145 Jurnal Sains Kesihatan Malaysia 16(1) 2018: 145-153 DOI : http://dx.doi.org./10.17576/JSKM-2018-1601-18 Artikel Asli/Original Article Willingness to Pay for Outpatient Services User Fees: Malaysian Community Perspective (Kesanggupan Membayar Caj Perkhidmatan Pesakit Luar: Pandangan Masyarakat Malaysia) AZIMATUN NOOR AIZUDDIN & SYED MOHAMED AL JUNID ABSTRACT Health care services are not often accessible and available for all people in one country due to multiple reasons such as the geographical barrier, affordability, etc. The aim of this study was to analyse willingness to pay (WTP) for healthcare services user fees among Malaysian population and determine its’ infuencing factors. Structured interviews were conducted involving 774 households in 4 states represents Peninsular Malaysia. Validated questionnaires with open ended, followed by bidding games were applied to elicit maximum amount of WTP. The study was analysed descriptively and with multivariate regression method to adjust for potential confounding factors. More than half of respondents WTP more than current fee for the government clinic outpatient registration fee with mean MYR3.76 (SD2.71). Majority of respondents not WTP more than usual for private clinic simple outpatient treatment charges with the mean MYR38.76 (SD5.45). Factors that were found to have signifcant associations with WTP for both government and private clinic were income and having health insurance. Community willing to pay for healthcare services user fees and charges but at certain amount. The healthcare services user fees and charges can be increased up to community WTP level to avoid from catastrophic expenditure. Keywords: Willingness to pay; health care services; health fnancing; government clinic; private clinic ABSTRAK Perkhidmatan penjagaan kesihatan tidak mudah diakses dan tersedia untuk semua orang di sesebuah negara disebabkan oleh beberapa factor seperti struktur geograf, kemampuan dan lain-lain. Kajian ini adalah bertujuan untuk menganalisa kesanggupan membayar caj perkhidmatan kesihatan dalam kalangan masyarakat Malaysia dan fakator-faktor yang mempengaruhinya. Soal selidik berstruktur telah dijalankan kepada 774 isi rumah dari 4 negeri yang mewakili Semenanjung Malaysia. Soal selidik yang telah divalidasi menggunakan soalan terbuka dan diikuti dengan soalan bidaan telah digunakan untuk mendapatkan nilai maksimum kesanggupan membayar. Kajian ini dianalisa secara deskriptif dan dengan kaedah regresi multivariate untuk mengawal faktor-faktor yang mengelirukan. Lebih separuh daripada responden sanggup membayar lebih daripada caj perkhidmatan pesakit luar di klinik kerajaan yang dikenakan pada masa kini dengan min RM3.76 (SP2.71). Majoriti responden tidak sanggup membayar lebih daripada biasa untuk caj rawatan pesakit di klinik swasta dengan min RM38.76 (SP5.45). Faktor-faktor yang didapati mempengaruhi secara signifkan dengan kesanggupan membayar untuk kedua-dua klinik kerajaan dan swasta adalah pendapatan dan mempunyai insuran kesihatan. Secara keseluruhan, masyarakat sanggup membayar caj perkhidmatan kesihatan tetapi pada kadar yang tertentu. Oleh itu, caj perkhidmatan kesihatan boleh dinaikkan ke tahap yang sanggup dibayar oleh masyarakat untuk mengelakkan daripada perbelanjaan katastropik. Kata kunci: Kesanggupan membayar; perkhidmatan kesihatan; pembiayaan kesihatan; klinik kerajaan; klinik swasta INTRODUCTION Financing healthcare can be challenging as every country is faced with the problem of health facilities and quality of health services while trying to keep the cost of health services bearable. Health expenditure affects various groups at various levels in the health service funding scheme. The issues of healthcare cost continue to increase and cost-sharing options are often disputed. Over the years, in countries all over the world, governments and citizens alike have been confronted with various issues pertaining to healthcare, especially that of healthcare access. Healthcare services are not often accessible or made available to all people in many countries, especially by those who cannot afford to pay for such services. With the differences in the living conditions of the rural and urban populations, it is also apparent that they have significant differences when it comes to their willingness to pay (WTP) for different healthcare services. In view of these differences, there have been strategies which were pursued by several sectors calling for equality in access to such services. Chap 18.indd 145 01/03/2018 12:16:56