A REVIEW ON THE DETERMINANTS AND IMPACT OF PRIVATE HEALTH INSURANCE UPTAKE IN ASIA
Keywords:
Private health insurance (PHI), Asia, determinants, healthcare utilization, financial protection.Abstract
This review paper examines the determinants and impacts of private health insurance (PHI) uptake across Asia through a comparative lens. Drawing upon quantitative analyses of multi-country survey data and system dynamics modeling, the paper synthesizes findings from diverse studies to elucidate how socio-demographic factors (such as age, education, and income), perceptual influences (like insurance literacy and product perception), and policy-driven variables shape PHI uptake in different Asian settings. The review further explores the effects of PHI on healthcare utilization, out-of-pocket expenditures, quality of care, and financial risk protection. Results reveal significant regional and economic disparities, highlight the influence of public healthcare policies on PHI demand, and underscore the importance of targeted policy interventions and regulatory reforms. Key research gaps and recommendations for future studies, including improved data methodologies and longitudinal approaches are discussed to inform more effective insurance strategies and health system improvements across the region.
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References
Abd Khalim, M. A., & Sukeri, S. (2023). Uptake and determinants of private health insurance enrollment in a country with heavily subsidised public healthcare: A cross-sectional survey in East Coast Malaysia. PLOS ONE, 18(1), e0278404. https://doi.org/10.1371/journal.pone.0278404
Adam, T. S. N., Sy, C., & Li, J. (2011). A system dynamics model of Singapore healthcare affordability. In S. Jain, R. R. Creasey, J. Himmelspach, K. P. White, & M. Fu (Eds.), Proceedings of the 2011 Winter Simulation Conference. IEEE.
Ali, E. A. A., Ismail, A., Abdul Manaf, M. R., Sudin, L. S., Mustafa, N., Sukor, N., Alabed, A. A. A., Alkhodary, A. A., & Aljunid, S. M. (2022). Health insurance status and its determinants among patients with type 2 diabetes mellitus in a tertiary teaching hospital in Malaysia. PLOS ONE, 17(5), e0267897. https://doi.org/10.1371/journal.pone.0267897
Arpah Abu Bakar, A., Regupathi, A., Aljunid, S. M., & Omar, M. A. (2012). Factors affecting demand for individual health insurance in Malaysia. BMC Public Health, 12, A10. https://doi.org/10.1186/1471-2458-12-S2-A10
Azhar, A., Rahman, M. M., & Arif, M. T. (2018). Willingness to pay for health insurance in Sarawak, Malaysia: A contingent valuation method. Bangladesh Journal of Medical Science, 17(2), 230–237. https://doi.org/10.3329/bjms.v17i2.35876
Diva Kurnianingtyas. (2019). System dynamics simulation to determine financial strategy for social health insurance in Indonesia. Journal of Physics: Conference Series, 1230, 012047. https://doi.org/10.1088/1742-6596/1230/1/012047
Hasazli Hasan, H., & Rahman, M. M. (2022). Willingness to pay for the National Health Insurance Scheme: A cross-sectional study in Sarawak, Malaysia. Bangladesh Journal of Medical Science, 21(3), 577–589. https://doi.org/10.3329/bjms.v21i3.59571
Jauhar, A. (2025). Analyzing the factors influencing public vs private healthcare utilization under JKN Program in Indonesia. Quantum Journal of Medical and Health Sciences, 4(2), 78–85. https://doi.org/10.51957/qjmhs.v4i2.140
Mamun, A., Khalim, et al. (2021). Predicting the intention and purchase of health insurance among Malaysian working adults. SAGE Open. https://doi.org/10.1177/21582440211061373
Mathur, T., Paul, U. K., Prasad, H. N., & Das, S. C. (2015). Understanding perception and factors influencing private voluntary health insurance policy subscription in the Lucknow region. International Journal of Health Policy and Management, 4(2), 75–83. https://doi.org/10.15171/ijhpm.2015.08
Na Young Kong, Dong Hee Kim. (2020). Factors influencing health care use by health insurance subscribers and medical aid beneficiaries: a study based on data from the Korea welfare panel study database. BMC Public Health, 20(nan), 1133. https://doi.org/10.1186/s12889-020-09073-x
Ng, R. J., Cheo, W. V., Ng, C.-W., & Hairi, N. N. (2024). Effect of supplementary private health insurance on out-of-pocket inpatient medical expenditure: Evidence from Malaysia. Health Policy and Planning, 39(3), 268–280. https://doi.org/10.1093/heapol/czae004
Nur Zahirah Balqis-Ali, Anis-Syakira, J., Fun, W. H., & Sararaks, S. (2021). Private health insurance in Malaysia: Who is left behind? Asia Pacific Journal of Public Health, 33(4), 861–869. https://doi.org/10.1177/10105395211009193
Tian, W., Liu, J., Li, G., & Xi, X. (2020). Factors influencing individuals’ take-up of tax-subsidized private health insurance: A cross-sectional study in China. Journal of Medical Economics, 23(7), 760–766. https://doi.org/10.1080/13696998.2020.1737535
Yiran Zou, & Junqiao Chen. (2022). The feedback loop between the demand for voluntary private insurance and the burden of healthcare system: An explanatory system dynamics model of Hong Kong. International Journal of Health Policy and Management, 11(12), 3040–3051. https://doi.org/10.34172/ijhpm.2022.6738
Wahab, M. Z. H., & Tajuddin, A. M. (2020). The Roles of Health Awareness and Knowledge in Medical Takaful Purchase Intention. The International Journal of Banking and Finance, 14, 95-116.