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Fulltext Mode choice between private and public transport in Klang Valley, Malaysia

Chiu Chuen O, Karim MR, Yusoff S

ScientificWorldJournal, 2014;2014:394587.
PMID: 24701165 DOI: 10.1155/2014/394587

In 2010, Klang Valley has only 17% trips each day were completed using public transport, with the rest of the 83% trips were made through private transport. The inclination towards private car usage will only get worse if the transport policy continues to be inefficient and ineffective. Under the National Key Economic Area, the priority aimed to stimulate the increase of modal share of public transport in the Klang Valley to 50% by 2020. In the 10th Malaysia Plan, the Klang Valley Mass Rapid Transit was proposed, equipped with 141 km of MRT system, and will integrate with the existing rail networks. Nevertheless, adding kilometers into the rail system will not help, if people do not make the shift from private into public transport. This research would like to assess the possible mode shift of travellers in the Klang Valley towards using public transport, based on the utility function of available transport modes. It intends to identify the criteria that will trigger their willingness to make changes in favour of public transport as targeted by the NKEA.

Matched MeSH terms: Private Sector*
Fulltext Rotavirus vaccines contribute towards universal health coverage in a mixed public-private healthcare system

Loganathan T, Jit M, Hutubessy R, Ng CW, Lee WS, Verguet S

Trop Med Int Health, 2016 Nov;21(11):1458-1467.
PMID: 27503549 DOI: 10.1111/tmi.12766

OBJECTIVES: To evaluate rotavirus vaccination in Malaysia from the household's perspective. The extended cost-effectiveness analysis (ECEA) framework quantifies the broader value of universal vaccination starting with non-health benefits such as financial risk protection and equity. These dimensions better enable decision-makers to evaluate policy on the public finance of health programmes.
METHODS: The incidence, health service utilisation and household expenditure related to rotavirus gastroenteritis according to national income quintiles were obtained from local data sources. Multiple birth cohorts were distributed into income quintiles and followed from birth over the first five years of life in a multicohort, static model.
RESULTS: We found that the rich pay more out of pocket (OOP) than the poor, as the rich use more expensive private care. OOP payments among the poorest although small are high as a proportion of household income. Rotavirus vaccination results in substantial reduction in rotavirus episodes and expenditure and provides financial risk protection to all income groups. Poverty reduction benefits are concentrated amongst the poorest two income quintiles.
CONCLUSION: We propose that universal vaccination complements health financing reforms in strengthening Universal Health Coverage (UHC). ECEA provides an important tool to understand the implications of vaccination for UHC, beyond traditional considerations of economic efficiency.

Matched MeSH terms: Public-Private Sector Partnerships*
Fulltext MUSLIM TRAVELLERS’ PERCEPTION ON QUALITY OF SERVICE BY UMRAH AND HAJJ TRAVEL AGENCIES IN MALAYSIA

AINATUN NABIHAH MOHD SHUKRI, AZIZUL YADI YAAKOP, KALSITINOOR SET

UMT Journal of Undergraduate Research, 2019;1(1):18-23.
MyJurnal

Millions of Muslims from all over the world perform Umrah and Hajj every year. There were 250,000 pilgrims from Malaysia in 2017, and the number is expected to grow by 20 percent in 2018. This projected increase will create a huge demand for Umrah and Hajj travel agencies’ services in Malaysia. At present, there are 328 Umrah and Hajj travel agencies registered under Malaysia’s Ministry of Tourism and Culture (MOTAC). However, the supposedly bright outlook maybe marred by undesirable consequences. Along with the increase in the number of Umrah and Hajj travel agencies, there also tends to be an increase in fraud Umrah packages offered by fake agents in Malaysia. Such incidents will cause sadness and anger in the victims and other involved parties. Umrah package fraud involving fake agents in Malaysia has attracted the attention of many including the public, the government, the private sector, even the media. Nevertheless, studies on correlation between Muslim travellers’ perception of the quality of service by Umrah travel agencies and their decision to purchase the Umrah package are scarce in Malaysia. Hence, this study investigated Muslim travellers’ perception of Umrah and Hajj travel agencies’ service quality and its influence on their decision to purchase the Umrah package, in an attempt to discover why some Muslim travellers fell into fake agents’ trap in Malaysia. A total of 319 Muslim respondents completed the questionnaire on service quality perception, specifically service quality elements and loyalty. The data obtained was examined using SPSS version 25 for descriptive and regression analysis. Umrah and Hajj travel agencies as well as relevant government agencies could use the findings of the study to assist with formulating plans and policies to improve the quality of service by Umrah and Hajj industry players and awareness among Muslim travellers on the importance of being able to identify bogus agencies. The limitations, implications andsuggestions for future research are also discussed.

Matched MeSH terms: Private Sector
Fulltext Health facility use by dengue patients in the Klang Valley, Malaysia: a secondary analysis of dengue surveillance data

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: Private Sector/statistics & numerical data*
Is there a role for academic medical centers in emerging markets?

Wiener CM, Thompson SJ, Wu S, Chellappa M, Hasham S

World Hosp Health Serv, 2012;48(4):4-6.
PMID: 23484425

Governments in emerging markets face mounting challenges in managing health spending, building capability and capacity, modernizing ageing infrastructure, and investing in skills and resources. One path to overcoming these challenges is to establish new public-private models of health care development and delivery based on United States academic medical centers, whose missions are to advance medical education and clinical delivery. Johns Hopkins Medicine is a participant in the collaboration developing between the Perdana University Hospital and the Perdana University Graduate School of Medicine in Malaysia. These two organizations comprise an academic health science center based on the United States model. The Perdana project provides constructive insights into the opportunities and challenges that governments, universities, and the private sector face when introducing new models of patient care that are integrated with medical education, clinical training, and biomedical research.

Matched MeSH terms: Public-Private Sector Partnerships*
Fulltext Equitable Access to State-of-the-Art Medical Technology-a Malaysian Mini-Public-Private Partnership Case Study

Waran V, Thillainathan R, Karuppiah R, Pickard JD

World Neurosurg, 2022 01;157:135-142.
PMID: 34687934 DOI: 10.1016/j.wneu.2021.10.112

BACKGROUND: The provision of equitable and affordable health care has become increasingly challenging as advanced technology is introduced, particularly in developing countries. We explored the hypothesis that focused, small-scale mini-public-private partnerships have a potential role in providing equitable and affordable access to advanced technology for the benefit of all patients in developing nations, particularly middle-income countries.
METHODS: A clinician-led financial plan was developed at the University of Malaya to create the Centre for Image Guidance and Minimally Invasive Therapy (CIGMIT) to provide an integrated platform for high-end care for Malaysian patients of all ages, both public and private, requiring complex neurosurgical and spinal procedures and stereotactic and intensity-modulated radiotherapy. The challenges faced during development of the plan were documented together with an audit of patient throughput and analyses of financial risk and return.
RESULTS: CIGMIT opened in 2015. Patient throughput, both public and private, progressively increased in all facilities. In 2015-2019, 37,724 patients used the Centre's facilities. CIGMIT has become progressively more profitable for the University of Malaya, the public and private hospitals, and the investor. CIGMIT has weathered the challenges posed by coronavirus disease 19.
CONCLUSIONS: Focused, small-scale mini-public-private partnerships have a potential role in providing advanced technology for the benefit of patients in developing nations, particularly middle-income countries, subject to an approach that balances equity of access between public and private health care systems with fair reward.

Matched MeSH terms: Public-Private Sector Partnerships/organization & administration*
Health Care In Malaysia: The Dynamics Of Provision, Financing And Access

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: Private Sector
Fulltext Malaysia Health System Review

Jaafar S, Mohd Noh K, Abdul Muttalib K, Othman NH, Healy J, Maskon K, et al.

ISBN: 978-92-9061-584-2

Citation: Jaafar S, Mohd Noh K, Abdul Muttalib K, Othman NH, Healy J, Maskon K, et al. Malaysia Health System Review. Geneva: World Health Organization; 2013

Malaysia is a federation of 13 states and 2 territories in a parliamentary democracy, with the Prime Minister the head of government and a constitutional monarch elected by the Sultans. Malaysia is a multicultural society and a secular state with Sunni Islam as the official religion. Classified by the World Bank as an upper middle-income country, its society and economy were transformed by rapid economic growth in the latter half of the 20th century. Malaysia’s population (now numbering over 28 million with 70% living in urban areas) has benefited from a well developed health care system, good access to clean water and sanitation, and strong social and economic programmes. Life expectancy at birth is 73 years. Noncommunicable diseases now account for most mortality and morbidity but communicable diseases remain a concern. Section 2 describes the organization and governance of the health system. Health care services consist of tax-funded and governmentrun primary health care centres and hospitals, and fast-growing private services mainly located in physician clinics and hospitals in urban areas. Public sector health services are administered by the Ministry of Health through its central, state and district offices. The Ministry of Health regulates the private sector, pharmaceutical industry and food safety and plans and regulates its own health care services. Legislation governing health care professionals requires them to register with statutory professional bodies. Section 3 reports on health care financing. Malaysia’s public health system is financed mainly through general revenue and taxation collected by the federal government, while the private sector is funded principally through out-of-pocket payments from patients and some private health insurance. Spending on health reached 4.6% of GDP in 2009 with the majority from public spending, reaching 56% of total health expenditure (THE) in 2009. The main sources of THE in 2008 were the Ministry of Health (42%), followed by household out-of-pocket expenditure at nearly 34%. The Ministry of Health funds public facilities through line item budgets and patients pay private physicians and private hospitals on a fee-for-service basis. Physical and human resources are described in Section 4. The number of public primary care facilities (currently 802 centres and over 2000 small community clinics) and dental clinics were expanded steadily in earlier decades, particularly to reach people in under-served rural areas. Secondary care is offered in smaller public hospitals and more complex tertiary care, in regional and national hospitals (including university teaching hospitals run by the Ministry of Higher Education). Growth has slowed in recent years, however, and public services in urban areas have not kept pace with rapid urbanization, while the population ratio of hospital beds has declined slightly. Private clinics and hospitals in urban areas have grown rapidly over the last decade. The supply of health professionals remains seriously below the required number, although the government has increased the number of training places. Section 5 looks at provision of services. National health policies stress public health and health promotion, that is, ‘a wellness’ as well as a ‘disease’ perspective. The Ministry of Health has developed an extensive network of public primary care centres and also dental services especially for children, but these services are under strain and have staff shortages, so patients often encounter long waits. Primary care exerts only a limited gatekeeper function since people can bypass a referral from a general practitioner and for a small additional fee (if in the public sector) can go directly to specialists and hospitals. Government services increasingly serve the poor and private services the better-off people who live in urban areas. Hospital policy currently has three main thrusts: strengthening specialty care in large public hospitals; increasing the number of day surgery centres; and expanding top-end private hospital care to cater to the medical tourism market (with 35 participating hospitals in 2010). Malaysia has a large pharmaceutical manufacturing sector that exports to other countries and also supplies 30% of domestic demand. The principal health care reforms are discussed in Section 6. The government has stepped up its surveillance and early response to infectious disease outbreaks as a result of recent pandemics such as SARS and avian flu, which had a major impact on the country’s economy. The Ministry of Health has maintained its extensive vaccination programmes, has consolidated its primary health care clinics and upgraded its hospitals, and is slowly introducing information communication technology into its public facilities. The government has increased training places to counter shortages of health professionals, has strengthened food and drug safety regulation, is considering price xv regulation of pharmaceuticals, and is positioning the country as a medical tourism destination. Section 7 provides an assessment of the health system. Malaysia has a strong population health tradition and well-established and extensive health care services. Although total health expenditure at 4.6% of GDP in 2008 is in the range for middle-income countries, the government is concerned about future sustainable financing. Successive administrators have prioritized the provision of cost-effective, preventative and mainly free primary health care in public clinics. The rapid growth of private health care means that private spending has risen faster than public spending, including out-of-pocket payments by the public, with the government share (from general revenue) just above half (56%) of health expenditure in 2009. In conclusion, Malaysia has achieved impressive health gains for its population with a low-cost health care system funded through general revenue that provides universal and comprehensive services. Like many other countries in the region, Malaysia has struggled to produce an adequate supply of health professionals, and to integrate and regulate its rapidly growing private health sector. Public services have not kept pace with population growth in urban areas and those with higher purchasing power use private rather than public doctors and hospitals, which leaves the public sector with more poorer and sicker patients. The Malaysian Government recently revived the debate over options for a national social health insurance scheme. The financing challenge is to agree on a scheme for fair and sustainable funding and its respective contributions from general revenue and private payments. The regulatory challenge for the Malaysian Government is to strengthen its governance of both public and private health services in order to ensure high quality and safe services and fair charges. The structural challenge is to determine the balance between public and private sector delivery and to engage in a more productive partnership between public and private sectors. The administrative challenge is to consider whether the community would be better served by more decentralized and responsive services. As Malaysia seeks to attain high income country status, and as demographic and epidemiological transitions continue and new technology expands the possibilities for intervention, the demand for xvi health care by the population will continue to rise. The government will need to address growing concerns about equity, efficiency and budgetary constraints and balance conflicting policy principles. Pressures are building up for health system reform in Malaysia looking towards the year 2020 and beyond.

Matched MeSH terms: Private Sector
Fulltext Guideline on utilisation of private doctors in public primary care clinics. [Buku Panduan Penggunaan Khidmat Doktor Swasta Untuk Perkhidmatan Kesihatan di Klinik Kesihatan]

Citation: Buku Panduan Penggunaan Khidmat Doktor Swasta Untuk Perkhidmatan Kesihatan di Klinik Kesihatan. Putrajaya: Kementerian Kesihatan Malaysia; 2008

Translation:
Guideline on utilisation of private doctors in public primary care clinics. Putrajaya: Ministry of Health, Malaysia; 2008

Matched MeSH terms: Private Sector