Faculty of Medicine, Department of Community Health, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Ministry of Public Health and Population, Sana'a, Yemen.
PLoS One. 2022 May 5;17(5):e0267897. doi: 10.1371/journal.pone.0267897. eCollection 2022.
Even in a country with a tax-based healthcare financing system, health insurance can play an important role, especially in the management of chronic diseases with high disease and economic burden such as Type 2 Diabetes Mellitus (T2DM). The insurance coverage among T2DM patients in Malaysia is currently unclear. The aim of this study was to determine the insurance status of T2DM patients in public and private healthcare facilities in Malaysia, and the association between this status and patients' sociodemographic and economic factors.
A cross-sectional study among T2DM patients seeking inpatient or outpatient treatment at a public tertiary hospital (Hospital Canselor Tuanku Muhriz) and a private tertiary hospital (Universiti Kebangsaan Malaysia Specialist Centre) in Kuala Lumpur between August 2019 and March 2020. Patients were identified via convenience sampling using a self-administered questionnaire. Data collection focused on identifying insurance status as the dependent factor while the independent factors were the patients' sociodemographic characteristics and economic factors.
Of 400 T2DM patients, 313 responded (response rate, 78.3%) and 76.0% were uninsured. About 69.6% of the respondents had low monthly incomes of <RM5000. Two-thirds of participants (59.1%) spent RM100-500 for outpatient visits whilst 58.5% spent <RM100 on medicines per month (RM1 = USD0.244). Patients who visited a private facility had five times more likely to have insurance than patients who visited a public facility. Participants aged 18-49 years with higher education levels were 4.8 times more likely to be insured than participants aged ≥50 years with low education levels (2 times).
The majority of T2DM patients were uninsured. The main factors determining health insurance status were public facilities, age of ≥ 50 years, low education level, unemployment, and monthly expenditure on medicines.
即使在一个以税收为基础的医疗保健融资系统的国家，健康保险也可以发挥重要作用，特别是在管理具有高疾病和经济负担的慢性病方面，如 2 型糖尿病（T2DM）。目前，马来西亚 T2DM 患者的保险覆盖情况尚不清楚。本研究旨在确定马来西亚公立和私立医疗机构中 T2DM 患者的保险状况，以及这种状况与患者社会人口经济学因素之间的关系。
这是一项在 2019 年 8 月至 2020 年 3 月期间，在吉隆坡的一家公立 tertiary 医院（Hospital Canselor Tuanku Muhriz）和一家私立 tertiary 医院（Universiti Kebangsaan Malaysia Specialist Centre），对接受门诊或住院治疗的 T2DM 患者进行的横断面研究。通过便利抽样，患者使用自我管理问卷进行识别。数据收集侧重于将保险状况确定为因变量，而患者的社会人口学特征和经济因素为自变量。
在 400 名 T2DM 患者中，有 313 名（应答率 78.3%）做出了回应，其中 76.0%没有保险。约 69.6%的受访者月收入<RM5000。69.6%的参与者（59.1%）门诊就诊花费在 RM100-500 之间，58.5%每月药品花费<RM100（RM1=0.244 美元）。与到公立机构就诊的患者相比，到私立机构就诊的患者有五倍的可能性拥有保险。与年龄≥50 岁、受教育程度较低的患者相比，年龄在 18-49 岁之间、教育程度较高的患者拥有保险的可能性高 4.8 倍（高 2 倍）。
大多数 T2DM 患者没有保险。决定健康保险状况的主要因素是公立机构、≥50 岁、低教育水平、失业和每月药品支出。
