Displaying publications 41 - 60 of 100 in total

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  1. Waikagul J
    Parasitol Int, 2006;55 Suppl:S297-300.
    PMID: 16326132
    The SEAMEO TROPMED Network is a regional cooperative network established in 1967 for education, training and research in tropical medicine and public health under the Southeast Asia Ministers of Education Organization. The Network operates through four Regional Centers with respective areas of specialization and host institutions: Community Nutrition/Tropmed Indonesia; Microbiology, Parasitology and Entomology/Tropmed Malaysia; Public Health/Tropmed Philippines; and Tropical Medicine/Tropmed Thailand. To train health workers, to support research on endemic and newly emerging diseases, and to advocate relevant health policies are the main functions of these centers. SEAMEO TROPMED Network in collaboration with the Faculty of Tropical Medicine, Mahidol University and other institutions has regularly organized the Seminar on Food-borne Parasitic Zoonoses every 3-5 years over the past 15 years. The Faculty of Tropical Medicine has organized the annual Joint International Tropical Medicine Meeting since 1996. Full papers of the presentations at these two meetings have been published as supplementary issues to the Southeast Asian Journal of Tropical Medicine and Public Health, an in-house journal of SEAMEO TROPMED Network. Recently, the Parasitology Association of ASEAN Countries has rotated the hosting of the ASEAN Congress of Parasitology and Tropical Medicine. These institutional and conference networks will enable closer links, to promote the health of people in the Southeast Asian region.
    Matched MeSH terms: Health Resources/organization & administration*
  2. Murthy S, John D, Godinho IP, Godinho MA, Guddattu V, Nair NS
    Syst Rev, 2017 12 12;6(1):252.
    PMID: 29233168 DOI: 10.1186/s13643-017-0648-7
    BACKGROUND: Neonatal systemic infections and their consequent impairments give rise to long-lasting health, economic and social effects on the neonate, the family and the nation. Considering the dearth of consolidated economic evidence in this important area, this systematic review aims to critically appraise and consolidate the evidence on economic evaluations of management of neonatal systemic infections in South Asia.

    METHODS: Full and partial economic evaluations, published in English, associated with the management of neonatal systemic infections in South Asia will be included. Any intervention related to management of neonatal systemic infections will be eligible for inclusion. Comparison can include a placebo or alternative standard of care. Interventions without any comparators will also be eligible for inclusion. Outcomes of this review will include measures related to resource use, costs and cost-effectiveness. Electronic searches will be conducted on PubMed, CINAHL, MEDLINE (Ovid), EMBASE, Web of Science, EconLit, the Centre for Reviews and Dissemination Library (CRD) Database, Popline, IndMed, MedKnow, IMSEAR, the Cost Effectiveness Analysis (CEA) Registry and Pediatric Economic Database Evaluation (PEDE). Conference proceedings and grey literature will be searched in addition to performing back referencing of bibliographies of included studies. Two authors will independently screen studies (in title, abstract and full-text stages), extract data and assess risk of bias. A narrative summary and tables will be used to summarize the characteristics and results of included studies.

    DISCUSSION: Neonatal systemic infections can have significant economic repercussions on the families, health care providers and, cumulatively, the nation. Pediatric economic evaluations have focused on the under-five age group, and published consolidated economic evidence for neonates is missing in the developing world context. To the best of our knowledge, this is the first review of economic evidence on neonatal systemic infections in the South Asian context. Further, this protocol provides an underst anding of the methods used to design and evaluate economic evidence for methodological quality, transparency and focus on health equity. This review will also highlight existing gaps in research and identify scope for further research.

    SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42017047275.

    Matched MeSH terms: Health Resources/economics*
  3. Zawiah M, Al-Ashwal FY, Saeed RM, Kubas M, Saeed S, Khan AH, et al.
    Front Public Health, 2020;8:419.
    PMID: 32850608 DOI: 10.3389/fpubh.2020.00419
    Background: In the past decade, Yemen has witnessed several disasters that resulted in a crumbled healthcare system. With the declaration of COVID-19 a global pandemic, and later the appearance of first confirmed cases in Yemen, there is an urgent need to assess the preparedness of healthcare facilities (HCFs) and their capacities to tackle a looming COVID-19 outbreak. Herein, we present an assessment of the current state of preparedness and capabilities of HCFs in Yemen to prevent and manage the COVID-19 outbreak. Methods: An online survey for HCFs was developed, validated, and distributed. The questionnaire is divided into five main sections: (1) Demographic variables for participants. (2) HCFs capabilities for COVID-19 outbreak. (3) Support received to face the emergence and spread of COVID-19. (4). Current practices of infection prevention and control measures in the HCFs. The last section focused on the recommendations to ensure effective and timely response to this outbreak in Yemen. Descriptive analysis was used to analyze data using statistical package for social sciences (SPSS), version 23. Results: Responses were received from healthcare workers (HCWs) from 18 out of 22 governorates in Yemen. Out of the 296 HCWs who participated in the study, the vast majority (93.9%) believed that the healthcare system in Yemen does not have the resources and capabilities to face and manage a COVID-19 outbreak. Approximately 82.4% of participants rated the general preparedness level of their HCFs as very poor or poor. More specifically, the majority of HCWs rated their HCFs as very poor or poor in term of availability of the following: an adequate number of mechanical ventilators (88.8%), diagnostic devices (88.2%), ICU rooms and beds (81.4%), and isolation rooms (79.7%). Conclusions: The healthcare facilities in Yemen are unprepared and lack the most basic resources and capabilities to cope with or tackle a COVID-19 outbreak. With the current state of a fragile healthcare system, a widespread outbreak of COVID-19 in Yemen could result in devastating consequences. There is an urgent need to provide support to the healthcare workers and HCFs that are on the frontline against COVID-19.
    Matched MeSH terms: Health Resources/supply & distribution
  4. Costas-Chavarri A, Nandakumar G, Temin S, Lopes G, Cervantes A, Cruz Correa M, et al.
    J Glob Oncol, 2019 02;5:1-19.
    PMID: 30802158 DOI: 10.1200/JGO.18.00214
    PURPOSE: To provide resource-stratified, evidence-based recommendations on the treatment and follow-up of patients with early-stage colorectal cancer.

    METHODS: ASCO convened a multidisciplinary, multinational Expert Panel that reviewed existing guidelines and conducted a modified ADAPTE process and a formal consensus process with additional experts for one round of formal ratings.

    RESULTS: Existing sets of guidelines from 12 guideline developers were identified and reviewed; adapted recommendations from six guidelines form the evidence base and provide evidence to inform the formal consensus process, which resulted in agreement of 75% or more on all recommendations.

    RECOMMENDATIONS: For nonmaximal settings, the recommended treatments for colon cancer stages nonobstructing, I-IIA: in basic and limited, open resection; in enhanced, adequately trained surgeons and laparoscopic or minimally invasive surgery, unless contraindicated. Treatments for IIB-IIC: in basic and limited, open en bloc resection following standard oncologic principles, if not possible, transfer to higher-level facility; in emergency, limit to life-saving procedures; in enhanced, laparoscopic en bloc resection, if not possible, then open. Treatments for obstructing, IIB-IIC: in basic, resection and/or diversion; in limited or enhanced, emergency surgical resection. Treatment for IIB-IIC with left-sided: in enhanced, may place colonic stent. Treatment for T4N0/T3N0 high-risk features or stage II high-risk obstructing: in enhanced, may offer adjuvant chemotherapy. Treatment for rectal cancer cT1N0 and cT2n0: in basic, limited, or enhanced, total mesorectal excision principles. Treatment for cT3n0: in basic and limited, total mesorectal excision, if not, diversion. Treatment for high-risk patients who did not receive neoadjuvant chemotherapy: in basic, limited, or enhanced, may offer adjuvant therapy. Treatment for resectable cT3N0 rectal cancer: in enhanced, base neoadjuvant chemotherapy on preoperative factors. For post-treatment surveillance, a combination of medical history, physical examination, carcinoembryonic antigen testing, imaging, and endoscopy is performed. Frequency depends on setting. Maximal setting recommendations are in the guideline. Additional information can be found at www.asco.org/resource-stratified-guidelines .

    NOTICE: It is the view of the American Society of Clinical Oncology that health care providers and health care system decision makers should be guided by the recommendations for the highest stratum of resources available. The guidelines are intended to complement but not replace local guidelines.

    Matched MeSH terms: Health Resources/standards*
  5. Lopes G, Stern MC, Temin S, Sharara AI, Cervantes A, Costas-Chavarri A, et al.
    J Glob Oncol, 2019 02;5:1-22.
    PMID: 30802159 DOI: 10.1200/JGO.18.00213
    PURPOSE: To provide resource-stratified, evidence-based recommendations on the early detection of colorectal cancer in four tiers to clinicians, patients, and caregivers.

    METHODS: American Society of Clinical Oncology convened a multidisciplinary, multinational panel of medical oncology, surgical oncology, surgery, gastroenterology, health technology assessment, cancer epidemiology, pathology, radiology, radiation oncology, and patient advocacy experts. The Expert Panel reviewed existing guidelines and conducted a modified ADAPTE process and a formal consensus-based process with additional experts (Consensus Ratings Group) for two round(s) of formal ratings.

    RESULTS: Existing sets of guidelines from eight guideline developers were identified and reviewed; adapted recommendations form the evidence base. These guidelines, along with cost-effectiveness analyses, provided evidence to inform the formal consensus process, which resulted in agreement of 75% or more.

    CONCLUSION: In nonmaximal settings, for people who are asymptomatic, are ages 50 to 75 years, have no family history of colorectal cancer, are at average risk, and are in settings with high incidences of colorectal cancer, the following screening options are recommended: guaiac fecal occult blood test and fecal immunochemical testing (basic), flexible sigmoidoscopy (add option in limited), and colonoscopy (add option in enhanced). Optimal reflex testing strategy for persons with positive screens is as follows: endoscopy; if not available, barium enema (basic or limited). Management of polyps in enhanced is as follows: colonoscopy, polypectomy; if not suitable, then surgical resection. For workup and diagnosis of people with symptoms, physical exam with digital rectal examination, double contrast barium enema (only in basic and limited); colonoscopy; flexible sigmoidoscopy with biopsy (if contraindication to latter) or computed tomography colonography if contraindications to two endoscopies (enhanced only).

    Matched MeSH terms: Health Resources/standards*
  6. Khoo EJ, Lantos JD
    Acta Paediatr, 2020 07;109(7):1323-1325.
    PMID: 32289175 DOI: 10.1111/apa.15307
    Matched MeSH terms: Health Resources/supply & distribution
  7. Atif M, Sulaiman SA, Shafie AA, Asif M, Babar ZU
    BMC Health Serv Res, 2014 Aug 19;14:353.
    PMID: 25138659 DOI: 10.1186/1472-6963-14-353
    BACKGROUND: Studies from both developed and developing countries have demonstrated a considerable fluctuation in the average cost of TB treatment. The objective of this study was to analyze the medical resource utilization among new smear positive pulmonary tuberculosis patients. We also estimated the cost of tuberculosis treatment from the provider and patient perspectives, and identified the significant cost driving factors.
    METHODS: All new smear positive pulmonary tuberculosis patients who were registered at the chest clinic of the Penang General Hospital, between March 2010 and February 2011, were invited to participate in the study. Provider sector costs were estimated using bottom-up, micro-costing technique. For the calculation of costs from the patients' perspective, all eligible patients who agreed to participate in the study were interviewed after the intensive phase and subsequently at the end of the treatment by a trained nurse. PASW was used to analyze the data (Predictive Analysis SoftWare, version 19.0, Armonk, NY: IBM Corp.).
    RESULTS: During the study period, 226 patients completed the treatment. However, complete costing data were available for 212 patients. The most highly utilized resources were chest X-ray followed by sputum smear examination. Only a smaller proportion of the patients were hospitalized. The average provider sector cost was MYR 992.34 (i.e., USD 325.35 per patient) whereby the average patient sector cost was MYR 1225.80 (i.e., USD 401.90 per patient). The average patient sector cost of our study population accounted for 5.7% of their annual family income. In multiple linear regression analysis, prolonged treatment duration (i.e., > 6 months) was the only predictor of higher provider sector costs whereby higher patient sector costs were determined by greater household income and persistent cough at the end of the intensive phase of the treatment.
    CONCLUSION: In relation to average provider sector cost, our estimates are substantially higher than the budget allocated by the Ministry of Health for the treatment of a tuberculosis case in Malaysia. The expenses borne by the patients and their families on the treatment of the current episode of tuberculosis were not catastrophic for them.
    Study site: Chest clinic, Hospital Pulau Pinang, Malaysia
    Matched MeSH terms: Health Resources/economics; Health Resources/statistics & numerical data*
  8. Yip CH, Taib NA
    Climacteric, 2014 Dec;17 Suppl 2:54-9.
    PMID: 25131779 DOI: 10.3109/13697137.2014.947255
    Breast cancer is one of the leading cancers world-wide. While the incidence in developing countries is lower than in developed countries, the mortality is much higher. Of the estimated 1 600 000 new cases of breast cancer globally in 2012, 794 000 were in the more developed world compared to 883 000 in the less developed world; however, there were 198 000 deaths in the more developed world compared to 324 000 in the less developed world (data from Globocan 2012, IARC). Survival from breast cancer depends on two main factors--early detection and optimal treatment. In developing countries, women present with late stages of disease. The barriers to early detection are physical, such as geographical isolation, financial as well as psychosocial, including lack of education, belief in traditional medicine and lack of autonomous decision-making in the male-dominated societies that prevail in the developing world. There are virtually no population-based breast cancer screening programs in developing countries. However, before any screening program can be implemented, there must be facilities to treat the cancers that are detected. Inadequate access to optimal treatment of breast cancer remains a problem. Lack of specialist manpower, facilities and anticancer drugs contribute to the suboptimal care that a woman with breast cancer in a low-income country receives. International groups such as the Breast Health Global Initiative were set up to develop economically feasible, clinical practice guidelines for breast cancer management to improve breast health outcomes in countries with limited resources.
    Matched MeSH terms: Health Resources/economics; Health Resources/trends
  9. Capuano C, Ozaki M
    J Trop Med, 2011;2011:642832.
    PMID: 22235208 DOI: 10.1155/2011/642832
    Until the middle of the 20th century, yaws was highly endemic and considered a serious public health problem in the Western Pacific Region (WPR), leading to intensive control efforts in the 1950s-1960s. Since then, little attention has been paid to its reemergence. Its current burden is unknown. This paper presents the results of an extensive literature review, focusing on yaws in the South Pacific. Available records suggest that the region remains largely free of yaws except for Papua New Guinea, Solomon Islands, and Vanuatu. Many clinical cases reported recently were described as "attenuated"; advanced stages are rare. A single intramuscular injection of benzathine penicillin is still effective in curing yaws. In the Pacific, yaws may be amenable to elimination if adequate resources are provided and political commitment revived. A mapping of yaws prevalence in PNG, Solomon, and Vanuatu is needed before comprehensive country-tailored strategies towards yaws elimination can be developed.
    Matched MeSH terms: Health Resources
  10. Foo CY, Lim KK, Sivasampu S, Dahian KB, Goh PP
    BMC Health Serv Res, 2015;15:349.
    PMID: 26315283 DOI: 10.1186/s12913-015-1011-0
    Rising demand of ophthalmology care is increasingly straining Malaysia's public healthcare sector due to its limited human and financial resources. Improving the effectiveness of ophthalmology service delivery can promote national policy goals of population health improvement and system sustainability. This study examined the performance variation of public ophthalmology service in Malaysia, estimated the potential output gain and investigated several factors that might explain the differential performance.
    Matched MeSH terms: Health Resources
  11. Tang R, Yang H, Choi JR, Gong Y, Hu J, Feng S, et al.
    Talanta, 2016 May 15;152:269-76.
    PMID: 26992520 DOI: 10.1016/j.talanta.2016.02.017
    Lateral flow assays (LFAs) hold great promise for point-of-care testing, especially in resource-poor settings. However, the poor sensitivity of LFAs limits their widespread applications. To address this, we developed a novel device by integrating dialysis-based concentration method into LFAs. The device successfully achieved 10-fold signal enhancement in Human Immunodeficiency Virus (HIV) nucleic acid detection with a detection limit of 0.1nM and 4-fold signal enhancement in myoglobin (MYO) detection with a detection limit of 1.56ng/mL in less than 25min. This simple, low-cost and portable integrated device holds great potential for highly sensitive detection of various target analytes for medical diagnostics, food safety analysis and environmental monitoring.
    Matched MeSH terms: Health Resources
  12. Daghash H, Lim Abdullah K, Ismail MD
    J Eval Clin Pract, 2020 Aug;26(4):1280-1291.
    PMID: 31489762 DOI: 10.1111/jep.13280
    BACKGROUND: Health care institutions need to construct management strategies for patients diagnosed with acute coronary syndrome (ACS) that focus on evidence-based treatments, adherence to treatment guidelines, and organized care. These help to reduce variations as well as the mortality and morbidity rates, which indicates the critical need for standardized care and adherence to evidence-based practices for patients hospitalized with ACS. The care pathways translate research and guidelines into clinical practice to close the gap between the guidelines and the clinical practices.

    OBJECTIVES: This review focuses on identifying the indicators used to evaluate ACS care pathways and their effect on the care process and clinical outcomes.

    METHODS: This review follows the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The systematic research was conducted using five research databases. Two groups were created by dividing the studies according to their year of publication. The first group included those studies published from 1997 to 2007 ("Group 1"), while the second included those published from 2008 to 2018 ("Group 2"). Selected studies were screened using the Effective Public Health Practice Project (EPHPP) quality assessment tool.

    RESULTS: Seventeen studies were included in this review. One study was a randomized controlled trial, 14 were predesigns and postdesigns, and two were longitudinal observational designs. The Group 1 studies demonstrated that ACS care pathways had a positive effect on reducing the length of the hospital stay and the door-to-balloon times. Similar effects were observed for the Group 2 studies.

    CONCLUSION: Implementing ACS care pathway helps to organize care processes and decrease treatment delays as well as improve the patient outcomes without adverse consequences for patients or additional resources and costs. While the current level of evidence is inadequate to warrant a formal recommendation, there is a need for more studies with an emphasis on well-designed randomization to measure patient outcomes.

    Matched MeSH terms: Health Resources
  13. Nurjasmine Aida Jaman, Nor Azam Kamaruzaman, Abdul Hadi Said
    Malaysian Family Physician, 2020;15(2):46-49.
    MyJurnal
    Undernutrition remains a major public health concern, especially in developing countries. Despite
    being rich in resources, Malaysia is still home to children sufering from severe undernutrition.
    Tis paper presents the case of a 5-month-old boy with kwashiorkor stemming from improper
    weaning which was overlooked. Tis case highlights the importance of recognizing the early signs of
    kwashiorkor to allow for early referrals for proper management and prevent its possible complications.
    Matched MeSH terms: Health Resources
  14. Chong LA, Khoo EJ, Kamar AA, Tan HS
    Asian Bioeth Rev, 2020 Aug 13.
    PMID: 32837563 DOI: 10.1007/s41649-020-00142-2
    Malaysia had its first four patients with COVID-19 on 25 January 2020. In the same week, the World Health Organization declared it as a public health emergency of international concern. The pandemic has since challenged the ethics and practice of medicine. There is palpable tension from the conflict of interest between public health initiatives and individual's rights. Ensuring equitable care and distribution of health resources for patients with and without COVID-19 is a recurring ethical challenge for clinicians. Palliative care aims to mitigate suffering caused by a life-limiting illness, and this crisis has led to the awareness and urgency to ensure it reaches all who needs it. We share here the palliative care perspectives and ethical challenges during the COVID-19 pandemic in Malaysia.
    Matched MeSH terms: Health Resources
  15. Kong YC, Sakti VV, Sullivan R, Bhoo-Pathy N
    Ecancermedicalscience, 2020;14:1134.
    PMID: 33281926 DOI: 10.3332/ecancer.2020.1134
    The ongoing COVID-19 pandemic may worsen the existing financial vulnerabilities of cancer survivors who may be experiencing a double financial hit, both from cancer-induced financial toxicity as well as economic strains arising from loss of income and prolonged unemployment following the pandemic. The impact of the pandemic is likely to be more pronounced on cancer survivors living in resource-limited settings, such as in Southeast Asia. As health care systems in the region try to streamline resources and accommodate the influx of patients from COVID-19, many in the cancer community have experienced severe disruptions in their care. The delays and disruption of timely access to cancer care could lead to patients presenting with worsened conditions and at more advanced cancer stages in which treatment options tended to be costlier. Similar to countries around the world, the various forms of movement restrictions that were enforced have aggravated the rates of unemployment, loss of wages and the limited access to support from family or friends around Southeast Asia. The economic impact of COVID-19 hits even harder on the large proportion of the population in the region that works in the informal sector, who are often one paycheque or one episode of illness away from financial catastrophe. More worryingly, the lack of a robust social security system in many Southeast Asian countries, especially in terms of income protection, could ultimately force many cancer survivors to choose between paying for their treatments, or to forego treatments, and feed their families. Early identification of cancer patients experiencing financial toxicity following the pandemic will enable timely and appropriate interventions to be undertaken by various stakeholders, potentially averting a cascade of other economic fallouts that may last for years after cancer treatment.
    Matched MeSH terms: Health Resources
  16. Nur Emmy Fizreena Shamsuddin, Huda Zainuddin, Salmiah Md. Said
    MyJurnal
    Introduction: Job stress is defined as harmful physical, negative, emotional responses that occur when the require-ments of the job do not match the capabilities, resources or needs of the worker. Factors influencing job stress among nurses in primary healthcare in Malaysia are poorly identified. The objective of this study is to assess the job stress score and identify the predictors of job stress among nurses in Primary Health Care (PHC) facilities in Kuala Lan-gat district of Selangor. Methods: A cross-sectional study conducted among 216 nurses in PHC facilities of Kuala Langat District. Data collection conducted using self-administered questionnaire adopted and modified from Job Stress Scale, Nursing Stress Scale (NSS) and Expanded Nursing Stress Scale (ENSS). Results: There is evidence of job stress with mean score of 28.4(5.5) among nurses in PHC facilities of Kuala Langat District, Selangor, Malaysia. There are association between age, role in organization, duration of services, outside job scope, family size, doing house chores, balance between work and family, balance between work and leisure activities, workload, inadequate preparation, lack of staff support, uncertainty concerning treatment, role conflicts and patients and their families with job stress (p
    Matched MeSH terms: Health Resources
  17. Lombe D, Sullivan R, Caduff C, Ali Z, Bhoo-Pathy N, Cleary J, et al.
    Ecancermedicalscience, 2021;15:1202.
    PMID: 33889211 DOI: 10.3332/ecancer.2021.1202
    Introduction: Public health emergencies and crises such as the current COVID-19 pandemic can accelerate innovation and place renewed focus on the value of health interventions. Capturing important lessons learnt, both positive and negative, is vital. We aimed to document the perceived positive changes (silver linings) in cancer care that emerged during the COVID-19 pandemic and identify challenges that may limit their long-term adoption.

    Methods: This study employed a qualitative design. Semi-structured interviews (n = 20) were conducted with key opinion leaders from 14 countries. The participants were predominantly members of the International COVID-19 and Cancer Taskforce, who convened in March 2020 to address delivery of cancer care in the context of the pandemic. The Framework Method was employed to analyse the positive changes of the pandemic with corresponding challenges to their maintenance post-pandemic.

    Results: Ten themes of positive changes were identified which included: value in cancer care, digital communication, convenience, inclusivity and cooperation, decentralisation of cancer care, acceleration of policy change, human interactions, hygiene practices, health awareness and promotion and systems improvement. Impediments to the scale-up of these positive changes included resource disparities and variation in legal frameworks across regions. Barriers were largely attributed to behaviours and attitudes of stakeholders.

    Conclusion: The COVID-19 pandemic has led to important value-based innovations and changes for better cancer care across different health systems. The challenges to maintaining/implementing these changes vary by setting. Efforts are needed to implement improved elements of care that evolved during the pandemic.

    Matched MeSH terms: Health Resources
  18. Kamaruzaman NA, Jamani NA, Said AH
    Malays Fam Physician, 2020;15(2):46-49.
    PMID: 32843945
    Undernutrition remains a major public health concern, especially in developing countries. Despite being rich in resources, Malaysia is still home to children suffering from severe undernutrition. This paper presents the case of a 5-month-old boy with kwashiorkor stemming from improper weaning which was overlooked. This case highlights the importance of recognizing the early signs of kwashiorkor to allow for early referrals for proper management and prevent its possible complications.
    Matched MeSH terms: Health Resources
  19. Zin, Thant, Myint, Than, Htay, Kyaw, Shamsul, B. S.
    MyJurnal
    Island health differs from other health care systems, particularly in that there are limited resources and referral faculties available. With globalisation and climate change, island populations have become increasingly vulnerable to natural disasters and global pandemics. This study will identify, explore, compare and report on island health issues facing in the western Pacific, before making appropriate recommendations. A review of selected health indicators in Pacific islands was collected from the World Health Organization (WHO) and other publicly available resources. In the Pacific region, 15 islands saw lower health expenditure (
    Matched MeSH terms: Health Resources
  20. Aniza I., Putri, N., Azimatun Noor, A., Amrizal, M.N., Saperi, S., Aljunid, S.M.
    MyJurnal
    Top-down costing and activity based costing are the most frequent costing methodologies used for analyzing cost. Top-down costing is accomplished by assigning total expenditure of hospital to patient by apportioning the expenditure of cost centers (unit of service) in hospital to give the cost per patient per visit, per day or per admission. Conversely, activity based costing is accomplished by tracking every resource used by patient individually. Since this study started in 2009, Top-down costing calculation was based on financial year in 2009 with adjusted up to 12.6% from 2008 data. This percentage was taken based on the trend of hospital expenditure during 2005 till 2008. An assumption was made that non-financial data (performance and administrative data) for 2009 was similar to 2008. Top-down costing was calculated using Clinical Cost Modeling Software developed by Unit Case-mix of UKMMC to obtain cost of elective lower segment caesarean section (LSCS) per day at ward which was RM922. Whereas activity based costing was calculated using clinical pathway of elective LSCS. Given the average length of stay in 2009 was 4 days, the cost of elective LSCS according to top-down costing was RM3, 688 and activity based costing was RM1774. As a result, cost of elective LSCS is 108% higher using top-down costing.
    Matched MeSH terms: Health Resources
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