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  1. Fulltext Remeasurement, evaluation and comparison the health services utilization among women staff at Universiti Kebangsaaan Malaysia after eleven years period (2001-2012)
    Siti Fatimah, A.G., Aniza, I., Shamsuddin, K., Zailiza, S.
    Malaysian Journal of Public Health Medicine, 2013;13(2):48-64.
    MyJurnal
    A cross-sectional study was carried out in July-October 2012 in UKM to remeasure, evaluate and compare the changes in health services utilization level among women staff in UKM with a previous study done in 2001 and its influencing factors. The services studied were blood pressure (BP) measurement and Pap smear test. A total of 234 respondents aged between 18 and 55 were selected using stratified random sampling from Bangi, Kuala Lumpur and UKMMC, Malaysia. Data was collected via self-administered questionnaire and was analyzed by using SPSS version 17.0. Majority 85.9% of the respondents were found to have utilized at least one BP measurement which is higher compared to previous study. The Pap smear test, 64.5% of women have had a Pap smear test done also higher compared to previous study. Multivariate analysis shows the factors associated with BP measurement are age (OR 2.7, CI 95% 1.2, 6.3), family history of general health problems (OR 3.4, CI 95% 1.5, 7.6), and health staff influence (OR 5.2, CI 95% 1.1, 25.5). The factors associated with Pap smear test are marital status (OR 62.8, CI 95% 7.2, 546.4), general health problems (OR 2.3, CI 95% 1.2, 4.5), family planning (OR 6.9, CI 95% 3.0, 16.5) and self-interest (OR 3.3, CI 95%, 1.3, 8.6). The level of health services utilization on BP measurement and Pap smear test in 2012 is higher than 2001. For both BP measurement and Pap smear test the determinant factors are differed in the aforesaid years.
  2. Fulltext Social health protection definition, financing, coverage
    Aniza, I., Moshiri, H., Radnaa, O., Yondonjamts, M.
    Malaysian Journal of Public Health Medicine, 2010;10(1):38-46.
    MyJurnal
    The Universal Declaration of Human Rights, 1948 stated that everyone, as a member of society, has the right to social security and is entitled to realization, through national effort and international cooperation and in accordance with the organization and resources of each State, of the economic, social and cultural rights indispensable for his dignity and the free development of his personality. Equity, solidarity and social justice are understood as basic characteristics of universal access to social health protection founded on burden sharing, risk pooling, empowerment and participation. It is up to national governments and institutions to put these values into practice. The financing of social health protection can be through a mixture of taxation and contributions to public and mandated private insurance. Through risk pooling, these funds provide for equity, solidarity and affordability of services. According to International Labour Organization (ILO), ultimate objective in social health protection is to achieve universal social health protection coverage defined as effective access to affordable health care of adequate quality and financial protection. Social protection plays a vital part in reducing the vulnerability of the poor so that they can fruitfully access health and education services.
  3. Fulltext Clinical microsystem approach-a method for health care improvement
    Samiei, V., Aniza, I., Sharifa Ezat, W.P., Alsheikh, H.I., Kari, H.A., Saleh, M., et al.
    Malaysian Journal of Public Health Medicine, 2011;11(1):16-28.
    MyJurnal
    The quality of the health care services has been always a big responsibility and sensitive issue. Health care delivery is complex and critical for many reasons related to management and organizational planning and development. Health system reorganization is one of the approaches that health care managers adopt to overcome dysfunction. Clinical Microsystems (CM) is believed to be a one of vital steps in providing a high quality of patient care through system reorganization. CM has the potential to drive the health care to greater success through proper understanding, process and resource planning and health outcomes continuous assessment and improvements. CM integrate patients, providers and family needs and roles to form a vision of community system that cooperate for better outcomes .The components of an effective CM are produce quality, patient safety, and cost outcomes at the front line of care. This article aims to explore the concept, characteristics models and components of these Clinical Microsystems. It also highlights the steps to initiate, plan and sustain this innovation in hospitals in a systematic manner.
  4. Fulltext Cost analysis of psoriasis treatment modalities in Malaysian public hospitals
    Azizam, N.A., Saperi, S., Aniza, I., Norazirah, M.N., Azura, M.A., Zafar, A., et al.
    Medicine & Health, 2019;14(1):23-33.
    MyJurnal
    Psoriasis imposes a great economic burden as a result of higher expenditures for different interventions, diagnostic procedures, pharmaceuticals and loss of productivity. Less is known about the economic impact of psoriasis treatment in Asean region. The aim of this research was to calculate the costs associated with four psoriasis treatment modalities. A prospective cohort study was conducted in five hospitals involving 91 moderate to severe psoriasis patients. Costs were calculated from the societal perspective using the principle of Step Down and Activity Based Costing (ABC) within a six (6) months follow-up duration. The components of the costs borne by the provider were inpatient cost, cost of medication, laboratory investigation and radiology. Patient’s cost included out of pocket expenses, travelling cost and loss of productivity. Cost per patient per day was RM1,105.24 (inpatient) (US$315.94) and RM298.02 (outpatient) (US$85.19). Medication accounted for almost 90% (RM457,014.00) (US$130 638.45) of the total provider cost. Meanwhile, loss of productivity represented 84% (RM167,439.00) (US$47,862.80) of the total patient’s cost. Biologic treatment exhibited the highest cost which was RM342,377.00 (US$97,869.21), followed by systemic treatment (RM105,607.00) (US$30,187.99), topical treatment (RM38,280.00) (US$10,942.42) and topical phototherapy treatment (RM21,824.00) (US$6,238.44). Understanding the relationship between direct and indirect costs from both perspectives is important to accurately identify and evaluate effective treatment for psoriasis.
  5. Fulltext Caregivers' satisfaction of healthcare delivery at paediatric clinics of Universiti Kebangsaan Malaysia Medical Centre in 2009
    Aniza I, Rizal AM, Ng YS, Mardhiyyah M, Helmi I, Syamimi BK, et al.
    Med J Malaysia, 2011 Jun;66(2):84-8.
    PMID: 22106682
    Patient's satisfaction has become increasingly important as patients evaluate healthcare services for both medical cost and quality. The purpose of this study was to measure the prevalence and the factors influencing caregivers' satisfaction. A cross sectional study of 262 respondents using universal sampling method was conducted at the paediatric clinics of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Overall, 90.5% were satisfied with the services provided. Satisfaction rates based on various healthcare delivery domains were: 95.0% for communication skills, 88.5% for interpersonal aspect, 83.6% for technical quality, 82.1% for financial aspect, 72.9% for time spent with doctors and 64.9% for ease of contact. This study shows that the caregivers (an unpaid person who helps a person cope with disease) were highly satisfied with the communicational aspect delivered by the clinic. However, there is still room for improvement on ease of contact domain and waiting time in order to produce high quality service.

    Study site: Paediatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
  6. Fulltext Assessing the service quality of physiotherapy services: a cross sectional study at teaching hospitals in Klang Valley, Malaysia
    Nasaruddin Mahdzir, M., Aniza, I., Nor Faridah, A.R., Sulha, A.
    Malaysian Journal of Public Health Medicine, 2013;13(2):27-37.
    MyJurnal
    The physiotherapy services have played major roles as a part of rehabilitation components and emerging in most hospitals throughout Malaysia as well as internationally. As such, there is still a lack of scientific research and reporting about the finding of service quality studies in physiotherapy services at teaching hospitals settings in Malaysia. This study was to assess the level of patients' satisfaction and its contributing factors as well as to assess the quality of physiotherapy services at teaching hospitals in Klang Valley. The cross sectional study was conducted from March until July 2011 among outpatients (311 patients) who has been referred to the Physiotherapy Clinics at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) and Universiti Malaya Medical Centre (UMMC) in Klang Valley. Patients were recruited using simple random sampling technique and data were collected by using the validated self-administered Service Quality (SERVQUAL) Questionnaire. About 62.4% respondents in teaching hospitals have met their expectation. ‘Assurance’ showed the highest satisfaction score and ‘Caring Services’ showed the lowest satisfaction score among the entire dimension studied. The factors which significantly influence patient satisfaction include age, education status, working status and number of visit. There are relationships between patient satisfaction with SERVQUAL, Outcome and Corporate Culture components. However, the predictors contributed for overall patient satisfaction at Physiotherapy Clinics at teaching hospitals was not influenced by factors studied (p>0.05). The levels of satisfaction that met patients’ expectation is ‘Moderate’ for teaching hospitals and the ‘Caring Services’ should be focus in order to improve the level of patient satisfaction.
    Study site: Physiotherapy department, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) and University Malaya Medical Centre (UMMC)
  7. Fulltext Clients satisfactions in ISO certified health clinic in Klinik Kesihatan Bandar Baru Bangi, Selangor and its associated factors
    Aniza I, Suhaila A
    Malaysian Journal of Community Health, 2011;17(1):18-25.
    MyJurnal
    Background: All healthcare services are moving towards quality management system including ISO 9000 due to pressure from various stakeholders involves and also to improve healthcare quality. The objective of this study was to measure the satisfaction level among the outpatients in ISO Certified Klinik Kesihatan Bandar Baru Bangi, Selangor. Also to identify the relations of patient’s satisfaction with the sociodemographic factors and service dimensions such as general satisfactions, technical quality of clinic staffs, interpersonal aspect of clinic staffs, time with doctors, communications with clinic staffs and availability/accessibility of clinic.
    Methodology: A cross sectional study was carried out from February 2008 to Jun 2008 and a total of 240 respondents in the clinic were selected using universal sampling. Only those who are Malaysians aged 18 and above and complied with the inclusions criteria’s were selected as the respondents to fill up the Patient’s Satisfaction Questionnaire III.
    Results: The study found that the satisfaction level of the respondents in Klinik Kesihatan Bandar Baru Bangi, Selangor were remarkable with 78.8%.It has been shown that the predictor factors of total patient’s satisfaction were general satisfaction (AOR=5.06, CI= 1.51-16.96), technical quality of clinic staff (AOR = 3.09, CI= 1.13-8.43), interpersonal aspect of clinic staff (AOR = 2.96,CI= 1.04-8.42), availability/accessibility of clinic (AOR = 9.38, CI= 9.37-87.95) and communication of clinic staff ( AOR=17.90, CI=3.74-85.73) with the R2 = 67.7%.
    Conclusion: The satisfaction level among the respondents in Klinik Kesihatan Bandar Baru Bangi, Selangor were remarkable with percentages of 78.8%. The study has shown that service dimensions factor influenced the patient’s satisfaction such as general satisfaction, interpersonal aspect of staff, communication of staff, technical quality of clinic staff and availability/accessibility of clinic. It could have also been contributed by the implementation of ISO and it can only be confirmed by carrying out a comparison study of patient’s satisfaction in clinics with and without ISO certification.
    Study site: Klinik Kesihatan Bandar Baru Bangi, Selangor, Malaysia
  8. Fulltext A cross sectional study was conducted among married women in Kg. Sasapan Kelubi, Hulu Langat, Selangor, Malaysia. [Amalan calitan pap dan faktor hubungkait di kalangan wanita berkahwin di Kg. Sesapan Kelubi , Daerah Hulu Langat, Selangor D.E. Malaysia]
    Jamsiah M, Shamsul AS, Aniza I, Rozhan S, Sharifah Ezat WP
    Malaysian Journal of Community Health, 2008;14(1):52-61.
    MyJurnal
    Introduction : A cross sectional study was conducted among married women in Kg. Sasapan Kelubi, Hulu Langat, Selangor, Malaysia. The objective of the study was to identify the prevalence of Pap Smear practice and it`s influencing factors.
    Methodology : Universal sampling was conducted from door to door to all married women who agreed to be involved in this study. Guided questionnaire was used as the main instrument in this study. The data was analyzed using SPSS version 12.0.
    Result : A total of 154 respondents gave their feedback. Mean age in this study was 23.3±4.4.years. Only 66 respondents (42.9%) have had the pap smear with only 6 respondents (3.9%) practiced as per recommended schedule. The reasons for the respondents never practicing pap smear were no knowledge (n=46,52.3%), scared (n=22, 42.5%), shyness (n=21,23.9%), no free time(n-6,6.8%), unconcerned (n=3,3.4%), no female doctors (n= 6,6.8%), not bother, health clinic too far and high cost (n=1,1.1%). The only factor that showed significant association with pap smear practice was the score of knowledge about smear whereby respondents who underwent pap smear showed higher score compared to those respondents who never underwent pap smear.
    Conclusion : The study showed that more efforts is required to improve knowledge and awareness among married women in rural area in order to overcome the knowledge gap, wrong perception and other reasons that prevent acceptance pap smear practice among them.
    Keywords : married women, pap smear practice, rural area, Malaysia
  9. Fulltext Kajian analisa kos pembekal perkhidmatan kesihatan bagi rawatan diabetic foot wad ortopedik Pusat Perubatan Universiti Kebangsaan Malaysia dalam tahun 2006
    Amin, S.A., Ali, M., Aniza, I., Rizal, A.M., Saperi, S., Amrizal, M., et al.
    Malaysian Journal of Community Health, 2009;15(1):32-38.
    MyJurnal
    Introduction : Diabetes mellitus is recognized as a major public health problem worldwide. The burden of diabetes to society are morbidity, mortality and extensive usage of health care services.
    Methodology : This study aimed to determine the provider’s cost in treating diabetic foot patient per day in orthopaedic ward, Universiti Kebangsaan Malaysia Medical Centre (UKMMC) in year 2006. Result : A total of 54 patients fulfilled the inclusion and exclusion criteria, only 29 were eligible for analysis. The cost of health care providers derived from cost calculation on capital and recurrent costs. Results showed that the average cost for treating diabetic foot patient per day is RM 634.57. Recurrent costs contributed 75.3% of the total diabetic foot treatment and Intensive Care Unit costs was the biggest percentage (40.5%).
    Discussion : The results were comparable with findings by Case-Mix Unit of UKMMC. Treatment cost of diabetic foot is substantial and therefore avoidance of this complication must be emphasized to all diabetic patients.
  10. Fulltext A cross sectional study on job satisfaction level and the influencing factors among public health specialists in the Ministry of Health Malaysia, September 2004 - October 2004
    Aniza, I., Syed Mohamed Al Junid, Sharifa Ezat
    Malaysian Journal of Public Health Medicine, 2005;5(2):25-31.
    MyJurnal
    Job satisfaction level of workers is among the important factors influencing the performance and productivity of an organization. A cross sectional study was conducted among Public Health Specialists in the Ministry of Health of Malaysia to identify their job satisfaction level and the factors influencing it. The respondents are from the Association of Public Health Specialists of Malaysia. A working in Ministry of Health. Focus group discussions were conducted in four states to develop a relevant and comprehensive questionnaire. Survey questionnaires were then mailed to the respondents. The response rate was 7 2.3%. In measuring the job satisfaction level seven aspects were studied. The study showed that ‘job and workload` is the main contributor to job dissatisfaction followed by ’management and policy aspect’, 'salary and remuneration: aspect’ and resources and facilities aspect. Most of the respondents (94.0%) were dissatisfied with their job. Gender and income were the predictors of general job satisfaction. As a conclusion, the management, policy and remuneration shouM be revised in order to overcome the problems identified and subsequently increase job satisfaction levels among Public Health Specialists in the Ministry of Health, Malaysia.
  11. Fulltext Factors affecting motivation level among public health specialists in the Ministry of Health Malaysia
    Aniza, I., Syed Mohamed Al Junid, Sharifa Ezat
    Malaysian Journal of Public Health Medicine, 2006;6(1):17-22.
    MyJurnal
    Employee motivation affects productivity and need to be channeled towards the accomplishment of organizational goals. A cross sectional study was conducted among Public Health Specialists (PHS) in the Ministry of Health Malaysia to study their motivation level and the factors influencing this. The respondents were from the Association of Public Health Specialists of Malaysia working in the Ministry of Health. Quantitative Technique self-administered questionnaires were used in this study and the questionnaires were mailed to the respondents. The response rate for this study was 72.3%. In measuring the motivation level, five (5) aspects were studied. The social aspect, self -achievement aspect and autonomy aspect were found to be the main aspects that motivated the respondents. With regard to motivation level, 55.8 % respondents had low motivation level. In order to improve the motivation level among PHS, the aspect of self actualization and autonomy required serious attention. In the future, PHS are expected to play a major role in controlling, promoting, preventing, maintaining, restoring and solving problems in order to enhance the health of the Malaysian population.
  12. Fulltext Post-traumatic stress disorder and its associated factors among school-going children exposed to a tsunami disaster in Malaysia
    Idris, I.B., Shamsudin K., Aniza, I, Khairani, O, Rahmah M.A.
    Malaysian Journal of Public Health Medicine, 2015;15(3):112-121.
    MyJurnal
    Posttraumatic stress disorder (PTSD) is a psychiatric diagnosis made when someone including children who experiences traumatic stressor. Those who are exposed to a more severe trauma have highest level of PTSD. The aim of this study was to measure the prevalence of PTSD and its associated factors among 219 children who were affected by a form of natural disaster which is the tsunami waves in a rural area in Malaysia. A cross sectional study was carried out among children aged 10-12 years 6 months after the traumatic event. Child Posttraumatic Stress Disorder –Reaction Index (CPTSD-RI) was used as a screening instrument which was answered by the affected children through a self-administered questionnaire. Forty six percent of these children had PTSD symptoms; 31.1% of these children had mild, 11.4% had moderate, 3.7% had severe PTSD and none had very severe PTSD. Result also showed that 91.8% had re-experiencing symptoms, 28.3% had numbing/avoidance symptoms and 49.3% had hyperarousal symptoms. Children with low social support (Adj OR = 2.3 (95% CI: = 1.3- 4.2)), and children who experienced deaths among someone close to them (Adj OR = 3.7 (95% CI =1.2 - 11.5)) were more likely to have symptoms of PTSD. This showed that children are at higher risk of developing PTSD as early as 6 months after the event and thus early intervention should be offered to them. Future longitudinal study can be carried out among affected children to assess whether these PTSD symptoms persist over time.
  13. Fulltext Barriers to health promotion for indigenous communities: lessons for Malaysia
    Aniza, I, Norhayati, M
    Malaysian Journal of Public Health Medicine, 2016;16(1):6-14.
    MyJurnal
    Globally, the health of the indigenous people is lagging behind as compared to the mainstream population in countries in which they live. Despite improved overall prosperity and population longevity, social and health inequalities seem to persist in this underprivileged community. Failure in delivering effective health promotion toward the indigenous community is determined by a range of factors. This includes the absence of culturally sensitive awareness among the healthcare workers, ineffective communication of the healthcare providers, poor access to health service, lack of culturally specific health promotional materials, lack of involvement by indigenous healthcare workers, lack of community based programs and inefficiency of indigenous health data collection. Effective interventions for indigenous health require a trans-disciplinary and holistic approach that incorporates indigenous health beliefs and engages with the social and cultural drivers of health.Such culturally congruent health promotion strategies are hoped to narrow down the existing wide gap of health outcomes that contribute to inequalities between indigenous communities and the mainstream population.
  14. Fulltext Housing infrastructure and quality of life of orang asli and non-orang asli populations in Kuala Langat Selangor
    Norhayati, M., Aniza, I., Norfazilah, A.
    Malaysian Journal of Public Health Medicine, 2018;18(1):0-0.
    MyJurnal
    We investigated the association between housing conditions with a primary focus on basic housing infrastructure and WHOQOL BREF score among the Orang Asli and non-Orang Asli populations. A cross–sectional study was conducted between August 2014 and May 2015 among the Orang Asli and non-Orang Asli populations in Kuala Langat, Selangor. Sampling of the population was done through multistage sampling while eligible respondents participated conveniently. The socio-demographic information collected consisted of age, ethnicity, marital status, educational level, and employment status. Basic housing infrastructure variables including the types of housing unit, wall construction material, availability and types of toilet, availability of electricity, source of water supply, and availability of garbage collection facilities were obtained. Among the Orang Asli respondents, having the pour type of toilet in the house was significantly (p=0.003) associated with a reduction in the physical health domain score by 0.36 (95% CI: -0.61,-0.12). Conversely, having no toilet in the house and living in a semi-detached house had significantly (p=0.023 and p=0.026 respectively) increased the social relationships domain score by 0.81 (CI: 0.11, 1.51) and 3.90 (CI: 0.47, 7.34) respectively. Unavailability of garbage disposal facilities was found to be significantly (p
  15. Fulltext Cost analysis of treating incomplete miscarriage with dilatation and curettage in Universiti Kebangsaan Malaysia Medical Centre in 2010
    Rizal, A.M., Aniza, I., Jannatul Madihah, A.B., Ahma Fareed, A.R., Natrah, M.S.
    Malaysian Journal of Community Health, 2010;16(1):54-59.
    MyJurnal
    Background : Miscarriage is a common problem in pregnancy which can occur during early, mid or late pregnancy. Incomplete miscarriage can be treated expectantly, medically or surgically. The most preferred method used in UKMMC is using sharp curettage.
    Methodology : This study is conducted in the UKMMC from 1st January 2010 to 30th March 2010. The purpose of this study is to analyze the cost of treating incomplete miscarriage using metal sharp curettage from the provider’s perspective per patient-day.
    Result : A total of 17 samples were eligible for analysis from 46 patients who fulfilled the inclusion and exclusion criteria. The cost is derived from cost calculation on capital and recurrent costs. Results showed that the average cost for treating incomplete miscarriage using sharp curettage per day is RM252.56. Recurrent costs contributed 83.3% of the total treatment with overhead cost was the biggest percentage (51.6%). Discussion The treatment cost for incomplete miscarriage using sharp curettage is found to be higher as compared to medical approach according to literatures. The higher cost of surgical approach was mainly attributed to the recurrent cost which is included in the calculation.
    Conclusion : Effective usage of the operation theatre and all resources should be managed and utilized well in order to achieve optimum outcome.
  16. Fulltext Importance of economic evaluation in health care decision making
    Aniza, I., Hossein, M., Otgonbayar, R., Munkhtuul, Y.
    Malaysian Journal of Community Health, 2008;14(1):1-10.
    MyJurnal
    Introduction : Economic evaluations can provide “value-for money” information to those making decisions about the allocation of limited health care resources. In particular, economic evaluations can be used to identify interventions that are worth providing and those that are not. Furthermore, evaluations can be used with other approaches to help set priorities, such as program-budgeting marginal-analysis.
    Methodology : Compile and systematically describe from the publications, articles and reports on economic evaluation in healthcare decision making.
    Result : A high quality economic evaluation should provide decision makers with information that is useful, relevant, and timely. In addition, evaluations should be based on rigorous analytical methods, be balanced and impartial (credible), and be transparent and accessible to the reader. There are many situations where economic evaluations can assist decision makers: decisions by various levels of government or administrative bodies (e.g., regional health authorities, hospitals, drug plans) to fund a program, service or technology, pricing decisions by government regulators and technology manufacturers, clinical practice guidelines, priorities for research funding by governments and researchbased firms, post-marketing surveillance and updates of economic information based on the use of the technology in the “real world” (which can then be used to inform one of the other types of decisions).
    Conclusion: This requires that decision makers take a broad view of the impact of a technology, and decision that are more explicit and transparent. The ultimate test of an evaluation is whether it leads to better decision in the presence of uncertainty, and results in the more efficient and effective use of resources.
  17. Fulltext The Malaysian health reform in primary health care services
    Aniza I, Jamsiah M, Amin SA, Ali M, Munizam AM
    Malaysian Journal of Community Health, 2008;14(2):1-10.
    MyJurnal
    Introduction : Family Health Development Division is one of the earliest divisions in Public Health Department, Ministry of Health Malaysia. The division has progressed each year with the extension and expansion of the scopes of services since the establishment of Maternal and Child Health Unit in 1956. The services currently include school children, adolescent, adult and elderly health and also known as life-course perspective: from womb to tomb.
    Objectives : The objective is to elaborate and explain the reformation of primary health care services implemented in the past and present.
    Methods : The methodology applied is compilation, data review and comparison from annual report, action plan report, articles, speeches, specialists and stake holder view.
    Results : The focus of Primary Health Care Service is covering health promotion, disease prevention, early detection and treatment, acute disease care, disease limitation and rehabilitation, clinical support services and teleprimary care. The reformation is caused by factors such as globalization, modernization, growth of health market, emergence and re-emergence of diseases, and development of medical technology. Three health fields that have underwent and under going reformation are concept and wellness practise in primary healthcare, primary healthcare clinical support services development and primary healthcare informatics development. The outcome of these reformations is the increment of service quality and outstanding services for patients and health staffs.
    Conclusion : Health reformation in primary healthcare is greatly needed to give excellent services for primary health care for today and future.
  18. Fulltext Cost analysis of hypertension management in an urban Primary Medical Centre Kuala Lumpur
    Azimatun Noor, A., Amrizal, M.N., Weng Kang, T, Rafidah, A.R., Hong, Y Geok, Adibah, A, et al.
    Malaysian Journal of Public Health Medicine, 2014;14(3):0-0.
    MyJurnal
    Hypertension is one of the commonest health problems in Malaysia and its cases are on a rise. In conjunction with the above statement, it is predictable that the cost of healthcare services will further increase in the future. Therefore, cost study is necessary to estimate the health related economic burden of hypertension in Malaysia. A cross sectional study was carried out to quantify the direct treatment cost of hypertension. Three hundred and ninety one hypertensive patients’ data from Bandar Tasik Selatan Primary Medical Centre in year 2010 were collected and analysed. The direct treatment costs were calculated. The result showed that out of 391 hypertensive patients, 12.5% was diagnosed hypertensive without any co-morbidity, 25.3% with 1 co-morbidity dyslipidemia only; 4.3% with diabetes mellitus type 2 only; 0.5% with chronic kidney disease only and none with ischaemic heart disease. Patients with 2 co-morbidities (dyslipidemia and diabetes mellitus type 2) were 42.2%; with 3 co-morbidities (diabetes mellitus type 2, dyslipidemia and chronic kidney disease) was 4.3%. The mean cost of direct treatment of hypertension per visit/ year was RM289.42 ±196.71 with the breakdown costs for each component were medicines 72.2%, salary 14.6%, laboratory tests 5.0%, administration 4.4% and radiology tests 3.8%. Dyslipidemia is by far the commonest co-morbidity among hypertensive patients. Direct costs of treating hypertension are mostly dependent on present of co-morbidity and numbers of drugs used. Thus, the annual budget could be calculated precisely in the future especially for drugs.
  19. Drone versus ambulance for blood products transportation: an economic evaluation study
    Zailani MA, Azma RZ, Aniza I, Rahana AR, Ismail MS, Shahnaz IS, et al.
    BMC Health Serv Res, 2021 Dec 05;21(1):1308.
    PMID: 34863156 DOI: 10.1186/s12913-021-07321-3
    BACKGROUND: Medical transportation is an essential step in health care services, and includes ground, air and water transportation. Among the important uses of medical transportation is the delivery of blood products in the event of a clinical emergency. Drone technology is the latest technological advancement that may revolutionize medical transportation globally. Nonetheless, its economic evaluation is scant and insufficient, whilst its cost-effectiveness remains controversial. The aim of this study was to compare the cost-effectiveness of drone transportation versus the ambulance.

    METHODS: The setting of the study was within a developing nation. An economic evaluation study of drone versus ambulance for emergency blood products transportation between the Sabah Women and Children Hospital (SWACH) and the Queen Elizabeth II Hospital (QEH2) on Borneo Island was conducted using the Cost-Effectiveness Analysis (CEA) technique. The total cost of each mode of transportation was calculated using the Activity Based Costing (ABC) method. Travel time was used as a denominator to estimate the Incremental Cost Effectiveness Ratio (ICER).

    RESULTS: For one clinical emergency in SWACH, a round trip of blood products transportation from SWACH to QEH2 costs RM1,266.02 (USD307.09) when using the ambulance, while the drone costs RM1,313.28 (USD319.36). The travel time for the drone was much shorter (18 min) compared to the ambulance (34 min). The Cost-Effectiveness Ratio (CER) of ambulance transportation was RM37.23 (USD9.05) per minute whilst the CER of drone transportation was RM72.96 (USD17.74) per minute. The ICER of drone versus ambulance was - 2.95, implying an increase of RM2.95 in cost for every minute saved using a drone instead of an ambulance.

    CONCLUSION: Although drone transportation of blood products costs more per minute compared to the ambulance, the significantly shorter transport time of the drone offset its cost. Thus, we believe there is good economic potential for drone usage for blood products transportation in developing nations particularly if the drone price decreases and its operational lifespan increases. Our limitation of a non-clinical denominator used in this study leads to the recommendation for use of clinical outcomes in future studies.

  20. Fulltext Prevalence of visual acuity impairment and its associated factors among secondary school students in Beranang, Selangor
    Aniza, I., Azmawati, M.N., Jamsiah, M., Idayu, B.I., Mae Lynn, C.B.
    Malaysian Journal of Public Health Medicine, 2012;12(1):39-44.
    MyJurnal
    Prevalence of visual impairment among students is increasing in trends especially in rural area. A cross sectional study was conducted among secondary school students in Taman PKNS Beranang, Selangor in March 2008 with the objective of determining the prevalence of visual acuity impairment and its influencing factors. A total of 77 secondary school students were interviewed using guided questionnaire. The prevalence of visual acuity impairment among the respondents was 25.0% and study found that being female and have been watching television at a distance of less than two meters were significantly associated with visual acuity impairment. In conclusion, the problem occurred maybe due to the students sit nearer to the television (
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