average of Int$114.38 per month per household for the plan.
马来西亚的医疗保健主要通过税收来提供，而这种方式已经不再可持续。一种筹资选择是自愿社区健康保险（VCHI），它为那些无法立即从社会或私人医疗保险计划中受益的人提供保险。本研究旨在评估马来西亚人参与 VCHI 计划的意愿。2009 年 8 月至 9 月中旬，在槟城州进行了一项横断面研究，共随机选取了 472 名受访者。首先要求受访者从三种方案（自付费用、强制性社会健康保险和 VCHI）中选择他们首选的健康融资方案。随后，使用条件价值评估法在预先投标博弈方法中评估家庭对所描述的 VCHI 计划的支付意愿程度，直到他们愿意支付的最大金额以获得该服务。54%的参与者为女性，平均年龄为 34 岁（标准差= 11.9），其中大多数人的月收入为 Int$1157-2312。结果表明，超过 63.1%的受访者愿意加入并平均每月每户为 VCHI 缴纳 Int$114.38。这一数额受到族裔、教育程度、家庭月收入、慢性病的存在以及私人保险覆盖范围的影响（p<0.05）。总之，我们的研究结果表明，大多数马来西亚人愿意加入拟议的 VCHI 计划，并愿意平均每月每户为该计划支付 Int$114.38。
