MOH/S/RAN/272.24(AR)-e HEALTH EXPENDITURE REPORT HEALTH EXPENDITURE REPORT 2011-2022MINISTRY OF HEALTH MALAYSIA MALAYSIA MALAYSIA HEALTH EXPENDITURE REPORT MALAYSIA 2011-2022 www.moh.gov.my
HEALTH EXPENDITURE REPORT MALAYSIA MALAYSIA NATIONAL HEAL TH ACCOUNTS SECTION PLANNING DIVISION MINISTRY OF HEAL TH MALAYSIA 2024 Published by Malaysia National Health Accounts (MNHA) Section, Planning Division, Ministry of Health, Level 6, Block E6, Complex E, Precinct 1, Federal Government Administrative Centre, 62590 Putrajaya, Malaysia. Website: www.moh.gov.my Email: [email protected] ISSN 1985-711 © MOH 2024. All rights reserved. First published: 2024 Enquiries concerning reproduction or interpretation of the contents of this publication should be directed to the Malaysia National Health Accounts Section, Planning Division, Ministry of Health, Malaysia. Printed in Malaysia
MESSAGE FROM
THE DIRECTOR-GENERAL
OF HEALTH MALAYSIA
T
he Malaysia National Health Accounts (MNHA)
established in 2005, serves as a cornerstone
for providing comprehensive data on national
health expenditure. This data is crucial for effective
healthcare planning and equips policymakers with
evidence-based insights for decision-making.
Information on health expenditure is sourced from
both public and private sectors, and is reported
at both national and international levels using
the MNHA and System of Health Accounts (SHA)
frameworks, respectively. MNHA adheres to
internationally accepted standardized methods
to ensure the provision of comparable time series
data.
The findings of the report showed that Malaysia’s
Total Expenditure on Health (TEH) in 2022
was estimated at RM79 billion, equivalent to
4.4% of Gross Domestic Product (GDP). Public
sector financing continued to outweigh private
sector financing, with total public sector health
expenditure reaching RM41 billion, constituting
52% of TEH. Out-of-pocket (OOP) expenses
represented the second highest source of funding
at 37%. The majority of health expenditure,
amounting to RM44 billion or 55% of TEH, was
allocated to hospitals. In terms of function,
expenditure on curative care services ranked
highest at RM52 billion, accounting for 66% of
TEH.
I eagerly anticipate the ongoing production of
the annual MNHA report, which provides valuable
insights into national health expenditure. This
data is indispensable for informed planning and
policymaking aimed at delivering sustainable,
equitable, and affordable healthcare services and
products tailored to the nation’s healthcare needs.
I extend my sincere gratitude to all stakeholders
for their contributions in providing the necessary
data for the compilation of health accounts.
Special appreciation is extended to the Planning
Division and, particularly, the MNHA team for their
dedicated efforts in preparing this report.
Datuk Dr. Muhammad Radzi bin Abu Hassan
Director-General of Health Malaysia
i
MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022
MESSAGE FROM
THE DEPUTY SECRETARY-GENERAL
(FINANCE)
MINISTRY OF HEALTH, MALAYSIA
T
he Malaysia National Health Accounts (MNHA),
under the Planning Division of the Ministry of
Health, produces 26 years of time-series data
(1997-2022) on national health expenditure.
These findings are presented to the MNHA
Steering Committee, comprising representatives
from both public and private sectors. This
collaborative effort facilitates effective healthcare
planning and enables policymakers to make
evidence-based decisions. It serves as a crucial
tool for monitoring health spending trends and
the allocation of funds across various healthcare
providers and functions. Therefore, MNHA plays
a pivotal role in informing financial planning and
policy formulation in our country.
The emergence of the COVID-19 pandemic has
not only posed a significant threat to public health
but has also had a profound impact on global
health expenditure. The insights gleaned from
health expenditure data for 2022 are invaluable
for understanding post-pandemic health spending
patterns. Such insights are essential for crafting
effective policies and strategies to address future
challenges.
I wish to express my gratitude to the multiple
agencies whose contributions have been
instrumental in the development of MNHA. Due
recognition to all members of the MNHA Steering
Committee for their steadfast participation
and contributions. Additionally, I extend my
appreciation to the MNHA Technical Advisory
Committee for their invaluable guidance in
ensuring data quality, as well as to data suppliers
for their cooperation. The MNHA team should
be commended for their efforts in consistently
producing high-quality national-level expenditure
data, which serve as an excellent reference for
tracking the country’s health expenditure trends.
Dato’ Sri Norazman Ayob
Deputy Secretary General (Finance)
Ministry of Health, Malaysia
ii
MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022
ACKNOWLEDGEMENT
The production of this MNHA Health Expenditure Report
2011-2022 report would not be possible without the guidance
and endorsement from MNHA Steering Committee. Gratitude is
also extended to the committee, co-chaired by the Secretary
General of Ministry of Health and the Director General of Health
Malaysia.
The deepest appreciation and special thanks also to all
members of the MNHA Technical Advisory Committee and to
all public and private stakeholders that provide continuous
cooperation and contribute the necessary data succession
of this report production.
Warm thanks to dedicated MNHA Section staff members for
their kind and consistent co-operation, invaluable assistance
and constructive suggestions in completion of this report.
iii
MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022
CONTENTS
Message from the Director-General of Health Malaysia i
M
essage from the Deputy Secretary-General (Finance) Ministry of Health, Malaysia
ii
A
cknowledgement
iii
Contents
iv
List of Tables
vi
Lis
t of Figures
viii
Lis
t of Appendix Tables
x
Lis
t of Abbreviations
xi
Ex
ecutive Summary
xiii
R
eport Information
xiv
Chap
ter
1
Background
1
2
Malaysia Na
tional Health Accounts (MNHA): Summary of Framework
2
2.1
T
he MNHA Classification
2
2.2
Ov
erview of Total Expenditure on Health (TEH)
2
2.
3
Ov
erview of Current Health Expenditure (CHE)
3
3
M
ethodology of Data Collection and Analysis
5
3.1
Gener
al Methodology
5
3.2
Da
ta Collection and Analysis
5
3.
3
Da
ta Processing of Various Agencies
7
3.
3.1
Public S
ector 7
3.
3.2
P
rivate Sector 8
3.
4
MNHA
Estimation of Constant Value
10
4
T
otal Expenditure on Health
12
4
.1
T
otal Expenditure on Health (TEH)
12
4
.2
P
er Capita Health Expenditure
12
4
.3
H
ealth Expenditure by States
14
5
H
ealth Expenditure by Sources of Financing
17
5
.1
H
ealth Expenditure by Public and Private Sources of Financing
18
5
.2
H
ealth Expenditure by Public Sources of Financing
23
5
.2.1
H
ealth Expenditure by All Public Sources of Financing
23
5
.2.2
Public S
ector Health Expenditure (PSHE) as Percentage of Public Sector
Expenditur
e (PSE)
26
5
.2.3
H
ealth Expenditure by Public Sources of Financing to Providers of Health Care
27
5
.2.4
H
ealth Expenditure by Public Sources of Financing for Functions of Health Care
30
iv
MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022
5.3 H ealth Expenditure by Private Sources of Financing 33
5
.3.1
H
ealth Expenditure by All Private Sources of Financing
33
5
.3.2
H
ealth Expenditure by Private Sources of Financing to Providers of Health Care
36
5
.3.3
H
ealth Expenditure by Private Sources of Financing for Functions of Health Care
39
6
H
ealth Expenditure to Providers of Health Care
42
6
.1
H
ealth Expenditure to All Providers of Health Care
42
6
.2
H
ealth Expenditure to Providers of Health Care - Hospitals
46
6
.3
H
ealth Expenditure to Providers of Health Care - Providers of Ambulatory Health Care
50
7
H
ealth Expenditure for Functions of Health Care
53
7
.1
H
ealth Expenditure for All Functions of Health Care
53
7
.2
H
ealth Expenditure for Functions of Health Care - Curative Care by Sources of Financing
57
7
.3
H
ealth Expenditure for Functions of Health Care - Public Health Services
(
including Health Promotion and Prevention) by Sources of Financing
60
7
.4
H
ealth Expenditure for Functions of Health Care - Health Education
and
Training by Sources of Financing
64
8
MOH H
ealth Expenditure
67
8.
1
MOH H
ealth Expenditure - MOH Share of Total Expenditure on Health and National GDP 67
8.2
MOH H
ealth Expenditure - MOH Hospital
69
8.2.
1
MOH H
ealth Expenditure - MOH Hospital, Sources of Financing
69
8.2.2
MOH H
ealth Expenditure - MOH Hospital, Functions of Curative Care
72
9
Out
-of-Pocket Health Expenditure
75
9
.1
Out
-of-Pocket Health Expenditure - OOP Share of Total Expenditure on
H
ealth and National GDP 76
9
.2
Out
-of-Pocket Health Expenditure to Providers of Health Care
79
9
.3
Out
-of-Pocket Health Expenditure for Functions of Health Care
84
10
P
rimary Health Care (PHC) Expenditure
88
10
.1
Concep
tualization of Primary Health Care
88
10
.2
V
arious International Primary Health Care Guidelines
88
10
.3
Malaysia
’s New Boundaries of Primary Health Care
89
10
.4
P
rimary Health Care Expenditure
91
11
I
nternational NHA Data
93
Appendix T
ables
97
MNHA
Committees and Members
107
Lis
t of Authors and Editorial Members
110
v
MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022
LIST OF TABLES
T3.4a
Example of Splicing Method with Different Base Year
11
T3.4b
Example of Calculating Total Expenditure on Health in Constant Value Base Year 2016
11
T4.1
Total Expenditure on Health, 2011-2022 (RM Million & Percent GDP)
12
T4.2
Per Capita Expenditure on Health, 2011-2022 (Nominal & Constant, RM)
13
T4.3
State Population and Health Expenditure, 2022
15
T5.1a
Total Expenditure on Health by Sources of Financing, 2022
18
T5.1b
Total Expenditure on Health by Sources of Financing, 2011-2022 (RM Million)
20
T5.1c
Total Expenditure on Health by Sources of Financing, 2011-2022 (Percent, %)
21
T5.1d
Total Expenditure on Health by Public & Private Sources of Financing, 2011-2022
22
T5.2.1a
Health Expenditure by Public Sources of Financing, 2022
23
T5.2.1b
Health Expenditure by Public Sources of Financing, 2011-2022 (RM Million)
25
T5.2.1c
Health Expenditure by Public Sources of Financing, 2011-2022 (Percent, %)
25
T5.2.2
Public Sources Health Expenditure (PSHE), 2011-2022 (RM Million, Percent PSE)
26
T5.2.3a
Public Sources Health Expenditure to Providers of Health Care, 2022
27
T5.2.3b
Public Sources Health Expenditure to Providers of Health Care,
2011-2022 (RM Million)
29
T5.2.3c
Public Sources Health Expenditure to Providers of Health Care, 2011-2022 (Percent, %)
29
T5.2.4a
Public Sources Health Expenditure for Functions of Health Care, 2022
30
T5.2.4b
Public Sources Health Expenditure for Functions of Health Care,
2011-2022 (RM Million)
32
T5.2.4c
Public Sources Health Expenditure for Functions of Health Care,
2011-2022 (Percent, %)
32
T5.3.1a
Health Expenditure by Private Sources of Financing, 2022
33
T5.3.1b
Health Expenditure by Private Sources of Financing, 2011-2022 (RM Million)
35
T5.3.1c
Health Expenditure by Private Sources of Financing, 2011-2022 (Percent, %)
35
T5.3.2a
Private Sources Health Expenditure to Providers of Health Care, 2022
36
T5.3.2b
Private Sources Health Expenditure to Providers of Health Care,
2011-2022 (RM Million)
38
T5.3.2c
Private Sources Health Expenditure to Providers of Health Care,
2011-2022 (Percent, %)
38
T5.3.3a
Private Sources Health Expenditure for Functions of Health Care, 2022
39
T5.3.3b
Private Sources Health Expenditure for Functions of Health Care,
2011-2022 (RM Million)
41
T5.3.3c
Private Sources Health Expenditure for Functions of Health Care,
2011-2022 (Percent, %)
41
T6.1a
Total Expenditure on Health to Providers of Health Care, 2022
43
T6.1b
Total Expenditure on Health to Providers of Health Care, 2011-2022 (RM Million)
45
T6.1c
Total Expenditure on Health to Providers of Health Care, 2011-2022 (Percent, %)
45
T6.2a
Health Expenditure at All Hospitals by Sources of Financing, 2022
46
T6.2b
Health Expenditure at All Hospitals by Sources of Financing,
2011-2022 (RM Million)
48
T6.2c
Health Expenditure at All Hospitals by Sources of Financing,
2011-2022 (Percent, %)
49
T6.3a
Health Expenditure to Providers of Ambulatory Health Care
by Sources of Financing, 2022
50
vi
MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022