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  1. Aljunid SM, Ali Jadoo SA
    Inquiry, 2018 2 14;55:46958018755483.
    PMID: 29436248 DOI: 10.1177/0046958018755483
    The steady growth of pharmaceutical expenditures is a major concern for health policy makers and health care managers in Malaysia. Our study examined the factors affecting the total inpatient pharmacy cost (TINPC) at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC). In this retrospective study, we used 2011 administration electronic prescriptions records and casemix databases at UKMMC to examine the impact of sociodemographic, diagnostic, and drug variables on the TINPC. Bivariate and multivariate analyses of the factors associated with TINPC were conducted. The mean inpatient pharmacy cost per patient was USD 102.07 (SD = 24.76). In the multivariate analysis, length of stay (LOS; B = 0.349, P < .0005) and severity level III ( B = 0.253, P < .0005) were the primary factors affecting the TINPC. For each day increase in the LOS and each increase of a case of severity level III, there was an increase of approximately USD 11.97 and USD 171.53 in the TINPC per year, respectively. Moreover, the number of prescribed items of drugs and supplies was positively associated with the TINPC ( B = 0.081, P < .0005). Gender appears to have affected the TINPC; male patients seem to be associated with a higher TINPC than females (mean = 139.55, 95% confidence interval [CI]: 112.97-166.13, P < .001). Surgical procedures were associated with higher cost than medical cases (mean = 87.93, 95% CI: 61.00-114.85, P < .001). Malay (MYR 242.02, SD = 65.37) and Chinese (MYR 214.66, SD = 27.99) ethnicities contributed to a lower TINPC compared with Indian (MYR 613.93, SD = 98.41) and other ethnicities (MYR 578.47, SD = 144.51). A longer hospitalization period accompanied by major complications and comorbidities had the greatest influence on the TINPC.
  2. Ali Jadoo SA, Aljunid SM, Sulku SN, Nur AM
    BMC Health Serv Res, 2014;14:30.
    PMID: 24447374 DOI: 10.1186/1472-6963-14-30
    Since 2003, Turkey has implemented major health care reforms to develop easily accessible, high-quality, efficient, and effective healthcare services for the population. The purpose of this study was to bring out opinions of the Turkish people on health system reform process, focusing on several aspects of health system and assessing whether the public prefer the current health system or that provided a decade ago.
  3. Ali Jadoo SA, Sulku SN, Aljunid SM, Dastan I
    J Health Econ Outcomes Res, 2014;2(1):96-107.
    PMID: 37664081 DOI: 10.36469/9891
    Objectives: This study was aimed to assess validation and reliability of knowledge of, attitude toward and practice (KAP) of a Case-mix and Diagnosis Related Group (DRG) system questionnaire. Methods: A sample of 238 health care providers selected conveniently from three public hospitals in Turkey was enrolled in a cross-sectional study from September 1 until November 30, 2012. The mean age was 38.63 years (standard deviation [SD] 10.52), ranging from age 21 to 60 years. More than one-half were males (52.1%), nearly two-fifths were medical doctors (39.9%), one-third were nurses (33.2%), one-sixth were auxiliary staff (16.4%) and the remaining were coders (10.5%). Only one-third (33.6%) of respondents attended a workshop or training program in the Case-mix or DRG system. After examining content validity, factor analysis was conducted, internal consistency of the questionnaire was assessed by Cronbach's alpha estimate, and test-retest reliability was evaluated. Results: The sample adequacy for extraction of the factors was confirmed by the Kaiser-Meyer-Olkin test (0.915) and the Bartlett test (1052). Factor analysis showed three factors, including attitude (36.43%), practice (23.39%) and knowledge (17%), with a total variance of 76.82%. The reliability of each section of the questionnaire was as follows: knowledge (0.963), attitude (0.964) and practice (0.973). Cronbach's alpha total was 0.941, which showed excellent internal consistency. Conclusions: This study demonstrated that the designed questionnaire provided high construct validity and reliability, and could be adequately used to measure KAP among health care staff of the Case-mix and DRG system in Turkey.
  4. Ganasegeran K, Perianayagam W, Manaf RA, Jadoo SA, Al-Dubai SA
    ScientificWorldJournal, 2015;2015:714754.
    PMID: 25654133 DOI: 10.1155/2015/714754
    This study aimed to explore factors associated with patient satisfaction of outpatient medical care in Malaysia. A cross-sectional exit survey was conducted among 340 outpatients aged between 13 and 80 years after successful clinical consultations and treatment acquirements using convenience sampling at the outpatient medical care of Tengku Ampuan Rahimah Hospital (HTAR), Malaysia, being the country's busiest medical outpatient facility. A survey that consisted of sociodemography, socioeconomic, and health characteristics and the validated Short-Form Patient Satisfaction Questionnaire (PSQ-18) scale were used. Patient satisfaction was the highest in terms of service factors or tangible priorities, particularly "technical quality" and "accessibility and convenience," but satisfaction was low in terms of service orientation of doctors, particularly the "time spent with doctor," "interpersonal manners," and "communication" during consultations. Gender, income level, and purpose of visit to the clinic were important correlates of patient satisfaction. Effort to improve service orientation among doctors through periodical professional development programs at hospital and national level is essential to boost the country's health service satisfaction.

    Study site: outpatient medical care of Tengku Ampuan Rahimah Hospital (HTAR
  5. Ali Jadoo SA, Aljunid SM, Dastan I, Tawfeeq RS, Mustafa MA, Ganasegeran K, et al.
    Hum Resour Health, 2015;13:21.
    PMID: 25903757 DOI: 10.1186/s12960-015-0014-6
    BACKGROUND: During the last two decades, the Iraqi human resources for health was exposed to an unprecedented turnover of trained and experienced medical professionals. This study aimed to explore prominent factors affecting turnover intentions among Iraqi doctors.
    METHODS: A descriptive cross-sectional multicentre study was carried out among 576 doctors across 20 hospitals in Iraq using multistage sampling technique. Participants completed a self-administered questionnaire, which included socio-demographic information, work characteristics, the 10-item Warr-Cook-Wall job satisfaction scale, and one question on turnover intention. Descriptive and bivariate and multiple logistic regression analyses were conducted to identify significant factors affecting turnover intentions.
    RESULTS: More than one half of Iraqi doctors (55.2%) were actively seeking alternative employment. Factors associated with turnover intentions among doctors were low job satisfaction score (odds ratio (OR) = 0.97; 95% confidence interval (CI): 0.95, 0.99), aged 40 years old or less (OR = 2.9; 95% CI: 1.74, 4.75), being male (OR = 4.2; 95% CI: 2.54, 7.03), being single (OR = 5.0; 95% CI: 2.61, 9.75), being threatened (OR = 3.5; 95% CI: 1.80, 6.69), internally displaced (OR = 3.1; 95% CI: 1.43, 6.57), having a perception of unsafe medical practice (OR = 4.1; 95% CI: 1.86, 9.21), working more than 40 h per week, (OR = 2.3; 95% CI: 1.27, 4.03), disagreement with the way manager handles staff (OR = 2.2; 95% CI: 1.19, 4.03), being non-specialist, (OR = 3.9, 95% CI: 2.08, 7.13), and being employed in the government sector only (OR = 2.0; 95% CI: 1.09, 3.82).
    CONCLUSION: The high-turnover intention among Iraqi doctors is significantly associated with working and security conditions. An urgent and effective strategy is required to prevent doctors' exodus.
  6. Alhusseiny AH, Al-Nimer MS, Mohammad FI, Ali Jadoo SA
    Int J Cardiol, 2016 Nov 15;223:514-518.
    PMID: 27552568 DOI: 10.1016/j.ijcard.2016.08.244
    Serum annexin A5 (anxA5) level is significantly increased in patients with acute coronary syndrome. Hematological indices are significantly increased in patients with ischemic heart disease. This study aimed to demonstrate the changes in the distribution of blood cells and the levels of anxA5 in patients presented with significant low ejection fraction ST-elevation acute myocardial infarction (STEMI) in comparison with corresponding patients with ischemic heart disease.
  7. Ali Jadoo SA, Aljunid SM, Nur AM, Ahmed Z, Van Dort D
    Daru, 2015 Feb 10;23:14.
    PMID: 25889668 DOI: 10.1186/s40199-014-0075-4
    BACKGROUND: The service weight is among several issues and challenges in the implementation of case-mix in developing countries, including Malaysia. The aim of this study is to develop the Malaysian Diagnosis Related Group (MY-DRG) case-mix pharmacy service weight in University Kebangsaan Malaysia-Medical Center (UKMMC) by identifying the actual cost of pharmacy services by MY-DRG groups in the hospital.

    METHODS: All patients admitted to UKMMC in 2011 were recruited in this study. Combination of Step-down and Bottom-up costing methodology has been used in this study. The drug and supplies cost; the cost of staff; the overhead cost; and the equipment cost make up the four components of pharmacy. Direct costing approach has been employed to calculate Drugs and supplies cost from electronic-prescription system; and the inpatient pharmacy staff cost, while the overhead cost and the pharmacy equipments cost have been calculated indirectly from MY-DRG data base. The total pharmacy cost was obtained by summing the four pharmacy components' cost per each MY-DRG. The Pharmacy service weight of a MY-DRG was estimated by dividing the average pharmacy cost of the investigated MY-DRG on the average of a specified MY-DRG (which usually the average pharmacy cost of all MY-DRGs).

    RESULTS: Drugs and supplies were the main component (86.0%) of pharmacy cost compared o overhead cost centers (7.3%), staff cost (6.5%) and pharmacy equipments (0.2%) respectively. Out of 789 inpatient MY-DRGs case-mix groups, 450 (57.0%) groups were utilized by the UKMMC. Pharmacy service weight has been calculated for each of these 450 MY-DRGs groups. MY-DRG case-mix group of Lymphoma & Chronic Leukemia group with severity level three (C-4-11-III) has the highest pharmacy service weight of 11.8 equivalents to average pharmacy cost of RM 5383.90. While the MY-DRG case-mix group for Circumcision with severity level one (V-1-15-I) has the lowest pharmacy service weight of 0.04 equivalents to average pharmacy cost of RM 17.83.

    CONCLUSION: A mixed approach which is based partly on top-down and partly on bottom up costing methodology has been recruited to develop MY-DRG case-mix pharmacy service weight for 450 groups utilized by the UKMMC in 2011.

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