Displaying publications 1 - 20 of 125 in total

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  1. 1998 National Conference on Quality in Health, Kuala Lumpur, Malaysia
    Hussein RH
    Int J Qual Health Care, 1998 Jun;10(3):284-5.
    PMID: 9661068
    Matched MeSH terms: Quality of Health Care*
  2. A Standard Set of Value-Based Patient-Centered Outcomes for Breast Cancer: The International Consortium for Health Outcomes Measurement (ICHOM) Initiative
    Ong WL, Schouwenburg MG, van Bommel ACM, Stowell C, Allison KH, Benn KE, et al.
    JAMA Oncol, 2017 May 01;3(5):677-685.
    PMID: 28033439 DOI: 10.1001/jamaoncol.2016.4851
    A major challenge in value-based health care is the lack of standardized health outcomes measurements, hindering optimal monitoring and comparison of the quality of health care across different settings globally. The International Consortium for Health Outcomes Measurement (ICHOM) assembled a multidisciplinary international working group, comprised of 26 health care providers and patient advocates, to develop a standard set of value-based patient-centered outcomes for breast cancer (BC). The working group convened via 8 teleconferences and completed a follow-up survey after each meeting. A modified 2-round Delphi method was used to achieve consensus on the outcomes and case-mix variables to be included. Patient focus group meetings (8 early or metastatic BC patients) and online anonymized surveys of 1225 multinational BC patients and survivors were also conducted to obtain patients' input. The standard set encompasses survival and cancer control, and disutility of care (eg, acute treatment complications) outcomes, to be collected through administrative data and/or clinical records. A combination of multiple patient-reported outcomes measurement (PROM) tools is recommended to capture long-term degree of health outcomes. Selected case-mix factors were recommended to be collected at baseline. The ICHOM will endeavor to achieve wide buy-in of this set and facilitate its implementation in routine clinical practice in various settings and institutions worldwide.
    Matched MeSH terms: Quality of Health Care
  3. A comparison of human elements and nonhuman elements in private health care settings: customers' perceptions and expectations
    Mohd Suki N, Chwee Lian JC, Suki NM
    J Hosp Mark Public Relations, 2009;19(2):113-28.
    PMID: 19827322 DOI: 10.1080/15390940903041567
    In today's highly competitive health care environment, many private health care settings are now looking into customer service indicators to learn customers' perceptions and determine whether they are meeting customers' expectations in order to ensure that their customers are satisfied with the services. This research paper aims to investigate whether the human elements were more important than the nonhuman elements in private health care settings. We used the internationally renowned SERVQUAL five-dimension model plus three additional dimensions-courtesy, communication, and understanding of customers of the human element-when evaluating health care services. A total of 191 respondents from three private health care settings in the Klang Valley region of Malaysia were investigated. Descriptive statistics were calculated by the Statistical Package for Social Sciences (SPSS) computer program, version 15. Interestingly, the results suggested that customers nowadays have very high expectations especially when it comes to the treatment they are receiving. Overall, the research indicated that the human elements were more important than the nonhuman element in private health care settings. Hospital management should look further to improve on areas that have been highlighted. Implications for management practice and directions for future research are discussed.
    Matched MeSH terms: Quality of Health Care*
  4. Fulltext A review of the acute pain service in Hospital Kuala Lumpur
    Neelima G, Chieng DC, Lim TA, Inbasegaran K
    Med J Malaysia, 2003 Jun;58(2):167-79.
    PMID: 14569736 MyJurnal
    This study is a review of the Acute Pain Service in Hospital Kuala Lumpur for the years 1998 to 2001. 5042 records from post-operative patients were analysed. The majority of patients (81.8%) had satisfactory pain control. Eighty-two percent of patients experienced only mild pain at rest on the first post-operative day. The highest pain score occurred on the first day in 68.3% of patients. Nausea or vomiting occurred in 23.2% of the patients. Eight patients had respiratory depression. The low pain scores recorded by most patients and the low incidence of side effects reflect the efficiency of the service provided.
    Matched MeSH terms: Quality of Health Care*
  5. Fulltext An approach toward public hospital performance assessment
    Nwagbara VC, Rasiah R, Aslam MM
    Medicine (Baltimore), 2016 Sep;95(36):e4688.
    PMID: 27603363 DOI: 10.1097/MD.0000000000004688
    Public hospitals have come under heavy scrutiny across the world owing to rising expenditures. However, much of the focus has been on cutting down costs to raise efficiency levels. Although not denying the importance of efficiency measures, this article targets a performance issue that is relevant to address the quality of services rendered in public hospitals. Thus, it is important to focus on the effectiveness of resource utilization in these hospitals. Consequently, this article seeks to examine the impact of average length of stay (ALOS) and bed turnover rates (BTR) on bed occupancy rates (BOR).
    Matched MeSH terms: Quality of Health Care*
  6. An integrated MUSA to measure health care service quality from a patient's perspective in a resource-constrained setting
    Al-Awlaqi MA, Aamer AM
    Int J Health Plann Manage, 2020 Jan;35(1):e119-e132.
    PMID: 31670407 DOI: 10.1002/hpm.2943
    PURPOSE: Although assessing the quality of health services offered in a least developed country such as Yemen is very important, it is not yet given attention. As a result, Yemeni patients started to look for higher quality of health services abroad. Thus, Yemeni health private providers need to know how to link their patients' satisfaction to the quality of the services offered to end up with more satisfied patients and higher health service quality offered.

    METHODOLOGY: Data were collected form 5310 patients in 249 private clinics. The patients evaluated their satisfaction on the quality of service on the basis of nine criteria that comprised 31 subcriteria. We used multicriteria satisfaction analysis (MUSA) to analyze the data.

    FINDINGS AND CONCLUSION: The data analysis results showed low level of satisfaction on the health care quality services offered by the private clinics in Yemen. The majority of the criteria and subcriteria showed low level of satisfaction, high demand, and high mandate for improvement.

    Matched MeSH terms: Quality of Health Care/standards
  7. Fulltext An internal audit of diabetes care for type 2 diabetic patients in a public hospital diabetes clinic in Malaysia
    Hieng YC
    Malays J Med Sci, 2017 Mar;24(2):55-60.
    PMID: 28894404 MyJurnal DOI: 10.21315/mjms2017.24.2.7
    INTRODUCTION: Earlier studies have identified a gap between guidelines and actual clinical diabetes care in Malaysia.
    OBJECTIVE: We audited the quality of care for patients with type 2 diabetes mellitus (T2DM) attending our diabetes clinic at a public hospital.
    METHODS: A structured review of the outpatient clinic cards, prescriptions and laboratory results was conducted for patients attending the diabetes clinic at Sibu Hospital in October and November 2014.
    RESULTS: For the total of 233 patients who were audited, the levels of fasting blood sugar, blood pressure, body mass index and fasting lipid profile were satisfactory at 99.1%, 99.6%, 92.6% and 99.6% respectively. 79.7% of the subjects had had HbA1c performed at least once over the previous six months. Only 25.8% had annual foot screening, while the eye screening rate was 71.2% and the albuminuria screening rate was 93.6%. For outcome measures, the mean (SD) HbA1c level was 9.2% (1.91%), with 13 patients (6.7%) having HbA1c less than 6.5%; 36.4% of participants achieved BP < 130/80 mmHg; and 69.4% had LDL < 2.6 mmol/L. The majority of the patients were overweight or obese (91.4%).
    CONCLUSIONS: Overall, the performance of diabetic care processes at our hospital was satisfactory, except for foot examination. The glycaemic and weight control among the subjects were suboptimal and warrant an optimised and comprehensive approach on the part of the management.

    Study site: diabetes clinic at Sibu Hospital
    Matched MeSH terms: Quality of Health Care
  8. Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM) study: Rationale, design and analysis
    Kelly AM, Keijzers G, Klim S, Graham CA, Craig S, Kuan WS, et al.
    Emerg Med Australas, 2015 Jun;27(3):187-91.
    PMID: 25940885 DOI: 10.1111/1742-6723.12397
    Shortness of breath is a common reason for ED attendance. This international study aims to describe the epidemiology of dyspnoea presenting to EDs in the South East Asia-Pacific region, to compare disease patterns across regions, to understand how conditions are investigated and treated, and to assess quality of care.
    Matched MeSH terms: Quality of Health Care/standards
  9. Fulltext Aspects of Multicomponent Integrated Care Promote Sustained Improvement in Surrogate Clinical Outcomes: A Systematic Review and Meta-analysis
    Lim LL, Lau ESH, Kong APS, Davies MJ, Levitt NS, Eliasson B, et al.
    Diabetes Care, 2018 06;41(6):1312-1320.
    PMID: 29784698 DOI: 10.2337/dc17-2010
    OBJECTIVE: The implementation of the Chronic Care Model (CCM) improves health care quality. We examined the sustained effectiveness of multicomponent integrated care in type 2 diabetes.

    RESEARCH DESIGN AND METHODS: We searched PubMed and Ovid MEDLINE (January 2000-August 2016) and identified randomized controlled trials comprising two or more quality improvement strategies from two or more domains (health system, health care providers, or patients) lasting ≥12 months with one or more clinical outcomes. Two reviewers extracted data and appraised the reporting quality.

    RESULTS: In a meta-analysis of 181 trials (N = 135,112), random-effects modeling revealed pooled mean differences in HbA1c of -0.28% (95% CI -0.35 to -0.21) (-3.1 mmol/mol [-3.9 to -2.3]), in systolic blood pressure (SBP) of -2.3 mmHg (-3.1 to -1.4), in diastolic blood pressure (DBP) of -1.1 mmHg (-1.5 to -0.6), and in LDL cholesterol (LDL-C) of -0.14 mmol/L (-0.21 to -0.07), with greater effects in patients with LDL-C ≥3.4 mmol/L (-0.31 vs. -0.10 mmol/L for <3.4 mmol/L; Pdifference = 0.013), studies from Asia (HbA1c -0.51% vs. -0.23% for North America [-5.5 vs. -2.5 mmol/mol]; Pdifference = 0.046), and studies lasting >12 months (SBP -3.4 vs. -1.4 mmHg, Pdifference = 0.034; DBP -1.7 vs. -0.7 mmHg, Pdifference = 0.047; LDL-C -0.21 vs. -0.07 mmol/L for 12-month studies, Pdifference = 0.049). Patients with median age <60 years had greater HbA1c reduction (-0.35% vs. -0.18% for ≥60 years [-3.8 vs. -2.0 mmol/mol]; Pdifference = 0.029). Team change, patient education/self-management, and improved patient-provider communication had the largest effect sizes (0.28-0.36% [3.0-3.9 mmol/mol]).

    CONCLUSIONS: Despite the small effect size of multicomponent integrated care (in part attenuated by good background care), team-based care with better information flow may improve patient-provider communication and self-management in patients who are young, with suboptimal control, and in low-resource settings.
    Matched MeSH terms: Quality of Health Care/standards*
  10. Fulltext Assessment of general public satisfaction with public healthcare services in Kedah, Malaysia
    Hassali MA, Alrasheedy AA, Ab Razak BA, Al-Tamimi SK, Saleem F, Ul Haq N, et al.
    Australas Med J, 2014;7(1):35-44.
    PMID: 24567765 DOI: 10.4066/AMJ.2014.1936
    Patient satisfaction is considered an essential component of healthcare services evaluation and an additional indicator of the quality of healthcare. Moreover, patient satisfaction may also predict health-related behaviours of patients such as adherence to treatment and recommendations.
    Matched MeSH terms: Quality of Health Care
  11. Fulltext Avoidable hospitalisation rates in Singapore, 1991-1998: assessing trends and inequities of quality in primary care
    Niti M, Ng TP
    J Epidemiol Community Health, 2003 Jan;57(1):17-22.
    PMID: 12490643
    STUDY OBJECTIVES: To assess avoidable hospitalisation as an indicator of quality of primary care by examining trends and gender and ethnic variations.
    DESIGN AND SETTING: Aggregated nationwide data in Singapore from 1991 to1998 were analysed for hospitalisations for chronic diseases that are avoidable by timely, appropriate, and effective primary care: asthma, congestive heart failure, chronic obstructive pulmonary disease, diabetes mellitus, and hypertension (avoidable hospitalisations).
    MAIN RESULTS: Of a total of 1 479 494 hospitalisations, 6.7% were for ambulatory care sensitive conditions (ACSC). The annual rate of avoidable hospitalisation was 29.4 per 10 000 population. Women had lower rates of avoidable hospitalisations than men (22.4 versus 29.5 per 10 000), as well as for total hospitalisations (496.2 versus 515.5 per 10 000). Adjusted for total hospitalisation, men were 1.3 times more likely than women to be hospitalised for ACSC. With similar adjustments for baseline utilisation, Indian and Malays had 1.7 and 1.8 times higher rates of avoidable hospitalisations than Chinese. Avoidable hospitalisation decline was -9.1% overall; greater in men (-11.8%) than in women (-5.3%); greater for Chinese (-15.8%), than Malays (-1.1%) and Indians (increase of +4.3%).
    CONCLUSION: Gender and ethnic differences and declining trends in avoidable hospitalisation demonstrated in this study suggest that avoidable hospitalisation rates are a sensitive indicator for assessing quality of primary ambulatory care.
    Matched MeSH terms: Quality of Health Care/trends*
  12. Barriers to neonatal care in developing countries: parents' and providers' perceptions
    Martinez AM, Khu DT, Boo NY, Neou L, Saysanasongkham B, Partridge JC
    J Paediatr Child Health, 2012 Sep;48(9):852-8.
    PMID: 22970681 DOI: 10.1111/j.1440-1754.2012.02544.x
    Hospital care and advanced medical technologies for sick neonates are increasingly available, but not always readily accessible, in many countries. We characterised parents' and providers' perceptions of barriers to neonatal care in developing countries.
    Matched MeSH terms: Quality of Health Care
  13. Building a tuberculosis-free world: The Lancet Commission on tuberculosis
    Reid MJA, Arinaminpathy N, Bloom A, Bloom BR, Boehme C, Chaisson R, et al.
    Lancet, 2019 Mar 30;393(10178):1331-1384.
    PMID: 30904263 DOI: 10.1016/S0140-6736(19)30024-8
    Matched MeSH terms: Quality of Health Care/standards; Quality of Health Care/trends*
  14. Challenges in volunteering from cancer care volunteers perspectives
    Kamaludin KM, Muhammad M, Wahat NW, Ibrahim R
    Asian Pac J Cancer Prev, 2013;14(8):4795-800.
    PMID: 24083746
    The involvement of non-government organizations (NGOs) and support groups has helped strengthen public health services in addressing cancer care burden. Owing to the contribution of volunteers in cancer care, this article documents a qualitative study that examined challenges in attracting and retaining cancer care volunteers as part of the effort to develop a volunteer recruitment model. Data were collected through three focus group discussions involving 19 cancer support group members in Malaysia. Findings of the study revealed that mobility and locality appeared to be significant in Malaysian context, while the need for financial support and time flexibility are challenges faced by cancer support groups to attract and retain volunteers. The findings imply that cancer care initiatives can benefit from more local volunteers but at the same time these volunteers require flexibility and financial support to sustain their engagement.
    Matched MeSH terms: Quality of Health Care*
  15. Changes in the process of care and outcome over a 10-year period in a neonatal nursery in a developing country
    Ho JJ, Chang AS
    J Trop Pediatr, 2007 Aug;53(4):232-7.
    PMID: 17578848
    Over a 10-year period there was increasing involvement by clinicians in the generation and implementation of evidence-based practices in the neonatal intensive care unit (NICU). For two cohorts of very low birth weight (VLBW) babies admitted 10 years apart to a developing country, NICU were compared and changes occurring in process of care that might have contributed to any change in outcome were documented.
    Matched MeSH terms: Quality of Health Care/trends*
  16. Child health in Malaysia
    Ariffin W
    Arch Dis Child, 1994 Nov;71(5):452-6.
    PMID: 7826121
    Matched MeSH terms: Quality of Health Care
  17. 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
    Matched MeSH terms: Quality of Health Care
  18. Fulltext Clinical Pathway as a Strategy in Improving Healthcare Quality and Cost Containment
    Anizal, I., Saperi, S., Aljundi, M.
    Medicine & Health, 2008;3(2):239-246.
    MyJurnal
    The increasing health care cost and public awareness on the delivery of high quality services has forced healthcare service providers to look into the healthcare delivery system. Clinical Pathway (CP) has been introduced in many hospitals and has been accepted as a beneficial tool in assisting healthcare organizations worldwide. Further, the CP also provides consistently high quality and coordinates services with minimum resources. It is proven to be a beneficial tool in other countries. CP is recently being introduced into the Malaysian healthcare system. The aim of this article was to high-light the benefits of CP in improving healthcare quality and controlling the medical cost. The relevant articles have been reviewed.  The majority of literature reviewed con-cluded that there were positive effects in  implementing CP. The CP was found to be significant in reducing length of stay and medical cost. The introduction of evidence based medicine, clinical outcomes, clinical audit, multidisciplinary communication, teamwork and care planning were also improved by CP. The challenges for healthcare providers and healthcare managers are to participate and be fully committed in path-way development and implementation in order to improve healthcare quality and cost control. 
    Matched MeSH terms: Quality of Health Care
  19. Fulltext Clinical audit: essential input for enhancing standards of care
    Khalid Y
    Med J Malaysia, 1998 Dec;53(4):325-6.
    PMID: 10971973
    Matched MeSH terms: Quality of Health Care/standards*
  20. Fulltext Clinical characteristics and mortality risk prediction in critically ill children in Malaysian Borneo
    Ganesan I, Thomas T, Ng FE, Soo TL
    Singapore Med J, 2014 May;55(5):261-5.
    PMID: 24862750
    INTRODUCTION: Mortality risk prediction scores are important for benchmarking quality of care in paediatric intensive care units (PICUs). We aimed to benchmark PICU outcomes at our hospital against the Pediatric Index of Mortality 2 (PIM2) mortality risk prediction score, and evaluate differences in diagnosis on admission and outcomes between Malaysian and immigrant children.

    METHODS: We prospectively collected demographic and clinical data on paediatric medical patients admitted to the PICU of Sabah Women's and Children's Hospital in Kota Kinabalu, Sabah, Malaysia. The PIM2 risk score for mortality was tabulated.

    RESULTS: Of the 131 patients who met the inclusion criteria, data was available for 115 patients. The mean age of the patients was 2.6 ± 3.8 years, with 79% of the cohort aged less than five years. Patients were mainly of Kadazan (38%) and Bajau (30%) descent, and 26% of patients were non-citizens. Leading diagnoses on admission were respiratory (37%), neurological (18%) and infectious (17%) disorders. Out of the 29 patients who died, 23 (79%) were Malaysians and the main mortality diagnostic categories were respiratory disorder (22%), septicaemia (22%), haemato-oncological disease (17%) and neurological disorder (13%). Calculated standardised mortality ratios (SMRs) were not significantly > 1 for any patient category for variables such as age and admission diagnosis. However, infants less than two years old with comorbidities were significantly worse (SMR 2.61, 95% confidence interval 1.02-6.66).

    CONCLUSION: The patient profile at our centre was similar to that reported from other PICUs in Asia. The PIM2 score is a useful mortality risk prediction model for our population.
    Matched MeSH terms: Quality of Health Care
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