mnha_2022.pdf

7.2 H E A LT H E X P E N D I T U R E F O R FUNCTIONS OF HEALTH CARE - CURATIVE CARE BY SOURCES OF FINANCING Services of curative care include medical, paramedical and allied health services, which could be either allopathic or TCM services and is inclusive of dental care services. It could be provided either at hospital or non-hospital settings. The non-hospital setting includes medical or dental clinics. In 2022, a total of RM51,930 million (65.8% of TEH) was for services of curative care. The source of financing for services of curative care was RM25,856 million (49.8% of curative care expenditure) from the public sector and the remaining RM26,074 million (50.2% of curative care expenditure) from the private sector. For the services of curative care expenditure in hospitals, the public sector spent 41.0%, and the private sector spent 35.2%. The remaining expenditure was spent at non-hospital settings, the public sector spent 8.8%, and the private sector spent 15.0% (Table 7.2a and Figure 7.2). The 2011-2022 time series data shows that the public sector share remains higher than the private sector share as a source of financing but vice versa for 2022 (Table 7.2b and 7.2c). TABLE 7.2a: Health Expenditure for Curative Care by Sources of Financing, 2022 Source Provider RM Million Percent Public Sector Hospital 21,268 40.96 Non-Hospital 4,588 8.83 Sub-Total 25,856 49.79 Private Sector Hospital 18,260 35.16 Non-Hospital 7,814 15.05 Sub-Total 26,074 50.21   Total 51,930 100.00 57 MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022

FIGURE 7.2: Health Expenditure for Curative Care by Sources of Financing, 2022 Health Expenditure for Curative Care, 2022 RM51,930 Million 66% of Total Expenditure on Health Source: Goverment RM25,856 Million 49.8% Curative Care Hospitals RM21,268 Million 82% Non-Hospitals RM4,588 Million 18% Source: Private RM26,074 Million 50.2% Curative Care Hospitals RM18,260 Million 70% Non-Hospitals RM7,814 Million 30% 58 MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022

TABLE 7.2b: Health Expenditure for Curative Care by Sources of Financing, 2011 - 2022 (RM Million) Source Provider 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 Public Source Hospital 10,873 12,651 13,011 15,240 15,885 16,104 17,373 18,684 19,721 18,580 20,323 21,268 Non-Hospital 2,077 2,370 2,001 2,479 2,823 3,017 3,352 3,742 3,436 3,594 3,617 4,588 Sub-Total 12,950 15,021 15,013 17,719 18,708 19,121 20,725 22,427 23,156 22,174 23,940 25,856 Private Source Hospital 7,018 7,363 7,961 8,652 9,921 10,760 12,065 12,692 13,866 13,542 14,834 18,260 Non-Hospital 3,271 3,788 4,218 5,034 4,858 5,045 5,629 5,902 6,270 6,080 6,513 7,814 Sub-Total 10,288 11,151 12,179 13,686 14,779 15,806 17,694 18,594 20,136 19,622 21,347 26,074 Total 23,238 26,172 27,191 31,405 33,487 34,927 38,420 41,021 43,292 41,796 45,287 51,930 TABLE 7.2c: Health Expenditure for Curative Care by Sources of Financing, 2011 - 2022 (Percent %) Source Provider 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 Public Source Hospital 46.79 48.34 47.85 48.53 47.44 46.11 45.22 45.55 45.55 44.45 44.88 40.96 Non-Hospital 8.94 9.06 7.36 7.89 8.43 8.64 8.73 9.12 7.94 8.60 7.99 8.83 Sub-Total 55.73 57.39 55.21 56.42 55.87 54.75 53.95 54.67 53.49 53.05 52.86 49.79 Private Source Hospital 30.20 28.13 29.28 27.55 29.63 30.81 31.40 30.94 32.03 32.40 32.76 35.16 Non-Hospital 14.07 14.47 15.51 16.03 14.51 14.45 14.65 14.39 14.48 14.55 14.38 15.05 Sub-Total 44.27 42.61 44.79 43.58 44.13 45.25 46.05 45.33 46.51 46.95 47.14 50.21 Total 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 59 MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022

7.3 H E A LT H E X P E N D I T U R E F O R FUNCTIONS OF HEALTH CARE – PUBLIC HEALTH SERVICES (INCLUDING HEALTH PROMOTION AND PREVENTION) BY SOURCES OF FINANCING This section refers to expenditure for services designed to improve the health status of the population in the form of structured public health services, including promotive and preventive programmes. This excludes the expenditure of similar services delivered on an individual basis which is captured as part of curative care services. In 2022, a total of RM5,181 million (6.6% of TEH) was spent for public health services. MOH was the highest financier of public health services, spending RM4,496 million or 86.8% of the total expenditure on public health services. The second- highest financier was all corporations (other than health insurance) that spent RM 343 million (6.6% of public service health expenditure), followed by other federal agencies (including statutory bodies) amounting to RM173 million (3.3% of public service health expenditure). The remaining expenditure for public health services spent at RM169 million (3.3% of public service health expenditure) (Table 7.3a). In 2022, 93% of public health service expenditure came from public sector RM4,823 million, MOH spent about 93.2 % of public sector health expenditure on public health services and non-MOH spent 6.8 % of public sector health expenditure on public health services. Private sector sources of financing on public health services spent RM358 million (6.9% of public health service expenditure) (Figure 7.3). The 2011-2022 time series data shows MOH as the largest source of financing for this function, with a 6-fold increase from RM752 million in 2011 to RM4,496 million in 2022. The second highest from all corporations (other than health insurance) decreased from RM563 million in 2011 to RM343 million in 2022 (Table 7.3b and 7.3c). TABLE 7.3a: Health Expenditure for Public Health Services (Including Health Promotion and Prevention) by Sources of Financing, 2022 MNHA Code Sources of Financing RM Million Percent MS1.1.1.1 Ministry of Health (MOH) 4,496 86.77 MS2.6 All corporations (other than health insurance) 343 6.63 MS1.1.1.9 Other federal agencies (including statutory bodies) 173 3.34 MS1.1.2.2 Other state agencies (including statutory bodies) 52 1.00 MS1.1.2.1 (General) State government 49 0.95 MS1.1.3 Local authorities (LA) 47 0.91 MS2.5 Non-profit institutions serving households (NGO) 10 0.20 MS1.2.2 Social Security Organization (SOCSO) 6 0.12 MS2.4 Private household out-of-pocket expenditures (OOP) 4 0.09 MS1.1.1.2 Ministry of Higher Education (MoHE) <1 < 0.09 Total 5,181 100.00 60 MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022

FIGURE 7.3: Health Expenditure for Public Health Services (Including Health Promotion and Prevention) by Sources of Financing, 2022 61 MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022

TABLE 7.3b: Health Expenditure for Public Health Services (including Health Promotion and Prevention) by Sources of Financing, 2011 - 2022
(RM Million) MNHA Code Sources of Financing 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 MS1.1.1.1 Ministry of Health (MOH) 752 898 1,634 1,541 1,653 1,777 1,902 2,118 3,010 3,622 8,728 4,496 MS1.1.1.2 Ministry of Higher Education (MoHE) na na na na na na na na na 75 1 0.15 MS1.1.1.9 Other federal agencies (including statutory bodies) 94 118 128 121 140 128 141 129 146 576 922 173 MS1.1.2.1 (General) State government 54 64 25 31 31 35 27 30 22 89 119 49 MS1.1.2.2 Other state agencies (including statutory bodies) 30 34 66 78 43 52 50 50 55 66 48 52 MS1.1.3 Local authorities (LA) 62 83 72 44 52 26 36 30 47 50 50 47 MS1.2.2 Social Security Organisation (SOCSO) 4 5 35 23 9 11 8 na na 8 5 6 MS2.4 Private household out-of- pocket expenditures (OOP) 8 10 10 8 6 6 6 8 7 8 21 4 MS2.5 Non-profit institutions serving households (NGO) 10 16 1 1 21 28 17 18 2 21 18 10 MS2.6 All corporations (other than health insurance) 563 698 832 924 1,267 1,339 1,283 1,256 787 769 692 343 Total 1,577 1,925 2,804 2,771 3,223 3,401 3,469 3,640 4,077 5,283 10,604 5,181 62 MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022

TABLE 7.3c: Health Expenditure for Public Health Services (including Health Promotion and Prevention) by Sources of Financing, 2011 - 2022 (Percent, %) MNHA Code Sources of Financing 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 MS1.1.1.1 Ministry of Health (MOH) 47.71 46.66 58.27 55.59 51.29 52.24 54.82 58.19 73.83 68.55 82.31 86.77 MS1.1.1.2 Ministry of Higher Education (MoHE) na na na na na na na na na 1.43 0.01 0.00 MS1.1.1.9 Other federal agencies (including statutory bodies) 5.95 6.11 4.57 4.38 4.35 3.75 4.06 3.55 3.58 10.91 8.69 3.34 MS1.1.2.1 (General) State government 3.41 3.30 0.90 1.13 0.96 1.02 0.76 0.83 0.54 1.69 1.13 0.95 MS1.1.2.2 Other state agencies (including statutory bodies) 1.89 1.75 2.35 2.81 1.33 1.52 1.43 1.38 1.36 1.24 0.45 1.00 MS1.1.3 Local authorities (LA) 3.90 4.29 2.58 1.59 1.62 0.76 1.04 0.82 1.15 0.94 0.48 0.91 MS1.2.2 Social Security Organisation (SOCSO) 0.26 0.27 1.26 0.83 0.27 0.33 0.24 na na 0.15 0.04 0.12 MS2.4 Private household out-of- pocket expenditures (OOP) 0.50 0.52 0.35 0.27 0.20 0.17 0.16 0.22 0.18 0.14 0.19 0.09 MS2.5 Non-profit institutions serving households (NGO) 0.66 0.81 0.04 0.04 0.67 0.84 0.49 0.49 0.05 0.40 0.17 0.20 MS2.6 All corporations (other than health insurance) 35.71 36.28 29.67 33.35 39.32 39.37 36.99 34.50 19.31 14.56 6.52 6.63 Total 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 63 MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022

7.4 H E A LT H E X P E N D I T U R E F O R FUNCTIONS OF HEALTH CARE - HEALTH EDUCATION AND TRAINING BY SOURCES OF FINANCING This section describes expenditure for all health and health-related education and training of personnel. Although MNHA Framework includes this expenditure under the TEH, the SHA 1.0 framework excludes this because of the shortfalls involved in making assumptions and the difficulties in capturing this expenditure in other countries. Furthermore, personnel who undergo health and health-related education and training may not continue to provide services in the health sector. In 2022, a total of RM2,465 million or about 3.1% of TEH was spent on health education and training of health personnel. Public sector sources of financing spent RM891 million (36.2% of health education and training expenditure). The MOH spent about 30.1% of public sector on health education and training expenditure and non-MOH spent 69.9% of public sector on health education and training expenditure. Private sector sources of financing spent RM1,573 million (63.8% of health education and training expenditure) (Table 7.4a and Figure 7.4). The 2011-2022 time series data shows that both public sector and private sector sources of financing range between 36% to 64% respectively (Table 7.4b and Table 7.4c). Public sources of financing show almost 2-fold decrease and private sources of financing show almost 2-fold increase in spending for health education and training throughout the 12 years. TABLE 7.4a: Health Expenditure for Health Education and Training by Sources of Financing, 2022 MNHA Code Sources of Financing RM Million Percent MS1.1.1.1 Public source (MOH) 268 10.88 MS1 (others) Public source (non-MOH) 623 25.29 MS2 Private source 1,573 63.83 Total 2,465 100.00 64 MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022