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Fulltext A case report of gastroschisis: Prenatal diagnosis in primary care settings matters

Said AH, Md Nor MZ, Che Yusof MD

Malays Fam Physician, 2023;18:53.
PMID: 37814671 DOI: 10.51866/cr.278

Gastroschisis may lead to serious congenital disability, as prolonged exposure to the amniotic fluid could compromise the mesenteric blood flow and irritate the foetal intestinal wall. The consequences of gastroschisis include spontaneous preterm birth, growth restriction and foetal demise. Awareness of this disease is essential, as a high mortality rate is linked to inadequate initial therapy. Early detection of the disease, mainly by primary care physicians as the initial point of contact, is crucial to improve the course of the condition through early monitoring and referral to tertiary care centres. With this case report, we hope to highlight the need of detecting gastroschisis before to the third trimester of pregnancy for better readiness, especially in primary care settings located far from tertiary centres.
Patient's satisfaction towards healthcare services and its associated factors at the highest patient loads government primary care clinic in Pahang

Md Nor MZ, Said AH, Che Man M, Yusof MZ

Med J Malaysia, 2024 Jan;79(1):34-41.
PMID: 38287755

INTRODUCTION: Patient satisfaction is widely used to monitor the quality of health care services. A significant patient load may influence health care services and patient satisfaction. Klinik Kesihatan Bandar Kuantan, Pahang (KKBK) has the highest patient loads in Pahang state, followed by Klinik Kesihatan Beserah and Klinik Kesihatan Kurnia. There are up to 700 attendees at KKBK per day, representing a population of 209679. KKBK had receives several complaints and patient unhappiness with its health care services, despite the administration's efforts to improve the clinics healthcare delivery. Thus, this study aimed to measure patients' satisfaction towards health care services at Pahang's highest patient loads primary care clinic.
MATERIALS AND METHODS: A cross-sectional study was conducted at Klinik Kesihatan Bandar Kuantan, Kuantan, Pahang. Patients were selected using stratified random sampling, and 201 participants were selected. The selected participants were asked to fill up the self-administered validated questionnaires consisting of background characteristics and Patient Satisfaction Questionnaire 18 (PSQ-18). Data collection period was from March 2022 to August 2022. Descriptive analysis was used to describe the background characteristics of respondents and the score of patient satisfaction. Multiple linear regression was used to determine the factors associated with patient satisfaction while adjusting for cofounders.
RESULTS: A total of 201 eligible data points were analysed in the study. The respondent mean age was 47.1 ± 16.9. Most respondents were Malay (68.7%), having secondary education (54.2%) and predominantly from the B40 income class (88.1%). The overall mean patient satisfaction score was 3.83 ± 0.31. There were significant associations between overall satisfaction with patient education level (B = -0.144; 95% CI -0.246, -0.042; p = 0.006), waiting time (B = -0.371; 95% CI -0.534, -0.209; p = 0.001) and consultation duration (B = -0.154; 95% CI -0.253, -0.055; p = 0.0020). It was found that patients with secondary education were less satisfied compared to patients with primary education level on health care services they received. Meanwhile, those who were not happy with the waiting time and consultation duration showed less satisfaction with overall healthcare services.
CONCLUSION: Despite serving the most significant number of patients in Pahang state, most of the patient were satisfied by the health care services at Klinik Kesihatan Bandar Kuantan. However, it is recommended to improve the waiting time and the consultation time in this clinic.

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