Displaying publications 321 - 340 of 607 in total

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  1. Role of teleconsultation in moving the healthcare system forward
    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: Delivery of Health Care/organization & administration*
  2. Optimisation of the continuum of supportive and palliative care for patients with breast cancer in low-income and middle-income countries: executive summary of the Breast Health Global Initiative, 2014
    Distelhorst SR, Cleary JF, Ganz PA, Bese N, Camacho-Rodriguez R, Cardoso F, et al.
    Lancet Oncol, 2015 Mar;16(3):e137-47.
    PMID: 25752564 DOI: 10.1016/S1470-2045(14)70457-7
    Supportive care and palliative care are now recognised as critical components of global cancer control programmes. Many aspects of supportive and palliative care services are already available in some low-income and middle-income countries. Full integration of supportive and palliative care into breast cancer programmes requires a systematic, resource-stratified approach. The Breast Health Global Initiative convened three expert panels to develop resource allocation recommendations for supportive and palliative care programmes in low-income and middle-income countries. Each panel focused on a specific phase of breast cancer care: during treatment, after treatment with curative intent (survivorship), and after diagnosis with metastatic disease. The panel consensus statements were published in October, 2013. This Executive Summary combines the three panels' recommendations into a single comprehensive document covering breast cancer care from diagnosis through curative treatment into survivorship, and metastatic disease and end-of-life care. The recommendations cover physical symptom management, pain management, monitoring and documentation, psychosocial and spiritual aspects of care, health professional education, and patient, family, and caregiver education.
    Matched MeSH terms: Delivery of Health Care, Integrated/economics; Delivery of Health Care, Integrated/standards*
  3. Nursing workforce planning: insights from seven Malaysian hospitals
    Drake R
    Br J Nurs, 2013 Jan-Feb;22(2):95-100.
    PMID: 23587892
    In 2010, the Royal College of Nursing asked: 'What is the optimal level and mix of nurses required to deliver quality care as cost-effectively as possible?' This question implies there is a relationship between staffing levels, quality of care and financial efficiency. This paper examines the relationship between the staff budget, the number of staff required to achieve a target level of care and the actual number of staff employed in seven hospitals in Malaysia. It seeks to critically evaluate local challenges arising from staff budgeting/planning procedures, identify general issues that apply beyond Malaysian healthcare institutions and, finally, to propose a model that combines finance, staffing and level of care.
    Matched MeSH terms: Delivery of Health Care/economics; Delivery of Health Care/organization & administration*
  4. Fulltext Setting up home-based palliative care in countries with limited resources: a model from Sarawak, Malaysia
    Devi BC, Tang TS, Corbex M
    Ann Oncol, 2008 Dec;19(12):2061-6.
    PMID: 18641007 DOI: 10.1093/annonc/mdn422
    The provision of palliative care (PC) and opioids is difficult to ensure in remote areas in low- and middle-income countries. We describe here the set up of a home-care program in Sarawak (the Malaysian part of the Borneo Island), where half the population lives in villages that are difficult to access.
    Matched MeSH terms: Delivery of Health Care/manpower; Delivery of Health Care/organization & administration
  5. Fulltext Guideline implementation for breast healthcare in low- and middle-income countries: early detection resource allocation
    Yip CH, Smith RA, Anderson BO, Miller AB, Thomas DB, Ang ES, et al.
    Cancer, 2008 Oct 15;113(8 Suppl):2244-56.
    PMID: 18837017 DOI: 10.1002/cncr.23842
    A key determinant of breast cancer outcome in any population is the degree to which cancers are detected at early stages of disease. Populations in which cancers are detected at earlier stages have lower breast cancer mortality rates. The Breast Health Global Initiative (BHGI) held its third Global Summit in Budapest, Hungary in October 2007, bringing together internationally recognized experts to address the implementation of breast healthcare guidelines for early detection, diagnosis, and treatment in low- and middle-income countries (LMCs). A multidisciplinary panel of experts specifically addressed the implementation of BHGI guidelines for the early detection of disease as they related to resource allocation for public education and awareness, cancer detection methods, and evaluation goals. Public education and awareness are the key first steps, because early detection programs cannot be successful if the public is unaware of the value of early detection. The effectiveness and efficiency of screening modalities, including screening mammography, clinical breast examination (CBE), and breast self-examination, were reviewed in the context of resource availability and population-based need by the panel. Social and cultural barriers should be considered when early detection programs are being established, and the evaluation of early detection programs should include the use of well developed, methodologically sound process metrics to determine the effectiveness of program implementation. The approach and scope of any screening program will determine the success of any early detection program as measured by cancer stage at diagnosis and will drive the breadth of resource allocation needed for program implementation.
    Matched MeSH terms: Delivery of Health Care/economics*; Delivery of Health Care/standards
  6. Knowledge and attitudes of Malaysian private medical practitioners toward guidelines-based medicine
    Lian PC, Marnoch G
    J Manag Med, 1999;13(2-3):178-89.
    PMID: 10747449
    This paper describes a study of the knowledge and attitudes of a sample of private medical practitioners in Malaysia in relation to questions posed on guidelines-based medicine. The study was conducted through a postal questionnaire sent to a sample of 2,000 private practitioners. Placing the research in context, a description of Malaysia and its health-care system is provided. Issues surrounding guidelines-based medicine in the Malaysian context are discussed. An analysis of the sample population's personal and professional characteristics is presented. Key research findings include identifying a substantial knowledge deficit--less than half of the respondents claimed to understand "guidelines". A majority of doctors (64 per cent) think guidelines are useful. Only 29 per cent of respondents knew where to find guidelines, with 22 per cent claiming to have used guidelines. The paper concludes with a discussion of issues in the implementation of guidelines-based medicine in Malaysia based on the study's findings.
    Matched MeSH terms: Delivery of Health Care/organization & administration; Delivery of Health Care/standards
  7. Tuberculosis screening in a novel substance abuse treatment center in Malaysia: implications for a comprehensive approach for integrated care
    Al-Darraji HA, Wong KC, Yeow DG, Fu JJ, Loeliger K, Paiji C, et al.
    J Subst Abuse Treat, 2014 Feb;46(2):144-9.
    PMID: 24074846 DOI: 10.1016/j.jsat.2013.08.023
    People who use drugs (PWUD) represent a key high risk group for tuberculosis (TB). The prevalence of both latent TB infection (LTBI) and active disease in drug treatment centers in Malaysia is unknown. A cross-sectional convenience survey was conducted to assess the prevalence and correlates of LTBI among attendees at a recently created voluntary drug treatment center using a standardized questionnaire and tuberculin skin testing (TST). Participants (N=196) were mostly men (95%), under 40 (median age=36 years) and reported heroin use immediately before treatment entry (75%). Positive TST prevalence was 86.7%. Nine (4.6%) participants were HIV-infected. Previous arrest/incarcerations (AOR=1.1 for every entry, p<0.05) and not being HIV-infected (AOR=6.04, p=0.03) were significantly associated with TST positivity. There is an urgent need to establish TB screening and treatment programs in substance abuse treatment centers and to tailor service delivery to the complex treatment needs of patients with multiple medical and psychiatric co-morbidities.
    Matched MeSH terms: Delivery of Health Care, Integrated/methods; Delivery of Health Care, Integrated/organization & administration
  8. The Global Gag Rule: The death trap for comprehensive sexual and reproductive healthcare and way to overcome the US gag rule
    Murshid ME, Haque M
    J Popul Ther Clin Pharmacol, 2020 06 11;27(2):e87-e99.
    PMID: 32621461 DOI: 10.15586/jptcp.v27i2.677
    The United States of America (USA) is one of the largest bilateral donors in the field of global health assistance. There are beneficiaries in 70 countries around the world. In 2015, the USA released US$638 million for the improvement of global health status by promoting family planning services. Unfortunately, in 2017, Trump administration reinstated Mexico City Policy/Global Gag Rule (GGR). This policy prevents non-US nongovernmental organizations (NGOs) from receiving US health financial assistance if they have any relationship with abortion-related services. This restriction pushed millions of lives into great danger due to the lack of comprehensive family planning services, especially lack of abortion-related services. This article has attempted to let the readers know about the impacts of GGR around the world and how global leaders are trying to overcome the harmful effects of this rule. Finally, it proposes some solutions to the impacts of the extension of Mexico City Policy.
    Matched MeSH terms: Delivery of Health Care/economics; Delivery of Health Care/legislation & jurisprudence*
  9. Determination of Cost-Effectiveness Threshold for Health Care Interventions in Malaysia
    Lim YW, Shafie AA, Chua GN, Ahmad Hassali MA
    Value Health, 2017 09;20(8):1131-1138.
    PMID: 28964445 DOI: 10.1016/j.jval.2017.04.002
    BACKGROUND: One major challenge in prioritizing health care using cost-effectiveness (CE) information is when alternatives are more expensive but more effective than existing technology. In such a situation, an external criterion in the form of a CE threshold that reflects the willingness to pay (WTP) per quality-adjusted life-year is necessary.

    OBJECTIVES: To determine a CE threshold for health care interventions in Malaysia.

    METHODS: A cross-sectional, contingent valuation study was conducted using a stratified multistage cluster random sampling technique in four states in Malaysia. One thousand thirteen respondents were interviewed in person for their socioeconomic background, quality of life, and WTP for a hypothetical scenario.

    RESULTS: The CE thresholds established using the nonparametric Turnbull method ranged from MYR12,810 to MYR22,840 (~US $4,000-US $7,000), whereas those estimated with the parametric interval regression model were between MYR19,929 and MYR28,470 (~US $6,200-US $8,900). Key factors that affected the CE thresholds were education level, estimated monthly household income, and the description of health state scenarios.

    CONCLUSIONS: These findings suggest that there is no single WTP value for a quality-adjusted life-year. The CE threshold estimated for Malaysia was found to be lower than the threshold value recommended by the World Health Organization.

    Matched MeSH terms: Delivery of Health Care/economics*; Delivery of Health Care/methods
  10. Hearing loss: a global health issue
    Looi LM, Ganten D, McGrath PF, Gross M, Griffin GE
    Lancet, 2015 Mar 14;385(9972):943-4.
    PMID: 25743174 DOI: 10.1016/S0140-6736(15)60208-2
    Matched MeSH terms: Delivery of Health Care
  11. Is there a role for academic medical centers in emerging markets?
    Wiener CM, Thompson SJ, Wu S, Chellappa M, Hasham S
    World Hosp Health Serv, 2012;48(4):4-6.
    PMID: 23484425
    Governments in emerging markets face mounting challenges in managing health spending, building capability and capacity, modernizing ageing infrastructure, and investing in skills and resources. One path to overcoming these challenges is to establish new public-private models of health care development and delivery based on United States academic medical centers, whose missions are to advance medical education and clinical delivery. Johns Hopkins Medicine is a participant in the collaboration developing between the Perdana University Hospital and the Perdana University Graduate School of Medicine in Malaysia. These two organizations comprise an academic health science center based on the United States model. The Perdana project provides constructive insights into the opportunities and challenges that governments, universities, and the private sector face when introducing new models of patient care that are integrated with medical education, clinical training, and biomedical research.
    Matched MeSH terms: Delivery of Health Care
  12. Fulltext How should Malaysia respond to its ageing society?
    Forsyth DR, Chia YC
    Med J Malaysia, 2009 Mar;64(1):46-50.
    PMID: 19852321
    As Malaysia ages its health and social care systems will have to adapt to a changing pattern of disease and dependency. Improved public health measures extend life expectancy at the relative expense of increased prevalence of currently incurable conditions such as dementia and Parkinson's disease. In this article we discuss how these demographic changes will impact and suggest possible means of coping with the altered epidemiology of disease and disability. Malaysia will need to swiftly develop sufficient expertise in acute Geriatric Medicine, rehabilitation of older people; the management of long-term conditions in older people with multiple complex problems within Primary Care; as well as an infrastructure for home and institutional care.
    Matched MeSH terms: Delivery of Health Care
  13. Fulltext Diabetes epidemic in Malaysia
    Mustaffa BE
    Med J Malaysia, 2004 Aug;59(3):295-6.
    PMID: 15727372 MyJurnal
    Matched MeSH terms: Delivery of Health Care
  14. Fulltext Economic evaluations of personalized medicine: existing challenges and current developments
    Shabaruddin FH, Fleeman ND, Payne K
    Pharmgenomics Pers Med, 2015;8:115-26.
    PMID: 26309416 DOI: 10.2147/PGPM.S35063
    Personalized medicine, with the aim of safely, effectively, and cost-effectively targeting treatment to a prespecified patient population, has always been a long-time goal within health care. It is often argued that personalizing treatment will inevitably improve clinical outcomes for patients and help achieve more effective use of health care resources. Demand is increasing for demonstrable evidence of clinical and cost-effectiveness to support the use of personalized medicine in health care. This paper begins with an overview of the existing challenges in conducting economic evaluations of genetics- and genomics-targeted technologies, as an example of personalized medicine. Our paper illustrates the complexity of the challenges faced by these technologies by highlighting the variations in the issues faced by diagnostic tests for somatic variations, generally referring to genetic variation in a tumor, and germline variations, generally referring to inherited genetic variation in enzymes involved in drug metabolic pathways. These tests are typically aimed at stratifying patient populations into subgroups on the basis of clinical effectiveness (response) or safety (avoidance of adverse events). The paper summarizes the data requirements for economic evaluations of genetics and genomics-based technologies while outlining that the main challenges relating to data requirements revolve around the availability and quality of existing data. We conclude by discussing current developments aimed to address the challenges of assessing the cost-effectiveness of genetics and genomics-based technologies, which revolve around two central issues that are interlinked: the need to adapt available evaluation methods and identifying who is responsible for generating evidence for these technologies.
    Matched MeSH terms: Delivery of Health Care
  15. Missions of a medical school: an Asian perspective
    Suleiman AB
    Acad Med, 1999 Aug;74(8 Suppl):S45-52.
    PMID: 10495743
    This case study of medical schools in Malaysia addresses their role in meeting the demands of a young nation. Throughout the growth and development of these medical schools, there have been efforts to coordinate and cooperate with providers of health care. The treatment of illness must mesh with the changing paradigm of health and wellness as an achievable and indeed desirable goal, not only for the individual but also for society. The scientific basis of medicine is being emphasized with the advent of evidence-based medicine and outcome measures. Innovations have been made to bring the schools in closer contact with the service providers. Malaysia has prepared farsighted plans to become a developed nation by the year 2020. Accordingly, its health services will use advances in information technology and will introduce telemedicine in various strategic applications to extend the reach of the health care team. It is incumbent on the medical schools to move in concert with the Ministry of Health to realize goals of the nation and the society.
    Matched MeSH terms: Delivery of Health Care
  16. Impressions of psychiatry in Singapore, Malaysia, Thailand, and Taiwan
    Bennett AE
    Biol Psychiatry, 1976 Jun;11(3):345-53.
    PMID: 938700
    Matched MeSH terms: Delivery of Health Care
  17. Economic stability and health status: evidence from East Asia before and after the 1990s economic crisis
    Hopkins S
    Health Policy, 2006 Feb;75(3):347-57.
    PMID: 15896870
    The East Asian economies of Indonesia, Malaysia and Thailand suffered declines in their economic growth rates in 1997. The Indonesian and Thai government followed the World Bank prescription for adjustment, which included a cut-back in government spending at a time when there were significant job losses. Malaysia chose its own path to adjustment. Evidence presented in this paper shows that although the declines were short-lived that there was an impact on the health status measured by mortality rates for the populations of Indonesia and Thailand. There was little apparent impact on the health status of Malaysians. The lessons for other developing economies include the importance of social safety nets and the maintenance of government expenditure in minimising the impact of economic shocks on health.
    Matched MeSH terms: Delivery of Health Care
  18. Fulltext A Review of Guidelines to Resuming Elective Orthopaedic Surgeries Amid COVID-19 Pandemic: Deriving a Simple Traffic Light Model
    Attia AK, Omar UF, Kaliya-Perumal AK
    Malays Orthop J, 2020 Nov;14(3):10-15.
    PMID: 33403057 DOI: 10.5704/MOJ.2011.003
    The COVID-19 pandemic has affected most healthcare systems around the world. Routine care operations such as outpatient clinics and elective surgery remain badly hit. This situation cannot continue for long as it puts patients at a higher risk for complications due to delayed management. Hence, it is essential to resume routine, especially elective surgery. Regarding orthopaedic practice, various authors and organisations have come out with guidelines to resume elective surgeries. However, clear consensus and common strategies need be derived. With this motive, we conducted a review of the literature for guidelines to resume elective orthopaedic surgery amid COVID-19 pandemic and shortlisted scholarly publications and information from regional organisations. We have summarised the information and derived an organised algorithm considering the guidelines provided by various sources. In this extraordinary time, guidelines come in as a relief for every surgeon who is in a dilemma whether to resume electives or not. Putting safety first, these guidelines or suitable versions should be followed at all levels wherever possible to avoid the lack of trained manpower in the event of staff morbidity.
    Matched MeSH terms: Delivery of Health Care
  19. Fulltext Smart technology for healthcare: Exploring the antecedents of adoption intention of healthcare wearable technology
    Chau KY, Lam MHS, Cheung ML, Tso EKH, Flint SW, Broom DR, et al.
    Health Psychol Res, 2019 Mar 11;7(1):8099.
    PMID: 31583292 DOI: 10.4081/hpr.2019.8099
    Technological advancement and personalized health information has led to an increase in people using and responding to wearable technology in the last decade. These changes are often perceived to be beneficial, providing greater information and insights about health for users, organizations and healthcare and government. However, to date, understanding the antecedents of its adoption is limited. Seeking to address this gap, this cross-sectional study examined what factors influence users' adoption intention of healthcare wearable technology. We used self-administrated online survey to explore adoption intentions of healthcare wearable devices in 171 adults residing in Hong Kong. We analyzed the data by Partial least squares - structural equation modelling (PLS-SEM). The results reveal that perceived convenience and perceived irreplaceability are key predictors of perceived usefulness, which in turn strengthens users' adoption intention. Additionally, the results also reveal that health belief is one of the key predictors of adoption intention. This paper contributes to the extant literature by providing understanding of how to strengthen users' intention to adopt healthcare wearable technology. This includes the strengthening of perceived convenience and perceived irreplaceability to enhance the perceived usefulness, incorporating the extensive communication in the area of healthcare messages, which is useful in strengthening consumers' adoption intention in healthcare wearable technology.
    Matched MeSH terms: Delivery of Health Care
  20. Fulltext A Narrative Review of Antimicrobial Stewardship Interventions within In-patient Settings and Resultant Patient Outcomes
    Shirazi OU, Ab Rahman NS, Zin CS
    J Pharm Bioallied Sci, 2020 10 08;12(4):369-380.
    PMID: 33679082 DOI: 10.4103/jpbs.JPBS_311_19
    The overuse of antibiotics has led to various healthcare problems such as the emergence of resistance in infectious microbes and mortality due to antibiotic resistant healthcare associated infections (HAIs). An antimicrobial stewardship (AMS) program is the set of interventions used worldwide to enhance the rational use of antibiotics especially for the hospitalized patients. This review aimed to describe the characteristics of the implemented AMS programs in various hospitals of the world mainly focusing on the interventions and patients outcomes. The literature about AMS program was searched through various databases such as PubMed, Google Scholar, Science Direct, Cochran Library, Ovid (Medline), Web of Science and Scopus. In this review the literature pertaining to the AMS programs for hospitalized patients is sorted on the basis of various interventions that are categorized as formulary restriction (pre-authorization), guideline development, clinical pathway development, educative interventions and prospective audit. Moreover a clear emphasis is laid on the patient outcomes obtained as a result of these interventions namely the infection control, drop in readmission rate, mortality control, resistance control and the control of an overall cost of antibiotic treatment obtained mainly by curbing the overuse of antibiotics within the hospital wards. AMS program is an efficient strategy of pharmacovigilance to rationalize the antimicrobial practice for hospitalized patients as it prevents the misuse of antibiotics, which ultimately retards the health threatening effects of various antibiotics.
    Matched MeSH terms: Delivery of Health Care
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