OBJECTIVES: Transboundary haze exposures were associated with substantial monetary burden towards healthcare providers. This study aims to determine the financial implications of haze-related respiratory illnesses in Selangor, Malaysia.

METHODS: This is a retrospective cross-sectional study using secondary data of particulate matter (PM) levels as the exposure, public healthcare utilisations of acute exacerbation of asthma and chronic obstructive pulmonary disease (COPD) as the primary outcomes and direct medical costs of aforementioned diseases as the secondary outcomes. Haze episodes were defined based on monthly PM levels of ≥50µg-3levels and healthcare utilisations from 2012 until 2015 were retrieved from Department of Environment and Ministry of Health Malaysia. As for the costing analysis, the unit costs were retrieved from published literatures and the estimated 4-year total direct medical costs of the respiratory illnesses were calculated for haze and non-haze episodes based on the healthcare utilisation rates.

RESULTS: The total number of haze episodes recorded was higher (n = 129, 67.2%) compared to non-haze episodes (n = 63, 32.8%). Mean healthcare utilisation rate for inpatient, outpatient and total cases were also significantly higher (p < 0.05) during haze episodes. 4-year cumulative direct medical cost differences between haze and non-haze episodes were approximately USD4.1 (RM13.1) millions for inpatient cases, USD440 thousands (RM1.4 millions) for outpatient cases and USD4.5 (RM14.6) millions for total cases.

CONCLUSIONS: The economic burden due to increase in healthcare utilisations associated with haze-related illnesses was huge. The evidence from this study will help the policy makers to prepare and allocate resources to control future impact of haze-related illnesses.