Improvement in the service quality system of health clinics in Malaysia had increase with the increase of national development. However, customer dissatisfaction towards regular service still has become an issue in the provision of health service in clinics throughout this country. This study aims to identify factors that influence customer satisfaction such as sociodemographic factors of patients, the location of clinic (rural or urban) and the most important SERVQUAL dimensions in determining customer satisfaction. This study conducted in October and November 2008 in Hulu Langat District. SERVQUAL questionnaires were used. Probabilistic sampling was used for the selection of respondents and the number of samples for each clinic was based on the workload of the clinic. Overall, the results showed that there are differences in levels of customer satisfaction between urban clinic (25.8%) and rural (30.7%). The most critical service quality dimensions for urban clinics are the responsiveness and reliability dimensions with a mean value of -0.7018 and -0.7434. Responsiveness, existence and reliability are the weakest quality service dimensions (mean -0.6317, -0.6718 and -0.6028) in rural clinics. It was found that customers’ ethnicity and education affect customer satisfaction in both the urban and rural clinics. Gender and type of work are factors that affect customer satisfaction only in urban clinics. Overall customer satisfaction at health clinics in Hulu Langat District is low. The difference between urban and rural clinics show the customers' needs in the area is different.
Key words: Customer satisfaction, SERVQUAL, health clinics, services.
Clostridium difficile infection (CDI) causes mild to severe diarrhoea and pseudomembranous colitis in patients who had prior antibiotic exposure. Despite CDI being prevalent worldwide, its epidemiological data is scanty in Malaysia. This study aimed to determine the prevalence and incidence of CDI at Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Stool specimens from 147-suspected CDI patients were obtained from 1 November 2011 until 31 October 2012. The presence of C. difficile toxin A and/or B were detected using a commercial immunochromatographic kit (Wampole™ Tox A/B Quik Chek). Surveillance data was collected from patients’ medical records to establish the demographic and clinical characteristics. The overall prevalence and incidence of CDI in UKMMC was 6.1% and 5.2 cases per 10 000 patient-days, respectively. Among nine CDI patients, 77.8% were males and 55.6% were Chinese. CDI was most common in medical wards (88.9%). The median age was 60 years and the median length of hospital stay was 13 days. Majority (88.9%) of CDI patients received antibiotics eight weeks prior to CDI. Penicillin-beta-lactamase inhibitors were the most common antecedent antibiotics. Five (55.6%) CDI patients received acid suppressant medications. The in-hospital mortality rate was 22.2%. In conclusion, the prevalence and incidence of CDI at UKMMC is relatively low and occurs sporadically.
Background : The worldwide prevalence of diabetes is increasing, as is the demand for and cost of medical care. Diabetic Mellitus (DM) prevalence in Malaysia rose from 6.3% of the population in 1986 to 8.3% in 1996 and costs need to be managed more effectively.
Objective : To estimate the financial burden of diabetic care, including providers’ and patients’ costs in government facilities in Selangor and to determine factors influencing cost of diabetic care.
Methodology : A cross-sectional study was conducted from September to November 2005 among Hospitals with and without Specialist and Health Clinics. Total sample of 361 subjects with type 2 diabetes representing both inpatient and outpatient were chosen randomly. Results were analyzed using SPSS version 13.0.
Results : The average cost for a diabetic patients’ admission in a Hospital with Specialist was RM1951 and RM1974 for patient admitted in a Hospital without Specialist and these cost difference was not statistically significant (p>0.05). Providers’ mean cost for outpatient care was RM772.69 and RM761.07 respectively for Hospital with Specialist and Hospital without Specialist per year. As for the health clinics the average providers’ cost for a patient was RM385.92 per year. The cost difference was statistically significant (p0.05). The mean total costs of outpatient care were RM841.46, RM832.80 and RM458.01 per year for Hospital with Specialist, Hospital without Specialist and Health Clinics respectively. Level of care and length of stay were the influencing factors for inpatient provider’s cost. The overall provider’s cost for outpatient diabetic care was influenced by level of care, number of visits and complications. Cost of treating diabetes mellitus year 2004, was estimated at RM18,956,021.51 which was equivalent to 3.3% of total state health expenditure.
Conclusion : As much as 60.2 % was spent on management of outpatient diabetic care and 39.8% for management of inpatient diabetic care. Financial burden of diabetic care is predominantly for outpatient care. Therefore, effective and efficient management of outpatient care is needed to improve allocate efficiency, equity, accessibility and appropriateness of the health care system so that the health care services delivered to the nation are of good quality.
Background : Two of the most common indicators of institutional healthcare quality are Hospital Accreditation Status and Patient Satisfaction. However, the relationship between them is not well understood. In Malaysia, only 20.48% hospitals have been accredited. This is very much less compared to hospitals in America, Europe, Australia and certain Asian countries whereby 90% of their hospitals have already been accredited.
Objective : The objective of this study was to compare the extent to which a patient’s satisfaction is related to hospital accreditation status, to examine the relationship between patient satisfaction and hospital work load and to determine factors that influence patients’ satisfaction.
Methodology : A cross-sectional study was conducted whereby 150 patients from each accredited and non-accredited hospital involved in this study group giving a total of 300 samples. `SERVQUAL’ instrument was used in this study. Patients were interviewed at 2 different times - during admission and upon discharge.
Result : Results showed 34.7% patients were satisfied with services in accredited hospital and 30.6% patients were satisfied with services in non-accredited hospital. `Corporate Culture’ component showed the lowest satisfaction score among the entire dimension in both categories hospitals. Patient satisfaction was noted to be reduced with increase in hospital work load. Other factors which significantly influence patient satisfaction include level of education, employment status and patient income. There was no significant difference in patient satisfaction between accredited and non-accredited hospital in all dimension measured.
Conclusion : Therefore there is no difference of patients’ satisfaction with regards to services provided by accredited and non-accredited hospitals.