Displaying publications 41 - 60 of 67 in total

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  1. Barnard B
    UFSI Rep, 1983.
    PMID: 12339664
    Matched MeSH terms: Public Sector*
  2. Chin MC, Sivasampu S, Wijemunige N, Rannan-Eliya RP, Atun R
    Health Policy Plan, 2020 Feb 01;35(1):7-15.
    PMID: 31625556 DOI: 10.1093/heapol/czz117
    In Malaysia, first-contact, primary care is provided by parallel public and private sectors, which are completely separate in organization, financing and governance. As the country considers new approaches to financing, including using public schemes to pay for private care, it is crucial to examine the quality of clinical care in the two sectors to make informed decisions on public policy. This study intends to measure and compare the quality of clinical care between public and private primary care services in Malaysia and, to the extent possible, assess quality with the developed economies that Malaysia aspires to join. We carried out a retrospective analysis of the National Medical Care Survey 2014, a nationally representative survey of doctor-patient encounters in Malaysia. We assessed clinical quality for 27 587 patient encounters using data on 66 internationally validated quality indicators. Aggregate scores were constructed, and comparisons made between the public and private sectors. Overall, patients received the recommended care just over half the time (56.5%). The public sector performed better than the private sector, especially in the treatment of acute conditions, chronic conditions and in prescribing practices. Both sectors performed poorly in the indicators that are most resource intensive, suggesting that resource constraints limit overall quality. A comparison with 2003 data from the USA, suggests that performance in Malaysia was similar to that a decade earlier in the USA for common indicators. The public sector showed better performance in clinical care than the private sector, contrary to common perceptions in Malaysia and despite providing worse consumer quality. The overall quality of outpatient clinical care in Malaysia appears comparable to other developed countries, yet there are gaps in quality, such as in the management of hypertension, which should be tackled to improve overall health outcomes.
    Matched MeSH terms: Public Sector/standards*
  3. Woon YL, Ng CW, Mudin RN, Suli Z
    Western Pac Surveill Response J, 2019 05 21;10(2):39-45.
    PMID: 31720053 DOI: 10.5365/wpsar.2019.10.1.001
    Background: Dengue patients in Malaysia have the choice to seek care from either public or private sector providers. This study aims to analyse the pattern of health facility use among dengue patients to provide input for the ongoing policy discussion regarding public-private integration. The focus of this study is in the Klang Valley, which has a high dengue burden as well as a high number of private facilities.

    Methods: This is a cross-sectional study using an available secondary data source - the Malaysian national dengue passive surveillance system, e-Dengue registry. A total of 61 455 serologically confirmed dengue cases from the Klang Valley, registered in year 2014, were included. We retrospectively examined the relationship between demographic factors and the choice of health-care sector by logistic regression.

    Results: The median age of the cohort was 26 (interquartile range: 17 to 37) years. More private facilities (54.4%) were used for inpatient care; more public facilities (68.2%) were used for outpatient care. The Chinese and urban populations showed significantly higher use of the private health-care sector with an adjusted odds ratio of 4.8 [95% confidence interval (CI): 4.6-5.1] and 2.3 (95% CI: 2.2-2.4), respectively.

    Conclusion: Both public and private health facilities bear significant responsibilities in delivering health-care services to dengue patients. The workload of both sectors should be included in future health policy planning by public agencies.

    Matched MeSH terms: Public Sector/statistics & numerical data*
  4. Babar ZD, Izham MI
    Public Health, 2009 Aug;123(8):523-33.
    PMID: 19665741 DOI: 10.1016/j.puhe.2009.06.011
    Previous studies on anti-infective and cardiovascular drugs have shown extraordinary price increases following privatization of the Malaysian drug distribution system. Therefore, it was felt that there was a need to undertake a full-scale study to evaluate the effect of privatization of the Malaysian drug distribution system on drug prices.
    Matched MeSH terms: Public Sector/economics
  5. Maakip I, Keegel T, Oakman J
    J Occup Rehabil, 2015 Dec;25(4):696-706.
    PMID: 25808991 DOI: 10.1007/s10926-015-9577-2
    PURPOSE: Workstyle can be defined as an individual pattern of cognitions, behaviours and physiological reactivity that can occur while performing job tasks. Workstyle has been associated with the development of musculoskeletal disorders (MSDs) amongst office workers in developed countries. However, little is known about the contribution of workstyle on MSDs in developing countries such as Malaysia. The objective of this cross-sectional study was to examine the relationship between workstyle and musculoskeletal discomfort in a sample of office workers in Malaysia.

    METHODS: Office workers (N = 417; response rate 65.5 %) from four organisations completed a survey measuring physical and psychosocial hazards, job satisfaction, work-life balance, workstyle, and MSD discomfort levels. Hierarchical regression analyses were undertaken to examine predictors associated with self-reported musculoskeletal discomfort, and more specifically the relationship between workstyle and MSD discomfort.

    RESULTS: Musculoskeletal discomfort was significantly associated with working through pain, mental health, physical demands, gender and work-life balance (R (2) = 50.2, adjusted R (2) = 0.48; F (13, 324) = 25.09, p = 0.001). Working through pain is the strongest risk factor associated with MSD discomfort (ß = 0.49, p = 0.001) compared to other potential risk factors.

    CONCLUSIONS: Working through pain is influenced by work, social culture and religious beliefs. Workplace MSDs interventions that focus on the impact of physical and psychosocial hazards with emphasis on addressing adverse workstyles should take into account aspects related to work and social culture of the target population. Changes are recommended at both employee and management levels such as better communications and understanding concerning workplace problems with regards to minimizing MSDs at work.
    Matched MeSH terms: Public Sector*
  6. Lim RBL
    J Pain Palliat Care Pharmacother, 2003;17(3-4):77-85; discussion 87-9.
    PMID: 15022953 DOI: 10.1080/j354v17n03_11
    Palliative care first began in Malaysia in 1991, and since then there has been a growing interest in the field and its development both from the government and nongovernmental organizations. It is important to recognize the potential advantages and disadvantages of palliative care provided by both government and private programs to maximize development for the greater benefit of patients. A close relationship between these two bodies must be created so that there is smooth continuity of service and no overlapping of roles. This article highlights some thoughts on how palliative care has developed over the years from the perspective of a clinician who is currently working in the government sector and cooperating with nongovernmental organizations to develop a palliative care network in the region.
    Matched MeSH terms: Public Sector/organization & administration
  7. Tee Y, Huang M
    SAHARA J, 2009 Dec;6(4):179-87.
    PMID: 20485857
    Stigma and discrimination towards people living with HIV have been widely documented, and have extended their impact into the workplace. Stigmatising attitudes towards people living with HIV (PLHIV) in the workplace significantly hinder HIV prevention efforts and indirectly affect national development. This cross-sectional study was designed to determine the level of knowledge about HIV and AIDS and assess attitudes towards PLHIV among the general staff of Universiti Putra Malaysia (UPM), as well as to identify factors that are associated with it. Self-administered questionnaires were posted to a total of 344 general staff from six randomly selected faculties, and they were a given a week to return the questionnaires. The response rate was 38%. Data were analysed using Pearson's correlation, independent t-test and multiple linear regression. The respondents showed a considerably high level of knowledge about HIV/AIDS (mean knowledge score of 15.57+/-1.93 out of 18 points) although there were some misconceptions (N=129). Likert scale responses to 20 attitude statements revealed that respondents generally had moderately positive attitudes toward PLHIV (average score of 69.65+/-10.08 out of 100 points). Attitudes were inconsistent when it involved direct contact and interaction with PLHIV. Factors significantly associated with level of knowledge and attitudes included age, education and income. There was no difference in mean score for knowledge and attitudes by gender. Further efforts are necessary to improve attitudes of the general staff towards PLHIV, particularly in areas of direct contact with PLHIV.
    Matched MeSH terms: Public Sector*
  8. Tong SF, Khoo EM, Nordin S, Teng CL, Lee VK, Zailinawati AH, et al.
    Asia Pac J Public Health, 2012 Sep;24(5):764-75.
    PMID: 21659332 DOI: 10.1177/1010539511402190
    This study aimed to compare the process of care and the choice of antihypertensive medications used in both public and private primary care clinics in Malaysia. A cross-sectional survey was completed in 2008 on randomly selected 100 public health clinics and 114 private primary care clinics in Malaysia. A total of 4076 patient records, 3753 (92.1%) from public clinics and 323 (7.9%) from private clinics were analyzed. Less than 80% of the records documented the recommended clinical and laboratory assessments. The rates of documentation for smoking status, family history of premature death, retinal assessment, and urine albumin tests were lower in public clinics. Overall, 21% of the prescription practices were less than optimal. The process of care and the use of antihypertensive medications were not satisfactory in both settings.
    Matched MeSH terms: Public Sector/statistics & numerical data*
  9. Chua GN, Yee LJ, Sim BA, Tan KH, Sin NK, Hassali MA, et al.
    Int J Pharm Pract, 2014 Aug;22(4):265-74.
    PMID: 25121161
    The aims of the study were to assess job satisfaction and organisational commitment among pharmacists working in the public sector and its influence on their likelihood to stay within the public workforce.
    Matched MeSH terms: Public Sector
  10. Sim SM, Achike FI, Geh SL
    Med J Malaysia, 2005 Aug;60 Suppl D:41-7.
    PMID: 16315623
    In Malaysia many new medical schools (both public and private) have been set up in the last 12 years. As a result of global changes and local adjustments made in medical training, cross-breeds of different medical curricula have produced a wide spectrum of teaching-learning methods in these medical schools. In this paper, we have selected three medical schools--two public (Universiti Malaya and Universiti Putra Malaysia) and one private (International Medical University) to illustrate different approaches in the teaching-learning of pharmacology that exist in Malaysia. How do these different teaching-learning approaches affect the students' interest and ability to "master" pharmacology and in turn to develop a good prescribing practice?
    Matched MeSH terms: Public Sector
  11. Shahabudin SH
    Med J Malaysia, 2005 Aug;60 Suppl D:4-10.
    PMID: 16315616
    With globalization education has become a tradable service governed by the rules and regulations of GATS and worth trillions of dollars. International standards are rapidly being developed to facilitate cross border supply of services. In medical education, the WFME has produced International Guidelines on Quality in Medical Education which has a regional equivalent in the WHO Western Pacific Region, and the IIME has defined the minimum essential requirements of standards in medical education in seven core competences. Malaysia, having an explicit policy of making education a sector for revenue generation, has put in place regulatory frameworks and incentives to make the country a centre of educational excellence. Within the ambit of this national aspiration, medical education has grown phenomenally in the last decade. Standards and procedures for accreditation of medical schools in line with the world standards have been developed and implemented and policies are enforced to facilitate compliance to the standards. The ultimate goal is for medical schools to be self-accredited. In striving towards self-accreditation medical schools should be innovative in making changes in the three requirements of medical education. These are the intellectual and social imperatives and strategies for effective implementation.
    Matched MeSH terms: Public Sector
  12. Elkalmi RM, Khan MU, Ahmad A, Srikanth AB, Abdurhaman NS, Jamshed SQ, et al.
    J Res Pharm Pract, 2015 Apr-Jun;4(2):94-8.
    PMID: 25984548 DOI: 10.4103/2279-042X.155760
    OBJECTIVE:This study aimed to assess the knowledge, awareness, and perception of contraception among senior pharmacy students of a public sector university in Malaysia.
    METHODS: A cross-sectional, questionnaire-based study was conducted among senior pharmacy students. The pretested questionnaire was used to collect data from the participants over the period of 1-month. The questionnaire was divided into four sections, for gathering the information about students' demographic data, and their knowledge, attitudes, and perception toward contraception. Data were statistically analyzed using SPSS version 20.
    FINDINGS: The response rate was 68.6%. The results showed that the contraceptive knowledge was comparatively higher in year four students (P < 0.001), married respondents (P < 0.001) and those taking elective courses (P = 0.022) as compared to their respective counterparts. Majority of the students were well aware and had a positive perception about contraception.
    CONCLUSION: Overall findings reflect that the majority of the students had good knowledge, perception, and awareness about contraception. The study recommends future studies to be conducted covering different pharmacy schools across the country to further establish the results.
    KEYWORDS: Awareness; contraceptive; knowledge; perception; students
    Matched MeSH terms: Public Sector
  13. Ismail H, Abdul Manaf MR, Abdul Gafor AH, Mohamad Zaher ZM, Ibrahim AIN
    Kidney Int Rep, 2019 Sep;4(9):1261-1270.
    PMID: 31517145 DOI: 10.1016/j.ekir.2019.05.016
    Introduction: Prevalence of chronic kidney disease (CKD) in Malaysia is 9.07% of the total population, of which 0.36% are at stage 5 CKD or end-stage renal disease (ESRD). Public-private partnership has improved accessibility of renal replacement therapies (RRT), especially dialysis, in Malaysia, but the economic burden of the existing RRT financing mechanism, which is predominantly provided by the public sector, has never been quantified.

    Methods: Primary data were collected through a standardized survey, and secondary data analysis was used to derive estimates of the ESRD expenditure.

    Results: Total annual expenditure of ESRD by the public sector has grown 94% within a span of 7 years, from Malaysian Ringgit [MYR] 572 million (US dollars [USD] 405 million, purchasing power parity [PPP] 2010) in 2010 to MYR 1.12 billion (USD 785 million, PPP 2016) in 2016. The total ESRD expenditure in 2010 constituted 2.95% of the public sector's total health expenditure, whereas in 2016, the proportion has increased to 4.2%. Only 6% of ESRD expenditure was spent on renal transplantation, and the remaining 94% was spent on dialysis.

    Conclusion: The share of ESRD expenditure in total health expenditure for the public sector is considered substantial given only a small proportion of the population is affected by the disease. The rapid increase in expenditure relative to the national total health expenditure should warrant the relevant authorities about sustainability of the existing financing mechanism of ESRD and the importance to institutionalize more drastic preventive measures.

    Matched MeSH terms: Public Sector
  14. Pyne S, Ravindran TKS
    PMID: 33786477 DOI: 10.1089/whr.2019.0007
    Background:
    The provision of safe abortion services upholds the realization of justice in sexual and reproductive health. Many state-level studies in India have identified poor availability of abortion services in the public sector and negative attitudes toward abortion among health providers, as potential barriers to access.
    Materials and Methods:
    A cross-sectional study was done to document the availability and utilization of medical termination of pregnancy (MTP or abortion) services and to assess public sector health providers' attitudes towards safe abortion. It was carried out in a representative district of West Bengal, using a facility checklist and a validated attitude scale.
    Results:
    Only 11 of 42 public health facilities had both trained doctors and equipment to provide MTP services. Twelve facilities provided MTP services, of which only three urban-based secondary-level facilities provided second trimester MTPs. There were female providers in just 2 of the 12 MTP-providing facilities. Among the 64 health providers interviewed, 40% were trained to provide MTP. According to the attitude scale, 38% had a negative attitude toward the provision of safe abortion services. There was no statistically significant association between attitudes of health providers and provision of MTP. However, there appeared to be a subtle process of gatekeeping in operation, such as making MTP conditional on acceptance of contraception, requiring the husband's consent, and so on.
    Conclusions:
    The study shows the poor availability of abortion services in public sector facilities in a district of West Bengal, although all public health facilities from the primary health center level upwards are authorized to provide abortion services.
    Matched MeSH terms: Public Sector
  15. Tuti Ningseh Mohd-Dom, Khairiyah Abdul-Muttalib, Rasidah Ayob, Yaw, Siew Lan, Ahmad Sharifuddin Mohd-Asadi, Mohd Rizal Abdul-Manaf, et al.
    MyJurnal
    The paucity of published literature on periodontal treatment needs and services in developing countries has undermined the significance of periodontal disease burden on healthcare systems. This study analyses periodontal status and population treatment needs of Malaysians, and patterns of periodontal services provided at public sector dental clinics. A retrospective approach to secondary data analysis was employed. Data for population treatment needs were extracted from three decennial national oral health surveys for adults (1990, 2000 and 2010). Annual reports from the dental subsystem of the government Health Information Management System (HIMS) provided information on oral health care delivery for years 2006-2010. They were based on summaries of aggregated data; analyses were limited to reporting absolute numbers and frequency distributions. Periodontal disease prevalence declined between 1990 (92.8%) to 2000 (87.2%) but a sharp rise was observed in the 2010 survey (94.0%). The proportion of participants demonstrating periodontal pockets of 6 mm and more increased in 2010 survey after showing improvements in 2000. Individuals not requiring periodontal treatment (TN0) increased in proportion from 1990 to 2000, only to drop in 2010. An increase in utilisation was observed alongside a growing uptake of periodontal procedures (62.2% in 2006 to 73.6% in 2010). Only about 10% of treatment was surgeries. While the clinical burden of periodontal disease is observed to be substantial, the types of treatment provided did not reflect the increasing needs for complex periodontal treatment. Emphasis on downstream and multi-collaborative efforts of oral health care is deemed fit to contain the burden of periodontal disease.
    Matched MeSH terms: Public Sector
  16. Anuar, I., Zahedi, F., Kadir, A., Mokhtar, A.B.
    MyJurnal
    Background : A safety culture practice through prevention needs skillful, knowledgeable and competencies workers. The effectiveness of occupational safety and health programme implementation needs the knowledge related to Occupational Safety and Health Acts, 1994 (OSHA 1994) and its regulations.
    Objective : This study was to determine the level of knowledge and awareness towards Occupational Safety and Health (OSH) aspects among workers in medical laboratory.
    Methodology : A cross-sectional study was carried out on 34 medical laboratories in which 17 were from private and another 17 laboratories were from public sectors. It consists of 112 medical laboratory disciplines. Data were obtained using self-administered questionnaire consisting of 33 questions related to Occupational Safety and Health (OSH). Each question was coded “know” and “do not know” and respondents were needed to state their understanding towards each OSH issue tendered.
    Results : Respondent’s level of knowledge was analyzed according to socio-demography and socioeconomic factors. OSH level of knowledge among medical laboratory workers showed that there are significant differences (p0.05) in OSH knowledge according to between sex, marital status, income and services sectors among workers in medical laboratories. Only about 60.5% of respondents knew the existence of OSHA 1994, whereas those who knew about OSHA 1994 regulations were below than 50.0% from overall respondents.
    Conclusion : Promotion and practices of dynamic safety culture through prevention needs high knowledge of OSH.
    Matched MeSH terms: Public Sector
  17. Mohd-Dom TN, Wan-Puteh SE, Muhd-Nur A, Ayob R, Abdul-Manaf MR, Abdul-Muttalib K, et al.
    Value Health Reg Issues, 2014 May;3:117-123.
    PMID: 29702916 DOI: 10.1016/j.vhri.2014.04.012
    OBJECTIVES: The aim of this study was to evaluate the cost-effectiveness of the national public sector specialist periodontal program in the management of periodontal disease.
    METHODS: This was a multicenter, time motion, prospective, economic evaluation study involving a total of 165 patients with periodontitis recruited from five selected specialist periodontal clinics. Treatment costs were measured in 2012 Malaysian ringgit (MYR) and estimated from the societal perspective using step-down and activity-based costing methods, and substantiated by clinical pathways. A cost-effectiveness analysis was done to compare the specialist periodontal program with a hypothetical scenario in which patients attend biannual dental visits only for regular dental check-up and scaling. The incremental cost-effectiveness ratio was defined as the difference in cost per gain in quality-adjusted life-years (QALYs) and clinical attachment levels (CALs). One-way scenario-based sensitivity analyses were carried out to assess the uncertainty of inputs.
    RESULTS: The average cost for managing patients with periodontitis was MYR 376 per outpatient visit and MYR 2820 per annum. Clinically, a gain of an average of 0.3 mm of CAL was attained at post-treatment (paired t test, P < .001). Patients gained an average of 3.8 QALY post-treatment (paired t test, P < .001). For cost-effectiveness analysis, the specialist periodontal program was more cost-effective than the hypothesized biannual dental visits, with incremental cost-effectiveness ratios of MYR 451 and MYR 5713 per additional QALY and millimeter CAL gained, respectively.
    CONCLUSIONS: It is very cost-effective for the public sector to provide specialist periodontal treatment for patients with periodontitis according to the World Health Organization criteria and when compared with conventional biannual dental treatment.
    Matched MeSH terms: Public Sector
  18. Rahim N, Iffat W, Shakeel S, Naeem MI, Qazi F, Rizvi M, et al.
    J Pharm Bioallied Sci, 2017 Apr-Jun;9(2):144-151.
    PMID: 28717338 DOI: 10.4103/jpbs.JPBS_328_16
    AIMS: In flu pandemics, pharmacy students' knowledge, attitudes, and practices are critical to save patients life. The objective of study was to determine the knowledge of and attitude toward the pandemic influenza among the pharmacy students of Karachi, Pakistan.
    SETTINGS AND DESIGNS: The cross-sectional study was conducted from September to December 2014 by adopting a prevalidated questionnaire distributed to senior pharmacy students (final year) in seven private and public sector universities of Karachi.
    MATERIALS AND METHODS: A total of 443 pharmacy students responded the survey. Data regarding sociodemographic characteristics of the students, perceptions, level of knowledge and attitudes toward influenza, and prophylactic measures were collected.
    STATISTICAL ANALYSIS: To compute the correlation between different variables, data were analyzed using Pearson's Chi-square statistic method. P < 0.05 was considered statistical significance for all analysis.
    RESULTS: Influenza was identified as a viral disease (n = 423; 95.48%) and 282 (71.2%) students correctly identified it as disease affecting humans and pigs. Textbooks reported as most common source of knowledge (n = 282; 64%). Most common symptoms identified were fever (81.94%), sore throat (64.1%), and nonproductive cough (43.34%). The most common preventive measures were covering nose and mouth (268; 60.5%) and wearing protective coverings (254; 57.3%). Only half of the students correctly reported about the route of administration (180; 40.6%) and strains in vaccine (186; 41.98%). The best time for administration of such vaccine was known by only 156 pharmacy students (35.34%). The majority of the students (82.6%) had no idea about the manifestation of influenza pandemic. Knowledge regarding influenza differed according to gender and institutions differing in their affiliation with tertiary care hospitals.
    CONCLUSION: It was observed that knowledge about disease progression, transmission, vaccination, and treatment in pharmacy students, especially those who are not getting clinical training in tertiary care hospitals was limited. There is an urgent need to develop awareness programs to increase knowledge of influenza among clinical pharmacists as they are more susceptible to infections and community as a whole.
    Matched MeSH terms: Public Sector
  19. Chee H L, Barraclough S
    ISBN: 978-0-203-96483-5
    Foreword. M K Rajakumar
    Introduction: The transformation of health care in Malaysia. p1. CHEE HENG LENG AND SIMON BARRACLOUGH
    PART I: The state and the private sector in the financing and provision of health care. p17
    1 The growth of corporate health care in Malaysia. p19. CHEE HENG LENG AND SIMON BARRACLOUGH
    2 Regulating Malaysia’s private health care sector. p40. NIK ROSNAH WAN ABDULLAH
    3 Rising health care costs: the contradictory responses of the Malaysian state. p59. PHUA KAI LIT
    4 Malaysian health policy in comparative perspective. p72. M. RAMESH
    5 The welfarist state under duress: global influences and local contingencies in Malaysia. p85. CHAN CHEE KHOON
    6 Equity in Malaysian health care: an analysis of public health expenditures and health care facilities. p102. WEE CHONG HUI AND JOMO K.S.
    PART II: People’s access to health care. p117
    7 Health care for the Orang Asli: consequences of paternalism and non-recognition. p119. COLIN NICHOLAS AND ADELA BAER
    8 Women’s access to health care services in Malaysia. p137. CHEE HENG LENG AND WONG YUT LIN
    9 HIV/AIDS health care policy and practice in Malaysia. p154. HUANG MARY S.L. AND MOHD NASIR MOHD TAIB
    10 Health care and long-term care issues for the elderly. p170. ONG FON SIM
    11 Health care in Sarawak: model of a public system. p187. KHOO KHAY JIN
    Epilogue: Civil society and health care policy in Malaysia. p208. CHEE HENG LENG AND SIMON BARRACLOUGH
    Index
    Matched MeSH terms: Public Sector
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