FIGURE 5.1b: Total Expenditure on Health by Sources of Financing (Public vs. Private), 2011-2022 TABLE 5.1d: Total Expenditure on Health by Public & Private Sources of Financing, 2011-2022 Year Public Sector Private Sector TEH (Nominal RM Million) Health Expenditure (Nominal, RM Million) Health Expenditure as Percentage of TEH (%) Health Expenditure (Nominal, RM Million) Health Expenditure as Percentage of TEH (%) 2011 20,251 56.33 15,702 43.67 35,953 2012 22,007 55.79 17,442 44.21 39,448 2013 22,868 54.91 18,780 45.09 41,647 2014 25,921 55.41 20,859 44.59 46,780 2015 27,034 53.79 23,222 46.21 50,256 2016 26,754 51.69 25,001 48.31 51,756 2017 29,283 51.92 27,121 48.08 56,404 2018 31,444 51.95 29,084 48.05 60,528 2019 34,290 53.30 30,046 46.70 64,336 2020 36,603 54.59 30,448 45.41 67,051 2021 44,803 57.66 32,900 42.34 77,703 2022 41,257 52.26 37,688 47.74 78,945 22 MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022
5.2 HEALTH EXPENDITURE BY PUBLIC SOURCES OF FINANCING This section describes health expenditure according to MNHA classification by public sources of health care financing for the year 2022, followed by time series data for 2011-2022. 5.2.1 Health Expenditure by All Public Sources of Financing In 2022, the Public Source Health Expenditure (PSHE) was RM41,257 million or 52.3% of TEH. An analysis of the public sources of health care financing showed that the highest expenditure was by MOH with a spending of RM33,863 million (82.1% of PSHE). This was followed by other federal agencies (including statutory bodies) at RM3,796 million (9.2% of PSHE), MoHE at RM1,807 million (4.4% of PSHE) and the remaining public sources of health care financing spent RM1,791 million or 4.3% of PSHE (Table 5.2.1a and Figure 5.2.1). The trend of expenditure by public sources of health care financing over the past 12 years shows that the MOH consistently ranks among the top three funders, other federal agencies (including statutory bodies) and MoHE. MOH as the largest financier in the public sector, shows more than two-fold increase in expenditure, spending RM16,496 million in 2011 to RM33,863 million in 2022. This MOH expenditure contributed to 81-85% of public sector health expenditure since 2011 (Table 5.2.1b and Table 5.2.1c). TABLE 5.2.1a: Health Expenditure by Public Sources of Financing, 2022 MNHA Code Sources of Financing RM Million Percent MS1.1.1.1 Ministry of Health (MOH) 33,863 82.08 MS1.1.1.9 Other federal agencies (including statutory bodies) 3,796 9.20 MS1.1.1.2 Ministry of Higher Education (MoHE) 1,807 4.38 MS1.1.2.2 Other state agencies (including statutory bodies) 587 1.42 MS1.2.2 Social Security Organisation (SOCSO) 496 1.20 MS1.1.3 Local authorities (LA) 251 0.61 MS1.1.1.3 Ministry of Defence (MOD) 194 0.47 MS1.1.2.1 (General) State government 175 0.42 MS1.2.1 Employees Provident Fund (EPF) 88 0.21 Total 41,257 100.00 23 MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022
FIGURE 5.2.1: Health Expenditure by Public Sources of Financing, 2022 Other public Source agencies MoHE MOH Other federal agencies 24 MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022
TABLE 5.2.1b: Health Expenditure by Public 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) 16,496 18,239 19,038 21,782 22,737 22,315 24,775 26,561 28,903 31,011 38,487 33,863 MS1.1.1.2 Ministry of Higher Education (MoHE) 1,245 1,311 1,261 1,376 1,314 1,279 1,256 1,371 1,642 1,464 1,721 1,807 MS1.1.1.3 Ministry of Defence (MOD) 140 172 175 186 169 154 132 103 150 135 197 194 MS1.1.1.9 Other federal agencies (including statutory bodies) 1,813 1,678 1,677 1,805 1,886 2,020 2,076 2,120 2,244 2,531 2,833 3,796 MS1.1.2.1 (General) State government 90 105 78 86 90 97 111 150 124 207 249 175 MS1.1.2.2 Other state agencies (including statutory bodies) 129 137 189 212 346 385 392 467 502 504 535 587 MS1.1.3 Local authorities (LA) 142 150 188 164 178 138 154 194 249 264 247 251 MS1.2.1 Employee Provident Funds (EPF) 39 38 42 46 52 56 58 67 83 79 102 88 MS1.2.2 Social Security Organisation (SOCSO) 157 176 219 264 261 310 329 410 394 409 434 496 Total 20,251 22,007 22,868 25,921 27,034 26,754 29,283 31,444 34,290 36,603 44,803 41,257 TABLE 5.2.1c: Health Expenditure by Public 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) 81.46 82.88 83.25 84.03 84.37 83.75 84.86 84.86 84.63 84.83 85.05 82.08 MS1.1.1.2 Ministry of Higher Education (MoHE) 6.15 5.96 5.51 5.31 4.88 4.80 4.30 4.38 4.81 4.00 3.80 4.38 MS1.1.1.3 Ministry of Defence (MOD) 0.69 0.78 0.77 0.72 0.63 0.58 0.45 0.33 0.44 0.37 0.43 0.47 MS1.1.1.9 Other federal agencies (including statutory bodies) 8.95 7.63 7.33 6.96 7.00 7.58 7.11 6.77 6.57 6.92 6.26 9.20 MS1.1.2.1 (General) State government 0.45 0.48 0.34 0.33 0.33 0.37 0.38 0.48 0.36 0.57 0.55 0.42 MS1.1.2.2 Other state agencies (including statutory bodies) 0.64 0.62 0.83 0.82 1.28 1.44 1.34 1.49 1.47 1.38 1.18 1.42 MS1.1.3 Local authorities (LA) 0.70 0.68 0.82 0.63 0.66 0.52 0.53 0.62 0.73 0.72 0.54 0.61 MS1.2.1 Employee Provident Funds (EPF) 0.19 0.17 0.18 0.18 0.19 0.21 0.20 0.21 0.24 0.22 0.23 0.21 MS1.2.2 Social Security Organisation (SOCSO) 0.78 0.80 0.96 1.02 0.97 1.16 1.13 1.31 1.15 1.12 0.96 1.20 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 25 MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022
5.2.2 Public Source Health Expenditure (PSHE) as Percentage of Public Source Expenditure (PSE) Public Source Health Expenditure (PSHE) includes expenditure by all public sources of health care TABLE 5.2.2: Public Source Health Expenditure (PSHE), 2011-2022 (RM Million, Percent PSE) Year Public Source Health Expenditure (PSHE) (RM Million) Public Source Expenditure (PSE)* (RM Million) PSHE as % PSE 2011 20,251 297,382 6.81 2012 22,007 365,600 6.02 2013 22,868 376,374 6.08 2014 25,921 405,788 6.39 2015 27,034 383,727 7.05 2016 26,754 375,489 7.13 2017 29,283 383,280 7.64 2018 31,444 410,482 7.66 2019 34,290 432,697 7.92 2020 36,603 418,949 8.74 2021 44,803 433,056 10.35 2022 41,257 497,306 8.30 *Source: Treasury Malaysia website Fiscal Outlook 2022, Section 6 : Consolidated Public Sector financing, namely federal government, state government, local authorities, social security funds and all other public entities. PSHE has more than doubled in RM value from RM20,251 million (6.8% of PSE) in 2011 to RM41,257 million (8.3% of PSE) in 2022 (Table 5.2.2 and Figure 5.2.2). FIGURE 5.2.2: Trend for Public Source Health Expenditure (PSHE) as Percentage of Public Source Expenditure (PSE), 2011-2022 26 MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022
5.2.3 Health Expenditure by Public Sources of Financing to Providers of Health Care Cross-tabulations of public sources of financing to providers of health care respond to the question of where these publicly sourced funds were spent or who provided the health care services and products. In 2022, the majority of financing health expenditure from public sources was allocated to hospitals (includes general hospitals, psychiatric hospitals and speciality hospitals) with a spending of RM23,846 million (57.8% of PSHE). This is followed by spending at providers of ambulatory health care of RM7,829 million (19.0% of PSHE), general health administration and insurance at RM5,264 million (12.8% of PSHE) and provision and administration of public health programmes at RM2,574 million (6.2% of PSHE). The remaining expenditure to all other providers of health care services and products was RM1,744 million or 4.2% of PSHE (Table 5.2.3a and Figure 5.2.3). The trend in spending by public sources of health care financing over the past 12 years shows that the top 3 providers of health care where the funds are being spent are at hospitals, providers of ambulatory health care and general health administration and insurance (Table 5.2.3b and Table 5.2.3c). TABLE 5.2.3a: Public Source Health Expenditure to Providers of Health Care, 2022 MNHA Code Providers of Health Care RM Million Percent MP1 All hospitals 23,846 57.80 MP3 Providers of ambulatory health care 7,829 18.98 MP6 General health administration and insurance 5,264 12.76 MP5 Provision and administration of public health programmes 2,574 6.24 MP8 Institutions providing health-related services 1,254 3.04 MP4 Retail sale and other providers of medical goods 296 0.72 MP7 Other industries (rest of the Malaysian economy) 192 0.47 MP2 Nursing and residential care facilities 1 <0.01 MP9 Rest of world (ROW) 1 <0.01 Total 41,257 100.00 27 MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022
FIGURE 5.2.3: Public Source Health Expenditure to Providers of Health Care, 2022
Hospitals Ambulatory health care providers General health administration and insurance Provision and administration of public health programmes All other providers 28 MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022 TABLE 5.2.3b: Public Source Health Expenditure to Providers of Health Care, 2011-2022 (RM Million) MNHA Code Providers of Health Care 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 MP1 All hospitals 11,357 13,350 13,706 15,762 16,455 16,688 17,719 19,006 20,399 20,755 22,978 23,846 MP2 Nursing and residential care facilities 2 2 1 1 1 1 1 1 1 50 1 1 MP3 Providers of ambulatory health care 2,745 3,191 3,554 4,186 4,374 4,539 4,951 5,511 6,151 6,646 11,877 7,829 MP4 Retail sale and other providers of medical goods 135 168 202 220 289 291 305 183 173 205 244 296 MP5 Provision and administration of public health programmes 1,125 1,449 1,163 1,427 1,411 1,597 1,535 1,315 1,679 2,272 2,754 2,574 MP6 General health administration and insurance 3,207 2,332 2,753 2,692 2,945 2,014 3,315 3,672 4,181 4,491 4,619 5,264 MP7 Other industries (rest of the Malaysian economy) 118 137 271 198 138 158 148 149 144 139 758 192 MP8 Institutions providing health-related services 1,562 1,376 1,216 1,435 1,416 1,465 1,308 1,606 1,562 2,046 1,571 1,254 MP9 Rest of the world (ROW) 1 1 1 1 4 2 1 1 1 1 1 1 Total 20,251 22,007 22,868 25,921 27,034 26,754 29,283 31,444 34,290 36,603 44,803 41,257 TABLE 5.2.3c: Public Source Health Expenditure to Providers of Health Care, 2011-2022 (Percent, %) MNHA Code Providers of Health Care 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 MP1 All Hospitals 56.08 60.66 59.94 60.81 60.87 62.38 60.51 60.44 59.49 56.70 51.29 57.80 MP2 Nursing and residential care facilities 0.01 0.01 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.14 0.00 0.00 MP3 Providers of ambulatory health care 13.55 14.50 15.54 16.15 16.18 16.96 16.91 17.53 17.94 18.16 26.51 18.98 MP4 Retail sale and other providers of medical goods 0.67 0.76 0.88 0.85 1.07 1.09 1.04 0.58 0.50 0.56 0.54 0.72 MP5 Provision and administration of public health programmes 5.56 6.59 5.09 5.50 5.22 5.97 5.24 4.18 4.90 6.21 6.15 6.24 MP6 General health administration and insurance 15.83 10.60 12.04 10.38 10.89 7.53 11.32 11.68 12.19 12.27 10.31 12.76 MP7 Other industries (rest of the Malaysian economy) 0.58 0.62 1.19 0.76 0.51 0.59 0.51 0.47 0.42 0.38 1.69 0.47 MP8 Institutions providing health-related services 7.71 6.25 5.32 5.53 5.24 5.48 4.47 5.11 4.55 5.59 3.51 3.04 MP9 Rest of the world (ROW) 0.00 0.00 0.01 0.00 0.02 0.01 0.00 0.00 0.00 0.00 0.00 0.00 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 29 MALAYSIA NATIONAL HEALTH ACCOUNTS HEALTH EXPENDITURE REPORT 2011-2022