Displaying publications 61 - 80 of 88 in total

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  1. Mohd Hassan NZA, Bahari MS, Aminuddin F, Mohd Nor Sham Kunusagaran MSJ, Zaimi NA, Mohd Hanafiah AN, et al.
    Front Public Health, 2022;10:959812.
    PMID: 36684911 DOI: 10.3389/fpubh.2022.959812
    INTRODUCTION: Ambulance services are pivotal in any country's healthcare system. An efficient ambulance service not only decreases patient mortality rate but also allows resource prioritization for better outputs. This study aims to measure the efficiency of ambulance services provided by health facilities in the Ministry of Health (MOH), Malaysia.

    METHODS: This cross-sectional study analyzed the efficiency of 76 Decision-Making Units (DMUs) or health facilities, consisting of 62 health clinics and 14 hospitals. Data Envelopment Analysis (DEA) was used for computing efficiency scores while adopting the Variable Return to Scale (VRS) approach. The analysis was based on input orientation. The input was the cost of ambulance services, while the output for this analysis was the distance coverage (in km), the number of patients transferred, and hours of usage (in hours). Subsequent analysis was conducted to test the Overall Technical Efficiency (OTE), the Pure Technical Efficiency (PTE), the Scale Efficiency (SE), and the Return to Scale with the type of health facilities and geographical areas using a Mann-Whitney U-test and a chi-square test.

    RESULTS: The mean scores of OTE, PTE, and SE were 0.508 (±0.207), 0.721 (±0.185), and 0.700 (±0.200), respectively. Approximately, 14.47% of the total health facilities were PTE. The results showed a significant difference in OTE and SE between ambulance services in hospitals and health clinics (p < 0.05), but no significant difference in PTE between hospitals and clinics (p>0.05). There was no significant difference in efficiency scores between urban and rural health facilities in terms of ambulance services except for OTE (p < 0.05).

    DISCUSSION: The ambulance services provided in healthcare facilities in the MOH Malaysia operate at 72.1% PTE. The difference in OTE between hospitals and health clinics' ambulance services was mainly due to the operating size rather than PTE. This study will be beneficial in providing a guide to the policymakers in improving ambulance services through the readjustment of health resources and improvement in the outputs.

    Matched MeSH terms: Efficiency, Organizational*
  2. Ewart KM, Lightson AL, Sitam FT, Rovie-Ryan JJ, Mather N, McEwing R
    Forensic Sci Int Genet, 2020 01;44:102187.
    PMID: 31670244 DOI: 10.1016/j.fsigen.2019.102187
    The illegal ivory trade continues to drive elephant poaching. Large ivory seizures in Africa and Asia are still commonplace. Wildlife forensics is recognised as a key enforcement tool to combat this trade. However, the time and resources required to effectively test large ivory seizures is often prohibitive. This limits or delays testing, which may impede investigations and/or prosecutions. Typically, DNA analysis of an ivory seizure involves pairing and sorting the tusks, sampling the tusks, powdering the sample, decalcification, then DNA extraction. Here, we optimize the most time-consuming components of this process: sampling and decalcification. Firstly, using simulations, we demonstrate that tusks do not need to be paired to ensure an adequate number of unique elephants are sampled in a large seizure. Secondly, we determined that directly powdering the ivory using a Dremel drill with a high-speed cutter bit, instead of cutting the ivory with a circular saw and subsequently powdering the sample in liquid nitrogen with a freezer mill, produces comparable results. Finally, we optimized a rapid 2 -h decalcification protocol that produces comparable results to a standard 3-day protocol. We tested/optimised the protocols on 33 raw and worked ivory samples, and demonstrated their utility on a case study, successfully identifying 94% of samples taken from 123 tusks. Using these new rapid protocols, the entire sampling and DNA extraction process takes less than one day and requires less-expensive equipment. We expect that the implementation of these rapid protocols will promote more consistent and timely testing of ivory seizures suitable for enforcement action.
    Matched MeSH terms: Efficiency*
  3. Nasarudin NM, Mohd Saiboon I, Ismail AK
    Eur J Emerg Med, 2013 Oct;20(5):335-8.
    PMID: 22976462 DOI: 10.1097/MEJ.0b013e328358fa40
    Dengue fever is endemic in Malaysia and poses a significant problem to the national health system. Because of its nonspecific clinical features, it creates clinical and administrative uncertainties. We evaluated the role of an emergency department short-stay ward (EDSSW) in the management of dengue fever in the Universiti Kebangsaan Malaysia Medical Centre (UKMMC).
    Matched MeSH terms: Efficiency, Organizational*
  4. Lim KS, Wu C, Choo WY, Tan CT
    Epilepsy Behav, 2012 Jun;24(2):207-12.
    PMID: 22564888 DOI: 10.1016/j.yebeh.2012.03.038
    A quantitative scale of public attitudes toward epilepsy is essential to determine the magnitude of social stigma against epilepsy. This study aims to develop and validate a cross-culturally applicable scale of public attitudes toward epilepsy.
    Matched MeSH terms: Efficiency
  5. Law SH, Moradbeigi M
    Environ Sci Pollut Res Int, 2017 Oct;24(28):22458-22475.
    PMID: 28803332 DOI: 10.1007/s11356-017-9871-y
    This study investigates whether financial development dampens the negative impact of oil resource abundance on economic growth. Because of substantial cross-sectional dependence in our data, which contain a core sample of 63 oil-producing countries from 1980 through 2010, we use the common correlated effect mean group (CCEMG) estimator to account for the high degree of heterogeneity and drop the outlier countries. The empirical results reveal that oil resource abundance affects the growth rate in output contingent on the degree of development in financial markets. More developed financial markets can channel the revenues from oil into more productive activities and thus offset the negative effects of oil resource abundance on economic growth. Thus, better financial development can reverse resource curse or enhance resource blessing in oil-rich economies.
    Matched MeSH terms: Efficiency
  6. Shair F, Shaorong S, Kamran HW, Hussain MS, Nawaz MA, Nguyen VC
    Environ Sci Pollut Res Int, 2021 Apr;28(16):20822-20838.
    PMID: 33405126 DOI: 10.1007/s11356-020-11938-y
    This paper investigates the efficiency and total factor productivity (TFP) growth of the Pakistani banking industry and determines the impact of risk and competition on the efficiency and TFP growth. The data envelopment analysis (DEA)-based Malmquist productivity index is used to measure efficiency and TFP growth of the Pakistani banking industry. The generalized method of moments (GMM) model is applied to observe the impact of risk and competition on efficiency and TFP growth. The motivation behind the use of GMM model is its ability to overcome unobserved heterogeneity, autocorrelation, and endogeneity issues. The results of the study show that the credit and liquidity risks have positive while insolvency risk has negative effect on the efficiency and TFP growth. The competition leads to improve technological efficiency but declines the technical efficiency growth. Among other explanatory variables, operational cost management, banking sector development, GDP growth rate, and infrastructure development show significant relationships with various efficiencies and TFP growth. The banks also facilitate for the purchase of carbon-intensive products in order to reduce carbon emissions. Strong banking development successfully allocate their financial resources for the development of energy-efficient technology while banking sector development is found to be negatively related with environmental sustainability. The strong banking sector possesses a significant negative influence on carbon reduction and environmental degradation.
    Matched MeSH terms: Efficiency*
  7. Aliero MS, Pasha MF, Toosi AN, Ghani I
    Environ Sci Pollut Res Int, 2022 Dec;29(57):85727-85741.
    PMID: 35001275 DOI: 10.1007/s11356-021-17862-z
    The enforcement of the Movement Control Order to curtail the spread of COVID-19 has affected home energy consumption, especially HVAC systems. Occupancy detection and estimation have been recognized as key contributors to improving building energy efficiency. Several solutions have been proposed for the past decade to improve the precision performance of occupancy detection and estimation in the building. Environmental sensing is one of the practical solutions to detect and estimate occupants in the building during uncertain behavior. However, the literature reveals that the performance of environmental sensing is relatively poor due to the poor quality of the training dataset used in the model. This study proposed a smart sensing framework that combined camera-based and environmental sensing approaches using supervised learning to gather standard and robust datasets related to indoor occupancy that can be used for cross-validation of different machine learning algorithms in formal research. The proposed solution is tested in the living room with a prototype system integrated with various sensors using a random forest regressor, although other techniques could be easily integrated within the proposed framework. The primary implication of this study is to predict the room occupation through the use of sensors providing inputs into a model to lower energy consumption. The results indicate that the proposed solution can obtain data, process, and predict occupant presence and number with 99.3% accuracy. Additionally, to demonstrate the impact of occupant number in energy saving, one room with two zones is modeled each zone with air condition with different thermostat controller. The first zone uses IoFClime and the second zone uses modified IoFClime using a design-builder. The simulation is conducted using EnergyPlus software with the random simulation of 10 occupants and local climate data under three scenarios. The Fanger model's thermal comfort analysis shows that up to 50% and 25% energy can be saved under the first and third scenarios.
    Matched MeSH terms: Efficiency
  8. Zhong C, Hamzah HZ, Yin J, Wu D, Cao J, Mao X, et al.
    Environ Sci Pollut Res Int, 2023 Mar;30(15):44490-44504.
    PMID: 36692722 DOI: 10.1007/s11356-023-25410-0
    As an important indicator of sustainable development, industrial eco-efficiency (IEE) has aroused growing attention from governments all over the world including China, in recent decades. The Chinese government has introduced numerous environmental regulations; however, the environmental pollution issue does not appear to have been solved. Moreover, although several earlier studies have shown that environmental regulations may promote innovation, there is no consensus on their ultimate effects on IEE. Therefore, this study took a critical look at the connection between environmental regulations and IEE in 36 Chinese sub-sectors from 2009 to 2018. Based on the weak Porter hypothesis (weak PH) and strong Porter hypothesis (strong PH), this paper constructed two panel regression models and conducted group analysis by pollution intensity to check the relationships among environmental regulations, technological innovation, and IEE. It was found that environmental regulations can improve technological innovation and IEE, but these impacts vary across different pollution groups. Specifically, environmental regulations have a U-shaped or inverted U-shaped relationship with technological innovation and IEE. Of the 36 sub-sectors, 26 prove the existence of the Weak PH while 10 verify the Strong PH, indicating that environmental regulations generally advocate technological innovation for most sub-sectors but only promote IEE in a few sub-sectors at present. Finally, differentiated policy implications for environmental regulations and technological innovation are provided for decision-makers.
    Matched MeSH terms: Efficiency*
  9. Kuah CT, Koh QY, Rajoo S, Wong KY
    Environ Sci Pollut Res Int, 2023 Jun;30(28):72074-72100.
    PMID: 35716302 DOI: 10.1007/s11356-022-21377-6
    Human usage of non-renewable energy resources has caused many environmental issues, which include air pollution, global warming, and climate irregularities. To counter these issues, researchers have been seeking after alternative renewable energy sources and ways to manage energy more efficiently. This is where energy recovery technologies such as waste heat recovery (WHR) come into play. WHR is a form of waste to energy conversion. Waste heat can be captured and converted into usable energy instead of dumping it into the environment. In the more recent years, the WHR research field has gained great attention in the scientific community as well as in some energy-intensive industries. This article presents a bibliometric overview of the academic research on WHR over the span of 30 years from 1991 to 2020. A total of 5682 documents from Web of Science (WoS) have been retrieved and analyzed using various bibliometric methods, including performance analysis and network analysis. The analyses were performed on different actors in the field, i.e., funding agencies, journals, authors, organizations, and countries. In addition, several network mappings were done based on co-citation, co-authorship, and co-occurrences of keywords analyses. The research identified the most productive and influential actors in the field, established and emergent research topics, as well as the interrelations and collaboration patterns between different actors. The findings can be a robust roadmap for further research in this field.
    Matched MeSH terms: Efficiency
  10. Zhang J, Lu G, Skitmore M, Ballesteros-Pérez P
    Environ Sci Pollut Res Int, 2021 Jul;28(27):35392-35405.
    PMID: 34018106 DOI: 10.1007/s11356-021-14467-4
    The current world economy needs to undergo a green transformation. Green total factor productivity provides the basis for judging whether a country or region can attain long-term sustainable development. However, there is little research into the factors that influence green total factor productivity and this has become an obstacle in the transition to a greener economy. On filtering relevant articles and interviews data collected from 2009 to 2019, open decoding, spindle decoding, and selective decoding are carried out to classify research conducted into green total factor productivity. From this analysis, cutting-edge research and knowledge gaps in green total factor productivity are identified. Also, an influencing factor model of green total factor productivity is built. Findings suggest that technical, economic, and government are the three main research streams involved in this transformation process. In particular, technology plays a decisive role, economy plays a guaranteeing role, and government plays a regulatory role. Moreover, the impact of these factors cannot be isolated, as each influence and mediate the other two. Results from this study will help further popularize green total factor productivity and provide a new starting point for reducing energy consumption and environmental pollution.
    Matched MeSH terms: Efficiency
  11. Kamaruzzaman SN, Egbu CO, Zawawi EM, Karim SB, Woon CJ
    Environ Monit Assess, 2015 May;187(5):242.
    PMID: 25864077 DOI: 10.1007/s10661-015-4447-0
    It is accepted that occupants who are more satisfied with their workplace's building internal environment are more productive. The main objective of the study was to measure the occupants' level of satisfaction and the perceived importance of the design or refurbishment on office conditions. The study also attempted to determine the factors affecting the occupants' satisfaction with their building or office conditions. Post-occupancy evaluations were conducted using a structured questionnaire developed by the Built Environment Research Group at the University of Manchester, UK. Our questionnaires incorporate 22 factors relating to the internal environment and rate these in terms of "user satisfaction" and "degree of importance." The questions were modified to reflect the specific setting of the study and take into consideration the local conditions and climate in Malaysia. The overall mean satisfaction of the occupants toward their office environment was 5.35. The results were measured by a single item of overall liking of office conditions in general. Occupants were more satisfied with their state of health in the workplace, but they were extremely dissatisfied with the distance away from a window. The factor analysis divided the variables into three groups, namely intrusion, air quality, and office appearance. Structural equation modeling (SEM) was then used to determine which factor had the most significant influence on occupants' satisfaction: appearance. The findings from the study suggest that continuous improvement in aspects of the building's appearance needs to be supported with effective and comprehensive maintenance to sustain the occupants' satisfaction.
    Matched MeSH terms: Efficiency
  12. Wu Y, Rahman RA, Yu Q
    Environ Monit Assess, 2022 Feb 08;194(3):154.
    PMID: 35132444 DOI: 10.1007/s10661-022-09817-9
    Sustainable agriculture is important for preserving environmental health and simultaneously gaining economic profits while maintaining social and economic equity. One way to evaluate sustainable agriculture is by studying agricultural eco-efficiency (AEE). Hence, this study constructed a data-driven method to evaluate and optimize AEE with the aim of providing a basis for improving the sustainable development of regional agriculture. Sixteen cities in Anhui Province, China, were considered in the study, and the variables used were agricultural resource inputs, environmental pollution, and agricultural economic development. Agricultural non-point source pollution (NPSP) emissions were considered the undesired output to build an AEE evaluation index system. Furthermore, a data envelopment analysis (DEA) model was established to analyse AEE from the static and dynamic perspectives. The spatial development and the temporal and spatial characteristics of AEE were also analysed. In addition, we applied a random effect (RE) panel Tobit model to quantitatively analyse the influencing factors of AEE from the input perspective and then proposed reasonable suggestions for improving the sustainable development of regional agriculture. Our findings show that the overall agricultural development in the 16 cities in Anhui Province has been continuously improving, even though there is an agglomeration of spatial development in some regions. In conclusion, this study provides suggestions and references for policy makers and agricultural practitioners regarding how to improve regional AEE and promote the sustainable development of the regional agricultural economy.
    Matched MeSH terms: Efficiency
  13. Dzullijah Ibrahim, Alifah Alyana, Hasrul Hafizuddin Hassim, Yusli Yaakob, Hamid Yusuf
    ESTEEM Academic Journal, 2018;14(1):83-92.
    MyJurnal
    A facility layout can be defined as an arrangement of the equipment area in the
    industry or organization of the factory. The main objective of this project was to
    improve the existing layout in SMEs using DELMIA QUEST simulation. In this
    project, new layouts are proposed to reduce the waiting time in a production
    line and increase the productivity. This study focused on packaging production
    line of a coffee manufacturing company located in Tasek Gelugor Pulau
    Pinang. The problems identified in this production line are limited working
    space, some processes overlap and are stuck due to high demands of the
    products. This results in high lead time. The existing layout was studied and
    simulated to improve certain parameters such as labour, machines, and shape
    of the layout. The workstations were repositioned in the proposed layout before
    undergoing simulation process using DELMIA QUEST software. From the
    simulation results, the significant improvement was determined and the best
    layout was chosen in terms of machines utilization and total output. Based on
    this, a new layout is proposed to increase the productivity capacity and to meet
    customers’ demands. Simulation data of the proposed layout showed its
    productivity had increased to approximately 41.5%.
    Matched MeSH terms: Efficiency
  14. Crawford B, Hashim SS, Prepageran N, See GB, Meier G, Wada K, et al.
    Drugs Real World Outcomes, 2017 Mar;4(1):21-31.
    PMID: 27888477 DOI: 10.1007/s40801-016-0099-9
    BACKGROUND: Acute otitis media (AOM) affects both child and parental quality of life (QoL). Data on QoL associated with AOM in Malaysia is sparse, and the burden of indirect costs have not been previously reported.

    OBJECTIVE: To determine the effect of pediatric AOM on child and parental QoL in Malaysia and its economic impact (indirect costs).

    METHODS: We utilized a set of QoL questionnaires (PAR-AOM-QOL, OM-6, and EQ-5D) combined with questions addressing work/productivity loss and financial costs associated with caring for a child during his or her illness in an observational, multicenter, prospective study.

    RESULTS: One hundred and ten AOM patients aged ≤5 years were included in the analysis. The majority of respondents were the patient's mother. Parental QoL was negatively affected for both emotional and daily disturbance scales, but the level of disturbance was low. Using OM-6, the greatest negative impact was on the child's QoL, followed by caregiver concerns, physical suffering, and emotional distress. Using EQ-5D, a moderately positive relationship between parents' emotional disturbance and daily disturbance, and a weak, negative correlation between parental emotional disturbance and parental health status was found. Parents with paid employment took an average of 21 h from work to care for their child, at an average cost of 321.8 Malaysian ringgit (US$97) in addition to their contribution to direct medical costs. Productivity losses whilst at work, uncompensated wage losses, and leisure time losses are also reported.

    CONCLUSIONS: This study found that AOM is associated with some negative impact on parental QoL and significant economic impact at both patient and societal levels. The findings provide useful data on healthcare resource utilization and disease burden of AOM in Malaysia.

    Matched MeSH terms: Efficiency
  15. Chan NW
    Disasters, 1997 Sep;21(3):206-22.
    PMID: 9301137
    Institutional aspects of flood hazards significantly affect their outcomes in Malaysia. Institutional arrangements to deal with floods include: legislative activity, organisational structures, attitudes and sub-culture, and policies and instruments. When assessed in terms of four specific criteria, institutional aspects of flood hazards are found to be largely inadequate. Disaster reduction programmes are over-dependent on a reactive approach based largely on technology and not even aimed at floods specifically. Structural flood reduction measures are the predominant management tool and, although the importance of non-structural measures is recognised, thus far they have been under-employed. Current laws and regulations with regard to flood management are also insufficient and both the financial and human resources of flood hazard organisations are generally found to be wanting. Finally, economic efficiency, equity and public accountability issues are not adequately addressed by institutional arrangements for flood hazards.
    Matched MeSH terms: Efficiency, Organizational
  16. Mokhtar D, Abdullah NA, Roshaizad NA
    Data Brief, 2020 Jun;30:105505.
    PMID: 32368580 DOI: 10.1016/j.dib.2020.105505
    This data belongs to a sample of 347 diplomatic officers from two different locations which are the National Institute of Public Administration (INTAN) in Johor and Terengganu. This data consists of the demographic characteristics of the sample and three main variables. Each variable has sub-dimension which are (1) presenteeism: ability to complete a task and avoid disturbance, (2) job demand: workload, emotional and cognitive demand, (3) job insecurity: the importance and probability of an event to take place. The data were collected using a cross-sectional questionnaire via paper-and-pencil mode and was analyzed using SPSS version 22. Pearson correlation analyses revealed a significant relationship between avoiding disturbance (sub-dimension of presenteeism) and the probability of an event happening (sub-dimension of job insecurity) and no significant correlation between other variables. Analyses of the data can provide insights into determinants of presenteeism that may be useful for researchers in the field and policymakers that are interested in this area. It may serve as a reference to expand research and to develop interventions to facilitate productivity and well-being in the workplace.
    Matched MeSH terms: Efficiency
  17. Kieny MP, Bekedam H, Dovlo D, Fitzgerald J, Habicht J, Harrison G, et al.
    Bull World Health Organ, 2017 07 01;95(7):537-539.
    PMID: 28670019 DOI: 10.2471/BLT.16.187476
    Matched MeSH terms: Efficiency, Organizational
  18. Mohd Suhaimi NAB, de Mey Y, Oude Lansink A
    Br Food J, 2017;119(12):2788-2803.
    PMID: 29720740 DOI: 10.1108/BFJ-11-2016-0549
    Purpose: The purpose of this paper is to measure the technical inefficiency of dairy farms and subsequently investigate the factors affecting technical inefficiency in the Malaysian dairy industry.

    Design/methodology/approach: This study uses multi-directional efficiency analysis to measure the technical inefficiency scores on a sample of 200 farm observations and single-bootstrap truncated regression model to define factors affecting technical inefficiency.

    Findings: Managerial and program inefficiency scores are presented for intensive and semi-intensive production systems. The results reveal marked differences in the inefficiency scores across inputs and between production systems.

    Practical implications: Intensive systems generally have lowest managerial and program inefficiency scores in the Malaysian dairy farming sector. Policy makers could use this information to advise dairy farmers to convert their farming system to the intensive system.

    Social implications: The results suggest that the Malaysian Government should redefine its policy for providing farm finance and should target young farmers when designing training and extension programs in order to improve the performance of the dairy sector.

    Originality/value: The existing literature on Southeast Asian dairy farming has neither focused on investigating input-specific efficiency nor on comparing managerial and program efficiency. This paper aims to fill this gap.

    Matched MeSH terms: Efficiency, Organizational
  19. Reidpath DD, Olafsdottir AE, Pokhrel S, Allotey P
    BMC Public Health, 2012;12 Suppl 1:S3.
    PMID: 22992346 DOI: 10.1186/1471-2458-12-S1-S3
    In the health systems literature one can see discussions about the trade off between the equity achievable by the system and its efficiency. Essentially it is argued that as greater health equity is achieved, so the level of efficiency will diminish. This argument is borrowed from economics literature on market efficiency. In the application of the economic argument to health, however, serious errors have been made, because it is quite reasonable to talk of both health equity being a desirable output of a health system, and the efficient production of that output. In this article we discuss notions of efficiency, and the equity-efficiency trade off, before considering the implications of this for health systems.
    Matched MeSH terms: Efficiency, Organizational*
  20. Zafirah SA, Nur AM, Puteh SEW, Aljunid SM
    BMC Health Serv Res, 2018 01 25;18(1):38.
    PMID: 29370785 DOI: 10.1186/s12913-018-2843-1
    BACKGROUND: The accuracy of clinical coding is crucial in the assignment of Diagnosis Related Groups (DRGs) codes, especially if the hospital is using Casemix System as a tool for resource allocations and efficiency monitoring. The aim of this study was to estimate the potential loss of income due to an error in clinical coding during the implementation of the Malaysia Diagnosis Related Group (MY-DRG®) Casemix System in a teaching hospital in Malaysia.

    METHODS: Four hundred and sixty-four (464) coded medical records were selected, re-examined and re-coded by an independent senior coder (ISC). This ISC re-examined and re-coded the error code that was originally entered by the hospital coders. The pre- and post-coding results were compared, and if there was any disagreement, the codes by the ISC were considered the accurate codes. The cases were then re-grouped using a MY-DRG® grouper to assess and compare the changes in the DRG assignment and the hospital tariff assignment. The outcomes were then verified by a casemix expert.

    RESULTS: Coding errors were found in 89.4% (415/424) of the selected patient medical records. Coding errors in secondary diagnoses were the highest, at 81.3% (377/464), followed by secondary procedures at 58.2% (270/464), principal procedures of 50.9% (236/464) and primary diagnoses at 49.8% (231/464), respectively. The coding errors resulted in the assignment of different MY-DRG® codes in 74.0% (307/415) of the cases. From this result, 52.1% (160/307) of the cases had a lower assigned hospital tariff. In total, the potential loss of income due to changes in the assignment of the MY-DRG® code was RM654,303.91.

    CONCLUSIONS: The quality of coding is a crucial aspect in implementing casemix systems. Intensive re-training and the close monitoring of coder performance in the hospital should be performed to prevent the potential loss of hospital income.
    Matched MeSH terms: Efficiency, Organizational/economics; Efficiency, Organizational/standards*
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