Sains Malaysiana 49(8)(2020): 1969-1980

http://dx.doi.org/10.17576/jsm-2020-4908-19

Gender Preferences, Socio-Demographic and Health Risks Associated with Preferred Preventive-Promotive Benefit Packages of Health Insurance for Women in Perak and Selangor, Malaysia

(Keutamaan Jantina, Sosio-Demografi dan Risiko Kesihatan yang Berkaitan dengan Pakej Manfaat Pencegahan-Promotif Pilihan untuk Insurans Kesihatan bagi Wanita di Perak dan Selangor, Malaysia)

NURUL AZWA MOHD ISMAIL¹*, SHARIFA EZAT WAN PUTEH¹, KHADIJAH SHAMSUDDIN¹, PANNARUNOTHAI² & HANIN FARHANA KAMARUZAMAN³

¹Department of Community Health, Faculty of Medicine, National University of Malaysia, Malaysia

²Center of Health Equity Monitoring Foundation, Naresuan University, Phitsanulok, Thailand

³Malaysia Health Technology Assessment Section, MaHTAS, Medical Development Division, Ministry of Health Malaysia, Malaysia

Received: 19 June 2019/Accepted: 28 March 2020

ABSTRACT

Given the escalating cost of healthcare, Malaysia has to consider implementing social health insurance to provide better financial health protection to the population, especially women. Women are vulnerable to financial distress because they need more complex healthcare needs than men. Therefore, this study will examine the perception among the Malaysian population towards preferred preventive/promotive benefit packages of health insurance for women by analyzing preferences among men and on women’s health services. This study determined respondents’ preferences towards preventive/promotive benefit packages for women using a cross-sectional study conducted in two states; Perak and Selangor from December 2016 to December 2017. This study looked at gender preferences and socio-demographic variables, health risks, and subscription to health insurance to preventive/promotive benefit packages preferences for women. A total of 638 respondents in the 18- to 60-year-old age group were drawn from both genders in this study. Analyzes used logistic regression to determine predictors of preventive/promotive benefit packages preferences for women. The results from the analysis showed that more women (66.7%) significantly preferred preventive/promotive services compared to 58.7% of males (p<0.05). In the multivariate analysis among women, Malay ethnicity (OR 2.42, 95% CI 1.37-4.24), self-employed (OR 6.24, 95% CI 2.41-16.10) and not-working/pensioner (compared to the civil servant; OR 2.71, 95% CI 1.35-5.40), obese (OR 16.24, 95% CI 4.50-58.62), no chronic illness (OR 3.72, 95% 2.01-6.88), and subscribed to health insurance (OR 4.21, 95% CI 1.33-5.52) were the factors associated with women’s preferences towards preventive/promotive benefit packages. Meanwhile, for men, age less than 40-year-old (OR 3.56, 95% CI 1.82-6.95), higher education (OR 3.40, 95% CI 1.77-6.52), self-employed (OR 4.65, 95% CI 2.01-10.72), ex-smoker (OR 5.17, 95% CI 1.42-18.75), heavy physical activity (OR 1.26, 95% CI 1.13-1.52), pre-obese (OR 5.35, 95% CI 2.03-14.05) and obese (compared to underweight; OR 2.28 95% CI 1.18-4.36), and subscribed to health insurance (OR 2.72, 95% CI 1.33-5.52), were associated with men’s preferences towards preventive/promotive benefit packages. The overall results of this study show the importance of socio-demographic factors, health risks, and subscription of health insurance among men and women towards the preferences for women’s benefits packages of health insurance.

Keywords: Health insurance; health services; preventive services; women’s health services

ABSTRAK

Malaysia perlu mempertimbangkan untuk melaksanakan insurans kesihatan sosial dalam menyediakan perlindungan kesihatan yang lebih baik kepada penduduk terutama wanita, disebabkan peningkatan kos penjagaan kesihatan. Wanita merupakan golongan yang seringkali mengalami kesulitan kewangan kerana penjagaan kesihatan wanita adalah lebih kompleks berbanding lelaki. Justeru, kajian ini adalah untuk mengkaji pandangan kalangan penduduk Malaysia terhadap kecenderungan pakej pencegahan/promosi dalam insurans kesihatan wanita dengan mengkaji kecenderungan jantina memilih pakej untuk wanita. Menggunakan kajian keratan rentas yang dijalankan di dua negeri; Perak dan Selangor, kajian ini dijalankan untuk mengetahui kecenderungan jantina dan faktor sosio-demografi, risiko kesihatan dan pemilikan insurans kesihatan terhadap pakej manfaat bagi wanita. Seramai 638 responden dalam lingkungan umur antara 18 hingga 60 tahun, lelaki dan wanita, terlibat dalam kajian ini. Analisis dijalankan menggunakan regresi logistik untuk mendapatkan peramalan bagi pakej pencegahan/promosi untuk wanita. Hasil kajian menunjukkan 66.7% wanita lebih cenderung memilih pakej pencegahan/promosi berbanding 58.7% lelaki (p<0.05). Dalam analisis multivariat dalam kalangan wanita, bangsa Melayu (OR 2.42, 95% CI 1.37-4.24), bekerja sendiri (OR 6.24, 95% CI 2.41-16.10) dan tidak bekerja/pesara (OR 2.71, 95% CI 1.35-5.40) (berbanding pekerja kerajaan), obes (OR 16.24, 95% CI 4.50-58.62), tiada penyakit kronik (OR 3.72, 95% 2.01-6.88) dan memiliki insurans kesihatan (OR 4.21, 95% CI 1.33-5.52) adalah faktor yang mempengaruhi kecenderungan wanita memilih pakej pencegahan/promosi. Bagi lelaki pula, umur kurang 40 tahun (OR 3.56, 95% CI 1.82-6.95), berpendidikan tinggi (OR 3.40, 95% CI 1.77-6.52), bekerja sendiri (OR 4.65, 95% CI 2.01-10.72), bekas perokok (OR 5.17, 95% CI 1.42-18.75), aktiviti fizikal berat (OR 1.26, 95% CI 1.13-1.52), pra-obes (OR 5.35, 95% CI 2.03-14.05), obes (OR 2.28 95% CI 1.18-4.36) (berbanding kurang berat badan) dan memiliki insurans kesihatan (OR 2.72, 95% CI 1.33-5.52), adalah faktor yang mempengaruhi kecenderungan lelaki memilih pakej pencegahan/promosi untuk wanita. Hasil keseluruhan kajian ini menunjukkan kepentingan faktor sosio-demografi, risiko kesihatan dan pemilikan insurans kesihatan responden dalam kecenderungan mereka memilih pakej pencegahan/promosi untuk wanita.

Kata kunci: Insurans kesihatan; perkhidmatan kesihatan; perkhidmatan kesihatan wanita; perkhidmatan pencegahan

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*Corresponding author; email: nnurulazwaa@ymail.com