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马来西亚社区对国家卫生筹资计划的接受程度和支付意愿。

The Malaysian community's acceptance and willingness to pay for a National Health Financing Scheme.

机构信息

Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Malaysia; International Centre for Casemix & Clinical Coding, Universiti Kebangsaan Malaysia Medical Centre, Malaysia.

Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Malaysia.

出版信息

Public Health. 2019 Oct;175:129-137. doi: 10.1016/j.puhe.2019.07.008. Epub 2019 Aug 29.

Abstract

OBJECTIVES

Currently, Malaysia faces great challenges in allocating adequate resources for healthcare services using a tax-based system. Therefore, Malaysia has no choice but to reform its healthcare financing system. The objective of this study is to assess Malaysian household willingness to pay and acceptance levels to the proposed National Health Financing Scheme.

STUDY DESIGN

This is a cross-sectional study.

METHODS

In total, 774 households from four states in Malaysia completed face-to-face interviews. A validated structured questionnaire was used, which was composed of a combination of open-ended questions, bidding games and contingent valuation methods regarding the participants' willingness to pay.

RESULTS

The study found that the majority of households supported the establishment of the National Health Financing Scheme, and half proposed that a government body should manage the scheme. Most (87.5%) of the households were willing to contribute 0.5-1% of their salaries to the scheme through monthly deductions. Over three-quarters (76.6%) were willing to contribute to a higher level scheme (1-2%) to gain access to both public and private healthcare basic services. Willingness to pay for the National Health Financing Scheme was significantly higher among younger persons, females, those located in rural areas, those with a higher income and those with an illness.

CONCLUSION

There is a high level of acceptance for the National Health Financing Scheme in the Malaysian community, and they are willing to pay for a scheme organised by a government body. However, acceptance and willingness to pay are strongly linked to household socio-economic status. Policymakers should initiate plans to establish the National Health Financing Scheme to provide the necessary financing for a sustainable health system.

摘要

目的

目前,马来西亚在利用税收系统为医疗服务分配足够资源方面面临巨大挑战。因此,马来西亚别无选择,只能改革其医疗保健融资体系。本研究的目的是评估马来西亚家庭对拟议的国家健康融资计划的支付意愿和接受程度。

研究设计

这是一项横断面研究。

方法

共有来自马来西亚四个州的 774 户家庭完成了面对面访谈。使用了经过验证的结构化问卷,该问卷由开放式问题、投标游戏和条件价值评估方法的组合组成,涉及参与者的支付意愿。

结果

研究发现,大多数家庭支持建立国家健康融资计划,其中一半建议由政府机构管理该计划。大多数(87.5%)家庭愿意通过每月扣款,从工资中拿出 0.5-1%来为该计划捐款。超过四分之三(76.6%)的家庭愿意为一个更高水平的计划(1-2%)做出贡献,以获得公共和私人基本医疗服务。年轻、女性、农村地区、收入较高和有疾病的人对国家健康融资计划的支付意愿更高。

结论

马来西亚社会对国家健康融资计划有很高的接受程度,并且愿意为政府组织的计划付费。然而,接受程度和支付意愿与家庭社会经济地位密切相关。政策制定者应启动建立国家健康融资计划的计划,为可持续的卫生系统提供必要的资金。

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