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Fulltext Occupational burnout and its influencing factors among primary health care providers under Tuaran Area Health Office

Joshua Teo Beng Chin, Shamsul Bahari Shamsudin, Noraziah Bakri

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):28-28.
MyJurnal

Introduction: Primary health care providers face a wide range of stressors and are at high risk of developing occu-pational burnout, which may cause ineffectiveness and reduce the productivity of the health care system. Methods: A cross-sectional study was conducted among the primary health care provider working in health facilities under Tuaran Area Health Office. A total of 199 of 604 providers randomly selected as respondents for this study. Self-ad-ministered questionnaire and the Maslach Burnout Inventory are used for data collection. Descriptive statistics were used to determine the prevalence and Chi-square test was used to determine the association of risk factors. Results: Prevalence of occupational burnout is 10.1% with high level of overall burnout (n = 20), 60.8% are having low to moderate level of overall burnout (n = 121) and 29.1% has no burnout (n = 58). A significant relationship was observed between burnout, high workload, out-of-scope workload and distance between home and workplace (p≤0.01). However, no significant relationship was observed between burnout and age, gender, marital status, finan-cial status, education level, experience and income. Conclusion: This study shows that distribution of workload as well as the job scope may affect burnout. Further study can be conducted to identify home-workplace distance re-lation to burnout. With the identification of these factors, a counter measures and intervention can be implemented.

Matched MeSH terms: Health Facilities
Fulltext Challenges in managing uncontrolled hypertension cases at relief centre in Kota Tinggi District, Johore

Hanihaselah, M.S., Norasikin, M.

Malaysian Journal of Community Health, 2009;15(3):24-34.
MyJurnal

Background : The management of chronic disease during flood seems to be one of the main challenges to the health care service. Chronic disease becomes worst during flood. Poor condition at the relief centres, loss of assets, fear, and lack of functional health facilities contribute to the morbidity and mortality during and after flood. Poor chronic disease management, especially on severe and uncontrolled hypertension, may threaten lives of victims during flood. In addition, comprehensive treatment cannot be delivered due to destroyed infrastructure, shortage of doctors on duty and delay in getting drug supply. Therefore, all aspects of chronic disease management shall be reviewed and included in the disaster preparedness in order to control and prevent acute incidence and complications of the chronic diseases. Previous Action Plan did not address this issue effectively which had caused many patients not getting their treatment adequately. The aim of this writing is to share experiences in managing chronic disease patients particularly hypertensive patients.
Methodology : A retrospective study based on data collection by health personnel while conducting health screening, clinical examination and giving treatment to flood victims at the relief centres. Hypertensive patients were identified when the victims came for treatment and while the medical team conducting medical rounds. New hypertensive cases as well as uncontrolled cases with no complication were treated and monitored at the relief centres.
Result : It was found that 34,530 cases of non communicable disease (11.1% of the total number of the flood victims) including hypertension and diabetes mellitus were reported in Johor. Kota Tinggi reported a total number of 5,317 cases of chronic disease. There was no data collection on specific chronic diseases collected at the state level during the floods thus the findings representing Kota Tinggi cases only. In retrospective search of 150 flood victims with hypertension in Kota Tinggi, only 95 cases had complete data. Among them 71.6% (68 cases) were hypertensive cases already on treatment and 28.4% (27 cases) were new cases. Also it has been found that 67.4% (64 cases) were uncontrolled hypertension and 32.6% (31 cases) were controlled hypertension. Four cases had been found diagnosed as uncontrolled hypertension with complications and have been referred to hospital.
Conclusion : Comprehensive health strategy for flood victims shall not be focused only on saving lives and giving emergency treatment to patients but also to update and strengthen an overall chronic disease management. Many factors contributed to increase in blood pressure during flooding. Good hypertensive treatment at the relief centres is needed to minimise morbidity and mortality. Information on care and treatment received by flood victims having chronic disease is vital in assessing their health needs during disaster and in formulating disaster preparedness in the future.

Matched MeSH terms: Health Facilities
A retrospective study of IUD usage in a Malaysian family planning clinic

Hamid Arshat, Jaffa Ali, Ayub Suhaimi, Yuliawiratman, Noorlaily Abu Bakar

Malays J Reprod Health, 1983 Dec;1(2):191-202.
PMID: 12313338
Matched MeSH terms: Health Facilities
Concentrated specimen smear microscopy utilising a polymer membrane sandwich filtration vessel for the detection of acid-fast bacilli in health facilities in Sabah, East Malaysia

Paul DC, Ngeow YF, Yap SF, Dony JF, Avoi R, Mohammad R, et al.

Tuberculosis (Edinb), 2022 Mar;133:102183.
PMID: 35180496 DOI: 10.1016/j.tube.2022.102183

A simple, ready-to-use concentrated specimen smear microscopy method employing a nanometer silicon polyvinylidene fluoride (PVDF) polymer membrane sandwich filtration vessel to concentrate acid-fast bacilli (AFB) in samples (SFV-CSSM, Hunan-Tech New Medical System Co. Ltd. China) was compared with direct sputum smear microscopy (DSSM) to determine its performance using culture on modified Ogawa agar as reference. The results for 4114 clinical samples collected from health facilities in Sabah were interpreted with reference to culture results, sample collection-transportation conditions and clinical data including responses to anti-TB drug treatment. The SFV-CSSM showed higher sensitivity than DSSM (79.4% versus 60.5%) and less background interference. Its ability to detect low levels of AFB at an affordable cost makes it an excellent tool for the screening of pauci-bacillary samples as well as for active case finding in TB control programs.

Matched MeSH terms: Health Facilities
Fulltext Cultural adaptation of a patient decision-aid for insulin therapy

Tan NC, Koong Ying Leng A, Phoon Kwong Yun I, Wang Zhen S, Paulpandi M, Lee YK, et al.

BMJ Open, 2020 03 08;10(3):e033791.
PMID: 32152165 DOI: 10.1136/bmjopen-2019-033791

INTRODUCTION: Patient decision-aids (PDAs) support patients in selecting evidence-based treatment options. PDA is useful only if the user understands the content to make personalised decisions. Cultural adaptation is a process of adjusting health messages so that the information is accurate, relevant and understandable to users from a different population. A PDA has been developed to assist Malaysian patients with secondary drug failure to initiate insulin therapy to control their type 2 diabetes mellitus (T2DM). Likewise, patients with T2DM in neighbouring Singapore face similar barriers in commencing insulin treatment, which a PDA may facilitate decision-making in selecting personalised therapy.
OBJECTIVE: The study aimed to explore the views and perceptions of Singaporean primary care providers on the Malaysia PDA to initiate insulin therapy and described the cultural adaptation process used in the design and development of a new PDA, which would be trialled in a Singapore primary healthcare institution.
METHOD: Qualitative research method was deployed to conduct one-to-one in-depth interviews of the healthcare providers at the trial site (SingHealth Polyclinics-SHP), including six primary care physicians and four nurses to gather their views and feedbacks on the Malaysian PDA. The interviews were transcribed, audited and analysed (standard content analysis) to identify themes relating to the content, layout, concerns of the original PDA and suggestions to the design of the new SHP PDA.
RESULTS: Cultural adaptation of the new PDA includes change to the overall design, graphics (including pictograms), presentation styles, additional contextualised content (personalisation, subheadings, cost and treatment option), modified phrasing of the subtitles and concerns (choice of words) relevant to the new users.
CONCLUSION: A PDA on insulin therapy underwent cultural adaptation before its implementation in another population in a neighbouring country. Its relevance and effectiveness will be evaluated in future research.

Matched MeSH terms: Health Facilities
Sweat analysis for urea sensing: trends and challenges

Futane A, Senthil M, S J, Srinivasan A, R K, Narayanamurthy V

Anal Methods, 2023 Sep 14;15(35):4405-4426.
PMID: 37646163 DOI: 10.1039/d3ay01089a

With increasing population there is a rise in pathological diseases that the healthcare facilities are grappling with. Sweat-based wearable technologies for continuous monitoring have overcome the demerits associated with sweat sampling and sensing. Hence, sweat as an alternative biofluid holds great promise for the quantification of a host of biomarkers and understanding the functioning of the body, thereby deducing ailments quickly and economically. This comprehensive review accounts for recent advances in sweat-based LOCs (Lab-On-Chips), which are a likely alternative to the existing blood-urea sample testing that is invasive and time-consuming. The present review is focused on the advancements in sweat-based Lab-On-Chips (LOCs) as an alternative to invasive and time-consuming blood-urea sample testing. In addition, different sweat collection methods (direct skin, near skin and microfluidic) and their mechanism for urea sensing are explained in detail. The mechanism of urea in biofluids in protein metabolism, balancing nitrogen levels and a crucial factor of kidney function is described. In the end, research and technological advancements are explained to address current challenges and enable its widespread implementation.

Matched MeSH terms: Health Facilities
Fulltext Genitourinary tuberculosis: an atypical clinical presentation

Lim PS, Atan IK, Naidu A

Case Rep Obstet Gynecol, 2012;2012:727146.
PMID: 23320216 DOI: 10.1155/2012/727146

Genitourinary tuberculosis is one of the common forms of extrapulmonary tuberculosis. We report a case of atypical genitourinary tuberculosis: massive uterovaginal prolapse with cervical lesion mimicking cervical carcinoma. This particular case highlights the problem of healthcare in most of the developing countries. Lack of patient education, awareness, and access to a healthcare system resulted in a complicated situation. In an endemic area or in an immunocompromised individual, a higher index of suspicion would allow early recognition and treatment institution to minimise its late consequences as well as spreading of the disease. Though anti-TB is the mainstay of treatment, surgical intervention might be needed in selected cases.

Matched MeSH terms: Health Facilities
Enabling cross-country learning and exchange to support universal health coverage implementation

Oliveira Hashiguchi L, Conlin M, Roberts D, McGee K, Marten R, Nachuk S, et al.

Health Policy Plan, 2024 Jan 23;39(Supplement_1):i125-i130.
PMID: 38253439 DOI: 10.1093/heapol/czad097

As countries transition from external assistance while pursuing ambitious plans to achieve universal health coverage (UHC), there is increasing need to facilitate knowledge sharing and learning among them. Country-led and country-owned knowledge management is foundational to sustainable, more equitable external assistance for health and is a useful complement to more conventional capacity-building modalities provided under external assistance. In the context of external assistance, few initiatives use country-to-country sharing of practitioner experiences, and link learning to receiving guidance on how to adapt, apply and sustain policy changes. Dominant knowledge exchange processes are didactic, implicitly assuming static technical needs, and that practitioners in low- and middle-income countries require problem-specific, time-bound solutions. In reality, the technical challenges of achieving UHC and the group of policymakers involved continuously evolve. This paper aims to explore factors which are supportive of experience-based knowledge exchange between practitioners from diverse settings, drawing from the experience of the Joint Learning Network (JLN) for UHC-a global network of practitioners and policymakers sharing experiences about common challenges to develop and implement knowledge products supporting reforms for UHC-as an illustration of a peer-to-peer learning approach. This paper considers: (1) an analysis of JLN monitoring and evaluation data between 2020 and 2023 and (2) a qualitative inquiry to explore policymakers' engagement with the JLN using semi-structured interviews (n = 14) with stakeholders from 10 countries. The JLN's experience provides insights to factors that contribute to successful peer-to-peer learning approaches. JLN relies on engaging a network of practitioners with diverse experiences who organically identify and pursue a common learning agenda. Meaningful peer-to-peer learning requires dynamic, structured interactions, and alignment with windows of opportunity for implementation that enable rapid response to emerging and timely issues. Peer-to-peer learning can facilitate in-country knowledge sharing, learning and catalyse action at the institutional and health system levels.

Matched MeSH terms: Health Facilities
The pattern of maternal mortality at maternity hospital Kuala Lumpur

Nafisah Adeeb

Malays J Reprod Health, 1983 Jan;1(1):34-9.
PMID: 12279887
Matched MeSH terms: Health Facilities*
Management of patients with type 2 diabetes mellitus in MPH hospitals and health centres

Haliza, A.M., Roslan Johari, M.G., Badrulnizam, M., Rosidah, S.S., Teng, S.C., Saiful Safuan, M.S., et al.

Journal of Health Management, 2008;4(1):73-87.
MyJurnal

Diabetes mellitus is a chronic disorder with many vascular complications, leading to significant morbidity and mortality. The prevalence of Type 2 diabetes mellitus in Malaysia has risen dramatically from 6.3% (NHMS 1 in 1986); to 8.3% (NHMS 2 in 1996); and to 14.9% (NHMS 3 in 2006). An audit was conducted on patient's medical records from selected MOH health facilities to assess the control of diabetes using HbA1c. The response rate was 69.6% and the control of diabetes was poor. Only 18.4% of patients with valid HbA1c had value less than 6.5%. This is notably worst amongst patients from younger age groups. Many recommended investigations such as fundoscopy and urine microalbumin had not been done regularly. Efforts to look for various vascular complications were under-reported. About 45% of patients had been treated with 2 oral antidiabetic agents; mainly the sulphonylureas and the biguanides. Only 13.3% of patients were on insulin despite having poorly controlled disease. There is an urgent need to improve the management of diabetes mellitus in these areas:- (i) improving the glycemic control status (particularly among younger diabetic patients) with early and optimal use of oral diabetic drugs and insulin; (ii) stringent monitoring of glycemic control with adequate funds for regular performance of HbA1c (at least every 6 monthly for all diabetic patients) (iii) organizing regular updates or interactive programme for diabetes healthcare providers from primary, secondary and tertiary care; (iv) ensuring regular and prompt review of diabetic complications so that the complications can be dealt with early; (v) producing more diabetes educators to strengthen and standardize the diabetes education programme; and promote patients adherence to non-pharmacological and pharmacological interventions.

Matched MeSH terms: Health Facilities
Fulltext A secure healthcare 5.0 system based on blockchain technology entangled with federated learning technique

Rehman A, Abbas S, Khan MA, Ghazal TM, Adnan KM, Mosavi A

Comput Biol Med, 2022 Nov;150:106019.
PMID: 36162198 DOI: 10.1016/j.compbiomed.2022.106019

In recent years, the global Internet of Medical Things (IoMT) industry has evolved at a tremendous speed. Security and privacy are key concerns on the IoMT, owing to the huge scale and deployment of IoMT networks. Machine learning (ML) and blockchain (BC) technologies have significantly enhanced the capabilities and facilities of healthcare 5.0, spawning a new area known as "Smart Healthcare." By identifying concerns early, a smart healthcare system can help avoid long-term damage. This will enhance the quality of life for patients while reducing their stress and healthcare costs. The IoMT enables a range of functionalities in the field of information technology, one of which is smart and interactive health care. However, combining medical data into a single storage location to train a powerful machine learning model raises concerns about privacy, ownership, and compliance with greater concentration. Federated learning (FL) overcomes the preceding difficulties by utilizing a centralized aggregate server to disseminate a global learning model. Simultaneously, the local participant keeps control of patient information, assuring data confidentiality and security. This article conducts a comprehensive analysis of the findings on blockchain technology entangled with federated learning in healthcare. 5.0. The purpose of this study is to construct a secure health monitoring system in healthcare 5.0 by utilizing a blockchain technology and Intrusion Detection System (IDS) to detect any malicious activity in a healthcare network and enables physicians to monitor patients through medical sensors and take necessary measures periodically by predicting diseases. The proposed system demonstrates that the approach is optimized effectively for healthcare monitoring. In contrast, the proposed healthcare 5.0 system entangled with FL Approach achieves 93.22% accuracy for disease prediction, and the proposed RTS-DELM-based secure healthcare 5.0 system achieves 96.18% accuracy for the estimation of intrusion detection.

Matched MeSH terms: Health Facilities
Establishing mercury-free medical facilities: a Malaysian case study

Amir Sultan MM, Goh CT, Wan Puteh SE, Mokhtar M

Int J Health Care Qual Assur, 2019 Feb 11;32(1):34-44.
PMID: 30859864 DOI: 10.1108/IJHCQA-08-2017-0161

PURPOSE: Mercury is widely used in medical and healthcare facilities as dental amalgam, mercury-added medical devices, thiomersal-containing vaccines, laboratory analysis and for other general applications despite the hazards. Various agencies consistently promote mercury-free medical facilities through mercury-free alternatives and better management practices, which are in line with the Minamata Convention on Mercury that aims to protect human health and environment from anthropogenic mercury release. The paper aims to discuss these issues.
DESIGN/METHODOLOGY/APPROACH: The authors conducted a gap analysis on recommended practices gathered from the literature and current practices gathered through semi-structured interviews with Malaysian medical personnel. A life cycle approach was adopted covering mercury use: input, storage, handling, accident, waste disposal and governance phases.
FINDINGS: The authors found that there are significant gaps between recommended and current mercury management practices. Analysis indicates improper mercury management as the main contributor to these gaps. The authors found from recommended practices that core components needing improvement include: mercury management action plan, mercury use identification team, purchasing policy, proper guidelines and monitoring systems.
PRACTICAL IMPLICATIONS: This study helps us to understand mercury management practices and suggests essential steps to establish a mercury-free medical facility.
ORIGINALITY/VALUE: This study explored the gaps between recommended and current mercury management practices in a medical facility and contributes to the Minamata Convention on Mercury aspirations.

Matched MeSH terms: Health Facilities/standards*
Fulltext The effectiveness of the buddy program training module to enhance the daily living function, social participation and emotional status of older adults in residential aged care homes

Asmuri SN, Kadar M, Razaob NA, Chui CS, Mohd Rasdi HF

PLoS One, 2024;19(4):e0301544.
PMID: 38568914 DOI: 10.1371/journal.pone.0301544

BACKGROUND: The Compeer Model, which was originally designed to match individuals recovering from mental illness with volunteers from their community, served as the basis for the development of the buddy program. However, limited research was available related to the buddy program among older adults in a Malaysian context.
AIM: The study aimed to identify the effectiveness of the buddy program training module to enhance the daily living function, social participation and emotional status of older adults in residential aged care homes.
METHODS: A quasi-experimental study was conducted with 30 pairs of buddies and older adults for both the experimental group and control group in two randomly selected residential aged care homes. The buddies in the experimental group received the buddy program training module related to activities of daily living (basic and instrumental) while the buddy-older adults pairs in the control group continued to perform their usual daily life activities in residential aged care homes. Baselines were performed before intervention and at eight weeks post-intervention.
RESULTS: Over the eight weeks, for the older adults in the experimental group, there was a significant main effect of time after the intervention on BADL (p = 0.010). There were no significant interaction effects for the experiment group and control group on IADL and social participation. Also, there were no significant interaction effects for all domains in emotional status: depression, anxiety and stress. For buddies, there was a significant interaction effect for depression (p = 0.045) in the control group.
CONCLUSIONS: The buddy program training module can be used as a guideline for older adults with more significant disabilities in residential aged care homes in managing activities of daily living. Future studies could be implemented to explore the intergenerational buddy program among older adults and young children in the community.

Matched MeSH terms: Health Facilities
Clinico-epidemiological nature and antibiotic susceptibility profile of Acinetobacter species

Biglari S, Hanafiah A, Ramli R, Mostafizur Rahman M, Mohd Nizam Khaithir T

Pak J Med Sci, 2013 Apr;29(2):469-73.
PMID: 24353558

Acinetobacter spp. has emerged as an important opportunistic pathogen responsible for nosocomial infections in many health-care settings worldwide. The study describes the clinico-epidemiology and antimicrobial susceptibility of Acinetobacter spp. in a tertiary health-care institution. Methodology : Acinetobacter spp. were isolated from 141 specimens of the patients who reported to Universiti Kebangsaan Medical Centre (UKMMC). The sources of specimens were wound, skin and soft tissue, respiratory and urinary tract from patients in various wards. Clinio-epidemiological features of patients infected with Acinetobacter spp. were recorded. Standard bacteriological techniques with API 20NE kits and disk diffusion method were followed for identification and antibiotic sensitivity of the organisms.

Matched MeSH terms: Health Facilities
Prevalence of musculoskeletal disorders among staffs in specialized healthcare centre

Ibrahim NI, Mohanadas D

Work, 2012;41 Suppl 1:2452-60.
PMID: 22317086 DOI: 10.3233/WOR-2012-0480-2452

This study was conducted to investigate pervasiveness of the musculoskeletal disorder (MSD) among staffs in a specialized healthcare centre. Sixty-eight staffs from three departments namely Cardiovascular Lab (CVL), Nuclear Radiology, and General Radiography were recruited in this study. A modified Nordic Musculoskeletal Questionnaire (NMQ) was distributed among study population. The result shows that the prevalence of MSD was highest in lower back (88.2%), neck (76.5%) and shoulder (60.3%) for the past 12 months followed by lower back and elbow (44.1%), and wrist (39.1%) correspondingly, for the past 7 days. Present results suggest that healthcare professionals - radiographers, patient assistants and nurses incurs MSD risks through work tasks as well as psychosocial factors. These include awkward posture during patient handling, workload, work stress and time pressure. Therefore, an ergonomics improvement on the job design and workspace are needed in order to reduce the MSD risks.

Matched MeSH terms: Health Facilities*
Notes From the Field: Availability of Satellite Pharmacies and Pharmacy Service Units in Nigerian Hospitals-Implications for Pharmaceutical Care

Daniel-Ebune E, Jatau AI, Burji SL, Mohammed M

Eval Health Prof, 2021 Jun;44(2):177-179.
PMID: 32552085 DOI: 10.1177/0163278720934174

The optimal provision of pharmaceutical care services requires an adequate number of pharmacists, satellite pharmacies and service units at healthcare facilities. We examined the availability of these requirements at Nigerian hospitals using the 2016 nationwide inspection reports of hospital pharmacies conducted by the Pharmacists Council of Nigeria. Records of 254 hospitals inspected were retrieved, of which 171 (67.3%) were public. The total number of pharmacists across facilities was 753. The most common satellite pharmacy units recorded were antiretroviral 80 (31.5%) and emergency departments 48 (18.8%). The most common service units were drug revolving funds 176 (69.3%) and drug information 112 (44.1%) units. These findings suggest the availability of pharmacists, satellite pharmacies and service units are inadequate for the optimal delivery of pharmaceutical care services at healthcare facilities in Nigeria. Therefore, there is a need for interventions to improve the provision of pharmaceutical care services at health care facilities in Nigeria.

Matched MeSH terms: Health Facilities
Fulltext Characteristics of unsafe deliveries in Malaysia: 2015 to 2017 [Abstract]

Dahlan SA, Mohamed M

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):92-92.
MyJurnal

ABSTRACTS FOR INTERNATIONAL FAMILY HEALTH CONFERENCE 2019 (I-FaH 2019). Health Intervention Towards Community Wellness, Held at Oriental Crystal Hotel, Kajang, Selangor, Malaysia. 4-5th September, 2019
Introduction: In Malaysia, the proportion of safe deliveries remains above 98% since 2010. Safe delivery is defined as deliveries conducted by trained personnel; either doctors, nurses with midwifery training or community nurses. Despite the good coverage of trained personnel and continuous effort to promote birth preparedness among antenatal mothers, unsafe delivery still occur in Malaysia and reported as 0.5% in NHMS 2016.
Methods: A retrospective analysis on the characteristics of unsafe deliveries from the national surveillance data for the period of 2015 to 2017 was carried out. Characteristics of mothers are extracted from the reports of unsafe delivery investigation by Ministry of Health Malaysia and descriptive analyses are carried out by year for trending.
Results: Total of 985 unsafe deliver-ies were reported and investigated in 2015, 1201 in 2016 and 1045 in 2017. About 37.7% to 49.9% (n=453-521) of these deliveries were among Malaysians followed by 22.9% to 40% (n=239-394) among non-citizen without identification document and 11.1% to 27.6% (109-332 deliveries) among non-citizen with identification document. It is commonly reported among mothers aged 26 to 35 years old (38.6% to 43.4%; n=454-463) and multiparous (47.3% to 52.0%; n=494-512). About 25.5% to 35.4% (n=251-370) of these mothers never attended antenatal check-up. Five main reported reasons which had contributed to the unsafe deliveries in 2015 to 2017 were; invalid identification documents, financial constraints, transportation problems, far distance from health facilities and mother’s personal choice.
Conclusion: These findings translate into possible intervention targeted the above population on unsafe deliveries. Multi-sectoral strategies and inter-agency partnership are needed in strengthening the intervention.

Matched MeSH terms: Health Facilities
Fulltext Analysis of costs and utilization of ambulance services in the ministry of health facilities, Malaysia

Bahari MS, Aminuddin F, Raman S, Hanafiah ANM, Kunusagaran MSJMNS, Zaimi NA, et al.

PLoS One, 2022;17(11):e0276632.
PMID: 36331901 DOI: 10.1371/journal.pone.0276632

BACKGROUND: Despite emergency ambulance services playing a pivotal role in accessibility to life-saving treatments in Malaysia, there are still numerous gaps in knowledge in terms of their utilization and cost. This leads to current policies on procurement, maintenance, and allocation being predicated on historical evidence and expert opinions. This study thus aims to analyse the cost and utilization of ambulance services in selected public health facilities in Malaysia.
METHODS: A cross-sectional study was employed involving 239 ambulances from selected hospitals and clinics. Ambulance service utilization was based on the number of trips, distance and duration of travel obtained from travel logbooks. A mixed top-down and activity-based costing approach was used to estimate the monthly cost of ambulance services. This constituted personnel, maintenance, fuel, overhead, consumables, ambulance, and medical equipment costs. The utilization and costs of ambulance services were further compared between settings and geographical locations.
RESULTS: The average total cost of ambulance services was MYR 11,410.44 (US$ 2,756.14) for hospitals and MYR 9,574.39 (US$ 2,312.65) for clinics, albeit not significantly different. Personnel cost was found to be the main contributor to the total cost, at around 44% and 42% in hospitals and clinics, respectively. There was however a significant difference in the total cost in terms of the type and age of ambulances, in addition to their location. In terms of service utilization, the median number of trips and duration of ambulance usage was significantly higher in clinics (31.88 trips and 58.58 hours) compared to hospitals (16.25 trips and 39.25 hours).
CONCLUSIONS: The total cost of ambulance services was higher in hospitals compared to clinics, while its utilization showed a converse trend. The current findings evidence that despite the ambulance services being all under the MOH, their operating process and utilization reflected an inherent difference by setting.

Matched MeSH terms: Health Facilities
Fulltext Collaboration at the Departmental, School, National and International Levels at the International Medical University, Kuala Lumpur

Michael John Rathbone

International e-Journal of Science, Medicine & Education, 2013;7(11):57-64.
MyJurnal

The nature, extent and definition of a collaboration varies between individuals, disciplines, departments and institutions. It depends upon such factors as the people involved, the nature of the research problem, the research environment, the institutional culture and demographic factors. This paper will examine the concept of collaborative research and discuss its place and position in an evolving university.

Matched MeSH terms: Health Facilities
Determinants of Caesarean Risk Factor in Northern Region of Bangladesh: A Multivariate Analysis

Rahman M, Ahmad Shariff A, Shafie A, Saaid R, Md Tahir R

Iran J Public Health, 2014 Jan;43(1):16-27.
PMID: 26060675

Caesarean section (c-section) rates have been increasing dramatically in the past decades around the world. This increase has been attributed to multiple factors such as maternal, socio-demographic and institutional fac-tors. Therefore, this study examines the impact of maternal, socio-demographic and relevant characteristics on caesar-ean delivery in the northern region of Bangladesh.

Matched MeSH terms: Health Facilities

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