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Geographical Debate on COVID-19’s Impact on Healthcare Access and Utilization in Vulnerable Malaysian Communities

Author

Listed:
  • Lay Im Lim

    (Department of Geography, Universiti Sains Malaysia, Pulau Pinang 11800, Malaysia)

  • Mohammad Javad Maghsoodi Tilaki

    (Department of Geography, Universiti Sains Malaysia, Pulau Pinang 11800, Malaysia)

  • Sharifah R. S. Dawood

    (Department of Geography, Universiti Sains Malaysia, Pulau Pinang 11800, Malaysia)

  • Su Jinxia

    (Department of Geography, Universiti Sains Malaysia, Pulau Pinang 11800, Malaysia)

Abstract

The COVID-19 pandemic has amplified concerns about healthcare access, particularly among vulnerable populations. This study extends Andersen’s behavioral model to investigate how fear of high-risk locations, alongside predisposing, enabling, and need factors, shapes healthcare-seeking behavior in Penang, Malaysia. A survey of 211 individuals (58% response rate) was analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). Results reveal that need factors—specifically self-rated health and chronic illness—strongly predict healthcare utilization. However, this relationship is moderated by fear of infection, leading some high-risk individuals to forgo care despite medical necessity. Enabling factors, including financial resources and access to public healthcare, showed limited influence, likely due to Malaysia’s universal healthcare system and growing use of telemedicine. Older adults maintained healthcare utilization among predisposing variables, while higher-educated individuals were more cautious, possibly due to heightened health literacy and trust in digital alternatives. Although fear influenced care-seeking behavior for minor ailments, it did not significantly deter individuals from accessing services for severe conditions. These findings underscore the nuanced interaction between psychosocial factors and institutional context in shaping healthcare decisions during health crises.

Suggested Citation

  • Lay Im Lim & Mohammad Javad Maghsoodi Tilaki & Sharifah R. S. Dawood & Su Jinxia, 2025. "Geographical Debate on COVID-19’s Impact on Healthcare Access and Utilization in Vulnerable Malaysian Communities," Societies, MDPI, vol. 15(7), pages 1-21, June.
    • Handle: RePEc:gam:jsoctx:v:15:y:2025:i:7:p:172-:d:1683601
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    References listed on IDEAS

    as
    1. Zen Yang Ang & Kit Yee Cheah & Md. Sharif Shakirah & Weng Hong Fun & Jailani Anis-Syakira & Yuke-Lin Kong & Sondi Sararaks, 2021. "Malaysia’s Health Systems Response to COVID-19," IJERPH, MDPI, vol. 18(21), pages 1-26, October.
    2. André Hajek & Benedikt Kretzler & Hans-Helmut König, 2021. "Factors Associated with Dental Service Use Based on the Andersen Model: A Systematic Review," IJERPH, MDPI, vol. 18(5), pages 1-28, March.
    3. Patrícia Soares & Andreia Leite & Sara Esteves & Ana Gama & Pedro Almeida Laires & Marta Moniz & Ana Rita Pedro & Cristina Mendes Santos & Ana Rita Goes & Carla Nunes & Sónia Dias, 2021. "Factors Associated with the Patient’s Decision to Avoid Healthcare during the COVID-19 Pandemic," IJERPH, MDPI, vol. 18(24), pages 1-12, December.
    4. Mohammad Javad Maghsoodi Tilaki & Gelareh Abooali & Massoomeh Hedayati Marzbali & Narimah Samat, 2021. "Vendors’ Attitudes and Perceptions towards International Tourists in the Malaysia Night Market: Does the COVID-19 Outbreak Matter?," Sustainability, MDPI, vol. 13(3), pages 1-20, February.
    5. Bayu Begashaw Bekele & Bahaa Aldin Alhaffar & Rahul Naresh Wasnik & János Sándor, 2022. "The Effect of the COVID-19 Pandemic on the Social Inequalities of Health Care Use in Hungary: A Nationally Representative Cross-Sectional Study," IJERPH, MDPI, vol. 19(4), pages 1-16, February.
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