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Fulltext Synthetic-type control charts for time-between-events monitoring

Yen FY, Chong KM, Ha LM

PLoS One, 2013;8(6):e65440.
PMID: 23755231 DOI: 10.1371/journal.pone.0065440

This paper proposes three synthetic-type control charts to monitor the mean time-between-events of a homogenous Poisson process. The first proposed chart combines an Erlang (cumulative time between events, Tr ) chart and a conforming run length (CRL) chart, denoted as Synth-Tr chart. The second proposed chart combines an exponential (or T) chart and a group conforming run length (GCRL) chart, denoted as GR-T chart. The third proposed chart combines an Erlang chart and a GCRL chart, denoted as GR-Tr chart. By using a Markov chain approach, the zero- and steady-state average number of observations to signal (ANOS) of the proposed charts are obtained, in order to evaluate the performance of the three charts. The optimal design of the proposed charts is shown in this paper. The proposed charts are superior to the existing T chart, Tr chart, and Synth-T chart. As compared to the EWMA-T chart, the GR-T chart performs better in detecting large shifts, in terms of the zero- and steady-state performances. The zero-state Synth-T4 and GR-Tr (r = 3 or 4) charts outperform the EWMA-T chart for all shifts, whereas the Synth-Tr (r = 2 or 3) and GR-T 2 charts perform better for moderate to large shifts. For the steady-state process, the Synth-Tr and GR-Tr charts are more efficient than the EWMA-T chart in detecting small to moderate shifts.

Matched MeSH terms: Ambulatory Care/statistics & numerical data
Fulltext Patient satisfaction in Malaysia's busiest outpatient medical care

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

Matched MeSH terms: Ambulatory Care/statistics & numerical data
Fulltext Prevalence of anxiety among women attending a primary care clinic in Malaysia

Mohd Sidik S, Arroll B, Goodyear-Smith F

Br J Gen Pract, 2011 Jun;61(587):e326-32.
PMID: 21801511 DOI: 10.3399/bjgp11X577990

Background: This is the first study investigating Anxiety among women attending a primary care clinic
in Malaysia.
Aim: The objective was to determine the factors associated with anxiety among these women.
Design: This cross-sectional study was conducted in a government-funded primary care clinic in Malaysia. Consecutive female patients attending the clinic during the data-collection period were invited to participate in the study.
Method: Participants were given self-administered questionnaires, which included the validated Generalised Anxiety Disorder-7 questionnaire (GAD-7) Malay version to detect anxiety.
Results: Of the 1023 patients who were invited, 895 agreed to participate (response rate 87.5%). The prevalence of anxiety in this study was 7.8%, based on the GAD-7 (score ≥8). Multiple logistic regression analysis found that certain stressful life events and the emotional aspect of domestic violence were significantly associated with anxiety (P<0.05).
Conclusion: The prevalence of anxiety among women in this study is similar to that found in other countries.
Factors found to be associated with anxiety, especially issues on domestic violence, need to be addressed andmanaged appropriately.
Keywords: anxiety; Malaysia; prevalence; primary care; women.
Questionnaire: Generalized Anxiety Disorder scale; GAD-7 (Malay version); Hark questionnaire

Matched MeSH terms: Ambulatory Care/statistics & numerical data
Extent and determinants of patients' unvoiced needs

Low LL, Sondi S, Azman AB, Goh PP, Maimunah AH, Ibrahim MY, et al.

Asia Pac J Public Health, 2011 Sep;23(5):690-702.
PMID: 21878464 DOI: 10.1177/1010539511418354

Patients with issues or health problems usually plan to discuss their concerns with their health care providers. If these concerns were not presented or voiced during the health care provider-patient encounter, the patients are considered to have unvoiced needs. This article examines the extent and possible determinants of patients' unvoiced needs in an outpatient setting. A cross-sectional study was conducted in 5 Ministry of Health Malaysia primary health facilities throughout the country. Of 1829 who participated, 5 did not respond to the question on planned issues. Of the 1824 respondents, 57.9% (95% confidence interval = 47.1-68.7) claimed to have issues/problems they planned to share, of whom 15.1% to 26.7% had unvoiced needs. Extent of unvoiced needs differed by employment status, perceived category of health care provider, and study center. Perceived category of health care provider, method of questionnaire administration, and study center were the only significant determinants of unvoiced needs. Unvoiced needs do exist in Malaysia and there is a need for health care providers to be aware and take steps to counter this.

Study site: 5 Ministry of Health Malaysia primary health facilities throughout the country

Matched MeSH terms: Ambulatory Care/statistics & numerical data*
Independent determinants of periodontitis in Yemeni adults: A case-control study

Al-Alimi A, Halboub E, Al-Sharabi AK, Taiyeb-Ali T, Jaafar N, Al-Hebshi NN

Int J Dent Hyg, 2018 Nov;16(4):503-511.
PMID: 29963753 DOI: 10.1111/idh.12352

OBJECTIVES: The relative importance of risk factors of periodontitis varies from one population to another. In this study, we sought to identify independent risk factors of periodontitis in a Yemeni population.
METHODS: One hundred and fifty periodontitis cases and 150 healthy controls, all Yemeni adults 30-60 years old, were recruited. Sociodemographic data and history of oral hygiene practices and oral habits were obtained. Plaque index (PI) was measured on index teeth. Periodontal health status was assessed using Community Periodontal Index (CPI) and Clinical Attachment Loss (CAL) according to WHO. Periodontitis was defined as having one or more sextants with a CPI score ≥ 3. Multiple logistic regression modelling was employed to identify distal, intermediate and proximal determinants of periodontitis, while ordinal regression was used to identify those of CAL scores.
RESULTS: In logistic regression, PI score was associated with the highest odds of periodontitis (OR = 82.9) followed by cigarette smoking (OR = 12.8), water pipe smoking (OR = 10.2), male gender (OR = 3.4) and age (OR = 1.19); on the other hand, regular visits to the dentist (OR = 0.05), higher level of education (OR = 0.37) and daily dental flossing (OR = 0.95) were associated with lower odds. Somewhat similar associations were seen for CAL scores (ordinal regression); however, qat chewing was identified as an additional determinant (OR = 4.69).
CONCLUSION: Water pipe smoking is identified as a risk factor of periodontitis in this cohort in addition to globally known risk factors. Adjusted effect of qat chewing is limited to CAL scores, suggestive of association with recession.

Matched MeSH terms: Ambulatory Care/statistics & numerical data