Displaying publications 1 - 20 of 88 in total

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  1. Zhong C, Hamzah HZ, Yin J, Wu D, Cao J, Mao X, et al.
    Environ Sci Pollut Res Int, 2023 Mar;30(15):44490-44504.
    PMID: 36692722 DOI: 10.1007/s11356-023-25410-0
    As an important indicator of sustainable development, industrial eco-efficiency (IEE) has aroused growing attention from governments all over the world including China, in recent decades. The Chinese government has introduced numerous environmental regulations; however, the environmental pollution issue does not appear to have been solved. Moreover, although several earlier studies have shown that environmental regulations may promote innovation, there is no consensus on their ultimate effects on IEE. Therefore, this study took a critical look at the connection between environmental regulations and IEE in 36 Chinese sub-sectors from 2009 to 2018. Based on the weak Porter hypothesis (weak PH) and strong Porter hypothesis (strong PH), this paper constructed two panel regression models and conducted group analysis by pollution intensity to check the relationships among environmental regulations, technological innovation, and IEE. It was found that environmental regulations can improve technological innovation and IEE, but these impacts vary across different pollution groups. Specifically, environmental regulations have a U-shaped or inverted U-shaped relationship with technological innovation and IEE. Of the 36 sub-sectors, 26 prove the existence of the Weak PH while 10 verify the Strong PH, indicating that environmental regulations generally advocate technological innovation for most sub-sectors but only promote IEE in a few sub-sectors at present. Finally, differentiated policy implications for environmental regulations and technological innovation are provided for decision-makers.
    Matched MeSH terms: Efficiency*
  2. Zhang J, Lu G, Skitmore M, Ballesteros-Pérez P
    Environ Sci Pollut Res Int, 2021 Jul;28(27):35392-35405.
    PMID: 34018106 DOI: 10.1007/s11356-021-14467-4
    The current world economy needs to undergo a green transformation. Green total factor productivity provides the basis for judging whether a country or region can attain long-term sustainable development. However, there is little research into the factors that influence green total factor productivity and this has become an obstacle in the transition to a greener economy. On filtering relevant articles and interviews data collected from 2009 to 2019, open decoding, spindle decoding, and selective decoding are carried out to classify research conducted into green total factor productivity. From this analysis, cutting-edge research and knowledge gaps in green total factor productivity are identified. Also, an influencing factor model of green total factor productivity is built. Findings suggest that technical, economic, and government are the three main research streams involved in this transformation process. In particular, technology plays a decisive role, economy plays a guaranteeing role, and government plays a regulatory role. Moreover, the impact of these factors cannot be isolated, as each influence and mediate the other two. Results from this study will help further popularize green total factor productivity and provide a new starting point for reducing energy consumption and environmental pollution.
    Matched MeSH terms: Efficiency
  3. Zare H, Tavana M, Mardani A, Masoudian S, Kamali Saraji M
    Health Care Manag Sci, 2019 Sep;22(3):475-488.
    PMID: 30225622 DOI: 10.1007/s10729-018-9456-4
    Performance measurement plays an important role in the successful design and reform of regional healthcare management systems. In this study, we propose a hybrid data envelopment analysis (DEA) and game theory model for measuring the performance and productivity in the healthcare centers. The input and output variables associated with the efficiency of the healthcare centers are identified by reviewing the relevant literature, and then used in conjunction with the internal organizational data. The selected indicators and collected data are then weighted and prioritized with the help of experts in the field. A case study is presented to demonstrate the applicability and efficacy of the proposed model. The results reveal useful information and insights on the efficiency levels of the regional healthcare centers in the case study.
    Matched MeSH terms: Efficiency, Organizational*
  4. Zainal H, Zainab AN
    Health Info Libr J, 2011 Sep;28(3):216-25.
    PMID: 21831221 DOI: 10.1111/j.1471-1842.2011.00943.x
    BACKGROUND: The aim of this study was to examine Malaysian contributions in the field of biomedical and health sciences.
    METHODS: In this study, 3697 publications affiliated to Malaysian addresses from the sci database between 1990 and 2005 were sampled. This study also explored publication productivity trends, authorship and collaboration pattern, core journals used, and citations obtained.
    RESULTS: Main contributions were journal articles (73.3%). Most authors (63.7%) contributed only one article and 16.1% produced over 30-68 publications. Multi-authored works were the norm. The productive authors were named either first or second in publications. There were active collaborations with authors from Asia-Pacific countries (35%) and Europe (30%). The majority of publications were contributed by institutions of higher learning (87%). Core journals used follow quite close to Bradford's zonal ratios of 44:152:581. The active research areas were identified. About 71.3% of publications received citations especially those published from 1995 to 1999.
    CONCLUSION: This study helped librarians identify active researchers, active research areas and journals relevant to biomedical and health sciences researchers and useful when producing reports to university management and planning medical collection policies and deciding on journal subscriptions and cancellations.
    Matched MeSH terms: Efficiency*
  5. Zaidi SZ, Abidi SS, Manickam S
    PMID: 15460713
    This paper presents a case for an intelligent agent based framework for knowledge discovery in a distributed healthcare environment comprising multiple heterogeneous healthcare data repositories. Data-mediated knowledge discovery, especially from multiple heterogeneous data resources, is a tedious process and imposes significant operational constraints on end-users. We demonstrate that autonomous, reactive and proactive intelligent agents provide an opportunity to generate end-user oriented, packaged, value-added decision-support/strategic planning services for healthcare professionals, manages and policy makers, without the need for a priori technical knowledge. Since effective healthcare is grounded in good communication, experience sharing, continuous learning and proactive actions, we use intelligent agents to implement an Agent based Data Mining Infostructure that provides a suite of healthcare-oriented decision-support/strategic planning services.
    Matched MeSH terms: Efficiency, Organizational
  6. Zafirah SA, Nur AM, Puteh SEW, Aljunid SM
    BMC Health Serv Res, 2018 01 25;18(1):38.
    PMID: 29370785 DOI: 10.1186/s12913-018-2843-1
    BACKGROUND: The accuracy of clinical coding is crucial in the assignment of Diagnosis Related Groups (DRGs) codes, especially if the hospital is using Casemix System as a tool for resource allocations and efficiency monitoring. The aim of this study was to estimate the potential loss of income due to an error in clinical coding during the implementation of the Malaysia Diagnosis Related Group (MY-DRG®) Casemix System in a teaching hospital in Malaysia.

    METHODS: Four hundred and sixty-four (464) coded medical records were selected, re-examined and re-coded by an independent senior coder (ISC). This ISC re-examined and re-coded the error code that was originally entered by the hospital coders. The pre- and post-coding results were compared, and if there was any disagreement, the codes by the ISC were considered the accurate codes. The cases were then re-grouped using a MY-DRG® grouper to assess and compare the changes in the DRG assignment and the hospital tariff assignment. The outcomes were then verified by a casemix expert.

    RESULTS: Coding errors were found in 89.4% (415/424) of the selected patient medical records. Coding errors in secondary diagnoses were the highest, at 81.3% (377/464), followed by secondary procedures at 58.2% (270/464), principal procedures of 50.9% (236/464) and primary diagnoses at 49.8% (231/464), respectively. The coding errors resulted in the assignment of different MY-DRG® codes in 74.0% (307/415) of the cases. From this result, 52.1% (160/307) of the cases had a lower assigned hospital tariff. In total, the potential loss of income due to changes in the assignment of the MY-DRG® code was RM654,303.91.

    CONCLUSIONS: The quality of coding is a crucial aspect in implementing casemix systems. Intensive re-training and the close monitoring of coder performance in the hospital should be performed to prevent the potential loss of hospital income.
    Matched MeSH terms: Efficiency, Organizational/economics; Efficiency, Organizational/standards*
  7. Zafir M.M., Fazilah M.H.
    MyJurnal
    Ergonomics management is a process that will have a significant, positive effect on a company’s profits through cost reduction, quality improvement, performance improvement and productivity enhancement. Also known as human factors of human engineering, it basically describes the interaction between an employee and his/her job functions, with the emphasis being on reducing unnecessary physical stress in the workplace. The goal of ergonomics is to enable workers to be more effective by matching the requirements and demands of the job to the abilities and limitations of the workers rather than trying to force the workers to fit the job. This paper theoretically describes the benefits of understanding the ergonomics to the workplace. The components and activities required to implement ergonomics management also have been discussed. Besides that, the practical approach of ergonomics has been described by giving practical workplace improvement suggested by scholars. By approaching work practices (stretching, reaching, and sitting) from an ergonomically correct point of view, a worker actually becomes stronger, healthier and more productive.
    Matched MeSH terms: Efficiency
  8. Yusof K, Neoh KH, bin Hashim MA, Ibrahim I
    Asia Pac J Public Health, 2002;14(1):29-34.
    PMID: 12597515
    The equitable access to quality healthcare by Malaysians has consistently been the primary objective of the Ministry of Health (MOH). The epidemiological transition to chronic illnesses, advances in medical technology, escalating healthcare costs and rising patient expectations has necessitated the strategic use of information systems in healthcare delivery. Malaysia has broken new ground by implementing a nationwide network to address inadequate access to healthcare, as well as to lower costs and achieve better health outcomes. Teleconsultation refers to the electronic transmission of medical information and services from one site to another using telecommunication technologies. This technology transforms the healthcare system by rapidly matching patient needs with the appropriate level of care however geographically remote they may be. Our findings suggest that even in these early stages of implementation, teleconsultation has led to cost savings, a more efficient allocation of resources, enhanced diagnostic options and better health outcomes.
    Matched MeSH terms: Efficiency, Organizational
  9. Yodfiatfinda, Mad Nasir, S., Zainalabidin, M., Md Ariff, H., Zulkornain, Y., Alias, R.
    MyJurnal
    This study investigates productivity growth and efficiency of Large Scale Enterprises (LSEs) in the
    Malaysian food processing industry. Malmquist productivity index of Data Envelopment Analysis (DEA) was employed to five-digit panel data for the period of 2000-2006. The findings suggest that average Technical Efficiency (TE) of the LSEs was 0.683 during the period of observation, which indicates that the industries are able to expand their output as much as 31.7 percent by using the same level of inputs. Total Factor Productivity (TFP) growth was positive at 7.3 percent, which is contributed by a Technical Efficiency Change (EFCH) of 4.3 percent and Technological Change (TECH) of 3.0 percent. Sub industries of manufacturing alcohol and wine as well as the processing and preserving of meat and meat products shows the highest productivity growth at 84.8 percent and 47.5 percent respectively. On the other hand, the sub industries of processing and preserving poultry and poultry products together with the manufacturing of chocolate are those which have the lowest TFP growth at -30.5percent and -14.8 percent respectively. The significant determinants of the productivity growth, with a positive relationship are public infrastructure, IT expenditure and foreign ownership, while energy price is the determinant with a negative relationship. The main contributor to the TFP growth of the LSEs in the Malaysian food processing industry is EFCH, however, the LSEs can also improve the TFP growth by moving forward the production frontier as well.
    Matched MeSH terms: Efficiency
  10. Wu Y, Rahman RA, Yu Q
    Environ Monit Assess, 2022 Feb 08;194(3):154.
    PMID: 35132444 DOI: 10.1007/s10661-022-09817-9
    Sustainable agriculture is important for preserving environmental health and simultaneously gaining economic profits while maintaining social and economic equity. One way to evaluate sustainable agriculture is by studying agricultural eco-efficiency (AEE). Hence, this study constructed a data-driven method to evaluate and optimize AEE with the aim of providing a basis for improving the sustainable development of regional agriculture. Sixteen cities in Anhui Province, China, were considered in the study, and the variables used were agricultural resource inputs, environmental pollution, and agricultural economic development. Agricultural non-point source pollution (NPSP) emissions were considered the undesired output to build an AEE evaluation index system. Furthermore, a data envelopment analysis (DEA) model was established to analyse AEE from the static and dynamic perspectives. The spatial development and the temporal and spatial characteristics of AEE were also analysed. In addition, we applied a random effect (RE) panel Tobit model to quantitatively analyse the influencing factors of AEE from the input perspective and then proposed reasonable suggestions for improving the sustainable development of regional agriculture. Our findings show that the overall agricultural development in the 16 cities in Anhui Province has been continuously improving, even though there is an agglomeration of spatial development in some regions. In conclusion, this study provides suggestions and references for policy makers and agricultural practitioners regarding how to improve regional AEE and promote the sustainable development of the regional agricultural economy.
    Matched MeSH terms: Efficiency
  11. Wong LP, Alias H, Bhoo-Pathy N, Chung I, Chong YC, Kalra S, et al.
    J Headache Pain, 2020 Jun 08;21(1):68.
    PMID: 32513174 DOI: 10.1186/s10194-020-01144-z
    BACKGROUND/OBJECTIVE: Productivity and monetary loss due to migraine in the workplace may be substantial. This study aimed to determine the impact of migraine on productivity and monetary lost among employees in the banking sectors, in a multiethnic middle income country.

    METHODS: A cross-sectional online survey was conducted among employees in two multinational banks in Malaysia between April and July 2019. Screening for migraine was conducted using the self-administered ID-Migraine™ questionnaire. Migraine-related disability (MIDAS) and headache frequency were recorded. Impact of migraine on work productivity and activities were evaluated using the Work Productivity and Activity Impairment (WPAI) questionnaire.

    RESULTS: Of the 1268 employees who submitted complete responses, 47.2% (n = 598) were screened positive for migraine. Strikingly, the mean percent productivity loss at work (presenteeism) was almost 20-fold higher than the mean percent work time missed due to migraine (absenteeism) (39.1% versus 1.9%). The mean percent productivity loss in regular activity (activity impairment) and overall work productivity loss (work impairment) was 38.4% and 39.9%, respectively. It was also found that the costs related to presenteeism (MYR 5392.6) (US$1296) was 3.5-fold higher than absenteeism (MYR1,548.3) (US$370). Highest monetary loss related to presenteeism was reported in migraineurs with frequency of headache of above 3 days (MYR 25,691.2) (US$6176), whereas highest monetary loss related to absenteeism was reported in migraineurs with MIDAS grade IV (MYR 12,369.1) (US$2973). Only 30% of migraineurs of MIDAS grade IV reported taking prescribed medication. Notably, a vast majority (96%) of migraineurs who had three or lower episodes of migraine per month did not seek treatment.

    CONCLUSION: The significant impact of migraine on work productivity and regular activity, appears to lead to substantial monetary loss attributed to not only absenteeism, but more importantly to presenteeism. This study also highlights the unmet needs in migraine management among employees in the banking sector.

    Matched MeSH terms: Efficiency/physiology*
  12. Weatherall J, Simonsen J, Odlaug BL
    J Med Econ, 2020 Oct;23(10):1186-1192.
    PMID: 32573296 DOI: 10.1080/13696998.2020.1786393
    AIM: To compare the health economic efficiency of health care systems across nations, within the area of schizophrenia, using a data envelopment analysis (DEA) approach.

    METHODS: The DEA was performed using countries as decision-making units, schizophrenia disease investment (cost of disease as a percentage of total health care expenditure) as the input, and disability-adjusted life years (DALYs) per patient due to schizophrenia as the output. Data were obtained from the Global Burden of Disease 2017 study, the World Bank Group, and a literature search of the PubMed database.

    RESULTS: Data were obtained for 44 countries; of these, 34 had complete data and were included in the DEA. Disease investment (percentage of total health care expenditure) ranged from 1.11 in Switzerland to 6.73 in Thailand. DALYs per patient ranged from 0.621 in Lithuania to 0.651 in Malaysia. According to the DEA, countries with the most efficient schizophrenia health care were Lithuania, Norway, Switzerland and the US (all with efficiency score 1.000). The least efficient countries were Malaysia (0.955), China (0.959) and Thailand (0.965).

    LIMITATIONS: DEA findings depend on the countries and variables that are included in the dataset.

    CONCLUSIONS: In this international DEA, despite the difference in schizophrenia disease investment across countries, there was little difference in output as measured by DALYs per patient. Potentially, Lithuania, Norway, Switzerland and the US should be considered 'benchmark' countries by policy makers, thereby providing useful information to countries with less efficient systems.

    Matched MeSH terms: Efficiency, Organizational*
  13. Wang Y, Cho SH, Lin HC, Ghoshal AG, Bin Abdul Muttalif AR, Thanaviratananich S, et al.
    Int Arch Allergy Immunol, 2018;177(1):69-79.
    PMID: 29874659 DOI: 10.1159/000489015
    BACKGROUND: Allergic rhinitis (AR), asthma, chronic obstructive pulmonary disease (COPD), and rhinosinusitis are common and little studied in the Asia-Pacific region.

    OBJECTIVES: We sought to investigate real-world practice patterns for these respiratory diseases in India, Korea, Malaysia, Singapore, Taiwan, and Thailand.

    METHODS: This cross-sectional observational study enrolled adults (age ≥18 years) presenting to general practitioners (GP) or specialists for physician-diagnosed AR, asthma, COPD, or rhinosinusitis. Physicians and patients completed study-specific surveys at one visit, recording patient characteristics, health-related quality of life (QoL), work impairment, and healthcare resource use. Findings by country and physician category (GP or specialist) were summarized.

    RESULTS: Of the 13,902 patients screened, 7,243 (52%) presented with AR (18%), asthma (18%), COPD (7%), or rhinosinusitis (9%); 5,250 of the 7,243 (72%) patients were eligible for this study. Most eligible patients (70-100%) in India, Korea, Malaysia, and Singapore attended GP, while most (83-85%) in Taiwan and Thailand attended specialists. From 42% (rhinosinusitis) to 67% (AR) of new diagnoses were made by GP. On average, patients with COPD reported the worst health-related QoL, particularly to GP. Median losses of work productivity for each condition and activity impairment, except for asthma, were numerically greater for patients presenting to GP vs. specialists. GP prescribed more antibiotics for AR and asthma, and fewer intranasal corticosteroids for AR, than specialists (p < 0.001 for all comparisons).

    CONCLUSIONS: Our findings, albeit mostly descriptive and influenced by between-country differences, suggest that practice patterns differ between physician types, and the disease burden may be substantial for patients presenting in general practice.
    Matched MeSH terms: Efficiency
  14. Wang Y, Ghoshal AG, Bin Abdul Muttalif AR, Lin HC, Thanaviratananich S, Bagga S, et al.
    Value Health Reg Issues, 2016 May;9:72-77.
    PMID: 27881264 DOI: 10.1016/j.vhri.2015.11.004
    OBJECTIVES: Asia-Pacific Burden of Respiratory Diseases is a cross-sectional, observational study examining the burden of disease in adults with respiratory diseases across six countries. The aim of this study was to describe health care resource use (HCRU), work impairment, cost burden, and health-related quality of life (HRQOL) associated with respiratory disease in the Asia-Pacific.

    METHODS: Consecutive participants aged 18 years or older with a primary diagnosis of asthma, allergic rhinitis, chronic obstructive pulmonary disease, or rhinosinusitis were enrolled. Participants completed a survey detailing respiratory symptoms, HCRU, work productivity and activity impairment, and HRQOL. Locally sourced unit costs for each country were used in the calculation of total costs.

    RESULTS: The study enrolled 5250 patients. Overall, the mean annual cost for patients with a respiratory disease was US $4191 (SGD 8489) per patient. For patients who reported impairment at work, the mean annual cost was US $7315 (SGD 10,244), with productivity loss being the highest cost component for all four diseases (US $6310 [SGD 9100]). On average, patients were impaired for one-third of their time at work and 5% of their work time missed because of respiratory disease, which resulted in a 36% reduction in productivity. Patients with a primary diagnosis of chronic obstructive pulmonary disease had the greatest impact on HRQOL.

    CONCLUSIONS: In the Asia-Pacific, respiratory diseases have a significant impact on HCRU and associated costs, along with work productivity. Timely and effective management of these diseases has the potential to reduce disease burden and health care costs and improve work productivity and HRQOL.

    Matched MeSH terms: Efficiency
  15. Vogel K, Karltun J, Yeow PH, Eklund J
    Meat Sci, 2015 Jul;105:81-8.
    PMID: 25828161 DOI: 10.1016/j.meatsci.2015.03.009
    The beef industry worldwide is showing a trend towards increased cutting pace aimed at higher profits. However, prior research in the duck meat industry suggested that a higher cutting pace reduced quality and yield, leading to losses. This study aimed to test this hypothesis by investigating the effects of varying beef-cutting paces on yield, quality and economy. A field experiment was conducted on six workers cutting beef fillet, sirloin and entrecôte. Three types of paces were sequentially tested: Baseline (i.e., status quo), 'Quantity focus' (i.e., pace required to maximise quantity) and 'Quality focus' (i.e., pace required to minimise errors). The results showed a significant drop in yield, increased rate of quality deficiency and economic losses with the change to 'Quantity focus' (from Baseline and 'Quality focus') for all meat types. Workers supported these results and also added health problems to the list. The results confirmed that an increased cutting pace is unprofitable.
    Matched MeSH terms: Efficiency, Organizational/economics
  16. Ur Rehman A, Hassali MAA, Muhammad SA, Shakeel S, Chin OS, Ali IABH, et al.
    Pharmacoecon Open, 2021 Mar;5(1):35-44.
    PMID: 32291727 DOI: 10.1007/s41669-020-00214-x
    BACKGROUND: Chronic obstructive pulmonary disease (COPD) requires long-term pharmacological and non-pharmacological management that encompasses continuous economic burden on patients and society, and also results in productivity losses due to compromised quality of life. Among working-age patients, COPD is the 11th leading cause of work productivity loss.

    OBJECTIVE: The aim of this study was to assess the economic burden of COPD in Malaysia, including direct costs for the management of COPD and indirect costs due to productivity losses for COPD patients.

    METHODOLOGY: Overall, 150 patients with an established diagnosis of COPD were followed-up for a period of 1 year from August 2018 to August 2019. An activity-based costing, 'bottom-up' approach was used to calculate direct costs, while indirect costs of patients were assessed using the Work Productivity and Activity Impairment Questionnaire.

    RESULTS: The mean annual per-patient direct cost for the management of COPD was calculated as US$506.92. The mean annual costs per patient in the management phase, emergency department visits, and hospital admissions were reported as US$395.65, US$86.4, and US$297.79, respectively; 31.66% of COPD patients visited the emergency department and 42.47% of COPD patients were admitted to the hospital due to exacerbation. The annual mean indirect cost per patient was calculated as US$1699.76. Productivity losses at the workplace were reported as 31.87% and activity limitations were reported as 17.42%.

    CONCLUSION: Drugs and consumables costs were the main cost-driving factors in the management of COPD. The higher ratio of indirect cost to direct medical costs shows that therapeutic interventions aimed to prevent work productivity losses may reduce the economic burden of COPD.

    Matched MeSH terms: Efficiency
  17. Touhidul IASM, Sorooshian S
    Sci Eng Ethics, 2019 10;25(5):1605-1607.
    PMID: 29717466 DOI: 10.1007/s11948-018-0055-z
    Communication is an essential part of all activities of organizations. However, it is affected by technology. Today, email and social media are popular methods of communication in organizations. Each of the listed methods has advantages and disadvantages which will be discussed in this letter which tries to drive the attention of organizations to the need for a standard and balanced approach toward communication.
    Matched MeSH terms: Efficiency, Organizational*
  18. Tiong Ngee-Wen, Suhaiza Zailani, Azmin Azliza Aziz, Rashidi Ahmad
    MyJurnal
    Introduction: Lean healthcare outcome is usually measured with multiple key performance metrics but there is a lack of tools that enabled efficiency assessment. This research aimed to assess the efficiency among lean public emergen- cy departments (ED) through Slack-Based Measure Data Envelopment Analysis (SBM-DEA) and evaluate the impact of lean on the efficiency in public emergency departments. Methods: A retrospective observational study design using data on the number of support staff, number of doctors, number of discharge, arrival to consultant and length of stay. Efficiency scores of 20 Malaysian public EDs were computed using SBM-DEA modelling and compared be- tween before and after lean implementation. Results: A total of 13 out of 20 public EDs exhibited improvement in ar- rival to consultant and length of stay upon lean implementation. However, only 9 out of the 13 public EDs have had an improvement in efficiency score. Conclusion: Lean healthcare demonstrated a positive impact on the efficiency level of some public EDs. The SBM-DEA model offers the benchmarking capability and slack elimination information that may complement the lean continuous improvement philosophy.
    Matched MeSH terms: Efficiency
  19. Teoh SL, Chong HY, Abdul Aziz S, Chemi N, Othman AR, Md Zaki N, et al.
    Neuropsychiatr Dis Treat, 2017;13:1979-1987.
    PMID: 28814869 DOI: 10.2147/NDT.S137140
    INTRODUCTION: Schizophrenia (SCZ) is a highly debilitating disease despite its low prevalence. The economic burden associated with SCZ is substantial and mainly attributed to productivity loss. To improve the understanding of economic burden of SCZ in the low- and middle-income country regions, we aimed to determine the economic burden of SCZ in Malaysia.

    METHODS: A retrospective study was conducted using a prevalence-based approach from a societal perspective in Malaysia with a 1 year period from 2013. We used micro-costing technique with bottom-up method and included direct medical cost, direct non-medical cost, and indirect cost. The main data source was medical chart review which was conducted in Hospital Kuala Lumpur (HKL). The medical charts were identified electronically by matching the unique patient's identification number registered under the National Mental Health Schizophrenia Registry and the list of patients in HKL in 2013. Other data sources were government documents, literatures, and local websites. To ensure robustness of result, probabilistic sensitivity analysis was conducted.

    RESULTS: The total estimated number of treated SCZ cases in Malaysia in 2015 was 15,104 with the total economic burden of USD 100 million (M) which was equivalent to 0.04% of the national gross domestic product. On average, the mean cost per patient was USD 6,594. Of the total economic burden of SCZ, 72% was attributed to indirect cost, costing at USD 72M, followed by direct medical cost (26%), costing at USD 26M, and direct non-medical cost (2%), costing at USD 1.7M.

    CONCLUSION: This study highlights the magnitude of economic burden of SCZ and informs the policy-makers that there is an inadequate support for SCZ patients. More resources should be allocated to improve the condition of SCZ patients and to reduce the economic burden.

    Matched MeSH terms: Efficiency
  20. Tan QY, Zomer E, Owen AJ, Chin KL, Liew D
    Tob Control, 2020 01;29(1):111-117.
    PMID: 30610080 DOI: 10.1136/tobaccocontrol-2018-054677
    BACKGROUND: The loss of productivity arising from tobacco use in low/middle-income countries has not been well described. We sought to examine the impact of cigarette smoking on population health and work productivity in Malaysia using a recently published measure, the productivity-adjusted life year (PALY).

    METHODS: A life table model was constructed using published Malaysian demographic and mortality data. Our analysis was limited to male smokers due to the low smoking prevalence in females (1.1%). Male smokers aged 15-64 years were followed up until 65 years or until death. The population attributable risk, health-related quality of life decrements and relative reduction in productivity due to smoking were sourced from published data. The analysis was repeated assuming the cohorts were never smokers, and the differences in outcomes represented the health and productivity burden conferred by smoking. The cost of productivity loss was estimated based on the gross domestic product per equivalent full-time worker in Malaysia.

    RESULTS: Tobacco use is highly prevalent among working-age males in Malaysia, with 4.2 million (37.5%) daily smokers among men aged between 15 and 64 years. Overall, our model estimated that smoking resulted in the loss of over 2.1 million life years (2.9%), 5.5 million (8.2%) quality-adjusted life years (QALYs) and 3.0 million (4.8%) PALYs. Smoking was estimated to incur RM275.3 billion (US$69.4 billion) in loss of productivity.

    CONCLUSION: Tobacco use imposes a significant public health and economic burden among working-age males in Malaysia. This study highlights the need of effective public health interventions to reduce tobacco use.

    Matched MeSH terms: Efficiency*
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