jawatankuasa pemandu mnha 2017 - moh.gov.my health...5 oop third party deduction and adjustment for...

Seksyen

Malaysia National Health Accounts (MNHA)

Bahagian Perancangan

Kementerian Kesihatan Malaysia

28hb Disember 2017

MESYUARAT JAWATANKUASA PEMANDU MNHA

2017

MNHA 1997-2016 Health Expenditure

• Q

• MNHA Data 1997-2016

• International Data

• MOH Reporting

• OOP Methodology & Reporting

SHA 2011

• Activity Update

• Mapping & New Code Development

• Reporting Preventive Expenditure

• Way Forward

2 Seksyen MNHA, Bahagian Perancangan - 2017

QC in MNHA

• Important that each agency submits as much raw expenditure data as possible . Good response rate is encouraged. This is to minimize data imputation for data gaps.

• Each officer in charge of assigned agency has to do own quality checks before submission of final analysis. There may be more than 1 output from each agency.

• The final analyzed data from each agency has to be merge into one master database.

• To do this final outputs from each agency have to be in standardized format (10D, 8D or others).

QC and Building Database


year state agency mnhasource mnhaprovider mnhafunction exp ichasource ichaprovider ichafunction

1997 18 1119050000 1119 1110 1100 0 111 110 110

1997 18 1119050000 1119 3105 1310 0 111 310 131

1997 18 1119050000 1119 3524 1200 586528.4928 111 344 120

1997 18 1119050000 1119 4100 5101 182221.0226 111 410 511

1997 18 1119050000 1119 4900 5202 47906.74165 111 490 522

1998 18 1119050000 1119 1110 1100 0 111 110 110

1998 18 1119050000 1119 3105 1310 0 111 310 131

1998 18 1119050000 1119 3524 1200 916441.5792 111 344 120

1998 18 1119050000 1119 4100 5101 284717.4924 111 410 511

1998 18 1119050000 1119 4900 5202 74853.53314 111 490 522

1999 18 1119050000 1119 1110 1100 0 111 110 110

1999 18 1119050000 1119 3105 1310 0 111 310 131

1999 18 1119050000 1119 3524 1200 1270249.7 111 344 120

1999 18 1119050000 1119 4100 5101 700200 111 410 511

1999 18 1119050000 1119 4900 5202 23300 111 490 522

2000 18 1119050000 1119 1110 1100 0 111 110 110

2000 18 1119050000 1119 3105 1310 0 111 310 131

2000 18 1119050000 1119 3524 1200 6783435.32 111 344 120

2000 18 1119050000 1119 4100 5101 1403812 111 410 511

2000 18 1119050000 1119 4900 5202 187250 111 490 522

2001 18 1119050000 1119 1110 1100 0 111 110 110

2001 18 1119050000 1119 3105 1310 0 111 310 131

2001 18 1119050000 1119 3524 1200 11702745.24 111 344 120

2001 18 1119050000 1119 4100 5101 3190941.54 111 410 511

An example of final agency output to produce Final Database MNHA database code ICHA database code

Building Database

• Various steps in data validation

• Validation is to verify value and code

• For each agency the total values for each dimension must tally

• For each agency the correct codes are assigned for provider, functions & other dimensions

• Necessary adjustments to avoid double counting especially for claims data

Importance of Data Quality Control


Database & Validation Process

1 1st trend verification of total expenditure values of each agency by MNHA Technical team in excel format (Previous vs New trend)

2 Collection of final outputs of all agencies in standardized format (stata compatible)

3 Verification of total expenditure values of each agency by assigned officer 1 using excel pivot table

4 Merging all agency outputs into single database for time series data by assigned officer 2 (in Stata)

5 OOP third party deduction and adjustment for double counting

6 Verification of codes MS, MP & MF for each agency by assigned officer 2 (in Stata)

7 2nd trend verification of total values for each agency through extraction from final database after merging OOP data by assigned officer 2 (Previous vs New trend)

8 Extraction of data from database in various identified formats for presentation

9 Review of final outputs by MNHA Technical Advisory Committee (TAC) prior presentation to MNHA Steering committee

10 Presentation to MNHA Steering committee for endorsement and data release

Final Steps in Building Database & Validation

6 Seksyen MNHA, Bahagian Perancangan, 2017

• Software used:

– Microsoft Excel :

• mainly for data entry & analysis

– Stata (important to ensure writing programs correctly based on purposes)

• for analysis of MOH & OOP

• for processing & validation

• For producing final outputs

Required NHA Software Expertise



• QC in MNHA

• MNHA Data 1997-2016


• MOH Reporting


SHA 2011

• Activity Update



• Way Forward

Seksyen MNHA, Cawangan Perancangan Pembiayaan, Informatik & Akaun Kesihatan, Bahagian Perancangan - 2017 8

• General trends

– Estimation & reporting of MNHA derived constant values

• Public Sector: MOH Reporting

– MOH allocation & expenditure

– MOH pharmaceutical expenditure

– MOH revenue

• Private Sector: OOP Analysis

– Refinement of OOP estimation especially residual (items)

What is New in Time Series Data?


NATIONAL HEALTH

EXPENDITURE TRENDS 1997-2016


Total Expenditure on Health (TEH) , 1997-2016 (RM Million, nominal & constant)

11

8,604

14,902

51,742

0

10,000

20,000

30,000

40,000

50,000

60,0001

99

7

19

98

19

99

20

00

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

08

20

09

20

10

20

11

20

12

20

13

20

14

20

15

20

16

RM

Mill

ion

Total Health Expenditure, Nominal (RM Million)

Total Health Expenditure, Constant (RM Million)

Seksyen MNHA, Bahagian Perancangan - 2017

Total Expenditure on Health (TEH), 1997-2016 (RM Million, nominal & constant*)

12

Year

Total Health Expenditure (TEH),

Nominal (RM Million)


Constant (RM Million)*

Total GDP, Nominal

(RM Million)**

MNHA estimated

GDP Deflator*

Total Health Expenditure (TEH)

as % GDP

1997 8,604 14,902 281,795 64 3.05

1998 9,218 14,729 283,243 69 3.25

1999 10,021 16,012 300,764 69 3.33

2000 11,811 17,945 356,401 73 3.31

2001 12,768 19,795 352,579 72 3.62

2002 13,709 20,622 383,213 74 3.58

2003 17,268 24,987 418,769 77 4.12

2004 18,265 25,001 474,048 81 3.85

2005 18,294 23,962 543,578 85 3.37

2006 22,144 27,888 596,784 88 3.71

2007 24,480 29,416 665,340 92 3.68

2008 27,840 30,387 769,949 102 3.62

2009 29,452 34,138 712,857 96 4.13

2010 32,962 36,587 821,434 100 4.01

2011 35,965 37,871 911,733 105 3.94

2012 39,586 41,271 971,252 106 4.08

2013 41,671 43,369 1,018,614 107 4.09

2014 46,756 47,489 1,106,443 109 4.23

2015 49,838 50,811 1,157,723 109 4.30

2016 51,742 51,742 1,230,120 111 4.21

Note: *Constant value derived by MNHA using GDP Deflator Values from DOSM Using Splicing Method with 2010 Base Year

Source: **Department of Statistics Malaysia, DOSM


Splicing method formula

GDP Deflator = GDP Current X 100 GDP Constant

Calculation of GDP Deflator base year 2010

Calculation of TEH Constant base year 2010

MNHA Estimation of Constant Value


Total & Current Expenditure on Health, 1997-2016 (RM Million, nominal)

14

Total Health Expenditure (THE) = Health & Health Related Items Current Health Expenditure (CHE) = Health Expenditure Excluding Health Related Items*

Note: *Health Related items includes Capital formation, Research & Development, And Education & Training


8,604

49,838 51,742

-

10,000

20,000

30,000

40,000

50,000

60,000

70,000

19

97

19

98

19

99

20

00

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

08

20

09

20

10

20

11

20

12

20

13

20

14

20

15

20

16

RM

Mill

ion

Current Health Expenditure (CHE)



15

Year Current Health

Expenditure Total Health Expenditure

1997 7,835 8,604

1998 8,127 9,218

1999 8,732 10,021

2000 9,999 11,811

2001 10,519 12,768

2002 11,410 13,709

2003 13,650 17,268

2004 15,116 18,265

2005 16,216 18,294

2006 19,822 22,144

Year Current Health

Expenditure Total Health Expenditure

2007 21,778 24,480

2008 24,850 27,840

2009 24,825 29,452

2010 26,932 32,962

2011 31,286 35,965

2012 34,912 39,586

2013 36,840 41,671

2014 42,262 46,756

2015 45,260 49,838

2016 47,125 51,742


Total Health Expenditure = Health & Health Related Items Current Health Expenditure = Health Expenditure Excluding Health Related Items (Capital formation, Research & Development, And Education & Training )

DOSM Reported GDP Values 1997-2016, RM Million

16

Year

New Total GDP*,

(RM Million)

Total GDP (Last MNHA Report),

(RM Million)

2007 665,340 665,340

2008 769,949 769,949

2009 712,857 712,857

2010 821,434 821,434

2011 911,733 911,733

2012 971,252 971,252

2013 1,018,614 1,018,614

2014 drop 1,106,443 1,106,466

2015 increase 1,157,723 1,157,139

2016 1,230,120


Source: * Department of Statistics Malaysia, DOSM

Year

New Total GDP*,

(RM Million)

Total GDP (Last MNHA Report),

(RM Million)

1997 81,795 281,795

1998 283,243 283,243

1999 300,764 300,764

2000 356,401 356,401

2001 352,579 352,579

2002 383,213 383,213

2003 418,769 418,769

2004 474,048 474,048

2005 543,578 543,578

2006 596,784 596,784

Total Expenditure on Health Nominal & Constant, 1997-2016 (RM Million & Per cent GDP*)


14,902

8,604

51,742 3.05

3.25 3.33 3.31

3.62 3.58

4.12

3.85

3.37

3.71 3.68 3.62

4.13 4.01 3.94

4.08 4.09 4.23 4.30

4.21

0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

4.00

4.50

5.00

5,000

15,000

25,000

35,000

45,000

55,000

65,000

75,000

TEH

% G

DP

RM

Mill

ion

TEH, Constant

TEH, Nominal

TEH % GDP

Note: *TEH % GDP dependent on National GDP values which was revised by DOSM – see previous slide

TEH, CHE, GDP, GDP Deflator, TEH % GDP, 1997-2016 (Nominal & Constant, RM Million & % GDP)

18

Year

Current Health Expenditure,

(CHE),Nominal (RM Million)

Total Health Expenditure,

(TEH),Nominal (RM Million)


Constant (RM Million)

Total GDP, Nominal

(RM Million)*

MNHA estimated

GDP Deflator

Total Health Expenditure (TEH), Nominal as % GDP

1997 7,835 8,604 14,902 281,795 64 3.05

1998 8,127 9,218 14,729 283,243 69 3.25

1999 8,732 10,021 16,012 300,764 69 3.33

2000 9,999 11,811 17,945 356,401 73 3.31

2001 10,519 12,768 19,795 352,579 72 3.62

2002 11,410 13,709 20,622 383,213 74 3.58

2003 13,650 17,268 24,987 418,769 77 4.12

2004 15,116 18,265 25,001 474,048 81 3.85

2005 16,216 18,294 23,962 543,578 85 3.37

2006 19,822 22,144 27,888 596,784 88 3.71

2007 21,778 24,480 29,416 665,340 92 3.68

2008 24,850 27,840 30,387 769,949 102 3.62

2009 24,825 29,452 34,138 712,857 96 4.13

2010 26,932 32,962 36,587 821,434 100 4.01

2011 31,286 35,965 37,871 911,733 105 3.94

2012 34,912 39,586 41,271 971,252 106 4.08

2013 36,840 41,671 43,369 1,018,614 107 4.09

2014 42,262 46,756 47,489 1,106,443 109 4.23

2015 45,260 49,838 50,811 1,157,723 109 4.30

2016 47,125 51,742 51,742 1,230,120 111 4.21

Seksyen MNHA, Bahagian Perancangan - 2017 Source: *Department of Statistics Malaysia, DOSM

Total Population as Reported by DOSM*, 1997-2016

19

Year

Population

1997 21,769,200

1998 22,333,500

1999 22,909,400

2000 23,494,900

2001 24,123,400

2002 24,727,100

2003 25,320,100

2004 25,905,100

2005 26,477,100

2006 26,831,400

2007 27,186,000

Source: *Department of Statistics Malaysia, DOSM obtained from Population Quick Info on 7 December 2017

Year

Population

2008 27,540,300

2009 27,895,100

2010 28,588,800

2011 29,062,100

2012 29,509,900

2013 30,213,800

2014 30,708,600

2015 31,186,100

2016 31,633,400

Per Capita Expenditure on Health (Total & Current), 1997-2016 (Constant, RM)*

20

Note: *Constant value derived by MNHA using GDP Deflator Values from DOSM Using Splicing Method with 2010 Base Year

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

623

1,490

685

1,636

Rin

ggit

Mal

aysi

a (R

M)

Per Capita CHE, Constant (RM)

Per Capita TEH, Constant (RM)

21

Year Total Health Expenditure

(TEH), Constant (RM Million)*

Current Health Expenditure (CHE),

Constant (RM Million)*

Total Population** Per Capita Expenditure

based on TEH, Constant (RM)

Per Capita Expenditure based on CHE, Constant (RM)

1997 14,902 13,570 21,769,200 685 623

1998 14,729 12,986 22,333,500 659 581

1999 16,012 13,952 22,909,400 699 609

2000 17,945 15,192 23,494,900 764 647

2001 19,795 16,308 24,123,400 821 676

2002 20,622 17,164 24,727,100 834 694

2003 24,987 19,752 25,320,100 987 780

2004 25,001 20,690 25,905,100 965 799

2005 23,962 21,239 26,477,100 905 802

2006 27,888 24,964 26,831,400 1,039 930

2007 29,416 26,170 27,186,000 1,082 963

2008 30,387 27,123 27,540,300 1,103 985

2009 34,138 28,774 27,895,100 1,224 1,032

2010 36,587 29,894 28,588,800 1,280 1,046

2011 37,871 32,944 29,062,100 1,303 1,134

2012 41,271 36,398 29,509,900 1,399 1,233

2013 43,369 38,342 30,213,800 1,435 1,269

2014 47,489 42,925 30,708,600 1,546 1,398

2015 50,811 46,143 31,186,100 1,629 1,480

2016 51,742 47,125 31,660,600 1,636 1,490

Per Capita Expenditure on Health (Total & Current), 1997-2016 (Constant, RM)*

Note: *Constant value derived by MNHA using GDP Deflator Values from DOSM using Splicing Method with 2010 Base Year Source: ** Department of Statistics Malaysia, DOSM

Health Expenditure by State, 2016, (RM Million)


-

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

10,000

RM

Mill

ion

Health Expenditure by State, 2016 (RM Million)

23

State Health Expenditure (RM Million)

Selangor 8,710

FT KL 7,005

Johore 4,187

Penang 3,853

Perak 3,507

Sarawak 3,202

Sabah 3,180

Kedah 2,272

Pahang 2,041

Kelantan 1,872

Malacca 1,804

N. Sembilan 1,505

Terengganu 1,213

FT Putrajaya 560

Perlis 347

FT Labuan 207

National (unable to allocate) 6,278

Total 51,742


CORPS NGO

MOHE EPF MOH

LA SOCSO MOD OOP

Source Who Pays?

Provider To Whom? Spent where?

Function For What?

Dimensions of National Health Accounts


SOURCES OF FINANCING

25

Who Pays? Where does the money come from?


Total Expenditure on Health by Sources of Financing by Public & Private Sectors, 1997-2016, RM Million

26

4,4

14

4,8

08

5,3

01

6,3

13

7,3

89

7,9

23

10

,44

1

10

,61

5

9,7

70

12

,69

0

13

,85

6

15

,84

9

17

,76

8

19

,40

0

20

,25

8

22

,12

1

22

,87

0

25

,99

4

26

,88

7

26

,66

2

4,1

90

4,4

11

4,7

20

5,4

98

5,3

79

5,7

86

6,8

28

7,6

50

8,5

25

9,4

54

10

,62

3

11

,99

1

11

,68

4

13

,56

2

15

,70

8

17

,46

5

18

,80

1

20

,76

1

22

,95

1

25

,08

1

-

5,000

10,000

15,000

20,000

25,000

30,000

RM

Mill

ion

Public

Private


Note: Trend shows Public Sector Health expenditure expected to increase from 2017 onwards

Total Expenditure on Health by Sources of Financing by Public & Private Sectors, 1997-2016, Proportion

27

-

10.0

20.0

30.0

40.0

50.0

60.0

70.0

Pro

po

rtio

n, %

Public Sector

Private Sector



Total Expenditure on Health by Public and Private Sectors, 1997-2016, RM Million & Proportions

28

Year Public Sector Private Sector Total

RM Million RM Million % RM Million %

1997 4,414 51.3 4,190 48.7 8,604

1998 4,808 52.2 4,411 47.8 9,218

1999 5,301 52.9 4,720 47.1 10,021

2000 6,313 53.5 5,498 46.5 11,811

2001 7,389 57.9 5,379 42.1 12,768

2002 7,923 57.8 5,786 42.2 13,709

2003 10,441 60.5 6,828 39.5 17,268

2004 10,615 58.1 7,650 41.9 18,265

2005 9,770 53.4 8,525 46.6 18,294

2006 12,690 57.3 9,454 42.7 22,144

2007 13,856 56.6 10,623 43.4 24,480

2008 15,849 56.9 11,991 43.1 27,840

2009 17,768 60.3 11,684 39.7 29,452

2010 19,400 58.9 13,562 41.1 32,962

2011 20,258 56.3 15,708 43.7 35,965

2012 22,121 55.9 17,465 44.1 39,586

2013 22,870 54.9 18,801 45.1 41,671

2014 25,994 55.6 20,761 44.4 46,756

2015 26,887 53.9 22,951 46.1 49,838

2016 26,662 51.5 25,081 48.5 51,742


29

1.5

7%

1.7

0%

1.7

6%

1.7

7%

2.1

0%

2.0

7%

2.4

9%

2.2

4%

1.8

0%

2.1

3%

2.0

8%

2.0

6%

2.4

9%

2.3

6%

2.2

2%

2.2

8%

2.2

5%

2.3

5%

2.3

2%

2.1

7%

1.4

9%

1.5

6%

1.5

7%

1.5

4%

1.5

3%

1.5

1%

1.6

3%

1.6

1%

1.5

7%

1.5

8%

1.6

0%

1.5

6%

1.6

4%

1.6

5%

1.7

2%

1.8

0%

1.8

5%

1.8

8%

1.9

8%

2.0

4%

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

3.00%

3.50%

Pe

rce

nta

ge G

DP

Public % GDP Private % GDP

Total Expenditure on Health by Public and Private Sectors, 1997-2016, % GDP



Total Expenditure on Health By All Sources of Financing,

2016

30

88% of expenditure by MOH, OOP &

Private Insurance agencies

MOH, RM22,287

43% Pr household OOP

RM19,570, 38%

Private insurance , RM3,811,

7%

Other Fed agencies, 4%

MOHE, 3% All Corps, 2%

All other agencies, 3%


Total Expenditure on Health by All Sources of Financing,

2016

MNHA code Sources of Financing RM Million Per cent,

%

MS1.1.1.1 Ministry of Health (MOH) 22,287 43.07

MS2.4 Private household out-of-pocket expenditures 19,570 37.82

MS2.2 Private insurance enterprises (other than social insurance) 3,811 7.37

MS1.1.1.9 Other federal agencies (including statutory bodies) 2,032 3.93

MS1.1.1.2 Ministry of Higher Education (MOHE) 1,379 2.66

MS2.6 All Corporations (other than health insurance) 1,173 2.27

MS2.3 Private MCOs and other similar entities 437 0.84

MS1.2.2 Social Security Organization (SOCSO) 310 0.60

MS1.1.2.2 Other state agencies (including statutory bodies) 209 0.40

MS1.1.1.3 Ministry of Defence (MOD) 164 0.32

MS1.1.3 Local authorities 126 0.24

MS1.1.2.1 (General) State Government 98 0.19

MS2.5 Non-profit organisations serving households 87 0.17

MS1.2.1 Employee Provident Funds (EPF) 56 0.11

MS9 Rest of the world 4 0.01

Total 51,742 100.00


SOURCES OF FINANCING –

Public Sector

32

Who Pays?

Where does the money come from?


Public Sector - General Government Health Expenditure (GGHE) as Per cent General Government Expenditure (GGE),

1997-2016

33

4.90

4.95 5.18

5.50 5.65 5.49

6.25 6.73

5.66

6.21 5.99

5.48

6.28

7.18 6.81

6.05 6.08 6.41

7.01

6.99

0.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00

8.00

GG

HE

% G

GE


Public Sector - General Government Health Expenditure (GGHE) as Per cent General Government Expenditure (GGE),

1997-2016

34

MNHA Code Sources of Financing - Public Sector

MS1.1.1.1 Ministry of Health (MOH)

MS1.1.1.2 Ministry of Higher Education (MOHE)

MS1.1.1.3 Ministry of Defence (MOD)

MS1.1.1.9 Other Fed Agencies (including Statutory Bodies)

MS1.1.2.1 General State Government

MS1.1.2.2 Other State Agencies (including Statutory Bodies)

MS1.1.3 Local Authorities (LA)

MS1.2.1 Employee Provident Funds (EPF)

MS1.2.2 Social Security Organization (SOCSO)


Public Sector - GGHE vs GGE*, 1997-2016 (RM, Million)

35

-

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

-

50,000

100,000

150,000

200,000

250,000

300,000

350,000

400,000

450,000

GG

HE,

RM

Mill

ion

GG

E, R

M M

illio

n

GGE (RM Million)*GGHE (RM Million)

Source: *Treasury Malaysia website Economy Report 2016/2017 dated 6/11/2017


Note: Trend shows although General Government Expenditure (GGE) decreased twice over last 20 years, total Government Health Expenditure (GGHE) continued to increase

Public Sector - GGHE vs GGE*, 1997-2016 (RM Million)

36

Year GGHE (RM Million) GGE (RM Million)* GGHE

as % GGE

1997 4,414 90,131 4.90 1998 4,808 97,040 4.95 1999 5,301 102,320 5.18 2000 6,313 114,884 5.50 2001 7,389 130,690 5.65 2002 7,923 144,278 5.49 2003 10,441 166,948 6.25 2004 10,615 157,742 6.73 2005 9,770 172,681 5.66 2006 12,690 204,255 6.21 2007 13,856 231,359 5.99 2008 15,849 289,394 5.48 2009 17,768 282,794 6.28 2010 19,400 270,171 7.18 2011 20,258 297,382 6.81 2012 22,121 365,600 6.05 2013 22,870 376,374 6.08 2014 25,994 405,788 6.41 2015 26,887 383,727 7.01 2016 26,662 381,366 6.99

Source: *Treasury Malaysia website Economy Report 2016/2017 dated 6/11/2017


Total Health Expenditure by Public Sources of Financing, 2016 (RM Million)

37

0

5,000

10,000

15,000

20,000

25,000

MOH Other FedAgencies &StatutoryAgencies

MOHE Others

22,287

2,032 1,379 963

RM

Mill

ion


Total Health Expenditure by Various Public Sector Sources of Financing, 2016 (RM Million)

38

Sources of Financing - Public Sector RM Million Per cent, %

Ministry of Health (MOH) 22,287 84%

Other Federal Agencies (including Statutory Bodies)

2,032 8%

Ministry of Higher Education (MOHE) 1,379 5%

Social Security Organization (SOCSO) 310 1%

Other State Government (including Statutory Bodies)

209 1%

Ministry of Defence (MOD) 164 1%

Local Authorities 126 <1%

General State Government 98 <1%

Employee Provident Funds (EPF) 56 <1%

TOTAL 26,662 100%


Health Expenditure by Public Sector Sources of Financing last 5 years (2012- 2016), RM Million

39

Sources of Financing - Public Sector 2012 2013 2014 2015 2016

Ministry of Health (MOH) 18,240 19,040 21,786 22,677 22,287

Other Federal Agencies (including Statutory Bodies)

1,756 1,583 1,885 1,899 2,032

Ministry of Higher Education (MOHE) 1,359 1,370 1,382 1,361 1,379

Social Security Organization (SOCSO) 176 219 264 261 310

Other State Agencies (including Statutory Bodies)

119 172 195 196 209

Ministry of Defence (MOD) 172 175 186 169 164

Local Authorities 150 188 164 178 126

General State Government 110 80 88 93 98

Employee Provident Funds (EPF) 38 42 46 52 56

TOTAL 22,121 22,870 25,994 26,887 26,662


SOURCES OF FINANCING –

Private Sector

40

Who Pays? Where does the money come from?


Total Health Expenditure by Private Sector Sources of Financing, 2016 (RM Million)

41

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Private HouseholdOOP

Private Insurance All Corporations All other agencies

78%

15%

5% 2% Pe

r ce

nt

of

Pri

vate

Se

cto

r


Health Expenditure by Private Sector Sources of Financing last 5 years (2012- 2016), RM Million

42

Sources of Financing - Private Sector 2012 2013 2014 2015 2016

Private household out-of-pocket expenditures

13,018 14,494 16,138 17,718 19,570

Private insurance enterprises (other than social insurance)

2,774 2,916 3,203 3,623 3,811

All Corporations (other than health insurance)

1,006 1,024 1,044 1,151 1,173

Private MCOs and other similar entities

302 287 333 386 437

Non-profit organisations serving households (NGO)

363 78 40 69 87

Rest of the world 2 3 4 5 4

TOTAL 17,465 8,801 20,761 22,951 25,081


PROVIDERS OF HEALTHCARE

2016

43

Where is the money spent? Who provide the services?


Total Expenditure on Health by Public & Private Providers of Health Care, 2016 (RM Million)

44

Expenditure at Hospitals &

Ambulatory health care providers

account for 77% of TEH

TEH = RM51,742 million

Hospitals, 52%

Ambulatory health care,

25%

7%

6% 6% 4%

Hospitals Ambulatory health care

Medical goods General health admin & insurance

Institutions All other Providers


Total Expenditure on Health by Public & Private Providers of Health Care Services,

2016 (RM Million)

45

MNHA code Providers of Health Care Services RM Million Per cent, %

MP1 Hospitals 27,166 52.50

MP3 Providers of ambulatory health care 12,806 24.75

MP4 Retail sale and other providers of medical goods 3,448 6.66

MP6 General health administration and insurance 3,062 5.92

MP8 Institutions providing health related services 2,944 5.69

MP5 Provision and administration of public health programmes

1,718 3.32

MP7 Other industries (rest of the Malaysian economy) 582 1.12

MP9 Rest of the world 11 0.02

MP2 Nursing and residential care facilities 4 0.01

Total 51,742 100


Expenditure at Public & Private Health Care Provider – Hospitals, 2016 (RM Million)

46


Public MOH Hospitals

54%

Public Non-MOH

Hospitals 9%

Private Hospitals

37%

Hospital Providers of Health Care Services

RM Million

Public MOH Hospitals 14,732

Public Non-MOH Hospitals

2,358

Private Hospitals 10,076

TOTAL

27,166

(52% TEH)


Expenditure at Public & Private Health Care Providers – Hospital over 5 years, 2012- 2016 (RM Million)

47

-

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000

2012 2013 2014 2015 2016

RM

Mill

ion

Public MOH Hospitals


Private MOH HospitalsPrivate Hospitals


48

Hospitals 2012 2013 2014 2015 2016

Public MOH Hospitals 11,567 11,956 13,845 14,519 14,732


2,092 2,200 2,166 2,252 2,358

Private Hospitals 7,468 7,943 8,809 9,446 10,076

TOTAL 21,127 22,099 24,820 26,217 27,166

Expenditure at Public & Private Health Care Providers – Hospital over 5 years, 2012- 2016 (RM Million)


Total Expenditure on Health by Public & Private Providers of Health Care, 2016 (RM Million)

49

Expenditure at Hospitals &

Ambulatory health care providers

account for 77% of TEH


Hospitals, 52%

Ambulatory health care,

25%

7%

6% 6% 4%

Hospitals Ambulatory health care

Medical goods General health admin & insurance

Institutions All other Providers


Ambulatory Health Care

50

This item comprises of establishments primarily engaged in providing health care services directly to outpatients who do not require inpatient services.

These providers include both public sector & private sector health care providers.

Outpatient care Providers (OP)

•Providers of Outpatient services in standalone clinics Medical (GP & Specialists) and Dental clinics ,all outside hospital facilities

Ancillary & Other Health Care Providers

• Standalone private laboratories (eg. Pathlab, etc.) & radiology centers

• Ambulance services

• Blood bank

• TCAM

• Dialysis Centers


Expenditure by Ambulatory Health Care Providers, 2016

51


Ambulatory Care Providers of Health

Services RM Million

Private Medical Clinics 6,921

MOH Medical Clinics 3,307

Public non-MOH Medical Clinics

23

TCAM Providers 484

All other ambulatory 2,071

TOTAL 12,806

(25% TEH)

Private Medical Clinics 54%

Public MOH Medical Clinics 26%

Public non-MOH

Medical Clinics <1%

TCAM Providers

4%

All other ambulatory

16%


80% of Ambulatory Health Care Expenditure occurs at Medical Clinics (standalone medical clinics in public & private sector)

Expenditure at Public & Private Medical Clinics over 5 years 2012- 2016 (RM Million)

52

-

1,000

2,000

3,000

4,000

5,000

6,000

7,000

2012 2013 2014 2015 2016

RM

Mill

ion

Private Clinics Public Clinics


Expenditure at Public & Private Medical Clinics over 5 years 2012- 2016 (RM Million)

53

Clinics 2012 2013 2014 2015 2016

Private Medical Clinics 3,441 4,054 4,894 5,759 6,921

Public Medical Clinics 2,362 2,572 3,046 3,140 3,330

Total 5,802 6,627 7,940 8,899 10,251


FUNCTIONS OF

HEALTHCARE 2016

54

What is the money used for?


Total Expenditure on Health by Functions of Health Care, 2016

55

Curative Care 70%

Medical Goods 9%

Admin 6%

Education & Training

6%

Prevention & Public Health

5%

Capital formation 3%

All other functions

1%




MNHA code Functions of Health services RM Million Per cent, %

MF1 Services of curative care 36,038 69.65

MF5 Medical goods dispensed to out-patients 4,600 8.89

MF7 Health program administration and health insurance

3,287 6.35

MR2 Education and training of health personnel 2,948 5.70

MF6 Prevention and public health services 2,816 5.44

MR1 Capital formation of health care provider institutions

1,406 2.72

MF4 Ancillary services to health care 380 0.73

MR3 Research & Development in Health 263 0.51

MF3 Services of long-term nursing care 4 0.01

MR9 All other health-related expenditures 1 0.00

MF2 Services of rehabilitative care 0 -

Total 51,742 100.00


Curative Care Health Expenditure, 2016 (RM Million)

Inpatient Care 47%

Outpatient Care 49%

Daycare 4%

Services of Curative Care

RM Million

Inpatient Care

16,941

Outpatient Care*

17,783

Daycare

1,315

Total

36,038 (70% TEH)


Note: *Outpatient care includes both at hospitals and standalone clinics & includes specialists and non-specialist care

Sources of Financing for Curative Care Health Expenditure, 2016

58

MNHA code Functions of Health Care Services RM Million Per cent

MS1.1.1.1 Ministry of Health (MOH) 15,723 43.63

MS2.4 Private household out-of-pocket expenditures (OOP)

14,205 39.42

MS2.2 Private insurance enterprises (other than social insurance)

3,163 8.78

MS1.1.1.2 Ministry of Higher Education (MOHE) 1,158 3.21

MS1.1.1.9 Other federal agencies (including statutory bodies) 749 2.08

MS2.6 All Corporations (other than health insurance) 349 0.97

MS1.2.2 Social Security Organization (SOCSO) 205 0.57

MS1.1.1.3 Ministry of Defence (MOD) 159 0.44

MS1.1.2.2 Other state agencies (including statutory bodies) 146 0.41

MS1.2.1 Employee Provident Funds (EPF) 53 0.15

MS1.1.2.1 (General) State Government 50 0.14

MS1.1.3 Local Authorities 41 0.11

MS2.5 Non-profit organisations serving households (NGO) 38 0.11

Total 36,038 100.00


Public and Private Source of Financing for Curative Care over 5 years 2012-2016 (RM Million)

59

15,190 15,099 17,154 17,885 18,283

11,609 12,533

14,210 15,834

17,755

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

2012 2013 2014 2015 2016

RM

Mill

ion

Public

Private


Curative Care Health Expenditure by Public and Private Source of Financing, 2016 (RM Million)

IP: 10,642

IP: 6,299

OP*: 6,879

OP*: 10,904

DC: 762 DC: 553

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000

Public Private

RM

Mill

ion


Note: *Outpatient care includes both at hospitals and standalone clinics & includes specialists and non-specialist care

DC : Daycare OP : Outpatient IP : Inpatient


61

Curative Care 70%

Medical Goods 9%

Admin 6%


6%


5%


All other functions

1%



Total Expenditure on Health by Education & Training Functions* of Health Care, 1997-2016


206

2,948

0 500 1,000 1,500 2,000 2,500 3,000

19971998199920002001200220032004200520062007200820092010201120122013201420152016

RM Million

Note: * -The value of this function is grossly underestimated especially for public sector and MOH - Data Inclusive of expenditure for undergraduate education & training

Total Expenditure on Health by Education & Training Functions* of Health Care, 2016


Source of Financing RM Million

Private household out-of-pocket expenditures 1,437

Other federal agencies (including statutory bodies)

883

Ministry of Health (MOH) 428

Ministry of Higher Education (MOHE) 143

All Corporations (other than health insurance) 46

Others 10

Total 2,948


Total Expenditure on Health by Education & Training Functions of Health Care by Public & Private Sources of

Financing*, 1997-2016


0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

RM

Mill

ion

Public Private




Curative Care 70%

Medical Goods 9%

Admin 6%


6%


5%


All other functions

1%


Total Expenditure on Health by Prevention & Public Health Functions of Health Care, 1997-2016 *


483

2,816

0 500 1,000 1,500 2,000 2,500 3,000

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

2015

2016

RM Million

Note: * This value is expenditure by Public & Private Sources of Financing

Total Expenditure on Health by Prevention & Public Health Functions of Health Care by Source of

Financing, 2016


Ministry of Health (MOH)

63% All Corporations (other than health

insurance) 25%


5%

Other state agencies (including statutory

bodies) 2%

(General) State Government

2%

Others 3%

Total Expenditure on Health by Prevention & Public Health Functions of Health Care, 2016


Source of Financing RM Million

Ministry of Health (MOH) 1,777

All Corporations (other than health insurance) 715


150

Other state agencies (including statutory bodies) 54

(General) State Government 39

Others 81

Total 2,816


• QC in MNHA

• MNHA Data 1997-2016


• MOH Reporting


SHA 2011

• Activity Update



• Way Forward



• WHO target was that by year 2017 all member countries report their NHA using SHA 2011 framework.

• During the MNHA Steering Committee meeting on 15 December 2015 it was agreed that Malaysia should also migrate to the new SHA 2011 framework and also continue to report national health expenditure using MNHA framework

• On 13th Dec 2017 WHO uploaded NHA data for years 2000-2015 using SHA 2011 framework whereby WHO did their own estimations for countries which have not fully migrated to the new framework

Seksyen MNHA, Bahagian Perancangan - 2017 70

INTERNATIONAL NHA DATA

• *Ref: http://www.who.int/health_financing/topics/resource-tracking/ghed-update/en/ updated on 13 Dec 2017

WHO-NHA (GHED )*


http://www.who.int/health_financing/topics/resource-tracking/ghed-update/en/





SHA 2011 framework

Consumer health interface

Provision interface

Financing interface

Characteristics of beneficiaries (ICHA-HB) (Diseases, age, gender, income, etc.)

Revenues of health care financing schemes (ICHA-FS)

Financing agents (ICHA-FA)

Gross capital formation (ICHA-HK)

Factors of provision (ICHA-FP) External trade

Health care financing schemes

ICHA-HF

Health care Providers ICHA-HP

Source: IHAT for SHA 2011

SHA 2011 Core & Extended Framework

Health care functions ICHA-HC

Seksyen MNHA, Bahagian Perancangan - 2017 72


73

Total Health Expenditure (TEH)= Health & Health Related Items Current Health Expenditure (CHE)= Health Expenditure Excluding Health Related Items*

Note: *Health Related items includes Capital formation, Research & Development, And Education & Training


8,604

49,838 51,742

-

10,000

20,000

30,000

40,000

50,000

60,000

70,000

19

97

19

98

19

99

20

00

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

08

20

09

20

10

20

11

20

12

20

13

20

14

20

15

20

16

RM

Mill

ion

Current Health Expenditure (CHE)


WHO & MNHA Differences in Current Expenditure on Health (CHE) Reporting for Malaysia, 2000-2015 (RM Million)

74

Year GHED-WHO Database* MNHA-SHA Database Difference

2000 9,319 9,593 (274)

2001 10,151 10,148 3

2002 11,223 11,053 170

2003 13,577 13,280 297

2004 15,199 14,742 457

2005 16,432 15,823 609

2006 20,138 19,383 755

2007 22,415 21,241 1,174

2008 24,652 24,255 397

2009 25,206 24,230 976

2010 27,348 26,249 1,099

2011 31,679 30,532 1,147

2012 35,254 34,086 1,168

2013 37,417 35,973 1,444

2014 43,041 41,313 1,728

2015 46,270 44,292 1,978 Source: * International data from Global Health Expenditure Database, WHO NHA Dec 2017


WHO & MNHA Differences in GDP & Population Reporting for Malaysia, 2000-2015 (RM Million)

75

Year GDP (RM Million) Population (Thousands)

GHED-WHO Database*

DOSM** GHED-WHO Database*

DOSM**

2000 382,731 356,401 23,186 23,495

2001 378,627 352,579 23,699 24,123

2002 411,522 383,213 24,199 24,727

2003 449,706 418,769 24,689 25,320

2004 509,071 474,048 25,174 25,905

2005 561,395 543,578 25,659 26,477

2006 616,344 596,784 26,144 26,831

2007 687,148 665,340 26,626 27,186

2008 795,184 769,949 27,111 27,540

2009 736,221 712,857 27,605 27,895

2010 821,435 821,434 28,112 28,589

2011 911,733 911,733 28,635 29,062

2012 971,251 971,252 29,170 29,510

2013 1,018,614 1,018,614 29,707 30,214

2014 1,106,465 1,106,443 30,228 30,709

2015 1,157,138 1,157,723 30,723 31,186 Source: * International data from Global Health Expenditure Database, WHO NHA Dec 2017 **Department of Statistics Malaysia, DOSM


Current Health Expenditure (CHE) as % of GDP: Selected Country Comparison, CHE 2015*

70

Source: * International data from Global Health Expenditure Database, WHO NHA Dec 2017

11.2 11.1 10.9 9.9

9.4

7.4

5.3 4.4 4.3 4.0 3.9 3.8

3.3 3.0 2.6

0.0

2.0

4.0

6.0

8.0

10.0

12.0

CH

E %

GD

P


Selected Country Comparison of Public-Private Share in Health Expenditure, 2015* (%)

77

Note: *No data for these categories for Japan & Australia **Total Domestic Health Expenditure (DOM) as percentage of CHE for Thailand is 98.51 Source: Global Health Expenditure Database, WHO NHA on 13th December 2017

84.5

80.4

78.9

77.1

59.8

56.4

53.7

52.1

51.9

38.2

31.4

25.6

14.7

15.5

19.6

21.1

21.1

40.2

43.6

45.2

47.9

48.1

61.2

68.1

73.5

74.3

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Germany

United Kingdom

France

Thailand**

China

Republic of Korea

Sri Lanka

Malaysia

Singapore

Indonesia

Phillipines

India

Bangladesh

Domestic General Government Health Expenditure (GGHE-D) as % Current Health Expenditure (CHE)

Domestic Private Health Expenditure (PVT-D) as % Current Health Expenditure (CHE)

External Health Expenditure (EXT) as % of Current Health Expenditure (CHE)

Selected Country Comparison of Government Health Expenditure (GGHE) as % General Government Expenditure (GGE) 2015*

78

21.4

18.5

16.6 15.3

12.9 12.0

10.1 8.3 7.9 7.4 7.4

3.4 2.8

0.0

5.0

10.0

15.0

20.0

25.0

GG

HE

by

GG

E (%

)

Note: *No data for these categories for Japan & Australia Source: Global Health Expenditure Database, WHO NHA on 13th December 2017


WHO & MNHA Differences in GGE Reporting for Malaysia, 2000-2015 (RM Million)

79

Year GHED-WHO Database* Treasury Malaysia** Difference

2000 99,496 114,884 15,388 2001 108,379 130,690 22,311 2002 113,290 144,278 30,988 2003 128,022 166,948 38,926 2004 133,642 157,742 24,100 2005 139,711 172,681 32,970 2006 159,865 204,255 44,390 2007 180,421 231,359 50,938 2008 217,105 289,394 72,289 2009 230,643 282,794 52,151 2010 221,643 270,171 48,528 2011 250,477 297,382 46,905 2012 279,700 365,600 85,900 2013 286,992 376,374 89,382 2014 291,279 405,788 114,509 2015 290,254 383,727 93,473



**Treasury Malaysia website Economy Report 2016/2017 dated 6/11/2017

Selected Country Current Health Expenditure (CHE) Per Capita in Purchasing Power Parity (PPP) 2015*

80

5,357

4,542 4,492 4,405 4,145

3,681

2,556

1,064 762

610 369 353 323 238

88 -

1,000

2,000

3,000

4,000

5,000

6,000

Pu

rch

asin

g P

ow

er

par

ity

(PP

P),

USD



Selected Country Out-of-Pocket (OOP) Expenditure as % Current Health Expenditure (CHE) 2015*

81


71.8

65.1

53.5 48.3

38.4 36.8 36.7 36.7 32.4

14.8 13.1 12.5 11.8 6.8

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

OO

P %

CH

E


WHO & MNHA Differences in OOP Reporting for Malaysia, 2000-2015 (RM Million)

82

Year GHED-WHO Database* MNHA-SHA Database Difference

2000 3,474 3,739 (265) 2001 3,483 3,475 8 2002 3,877 3,702 175 2003 4,754 4,464 290 2004 5,661 5,225 436 2005 6,486 5,914 572 2006 7,342 6,618 724 2007 8,098 7,330 768 2008 8,720 8,428 292 2009 8,395 7,645 750 2010 9,798 8,808 990 2011 11,471 10,472 999 2012 12,535 11,497 1,038 2013 13,748 12,444 1,304 2014 15,744 14,239 1,505 2015 16,967 15,675 1,292

Source: * International data from Global Health Expenditure Database, WHO NHA Dec 2017 Seksyen MNHA, Bahagian Perancangan - 2017


• QC in MNHA

• MNHA Data 1997-2016


• MOH Reporting


SHA 2011

• Activity Update



• Way Forward


MOH EXPENDITURE 1997 - 2016


Note: Data presented using NHA Framework and also

Government Accounting System using AG Data

85

MOH, RM22,287 43%

Private household OOP

RM19,570, 38%

Private insurance , RM3,811,

7%

Other Fed agencies, 4%

MOHE, 3% All Corps, 2%

All other agencies, 3%

TOTAL HEALTH EXPENDITURE BY SOURCES OF FINANCING (MS CODE) 2016


86

MNHA Methodology 1-

Public

Sub accounts

MOH

MNHA MOH REFERENCES

Data Reporting

Using MNHA Framework

& AG Accounting

System


87

MOH SHARE OF NATIONAL GDP AND PUBLIC SECTOR EXPENDITURE 1997-2016

1.28%

1.81%

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

RM

Mill

ion

Total MOH Expenditure Other Public Expenditure

MOH (as % of GDP)


Note: MOH Share of Public Sector Expenditure 1997-2016 = 82%-84%

88

MOH SHARE OF TOTAL HEALTH EXPENDITURE 1997-2016


3,616

22,287

-

10,000

20,000

30,000

40,000

50,000

60,000

RM

Mill

ion

MOH Expenditure Others

Note: MOH Share of Public Sector Expenditure 1997-2016 = 42%- 43%

CORPS NGO

MOHE EPF MOH

LA SOCSO MOD OOP

Source Who Pays?

Provider To Whom? Spent where?

Function For What?

89

MOH

Provider (MP) To Whom?

Function (MF) For What?

MOH REPORTING USING MNHA FRAMEWORK (DIMENSIONS OF NHA)

Source Who Pays?


90

3,707

22,741

3,616

22,287

0

5,000

10,000

15,000

20,000

25,000

RM

Mill

ion

MOH EXPENDITURE VS SOURCE OF FINANCING 1997-2016

MOH Operational & Development Expenditure MOH “Source of Financing” (NHA)


91

Year

MOH Operational & Development Expenditure

MOH "Source of Financing" (NHA)

Claims for Services at MOH Facilities

RM Million

1997 3,707 3,616 91 1998 4,033 3,944 89 1999 4,450 4,358 92 2000 5,367 5,267 100 2001 6,251 6,142 108 2002 6,670 6,546 124 2003 9,013 8,877 136 2004 8,917 8,762 155 2005 8,060 7,894 165 2006 10,838 10,656 182 2007 11,243 11,037 206 2008 13,036 12,815 222 2009 14,713 14,432 280 2010 16,266 15,946 319 2011 16,856 16,497 359 2012 18,593 18,240 353 2013 19,370 19,040 330 2014 22,084 21,786 299 2015 23,057 22,677 380 2016 22,741 22,287 453

MOH EXPENDITURE VS SOURCE OF FINANCING 1997-2016

92

3,815

2017 – 24,801

2018 – 26,582

3,707

2016- 22,741

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

RM

Mill

ion

ALLOCATION EXPENDITURE

2016 - 22,910

MOH ALLOCATION* VS EXPENDITURE** 1997-2018

Source : * Finance Division, MOH dated 28 November 2017 – for allocation data : ** Accountant General Malaysia– for expenditure data


93

YEAR

OPERATIONAL DEVELOPMENT TOTAL

Allocation vs

Expenditure

ALLOCATION EXPENDITURE ALLOCATION EXPENDITURE ALLOCATION EXPENDITURE

RM Million

1997 3,236 3,258 579 449 3,815 3,707 -2.81%

1998 3,359 3,316 733 716 4,092 4,033 -1.46%

1999 3,612 3,615 900 835 4,512 4,450 -1.38%

2000 4,214 4,091 1,290 1,276 5,504 5,367 -2.49%

2001 4,631 4,680 1,500 1,570 6,131 6,251 1.95%

2002 5,139 5,157 1,715 1,514 6,855 6,670 -2.69%

2003 5,786 6,322 1,990 2,690 7,776 9,013 15.91%

2004 7,026 6,686 2,643 2,231 9,669 8,917 -7.77%

2005 7,302 6,866 1,197 1,194 8,499 8,060 -5.17%

2006 8,206 9,538 1,297 1,300 9,503 10,838 14.05%

2007 9,572 9,772 1,629 1,471 11,201 11,243 0.38%

2008 10,880 11,569 2,222 1,467 13,102 13,036 -0.50%

2009 11,863 12,173 2,567 2,540 14,430 14,713 1.96%

2010 11,765 12,697 3,584 3,569 15,349 16,266 5.97%

2011 14,302 14,899 1,984 1,958 16,287 16,856 3.50%

2012 15,151 16,808 1,873 1,785 17,023 18,593 9.22%

2013 17,653 17,652 1,756 1,718 19,409 19,370 0.20%

2014 20,494 20,695 1,495 1,389 21,989 22,084 0.43%

2015 21,714 21,714 1,350 1,343 23,064 23,057 0.03%

2016 21,535 21,423 1,375 1,318 22,910 22,741 -0.74%

2017 23,463

1,338 24,801

2018 24,737 1,845 26,582

MOH ALLOCATION* VS EXPENDITURE** 1997-2018

Source : *Finance Division, MOH dated 28 November 2017 – for allocation data : ** Accountant General Malaysia– for expenditure data

94

2,248

14,732

349

3,841

-

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

RM

Mill

ion

HospitalClinic

MOH PROVIDER - HOSPITAL & CLINIC** EXPENDITURE* (MP CODE) 1997-2016

Note : *Data includes Operational & Development Expenditure ** Clinic includes both Medical & Dental Clinic Seksyen MNHA, Bahagian Perancangan - 2017

95

MOH PROVIDER - HOSPITAL & CLINIC** EXPENDITURE* (MP CODE) 1997-2016

Year Hospital Clinic**

RM Million* 1997 2,248 349 1998 2,361 374 1999 2,552 436 2000 2,831 509 2001 3,223 585 2002 3,331 647 2003 4,006 889 2004 4,317 995 2005 4,553 1,089 2006 6,221 1,508 2007 6,591 1,581 2008 7,597 1,820 2009 7,967 1,806 2010 8,784 2,064 2011 9,816 2,272 2012 11,567 2,768 2013 11,956 3,038 2014 13,845 3,540 2015 14,519 3,634 2016 14,732 3,841

Note : * Data includes Operational & Development Expenditure ** Clinic includes both Medical & Dental Clinic


96

MOH PHARMACEUTICAL EXPENDITURE USING

AG SODO CODES

97

Year Operational Expenditure

Development Expenditure

MOH Total Expenditure

RM Million

1997 3,258 449 3,707 1998 3,316 716 4,033 1999 3,615 835 4,450 2000 4,091 1,276 5,367 2001 4,680 1,570 6,251 2002 5,157 1,514 6,670 2003 6,322 2,690 9,013 2004 6,686 2,231 8,917 2005 6,866 1,194 8,060 2006 9,538 1,300 10,838 2007 9,772 1,471 11,243 2008 11,569 1,467 13,036 2009 12,173 2,540 14,713 2010 12,697 3,569 16,266 2011 14,899 1,958 16,856 2012 16,808 1,785 18,593 2013 17,652 1,718 19,370 2014 20,695 1,389 22,084 2015 21,714 1,343 23,057 2016 21,423 1,318 22,741

MOH EXPENDITURE (AG DATA) 1997-2016


19% 20%

19% 18% 16%

MOH OPERATIONAL EXPENDITURE

AG SODO Codes

DESCRIPTION

10000 Emolument (Emolumen)

20000 Services and supplies (Perkhidmatan dan bekalan)

30000 Assets (Aset)

40000 Payment and fixed payments (Pemberian dan kenaan bayaran tetap)

50000 Other expenses (Perbelanjaan –perbelanjaan lain)

98

All MOH Operational Expenditure captured under above Five SODO Code Series


19% 20%

19% 18% 16%

MOH SODO CODES 20000 SERIES

Seksyen MNHA, Bahagian Perancangan, 2017

SODO DESCRIPTION

21000 Travel and living expenses (Perbelanjaan perjalanan dan sara hidup)

22000 Transportation of goods (Pengangkutan barang-barang)

23000 Communication and utilities (Perhubungan dan utiliti)

24000 Rental (Sewaan)

25000 Food and beverage materials (Bahan-bahan makanan dan minuman)

26000 Supply of raw materials and materials for maintenance and repair (Bekalan bahan mentah dan bahan-bahan untuk penyelenggaraan dan pembaikan)

27000 Supply and other materials (Bekalan dan bahan-bahan lain)

28000 Small maintenance and repairs purchased (Penyelenggaraan dan pembaikan yang kecil yang dibeli)

29000 Professional service and other services purchased and hospitality (Perkhidmatan iktisas dan perkhidmatan lain yang dibeli dan hospitaliti)

SODO 20000 : Services and supplies (Perkhidmatan dan bekalan)

19% 20%

19% 18% 16%

MOH PHARMACEUTICAL & SUPPLIES

SODO DESCRIPTION

27401 Medicines and drugs (Ubat dan dadah)

27402 Medical gases (Gas perubatan)

27403 Supply of reagent (Bekalan Reagen)

27404 Vaccine supplies (Bekalan vaksin)

27499 Other supply of medical and dental (consumable) (Bekalan perubatan kesihatan dan pergigian yang lain)

SODO 27400 : Medical and dental supplies


-

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

10,000

2012 2013 2014 2015 2016

RM

Mill

ion

Other Expenditure of 20000 Expenditure of 27400

16%

MOH 20000 SERIES EXPENDITURE, 2012-2016 FOR PHARMACEUTICAL & SUPPLIES

(27400 VS OTHER 20000 SERIES)

46% 52%

45% 48%

46%

54% 55% 52% 54% 48%


MOH PHARMACEUTICAL & SUPPLIES AS PROPORTION OF SERVICES & SUPPLIES 2012-2016

2012

2013

2014

2015

2016

RM Million Expenditure of

27400

3,240

3,535

3,936

3,907

3,531

Other

Expenditure of 20000

3,736

4,161

4,217

4,779

3,306

Total

Expenditure under 20000

6,976

7,697

8,154

8,686

6,836

102

MOH 20000 SERIES EXPENDITURE, 2012-2016 FOR PHARMACEUTICAL & SUPPLIES VS OTHERS


-

5,000

10,000

15,000

20,000

25,000

2012 2013 2014 2015 2016

RM

Mill

ion

Other Recurrent Spending

Pharmacy Expenditure

19% 20%

19% 18% 16%

81% 80% 81% 82% 84%

MOH PHARMACEUTICAL & SUPPLIES AS PROPORTION OF OPERATIONAL EXPENDITURE 2012-2016

All Other Operational Expenditure (All SODO excluding 27400 )

Pharmaceutical & Supply Expenditure (SODO 27400)


MOH PHARMACEUTICAL & SUPPLIES AS PROPORTION OF OPERATIONAL EXPENDITURE 2012-2016, RM Million


2012 2013 2014 2015 2016

Pharmaceutical & Supply Expenditure (27400)

3,240

3,535

3,936

3,907

3,531

Operational Expenditure (All Other SODO)

13,568

14,117

16,759

17,808

17,892

Total Operational Expenditure

16,808

17,652

20,695

21,714

21,423

-

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

5,000

2012 2013 2014 2015 2016

RM

Mill

ion

Medical Gases Vaccine Reagent Medical Durables Medicine & Drugs

MOH PHARMACEUTICAL & SUPPLIES 2012-2016 (27400 SERIES)

61%

57% 59% 58%

57%

25% 26%

27% 28% 27%

10% 10% 10% 10% 11% 3% 3% 3% 3% 3%

1% 2% 2% 2% 2%

3240

3531

3907 3936

3535


106

MOH REVENUE Using ag SODO Codes

19% 20%

19% 18% 16%

REVENUE CODES

MOH Types of Revenue

DESCRIPTION

Licensing SODO 71000: License, registration fee and permit

User chargers

SODO 72000: Services and service fees (user charges) except 72150 which is payment of blood supply service charges and 72199 for other professional fees

OTHERS all remaining 70000 (non-tax revenue) , 80000 (non-revenue collection) & 90000 (federal territory revenue)


-

100

200

300

400

500

600

700

2012 2013 2014 2015 2016

RM

Mill

ion

Licensing Other revenues

User chargers

MOH TYPES OF REVENUE 2012-2016

65%

65%

65% 63% 59%

33%

33% 33% 34% 39%

2% 2% 2% 3% 2%

402

651

560

442 441


MOH EXPENDITURE VS REVENUE, 1997-2016

2012

2013

2014

2015

2016

RM Million Operational Expenditure

16,808

17,652

20,695

21,714

21,423

Total MOH Revenue *

402

441

442

560

651

Revenue share of Total Health Expenditure

0.7%

0.9%

0.7%

0.8%

0.9%

Revenue share of Operational Expenditure

2.4%

2.5%

2.1%

2.6%

3.0%

*Excluding proportion of Full Paying Patient (FPP) to Specialist / Consultant 109


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