Economic Burden of Healthcare Utilisation by Older Persons Living in the Community in Malaysia

Objective: The aim of the study is to estimate the economic burden of healthcare utilisation by older persons in Malaysia at a national scale. The specific objectives are to: (1) identify the healthcare utilisation behaviour of older persons; (2) estimate the direct and indirect healthcare costs at the community setting, and (3) estimate the economic burden of healthcare utilisation by older persons. Methods: The survey utilised multi-stage random sampling techniques to recruit a total of 2,274 elderly respondents aged 60 years and above. The economic burden of healthcare utilisation by an older person was estimated using multiple sources of data, namely administrative cost and healthcare cost from both institutional and community settings. Results: The prevalence of outpatient and inpatient care was 60.5% and 5.6%, respectively. Older persons generally chose government facilities for both inpatient and outpatient services. The average direct cost for outpatient and inpatient care were RM 141.24 and RM 2,527, respectively. The average indirect costs for outpatient and inpatient care were RM 31.44 and RM 524.07, respectively. The economic burden of healthcare utilisation by an older person was estimated at RM 3,807,481,491, which represent 0.34% of the total GDP in 2014 or 8% of the total health expenditure in the same year. By 2040, the burden is projected to reach a staggering RM 21 billion, or around 1.08% of the total GDP. The economic burden of healthcare utilisation by older persons is expected to increase as Malaysia is moving towards an aged nation by 2045. Conclusion: The utilization of outpatient care for older persons was estimated at 60% and most of the sought-after services were heavily subsidized government facilities. This study highlights the needs for the government to embark on preventive health and comprehensive education to decrease the prevalence and severity of non-communicable diseases (NCDs) among both the future aged and existing elderly in Malaysia. Alternatively, health care reform may be timely to ease the burden of healthcare utilisation by an even bigger percentage of older persons, once we become an aged nation.