AGE-GENDER DISTRIB THE PATIENTS

56 National Medical Care Statistics 2014

6.4 MODE OF PAYMENT

The provision of primary care was funded by different mechanisms in different sectors. • All patient encounters in public clinics were paid for by government subsidies. • In the private sector, more than half 59.7 of the encounters were paid for through out-of-pocket payments, while nearly all of the remaining encounters 39.1 were paid, either fully or partially, by third party payers, such as private insurance, employers and managed care organisations Figure 6.4.1. Figure 6.4.1: Distribution o  private patients by mode o  payment in 2014 Ž Combination of two or more modes of payment  Includes Foreign Workers Medical Examination Monitoring Agency FOMEMA, Social Security Organisation SOCSO and no payment Note: Missing data excluded from analysis.

6.5 INDIVI

 ‘ ’ L INCOME Individual income of patients presenting to primary care was captured in NMCS 2014. For patients less than 15 years old who had income reported in the survey questionnaires, the type of income was assumed to be parental income. Figure 6.5.1 shows the distribution of public and private patients by type of income, while the income distribution of patients who reported having a personal income is presented in Figure 6.5.2. • Nearly half 45.5 of the patients seen in public clinics reported having no income. In contrast, more than two-thirds 70.9 of private patients reported having personal income, including 4.0 who were on pension. • In general, patients who visited private clinics had higher incomes than those who presented to public clinics. Nearly two-thirds 63.0 of the patients who earned less than MYR 1,000 per month attended public clinics, while private patients constituted 79.3 of the patients who had a monthly income of MYR 3,000 or over. “” • –— ˜ – ™š› • œ  žŸ Third party payer ¡  ž¢ Combination £ ž¤ “ • ¥ › ¦ §¨ £ ž¤ 57 Figure 6.5.1: Distribution o © public and private patients by typ ª «© income in 2014 a Patients below age 15 with income recorded Note: Missing data excluded from analysis. Figure 6.5.2: Distribution o © primary care patients by income and sector in 2014 Note: Patients with missing income, patients who reported no income and patients below age 15 were excluded.

0.7 0.5

7.0 4.0

¬ ­ ®¯

66.9 45.5

° ¯ ® ­ 10 20 30 40 50 60 70 80 90 100 Public Private ± ² ³ ´ ² µ ¶ · ¸ ± ¹ ¶ º ² µ ¶ » ¼ ½ ¾ No income Income Pension ¿ÀÁÂÃÄÀÅ ÆÃ ÇÈÉ Â Ê

0.3 6.2

19.5 16.3

10.7 ¬ ®¯ 6.0 ° ®¯ ¯ ® ¬ 12.6 ­ ®¯

3.6 1.1

0.9 5 10 15 20 25 30 35 ± ² ³ ´ ² µ ¶ · ¸ ² µ ´ · Ë µ ¶ ² ³ » ¼ ½ ¾ Monthly income MYR Public Private • • • • Chapter 6 : The Patients 58 National Medical Care Statistics 2014

6.6 ED

Ì CATION LEVEL Patient education level is an important determinant of patient outcomes. 2-4 Figure 6.6.1 presents the distribution of patients by educational level for both public and private sectors. • In general, private patients reported higher levels of educational attainment compared to those who presented to public clinics. • More than one-quarter 28.0 of patients in the private sector had attained or completed education at the tertiary level, compared to only 12.3 in the public sector. • Patients who had not undertaken any formal education accounted for a higher proportion of encounters in public clinics than in private clinics 13.4 versus 9.2, respectively. • Nearly half of the patients seen in public and private clinics 47.6 and 46.3, respectively had completed at least some secondary education. Figure 6.6.1: Distribution o Í public and private patients by education level in 2014 Note: Missing data excluded from analysis . 6.7 MEDICAL CERTIFICATE A Î Ï Ï Ì Ð ATION OF SICK LEAVE A total of 77,884 31.2 patients were issued medical certificates during their visit to primary care clinics. • Medical certificates were issued three times more frequently in private clinics than in the public settings 41.5 versus 13.9 of encounters, respectively Figure 6.7.1. • About 80 of the medical certificates issued in both public and private clinics entitled the patient to a sick leave of half to one day Figure 6.7.2. 12.3 Ñ Ò ÓÔ

47.6 46.3

26.7 16.5

13.4 9.2

10 20 30 40 50 60 70 80 90 100 Public Private Õ Ö × Ø Ö Ù Ú Û Ü Ý Þ Ú ß Ö Ù Ú à á â ã No formal education Primary Secondary Tertiary