Remeasurement, Evaluation and Comparison of Health Services Utilization Among Women Staff at Universiti Kebangsaan Malaysia

Last reviewed: March 2026

Summary

This study examined patterns of health services utilisation among female staff members at Universiti Kebangsaan Malaysia (UKM), one of Malaysia’s leading public universities. By conducting a remeasurement of healthcare utilisation patterns, the researchers aimed to evaluate how usage had changed over time and to compare these patterns with national benchmarks. The study contributes to an important body of literature on occupational health and gender-specific healthcare access in Malaysia’s higher education sector.

Background

Health services utilisation research examines how individuals access and use healthcare resources, and the factors that facilitate or impede this access. In Malaysia, the dual public-private healthcare system creates a complex landscape for healthcare access. Public sector employees, including university staff, typically benefit from employer-supported healthcare that includes access to government hospital services at subsidised rates and reimbursement for certain outpatient services.

Women’s health services utilisation is a particularly important area of study for several reasons. Women generally have higher rates of healthcare utilisation than men across most service categories, driven by reproductive health needs, higher prevalence of certain chronic conditions, and greater health-seeking behaviour. In the Malaysian context, where women’s participation in the workforce has grown substantially — particularly in the education and public administration sectors — understanding the healthcare needs and utilisation patterns of working women is crucial for workplace health policy.

The university setting provides an instructive case study because it encompasses a diverse workforce ranging from academic staff with advanced qualifications to support and administrative personnel, creating natural variation in socioeconomic status and health literacy within a single organisational environment. Previous studies at UKM had established baseline utilisation rates, and this remeasurement allowed for temporal comparison.

Methods

The study employed a cross-sectional survey design targeting female staff across all employment categories at UKM. A structured questionnaire was administered to collect data on demographic characteristics, employment details, health status, and healthcare utilisation patterns over the preceding 12 months. Utilisation measures included the number of outpatient visits (disaggregated by provider type), hospitalisation episodes, use of preventive services (such as screening examinations and immunisations), and use of traditional and complementary medicine.

Data analysis incorporated descriptive statistics to characterise utilisation patterns and bivariate and multivariate analyses to identify factors associated with different levels of healthcare use. Comparisons were drawn with earlier surveys conducted at the same institution and with national-level data from the National Health and Morbidity Survey (NHMS).

Key Findings

The results indicated that female university staff had relatively high rates of outpatient healthcare utilisation. The majority of respondents reported at least one outpatient visit in the preceding year, with a substantial proportion making four or more visits. Government health facilities, including the university’s own health centre and nearby government hospitals, were the most commonly used sources of care, reflecting both the availability of these services and the financial incentives created by the staff healthcare benefit scheme.

Age was a significant predictor of utilisation, with older women reporting more healthcare contacts, consistent with the higher burden of chronic disease in older age groups. Marital status also influenced utilisation patterns: married women reported more visits, potentially reflecting both reproductive health needs and the psychosocial factors associated with family health responsibilities. Employment grade, which serves as a proxy for socioeconomic status and educational attainment, showed a more complex relationship with utilisation — higher-grade staff demonstrated greater use of preventive services but not necessarily higher overall visit rates.

The remeasurement component of the study revealed some temporal shifts in utilisation patterns compared to earlier surveys. These shifts likely reflected both changes in the healthcare system (including the expansion of available services and changes in benefit structures) and demographic changes in the university workforce itself.

Discussion

The findings contribute to a nuanced understanding of how institutional and policy environments shape healthcare-seeking behaviour. The relatively high utilisation rates among university staff may reflect favourable conditions of access — including proximity to health facilities, health literacy, financial support through employment benefits, and workplace cultures that support health-seeking behaviour. However, the study also identified subgroups with lower utilisation, suggesting that even within a relatively privileged employment setting, barriers to healthcare access persist.

The significance of employment grade as a determinant of preventive service use highlights the role of health literacy and empowerment in driving proactive health behaviour. This finding suggests that workplace health promotion programmes targeted at lower-grade staff could help reduce disparities in preventive care utilisation within university settings.

Limitations

The study was limited to a single university and therefore findings may not be generalisable to all Malaysian workplaces. Self-reported utilisation data may be subject to recall bias, particularly for visits made early in the 12-month recall period. The cross-sectional design precludes causal inference. Additionally, the study did not capture quality-of-care measures or health outcomes, which limits the ability to assess whether observed utilisation patterns translate into appropriate and effective healthcare.

Implications for Policy

The results have practical implications for the design of employer-provided health benefits and workplace health programmes in Malaysia’s public sector. Ensuring that benefit structures encourage both appropriate utilisation and preventive care, while addressing the specific needs of women at different career stages, can contribute to a healthier and more productive workforce. The study also demonstrates the value of periodic remeasurement to track changes in utilisation patterns and inform policy adjustments.