Understanding care-seeking behavior among urban and rural populations can help to support the planning and implementation of appropriate measures to improve health in the community. This study aims to determine the factors associated with the health-seeking behavior among Malaysian adults in urban and rural areas who reported sickness. This study used data of Malaysian adults aged 18 years and over from the National Health and Morbidity Survey 2019; a cross-sectional, national household survey that targeted all non-institutionalized residents in Malaysia. Respondent’s characteristics and health-seeking behavior were described using complex sample descriptive statistics. Multivariable logistic regression analysis was conducted to examine the association between potential factors (sociodemographic characteristics, enabling, and health need) and health-seeking behaviors (seeking treatment from healthcare practitioners and self-medication). A total of 10,484 respondents, estimated to represent 18.9 million Malaysian adults aged 18 years and over, were included in the analysis. Prevalence of seeking treatment from healthcare practitioners and self-medication among Malaysian adults with self-reported sickness were 57.3% and 23.3%, respectively. Self-reported sickness among both the urban and rural populations who rated their health as poor to very poor was more likely to seek treatment than those who rated good to excellent. However, among the urban population, those who rated their health as poor to very poor were less likely to self-medicate. Among the urban population, government employees were more likely to seek treatment, and being without formal education significantly increased the likelihood to self-medicate. Among the rural population, those with at least one long-term condition were more likely to seek treatment than those with none. Understanding the factors which influence health-seeking behavior among the urban and rural population could close the gaps in healthcare utilization among the population in Malaysia.

The proportion of Malaysians of all ages who use private outpatient services has dropped over time, highlighting the overstretched condition of public outpatient facilities compared to their private counterparts. This paper aims to determine the prevalence of outpatient care, characteristics of outpatient care users by sector, and the factors affecting the utilisation of private outpatient services among the adult population of Malaysia using Andersen’s behavioural model. Data from the National Health Morbidity Survey 2019 (NHMS 2019), a nationwide survey, were analysed. Logistic regression analysis was performed to explore the association of predisposing (locality, age, sex, ethnicity, education level, and marital status), enabling (working status, health care coverage, and household income), and need factors (perceived and evaluated needs) with the use of private outpatient services. Variables with a statistical significance ≤ 0.25 in the univariate regression analysis were included in the final multivariable logistic regression analysis. A total of 11,674 respondents, estimated to represent 22.4 million adults aged 18 years and above in Malaysia, were included for analysis. Overall, 8.3% of the adult population of Malaysia used outpatient care and 33.9% used the private sector. Those living in urban areas (OR = 1.80, 95% CI = 1.02, 3.18), non-Malays (OR = 1.74, 95% CI = 1.04, 2.93), those working (OR = 2.47, 95% CI = 1.48, 4.10), those with employer coverage (OR = 4.73, 95% CI = 2.79, 8.01), and those with health problems (OR = 2.26, 95% CI = 1.26, 4.05) were more likely to utilise private outpatient services. Those who self-rated their health status as fair (OR = 0.54, 95% CI = 0.33, 0.91) and who had diabetes, hypertension, or hypercholesterolemia (OR = 0.56, 95% CI = 0.31, 1.02) were less likely to utilise private outpatient services. The predisposing and enabling factors were associated with the use of private outpatient services, and the need factors were strong predictors of private outpatient care utilisation among adults. Understanding the factors associated with the utilisation of private outpatient services could aid in the development of effective initiatives designed to enhance outpatient care access among the population of Malaysia and balance the burden of outpatient care provision on the public and private sector.

Objectives Multimorbidity has been recognised as a global public health issue, and individuals with multimorbidity have been found to have high healthcare utilisation. This study aims to estimate the prevalence of non-communicable diseases among adults in Malaysia, identify factors associated with multimorbidity, and assess the association between the number of non-communicable diseases and outpatient services utilisation. Design and setting A retrospective secondary data analysis using data from the National Health and Morbidity Survey 2019, a cross-sectional household survey among the population in Malaysia. Participants All adults aged 18 years and above. Outcome measures The two outcome variables were multimorbidity and outpatient services utilisation. Characteristics of respondents and those having multimorbidity were described using complex sample descriptive statistics. We used multivariable logistic regression to determine the associated factors of having multimorbidity and the association between the number of non-communicable diseases and outpatient services utilisation. Results Overall, 11 347 respondents were included in the analysis. This study found a prevalence of 11.4 (95% CI=10.43–12.39) for multimorbidity. Age, marital status and working status were the factors associated with multimorbidity. Adults with multimorbidity were high users of outpatient services (20.4%, 95% CI=17.5–23.7), approximately threefold of adults with no non-communicable diseases. In the final model, multimorbidity showed an adjusted OR of 3.28 (95% CI=2.48–4.32) for outpatient services utilisation. Conclusion Understanding factors associated with multimorbidity and the magnitude of the impact of having multimorbidity towards outpatient services utilisation could help in future planning for healthcare system transformation. The recently launched Health White Paper for Malaysia has emphasised primary healthcare as a critical component to achieve aspirations of the health system, which includes equity and responsiveness. Strengthening primary care services and improving patient navigation across healthcare levels are critical to supporting individuals with multimorbidity. Avenues for further research include exploring a wider range of conditions and assessing the longitudinal impact of multimorbidity on healthcare utilisation and health outcomes.

Background: Indigenous populations, including the Orang Asli in Malaysia, experience persistent health disparities due to historical, socioeconomic, geographic, and cultural barriers. Despite government initiatives to improve access, significant gaps remain, and limited nationwide data hinder policy development. This study examines the prevalence and determinants of outpatient healthcare utilisation among the Orang Asli. Methods: This study utilised data from the Orang Asli Health Survey, a nationwide cross-sectional survey of Orang Asli communities in Peninsular Malaysia, with 89.8% response rate. Andersen’s Behavioural Model was applied in the analysis to assess the predisposing, enabling, and health need factors influencing outpatient healthcare use among the adult (aged 18 and over) population. Weighted descriptive statistics and logistic regression were used to examine outpatient healthcare utilisation and its determinants. Analyses were performed in STATA 18. Results: The overall prevalence of outpatient service utilisation in the past 12 months was 17.9%. Higher utilisation was observed among females, urban residents, and the Senoi and Negrito tribes. Determinants of outpatient use included female (adjusted odds ratio [aOR]: 1.64, 95% CI: 1.31–2.06), urban locality (aOR: 2.39, 95% CI: 1.15–4.96), Senoi (aOR 2.66; 95% CI: 1.52–4.64) and Negrito (aOR: 3.91, 95% CI: 2.01–7.60) tribes, unemployment (aOR: 1.27, 95% CI: 1.11–1.46), recent acute health problems (aOR: 2.17, 95% CI: 1.68–2.81), fair to very poor self-rated health (aOR: 2.30, 95% CI: 1.39–3.79), and presence of one (aOR: 2.90, 95% CI: 2.00–4.21) or two or more non-communicable diseases (NCD) (aOR: 4.63, 95% CI: 2.89–7.41). Interaction effects indicated lower outpatient use among Senoi and Negrito adults with poor self-rated health compared to other groups. Conclusion: Outpatient healthcare utilisation among Orang Asli adults was driven by gender, tribe, health needs, and NCDs. Improved access requires needs-based sensitive interventions and existing services optimisation. Follow-up studies are warranted to explore the underlying cultural behavioural aspects.

The Orang Asli, the indigenous community of Peninsular Malaysia, experience significant health disparities. This study assesses the prevalence and factors associated with poor self-rated health (SRH) among adults aged 18 and above using data from the Orang Asli Health Survey 2022. The prevalence of poor SRH was 12.8% (95% CI: [9.74, 16.68]). Factors associated with poor SRH are health-related factors (acute illness [adjusted odds ratio, aOR = 4.61, 95% CI: [3.54, 5.99]], recent hospitalization [aOR = 2.58, 95% CI: [1.78, 3.74]]), sociodemographic (unemployment [aOR = 1.51, 95% CI: [1.30, 1.76]], older age [aOR = 0.43, 95% CI: [0.30, 0.64]], and the Negrito tribes [aOR = 0.61, 95% CI: [0.37, 0.99]]) as well as lifestyle (tobacco use [aOR = 1.26, 95% CI: [1.03, 1.53]]). These findings underscore the importance of integrated health and social interventions sensitive to Orang Asli beliefs to improve health equity.