MyMedR

Displaying publications 61 - 80 of 594 in total

Abstract:

Sort:

The Breast Health Global Initiative: clinical practice guidelines for management of breast cancer in low- and middle-income countries

Yip CH, Anderson BO

Expert Rev Anticancer Ther, 2007 Aug;7(8):1095-104.
PMID: 18028018

Breast cancer is an increasingly urgent problem in low- and mid-level resource countries of the world. Despite knowing the optimal management strategy based on guidelines developed in wealthy countries, clinicians are forced to provide less-than-optimal care to patients when diagnostic and/or treatment resources are lacking. For this reason, it is important to identify which resources commonly applied in resource-abundant countries most effectively fill the healthcare needs in limited-resource regions, where patients commonly present with more advanced disease at diagnosis, and to provide guidance on how new resource allocations should be made in order to maximize improvement in outcome. Established in 2002, the Breast Health Global Initiative (BHGI) created an international health alliance to develop evidence-based guidelines for countries with limited resources (low- and middle-income countries) to improve breast health outcomes. The BHGI serves as a program for international guideline development and as a hub for linkage among clinicians, governmental health agencies and advocacy groups to translate guidelines into policy and practice. The BHGI collaborated with 12 national and international health organizations, cancer societies and nongovernmental organizations to host two BHGI international summits. The evidence-based BHGI Guidelines, developed at the 2002 Global Summit, were published in 2003 as a theoretical treatise on international breast healthcare. These guidelines were then updated and expanded at the 2005 Global Summit into a fully comprehensive and flexible framework to permit incremental improvements in healthcare delivery, based upon outcomes, cost, cost-effectiveness and use of healthcare services.

Matched MeSH terms: Delivery of Health Care
Fulltext Breast cancer early detection: A phased approach to implementation

Ginsburg O, Yip CH, Brooks A, Cabanes A, Caleffi M, Dunstan Yataco JA, et al.

Cancer, 2020 May 15;126 Suppl 10(Suppl 10):2379-2393.
PMID: 32348566 DOI: 10.1002/cncr.32887

When breast cancer is detected and treated early, the chances of survival are very high. However, women in many settings face complex barriers to early detection, including social, economic, geographic, and other interrelated factors, which can limit their access to timely, affordable, and effective breast health care services. Previously, the Breast Health Global Initiative (BHGI) developed resource-stratified guidelines for the early detection and diagnosis of breast cancer. In this consensus article from the sixth BHGI Global Summit held in October 2018, the authors describe phases of early detection program development, beginning with management strategies required for the diagnosis of clinically detectable disease based on awareness education and technical training, history and physical examination, and accurate tissue diagnosis. The core issues address include finance and governance, which pertain to successful planning, implementation, and the iterative process of program improvement and are needed for a breast cancer early detection program to succeed in any resource setting. Examples are presented of implementation, process, and clinical outcome metrics that assist in program implementation monitoring. Country case examples are presented to highlight the challenges and opportunities of implementing successful breast cancer early detection programs, and the complex interplay of barriers and facilitators to achieving early detection for breast cancer in real-world settings are considered.

Matched MeSH terms: Delivery of Health Care
The effect of health programs on breastfeeding and child mortality in Peninsular Malaysia

Anderson KH

Res Popul Econ, 1984;5:87-112.
PMID: 12266419
Matched MeSH terms: Delivery of Health Care*
Ageing in the developing countries of Asia and the Pacific--implications for health care

Andrews GR

Ann Acad Med Singap, 1987 Jan;16(1):3-10.
PMID: 3592590

While ageing is still clearly not a high priority issue for health planners, policy makers and clinicians in developing countries of Asia and the Pacific, there will be a growing need in coming years to pay more and more attention to the important health issues associated with population ageing in countries which make up this region of the world. This paper reports some of the relevant findings of a WHO sponsored cross national study of the health and social aspects of ageing in four of the countries, namely Korea, the Philippines, Fiji and Malaysia. The key findings are compared and contrasted with those of a similar WHO eleven country study in Europe. The paper argues that there is an urgent need to develop health care strategies which will minimise the impact of population ageing and will maintain the growing numbers of old people in relatively good physical and mental health through preventive measures and through programmes directed to the maintenance of physical and mental health.

Matched MeSH terms: Delivery of Health Care*
Fulltext Patients’ expectations and perceptions of services provided by primary health clinics in Kota Bharu, Kelantan, Malaysia

Ahmad Badruridzwanullah Zun, Mohd Ismail Ibrahim, Anees Abdul Hamid

Malaysian Journal of Medicine and Health Sciences, 2020;16(3):225-230.
MyJurnal

Introduction: Primary health care plays an important role in healthcare systems. In Malaysia, One (1) Malaysia Clinic (now known as Community Clinic since 2018) was established in 2010 aims to increase healthcare services accessibility within the poor urban population. The aim was to look at the effectiveness of One (1) Malaysia Clinic as a new form of public primary health clinic by looking at expectations and perceptions of the quality of the provided services by the patients. Method: It applied a cross sectional study involving nine clinics in of the busiest district in Kelantan namely, Kota Bharu district. 386 respondents which were Malaysian citizen, 18 years old and above were involved in this study. The survey used Malay validated SERVQUAL questionnaire. The Service Quality (SQ) gap was calculated. Result: The empathy dimension obtained the highest expectation and perception score, while the tangi- ble dimension has the lowest expectation and perception score. In all SERVQUAL dimension, the expectations and perceptions of the service provided was significantly different with P < 0.001. The most critical dimension identified was tangible dimension as it has the largest negative SQ gap score. Conclusion: Negative gaps for all SERVQUAL dimensions and individual items indicated that provided services at One (1) Malaysia Clinic still could not fulfilled the patient’s expectation. A continuous improvement program is needed especially on tangible dimension in deliv- ering a quality healthcare services.

Matched MeSH terms: Delivery of Health Care
Fulltext Nucleic Acid-Based Diagnostic Tests for the Detection SARS-CoV-2: An Update

Yu CY, Chan KG, Yean CY, Ang GY

Diagnostics (Basel), 2021 Jan 01;11(1).
PMID: 33401392 DOI: 10.3390/diagnostics11010053

The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began as a cluster of pneumonia cases in Wuhan, China before spreading to over 200 countries and territories on six continents in less than six months. Despite rigorous global containment and quarantine efforts to limit the transmission of the virus, COVID-19 cases and deaths have continued to increase, leaving devastating impacts on the lives of many with far-reaching effects on the global society, economy and healthcare system. With over 43 million cases and 1.1 million deaths recorded worldwide, accurate and rapid diagnosis continues to be a cornerstone of pandemic control. In this review, we aim to present an objective overview of the latest nucleic acid-based diagnostic tests for the detection of SARS-CoV-2 that have been authorized by the Food and Drug Administration (FDA) under emergency use authorization (EUA) as of 31 October 2020. We systematically summarize and compare the principles, technologies, protocols and performance characteristics of amplification- and sequencing-based tests that have become alternatives to the CDC 2019-nCoV Real-Time RT-PCR Diagnostic Panel. We highlight the notable features of the tests including authorized settings, along with the advantages and disadvantages of the tests. We conclude with a brief discussion on the current challenges and future perspectives of COVID-19 diagnostics.

Matched MeSH terms: Delivery of Health Care
Fulltext The evaluation of knowledge and practice on Clinical Pathways among health care workers at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) Malaysia

Saperi Sulong, Haris Cendera Khazaani Osman, Aniza Ismail

Malaysian Journal of Public Health Medicine, 2015;15(1):0-0.
MyJurnal

The rapid development in the health sector has spurred many healthcare organizations to improve their productivity and quality, particularly in terms of service. Clinical Pathways was introduced with the objective of improving the quality of care and services in health; while at the same time eyeing the possibility of reducing the medical expenses. It can be defined as a document based tool that links the best available evidence and clinical practice and provides recommendations, the process and time frame for the clinical management of healthcare. A cross sectional study was carried out at University Kebangsaan Malaysia Medical Centre (UKMMC) Malaysia with the aim to evaluate the level of knowledge about Clinical Pathways (CP) and to ascertain its level of practice in the implementation of CP among healthcare workers at UKMMC; and to establish correlated determinant factors. The study involved a total of 127 respondents; majority of whom were female (77.2%), aged between 32 and 45 years (51.2%), working as nurses (71.7%), and having working experience of six years or longer (52.0%) at UKMMC. The findings reveal that 52.8% of respondents agreed that there is a proper implementation of the Clinical Pathways (CP) programme at UKMMC; and that 52.0% of the respondents have a higher level of knowledge about CP and 70.1% of them practiced it well. The findings also unravel two factors (position and working experience) as the predictors of respondents’ level of knowledge about CP, and position as a predictor representing the practice of it at UKMMC. It can be safely surmised that most of the respondents have a higher level of knowledge about Clinical Pathways and that they practice it well in their daily task as healthcare workers.

Matched MeSH terms: Delivery of Health Care
Fulltext Childhood-Onset Systemic Lupus Erythematosus: Southeast Asian Perspectives

Tang SP, Lim SC, Arkachaisri T

J Clin Med, 2021 Feb 03;10(4).
PMID: 33546120 DOI: 10.3390/jcm10040559

Childhood onset systemic lupus erythematosus is a rare disease that is more common amongst Southeast Asian children compared to the West. It is typified by a peripubertal onset and a female preponderance, which increases with advancing age. Organs commonly involved at diagnosis include haematological, renal, and mucocutaneous. Fever, malar rash, and cutaneous vasculitis are common. Lupus nephritis is typically proliferative especially Class IV and contributes to both disease activity and damage. Antinuclear antibody and anti-dsDNA positivity are both prevalent in this region. Disease activity is higher than Western cohorts at onset but responds to therapy reducing to low disease activity by six months. However, organ damage occurs early and continues to accumulate over the time, a consequence of both active disease (neurological and renal systems) and steroid-related complications especially in the eye (cataract and glaucoma) and musculoskeletal systems (avascular necrosis). Infections remain the leading cause of death and mortality in this region is highly variable contributed by the heterogeneity in social economic status, healthcare access, and availability of paediatric rheumatology expertise in the region.

Matched MeSH terms: Delivery of Health Care
Photonics-powered augmented reality skin electronics for proactive healthcare: multifaceted opportunities

Taha BA, Addie AJ, Kadhim AC, Azzahran AS, Haider AJ, Chaudhary V, et al.

Mikrochim Acta, 2024 Apr 08;191(5):250.
PMID: 38587660 DOI: 10.1007/s00604-024-06314-3

Rapid technological advancements have created opportunities for new solutions in various industries, including healthcare. One exciting new direction in this field of innovation is the combination of skin-based technologies and augmented reality (AR). These dermatological devices allow for the continuous and non-invasive measurement of vital signs and biomarkers, enabling the real-time diagnosis of anomalies, which have applications in telemedicine, oncology, dermatology, and early diagnostics. Despite its many potential benefits, there is a substantial information vacuum regarding using flexible photonics in conjunction with augmented reality for medical purposes. This review explores the current state of dermal augmented reality and flexible optics in skin-conforming sensing platforms by examining the obstacles faced thus far, including technical hurdles, demanding clinical validation standards, and problems with user acceptance. Our main areas of interest are skills, chiroptical properties, and health platform applications, such as optogenetic pixels, spectroscopic imagers, and optical biosensors. My skin-enhanced spherical dichroism and powerful spherically polarized light enable thorough physical inspection with these augmented reality devices: diabetic tracking, skin cancer diagnosis, and cardiovascular illness: preventative medicine, namely blood pressure screening. We demonstrate how to accomplish early prevention using case studies and emergency detection. Finally, it addresses real-world obstacles that hinder fully realizing these materials' extraordinary potential in advancing proactive and preventative personalized medicine, including technical constraints, clinical validation gaps, and barriers to widespread adoption.

Matched MeSH terms: Delivery of Health Care
Some aspects of maternal care in rural peninsular Malaysia

Salleh NM, Tan BA, Arshat H

Malays J Reprod Health, 1986 Jun;4(1):20-8.
PMID: 12268569

PIP: The effectiveness and impact of the Population and Family Health Project in the rural areas of Malaysia is evaluated. A total of 790 women who delivered during the past 3 years from the time of the survey, were identified from 2,013 women aged 15-49 years, during the 2nd Family and Health Survey (1979) in Peninsular Malaysia. The rural health districts which were selected by random sampling include: Perlis, Kubang Pasu, Sebeang Perai Selatan, Kuala Selangor, Hulu Langat, Melaka Utara, Kota Bharu/Tumpat, and Pasir Mas. The pattern of maternal care during pregnancy, delivery and puerperium are examined with respect to selected variables. These women are further classified into 2 groups by type of birth attendant at delivery and these 2 groups are also examined in relation to selected socioeconomic variables. The major proportion of women had their 1st antenatal visit during the 2nd and 3rd trimester of pregnancy. The highest % (28.3%) of 1st antenatal visits occurred during the 5th month of pregnancy. Use of a trained medical practitioner is preferred (82.5%), while only 17.5% of women preferred the services of traditonal birth attendants. Women in this latter group had less education and were in lower income groups, than the former group of women. Majority of women in all ethnic and age groups had no postnatal check after their last childbirth.

Matched MeSH terms: Delivery of Health Care
Laparoscopic female sterilization--an evaluation exercise in a Malaysian family planning clinic

Kim KS, Arshat H

Malays J Reprod Health, 1986 Jun;4(1):12-9.
PMID: 12268568
Matched MeSH terms: Delivery of Health Care
Perceived training needs of nurses working with mentally ill patients

Oranye NO, Arumugam U, Ahmad N, Arumugam ME

Contemp Nurse, 2016 Oct;52(5):555-566.
PMID: 27248157 DOI: 10.1080/10376178.2016.1194726

Introductio n: In Malaysia, nurses form a significant part of the clinical mental health team, but the current level of training in mental health results in suboptimal nursing care delivery.
METHODS: For this study 220 registered nurses and medical assistants working with the mentally ill completed a structured questionnaire. The purpose of this study was to explore perceived competence in mental healthcare and the training needs of nurses working with mentally ill patients in inpatient mental healthcare facilities.
RESULTS: The skills perceived as important for practicing in mental health varied among the nurse participants. Post basic training in mental health was significantly related to perceived competence in patient mental state assessment (p=0.036), risk assessment for suicide (p=0.024), violence (p=0.044) and self-harm (p=0.013).
CONCLUSION: There is little emphasis on psychosocial skills in current post basic mental health training in Malaysia.

Matched MeSH terms: Delivery of Health Care/organization & administration*
Fulltext Readiness for interprofessional education among preclinical and clinical year medical students - does it change over the years?

Kavitha Ashok Kumar, Ashok Kumar Jeppu

Malaysian Journal of Medicine and Health Sciences, 2020;16(107):63-66.
MyJurnal

Introduction: Health care involves team work. Physicians, nurses, pharmacists and social workers need to work in collaboration to deliver quality health care. It is therefore vital that team work and collaboration are integrated into the training of medical students. In a medical school where interprofessional education has not been introduced, the preclinical students are trained in silos whereas the clinical students have interprofessional experiences in hospital and community centers. This study was conducted to explore medical student’s receptiveness for interprofessional education and to identify any differences in attitude among the preclinical and clinical year students. Methods: This study adopted a cross-sectional study design using purposive sampling technique at a private medical school in Malaysia. Participants completedthe standardized Readiness for inter-professional learning Scale and the data was analyzed. Results: 436 students witha mean age of 22 years participated in this study. Among them, 170 were from preclinical and 266 were from clinical years Both the groups scored high on team work while clinical students scored better than preclinical students in understanding professional identity and recognizing their roles. Conclusion: This study shows a readiness among medical students for IPE. Clinical year medical student’s attitude was similar to preclinical students.

Matched MeSH terms: Delivery of Health Care
Fulltext Exploring challenges faced by parents of children with tuberculosis in Klang and Petaling districts of Selangor state, Malaysia: A qualitative study

S Maria Awaluddin, Nurhuda Ismail, Siti Munira Yasin, Yuslina Zakaria, Norzila Mohamed Zainudin, Faridah Kusnin, et al.

Journal of Clinical and Health Sciences, 2020;5(2):46-56.
MyJurnal

Introduction: Parents play an essential role in their children’s tuberculosis (TB) treatment
success despite many challenges from the beginning of their children’s symptoms until
completion of the TB treatment. The challenges can be described as perceived barriers,
according to the Health Belief Model, a theory of behaviour change. This study aims to explore
parents’ experiences on the challenges in achieving a successful TB treatment for their child
in two districts of Selangor state, Malaysia. Methods: The research was carried out using a
phenomenology study design. In-depth interviews were conducted among purposively
sampled parents of children with TB disease who have completed TB treatment or still
undergoing treatment from MyTB version 2.1, a national TB surveillance database. The
collected data was considered as achieving its saturation level if no new themes arise from
the latest interviews’ session. The R-based Qualitative Data Analysis (RQDA) package
version 0.2-8 was used for the thematic data analysis. Results: The total number of
participants in this study was 15 mothers of children with TB disease; 12 (80%) of the children
had completed TB treatment. There were six subthemes identified from this study focusing on
the theme of multiple challenges, such as health symptoms challenges, TB investigation
challenges, personal challenges, healthcare facilities challenges, administration medication
challenges, and community challenges. Conclusions: Parents highlighted many challenges
during the child’s illness phase, and they should be given adequate education and appropriate
support to ensure TB treatment adherence. TB program managers should take action
following the relevant parents’ feedback regarding the quality of TB care in a healthcare
facility

Matched MeSH terms: Delivery of Health Care
Fulltext From nature to nanotechnology: The interplay of traditional medicine, green chemistry, and biogenic metallic phytonanoparticles in modern healthcare innovation and sustainability

Puri A, Mohite P, Maitra S, Subramaniyan V, Kumarasamy V, Uti DE, et al.

Biomed Pharmacother, 2024 Jan;170:116083.
PMID: 38163395 DOI: 10.1016/j.biopha.2023.116083

As we navigate the modern era, the intersection of time-honoured natural remedies and contemporary scientific approaches forms a burgeoning frontier in global healthcare. For generations, natural products have been foundational to health solutions, serving as the primary healthcare choice for 80% to 85% of the world's population. These herbal-based, nature-derived substances, significant across diverse geographies, necessitate a renewed emphasis on enhancing their quality, efficacy, and safety. In the current century, the advent of biogenic phytonanoparticles has emerged as an innovative therapeutic conduit, perfectly aligning with principles of environmental safety and scientific ingenuity. Utilizing green chemistry techniques, a spectrum of metallic nanoparticles including elements such as copper, silver, iron, zinc, and titanium oxide can be produced with attributes of non-toxicity, sustainability, and economic efficiency. Sophisticated herb-mediated processes yield an array of plant-originated nanomaterials, each demonstrating unique physical, chemical, and biological characteristics. These attributes herald new therapeutic potentials, encompassing antioxidants, anti-aging applications, and more. Modern technology further accelerates the synthesis of natural products within laboratory settings, providing an efficient alternative to conventional isolation methods. The collaboration between traditional wisdom and advanced methodologies now signals a new epoch in healthcare. Here, the augmentation of traditional medicine is realized through rigorous scientific examination. By intertwining ethical considerations, cutting-edge technology, and natural philosophy, the realms of biogenic phytonanoparticles and traditional medicine forge promising pathways for research, development, and healing. The narrative of this seamless integration marks an exciting evolution in healthcare, where the fusion of sustainability and innovation crafts a future filled with endless possibilities for human well-being. The research in the development of metallic nanoparticles is crucial for unlocking their potential in revolutionizing fields such as medicine, catalysis, and electronics, promising groundbreaking applications with enhanced efficiency and tailored functionalities in future technologies. This exploration is essential for harnessing the unique properties of metallic nanoparticles to address pressing challenges and advance innovations across diverse scientific and industrial domains.

Matched MeSH terms: Delivery of Health Care
Fulltext An analytical model to minimize the latency in healthcare internet-of-things in fog computing environment

Shukla S, Hassan MF, Khan MK, Jung LT, Awang A

PLoS One, 2019;14(11):e0224934.
PMID: 31721807 DOI: 10.1371/journal.pone.0224934

Fog computing (FC) is an evolving computing technology that operates in a distributed environment. FC aims to bring cloud computing features close to edge devices. The approach is expected to fulfill the minimum latency requirement for healthcare Internet-of-Things (IoT) devices. Healthcare IoT devices generate various volumes of healthcare data. This large volume of data results in high data traffic that causes network congestion and high latency. An increase in round-trip time delay owing to large data transmission and large hop counts between IoTs and cloud servers render healthcare data meaningless and inadequate for end-users. Time-sensitive healthcare applications require real-time data. Traditional cloud servers cannot fulfill the minimum latency demands of healthcare IoT devices and end-users. Therefore, communication latency, computation latency, and network latency must be reduced for IoT data transmission. FC affords the storage, processing, and analysis of data from cloud computing to a network edge to reduce high latency. A novel solution for the abovementioned problem is proposed herein. It includes an analytical model and a hybrid fuzzy-based reinforcement learning algorithm in an FC environment. The aim is to reduce high latency among healthcare IoTs, end-users, and cloud servers. The proposed intelligent FC analytical model and algorithm use a fuzzy inference system combined with reinforcement learning and neural network evolution strategies for data packet allocation and selection in an IoT-FC environment. The approach is tested on simulators iFogSim (Net-Beans) and Spyder (Python). The obtained results indicated the better performance of the proposed approach compared with existing methods.

Matched MeSH terms: Delivery of Health Care*
Fulltext Muslim female healthcare personnel dress code: a proposed guideline

Saidun, S., Akhmetova, E., Awang Abd Rahman, A.

International Medical Journal Malaysia, 2018;17(2):57-70.
MyJurnal

Introduction: The struggle of Muslim women to comply with Islamic teaching while working in the healthcare sector has been a long-standing issue. Following the case of a Muslim nurse who was allegedly fired for non-adherence to the short-sleeve uniform rule, the Malaysian Muslim Consumers Association highlighted the need for a uniform guideline to prevent similar instances. Yet, no guideline has been issued to date. Materials and Methods: This conceptual study employed library research method to gather relevant materials. Library research was able to retrieve guidelines from seven Muslim-minority countries but none from Muslim-majority countries. Document analysis of the materials gathered was undertaken. The different guidelines were compared, with special reference to awrah-related issues. Results: Several major issues that healthcare personnel dress code considers are the safety, health, cleanliness, and comfort for both patients and healthcare personnel. Islamic dressing requirement is not only in line with clinical practice but Islam also highly promotes maintenance of safety, health, cleanliness, and comfort. The widely adopted ‘bare below the elbows (BBE) policy is the only practice that may contradict Islamic rules. However, some healthcare institutions in Muslim-minority countries allow modifications of uniform rules on religious grounds; some of the modifications are not observed in Muslim-majority countries. When providing direct patient care that requires BBE, the use of disposable over-sleeves is a good alternative to adhere to both clinical and Islamic standards. Conclusion: Healthcare personnel dress code policy that is concordant to both clinical and Islamic standards is possible although it may require greater resources.

Matched MeSH terms: Delivery of Health Care
Fulltext A qualitative study on the implementation of family health team: the perspectives of providers and patients

Mohd Hanafiah AN, Johari MZ, Azam S

BMC Fam Pract, 2020 08 09;21(1):162.
PMID: 32772931 DOI: 10.1186/s12875-020-01217-7

BACKGROUND: Malaysia has committed to the global call to achieve universal health coverage, and with the adoption of Sustainable Development Goals, is further strengthening the health system through the primary health care services, particularly the family doctor concept. The Enhanced Primary Health Care (EnPHC) initiative was implemented to address the worrying upward trend of non-communicable disease prevalence, and incorporates the Family Health Team (FHT) concept. The aim of this paper is to describe the implementation of the FHT as part of the EnPHC intervention.
METHODS: In-depth interviews and focus group discussions were conducted with the intervention design team, healthcare providers and patients in two rounds during the implementation period. A total of 121 individuals in the two rounds, split into different groups, where some of the participants of the FGD were also interviewed individually. Data were analysed using a thematic analysis, with codes being organised into larger themes.
RESULTS: Themes that emerged from the data were around the process of FHT implementation and the advantages of the FHT, which included continuity of health care and improved quality of care. Patients and health care providers were receptive to the FHT concept, and took the effort to adapt the concept in the local settings.
CONCLUSIONS: The FHT concept implemented at 20 public primary health clinics has benefits appreciated by health care providers and patients. Addressing the viable shortcomings would better prepare the current primary healthcare system to scale up the FHT concept nationwide and enhance its feasibility and sustainability.
TRIAL REGISTRATION: The study is registered with the National Medical Research Register, Ministry of Health Malaysia ( NMRR-17-295-34711 ).

Matched MeSH terms: Delivery of Health Care
Fulltext Inpatient Case-mix Cost Vs Average Cost for Health Care Services in King Fahd Central Hospital, Saudi Arabia: A Comparative Study

Mehmood A, Ahmed Z, Ghilan K, Damad A, Azeez FK

Inquiry, 2021 11 20;58:469580211056060.
PMID: 34796754 DOI: 10.1177/00469580211056060

Health care systems aim to deliver high-quality medical care while considering efficient resource usage and cost-effective forms of interventions. Such purposes require scientific tools or mechanisms which aid in cost assessment before the efforts of cost reduction are considered. Diagnosis-related groups based costing methodology (Case-mix) is considered one of the preferred costing approaches in the health care sector. King Fahd Central hospital Jazan, the only tertiary hospital in the Jazan region, was selected for case-mix system-based patient-level costing of health services. The study's objective was to estimate the cost per Diagnosis-Related Group (DRG) per inpatient admission and compare it with the already established average cost of health care services for inpatients. We applied a cross-sectional retrospective approach to categorize the inpatients based on their diagnosis and procedures and then estimate the actual cost of health care services provided to inpatients during 2018 and compared it with the average cost of the health services. There was a considerable difference between DRG-based costing (SAR 269,663,897) and average costing (SAR 247,035,938). The Diagnosis Related Group costing was found to be more reliable and representative of the services provided to the patients and is recommended to be used for reimbursement purposes.

Matched MeSH terms: Delivery of Health Care
Benefits and challenges of teleconsultation service for non-communicable disease follow-up in public healthcare clinics in Malaysia: a qualitative study

Rambli R, Aznida FAA, Azimatun Noor A

Med J Malaysia, 2023 Jul;78(4):449-457.
PMID: 37518911

INTRODUCTION: Teleconsultation gained popularity to provide safe medical care during the pandemic. However, literature on the sustainability of teleconsultation service at primary care beyond pandemic situations is scarce. This study aimed to determine the use of teleconsultation services for non-communicable disease (NCD) follow-up and explore the benefits and challenges of the service implementation during and beyond COVID-19 pandemic in Malaysia.
MATERIALS AND METHODS: An exploratory qualitative study was conducted using videoconferencing. Fourteen medical officers working in public primary healthcare clinics from various regions of Malaysia were chosen using purposive sampling process, and participants underwent a total of seven paired in-depth interview (IDI) sessions. IDIs were video recorded, transcribed and subjected to interpretive thematic analysis.
RESULTS: The two main themes which emerged were the benefits and challenges of NCD teleconsultation service. Various categories relating to benefits of teleconsultation for NCD care are as follows: (1) Improved efficiency for patient care delivery (improved effectiveness, convenient, improved safety, better disease monitoring, patient empowerment) and (2) Benefits for Health Care Providers (improved healthcare and service delivery). Main challenges identified were as follows: (1) Challenges for Delivery of Care (Patients' adaptation in using teleconsultation service, Patients abusing the system, Poor digital literacy, No proper disease monitoring record), (2) Challenges for Health Care Providers (Lack of dedicated team and training, Higher workload and time-consuming) and (3) Challenges for Health Care System (Institutional policy, legal and regulatory weakness, Medical record documentation and prescription updates).
CONCLUSION: Optimisation of NCD patient healthcare delivery via teleconsultation is beneficial during and after pandemic. Targeted improvements to address current challenges are crucial to optimise its use beyond the pandemic period in the Malaysian public healthcare system.

Matched MeSH terms: Delivery of Health Care

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links