ArticleBMC public health2025
Factors influencing the intention to purchase health insurance among middle-income Malaysians: a qualitative study.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThis study explores the factors influencing health insurance purchase intentions among Malaysia's middle-income population. It draws on behavioural theories to examine key determinants such as perceived usefulness, financial risk protection, social influence, and financial management, with the aim of informing policies that could increase health insurance uptake in this demographic.
methodAn exploratory qualitative design with a phenomenological approach was used, involving semi-structured interviews with 78 Malaysian adults aged over 25 years. These participants had accessed public or private healthcare services within the past two years. Thematic analysis was performed using a deductive approach based on the decomposed theory of planned behaviour framework, and data analysis was facilitated by NVivo 12 Plus software.
findingsThe study found that health insurance is primarily valued for private healthcare access but often seen as wasteful if unused. Participants with pre-existing conditions faced challenges in finding suitable plans. Health insurance was viewed as a financial safeguard, complementing employer-based coverage. Social norms, generational differences, and financial stability influenced purchase decisions, with uninsured individuals often demonstrating self-efficacy in managing healthcare costs.
conclusionA multi-sectoral approach is recommended to improve health insurance uptake among middle-income groups. This includes increasing insurance literacy, implementing navigator programs to assist decision-making, and establishing policies to protect both consumers and the insurance industry. These strategies can enhance understanding within families and communities and ultimately increase healthcare access and financial security for this population.
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