RISING HEALTHCARE EXPENDITURE – DEMAND SIDE: A SYSTEMATIC REVIEW

Abstract

Background: Globally, total health expenditure is rising including in Malaysia. Healthcare demand is the decision that is made based on variety of choices that is available for utilising healthcare, consequently stimulating productivity. Among others, healthcare demand can be represented by healthcare expenditure. The concept of estimation of health production function provides derivative of utility/satisfaction. Elasticity is the responsiveness of quantity demanded that alters with respect to for example, income. Healthcare is generally inelastic; therefore there is increment of expenditure on healthcare despite price increment for healthcare utilisation - reflecting quantity demanded for healthcare. The aim of this manuscript is to critically analyse demand-side of rising healthcare expenditure. Materials and Methods: A systematic review was conducted using the PRISMA 2009 flow. Public domains used were PubMed, Medline, CINAHL and Scopus. Keywords used were health OR health care OR medical care AND expenditure OR household expenditure OR spending AND demand OR demand side OR demand-side. Inclusion criteria included publications in English and were published within 15 years. Reviews and commentaries were excluded. Finally, 30 articles were included in the review. Result and Discussion: The chosen articles are divided into sections on healthcare demand and expenditure and also health insurance. Based on the review, rising healthcare expenditure can be as a result of the demand for healthcare according to healthcare expenditure and financial hardship, prepayment programme and also demand-side policies, Conclusion: This review showed that the rise of healthcare expenditure could be resulted from healthcare demand based on healthcare expenditure and financial hardship, prepayment programme and also demand-side policies. The rise would not be solved with just the exchange of private sector’s third-party payment to public domain system. Third-party payers and consumers should implement cost-sharing and more importantly a cost effective national health policy be present without the compromise of a good quality healthcare service. Keywords: healthcare, health, medical care, household expenditure, demand, demand side