Cost-Utility Analysis of Malaysian Elderlies Living in Public Long-Term Care Institutions

Sachi Purcal, Syazreen Shair*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


This research compares the quality of life of Malaysian elderlies living in public formal long-term care institutions, including residential care and nursing home care. It provides
evidence of the cost-effectiveness of both programs. The sample of Malaysian elderlies aged 60 years and above was collected from the World Health Survey, including five dimensions of health status: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression. Each of the dimensions has three levels, including 1 (“no problems”), 2 (“some problems”) and 3 (“major problem”). The quality-adjusted life-years (QALYs) of elderlies living in both institutions are estimated using a generic health-related measurement method, EQ-5D. In addition, cost-utility analysis is adopted to compare the effectiveness of programs in allocating resources. The QALY of those living in nursing home care is reasonably lower than those in residential care due to their worse chronic health conditions. The majority are categorised as severely disabled. The cost-effectiveness evaluation of each public long-term care model suggests that the residential care program is cost-effective, with the cost per QALY being MYR22 945. At the same time, a nursing home for disabled people is not effective as the cost per QALY is MYR57 822, falls outside the willingness to pay (WTP) range between (MYR 19,929–MYR 28,470)
Original languageEnglish
Number of pages12
JournalPertanika Journal of Social Science and Humanities
Issue number4
Publication statusAccepted/In press - 10 Sep 2021


  • Cost-utility analysis
  • EQ5D
  • long term care
  • population ageing
  • quality-adjusted-life-years


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