title: Factors affecting Japanese retirees' healthcare service utilisation in Malaysia: a qualitative study.
abstract: OBJECTIVE
  While living overseas in another culture, retirees need to adapt to a new environment but often this causes difficulties, particularly among those elderly who require healthcare services. This study examines factors affecting healthcare service utilisation among Japanese retirees in Malaysia.
  
  
  METHODS
  We conducted 6 focus group discussions with Japanese retirees and interviewed 8 relevant medical services providers in-depth. Guided by the Andersen Healthcare Utilisation Model, we managed and analysed the data, using QSR NVivo 10 software and the directed content analysis method.
  
  
  METHODS
  We interviewed participants at Japan Clubs and their offices.
  
  
  METHODS
  30 Japanese retirees who live in Kuala Lumpur and Ipoh, and 8 medical services providers.
  
  
  RESULTS
  We identified health beliefs, medical symptoms and health insurance as the 3 most important themes, respectively, representing the 3 dimensions within the Andersen Healthcare Utilisation Model. Additionally, language barriers, voluntary health repatriation to Japan and psychological support were unique themes that influence healthcare service utilisation among Japanese retirees.
  
  
  CONCLUSIONS
  The healthcare service utilisation among Japanese retirees in Malaysia could be partially explained by the Andersen Healthcare Utilisation Model, together with some factors that were unique findings to this study. Healthcare service utilisation among Japanese retirees in Malaysia could be improved by alleviating negative health beliefs through awareness programmes for Japanese retirees about the healthcare systems and cultural aspects of medical care in Malaysia.
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Kohno
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Nik Daliana
authors.initials: ND
authors.lastname: Nik Farid
authors.affiliation: Faculty of Business and Accountancy, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Ghazali
authors.initials: G
authors.lastname: Musa
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Norlaili
authors.initials: N
authors.lastname: Abdul Aziz
authors.affiliation: Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Nakayama
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Faculty of Medicine, Julius Centre, University of Malaya (JCUM), University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Maznah
authors.initials: M
authors.lastname: Dahlui
mesh_terms: D000368:Aged; D044466:Asian People / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006296:Health Services / Q000592:standards*; D006801:Humans; D007348:Insurance, Health; D007407:Interviews as Topic; D007802:Language; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D036301:Qualitative Research; D012179:Retirement
keywords: Japanese retirees; Malaysia My Second Home; healthcare; qualitative study; services