Effect of socioeconomic status and healthcare provider on post-transplantation care in Malaysia: A multi-centre survey of kidney transplant recipients

As the rate of end-stage kidney disease rises, there is an urgent need to consider the catastrophic health expenditure of post-transplantation care. Even a small amount of out-of-pocket payment for healthcare can negatively affect households' financial security. This study aims to determine the...

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Bibliographic Details
Published in:PloS one 2023-04, Vol.18 (4), p.e0284607-e0284607
Main Authors: Gan Kim Soon, Peter, Rampal, Sanjay, Lim, Soo Kun, Su, Tin Tin
Format: Article
Language:English
Subjects:
Catastrophic Illness
Chi-square test
Cost control
Cross-Sectional Studies
Earth Sciences
Education
Educational attainment
End-stage renal disease
Evaluation
Expenditures
Family income
Health care
Health care expenditures
Health care policy
Health Expenditures
Health insurance
Health Personnel
Hemodialysis
Hospitals
Households
Humans
Income
Industrialized nations
Kidney diseases
Kidney Transplantation
Kidney transplants
Kidneys
Malaysia
Medical care
Medical care, Cost of
Medicine and Health Sciences
People and Places
Quality management
Questionnaires
Regression analysis
Renal replacement therapy
Social Class
Social Sciences
Sociodemographics
Socioeconomic factors
Socioeconomic status
Socioeconomics
Surveys
Transplantation
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Summary:As the rate of end-stage kidney disease rises, there is an urgent need to consider the catastrophic health expenditure of post-transplantation care. Even a small amount of out-of-pocket payment for healthcare can negatively affect households' financial security. This study aims to determine the association between socioeconomic status and the prevalence of catastrophic health expenditure in post-transplantation care. A multi-centre cross-sectional survey was conducted in person among 409 kidney transplant recipients in six public hospitals in the Klang Valley, Malaysia. Catastrophic health expenditure is considered at 10% out-of-pocket payment from household income used for healthcare expenditure. The association of socioeconomic status with catastrophic health expenditure is determined via multiple logistic regression analysis. 93 kidney transplant recipients (23.6%) incurred catastrophic health expenditures. Kidney transplant recipients in the Middle 40% (RM 4360 to RM 9619 or USD 1085.39 -USD 2394.57) and Bottom 40% (RM 9619 or > USD 2394.57) income group. Kidney transplant recipients in the Bottom 40% and Middle 40% income groups were more susceptible to catastrophic health expenditure at 2.8 times and 3.1 times compared to higher-income groups, even under the care of the Ministry of Health. Universal health coverage in Malaysia cannot address the burden of out-of-pocket healthcare expenditure on low-income Kidney transplant recipients for long-term post-transplantation care. Policymakers must reexamine the healthcare system to protect vulnerable households from catastrophic health expenditures.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0284607