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  1. Aljunid SM, Srithamrongsawat S, Chen W, Bae SJ, Pwu RF, Ikeda S, et al.
    Value Health, 2012 2 1;15(1 Suppl):S132-8.
    PMID: 22265060 DOI: 10.1016/j.jval.2011.11.004
    This article sought to describe the health-care data situation in six selected economies in the Asia-Pacific region. Authors from Thailand, China mainland, South Korea, Taiwan, Japan, and Malaysia present their analyses in three parts. The first part of the article describes the data-collection process and the sources of data. The second part of the article presents issues around policies of data sharing with the stakeholders. The third and final part of the article focuses on the extent of health-care data use for policy reform in these different economies. Even though these economies differ in their economic structure and population size, they share some similarities on issues related to health-care data. There are two main institutions that collect and manage the health-care data in these economies. In Thailand, China mainland, Taiwan, and Malaysia, the Ministry of Health is responsible through its various agencies for collecting and managing the health-care data. On the other hand, health insurance is the main institution that collects and stores health-care data in South Korea and Japan. In all economies, sharing of and access to data is an issue. The reasons for limited access to some data are privacy protection, fragmented health-care system, poor quality of routinely collected data, unclear policies and procedures to access the data, and control on the freedom on publication. The primary objective of collecting health-care data in these economies is to aid the policymakers and researchers in policy decision making as well as create an awareness on health-care issues for the general public. The usage of data in monitoring the performance of the heath system is still in the process of development. In conclusion, for the region under discussion, health-care data collection is under the responsibility of the Ministry of Health and health insurance agencies. Data are collected from health-care providers mainly from the public sector. Routinely collected data are supplemented by national surveys. Accessibility to the data is a major issue in most of the economies under discussion. Accurate health-care data are required mainly to support policy making and evidence-based decisions.
    Matched MeSH terms: Delivery of Health Care/statistics & numerical data*
  2. Ng JC, Churojana A, Pongpech S, Vu LD, Sadikin C, Mahadevan J, et al.
    Interv Neuroradiol, 2019 Jun;25(3):291-296.
    PMID: 30463501 DOI: 10.1177/1591019918811804
    Acute stroke care systems in Southeast Asian countries are at various stages of development, with disparate treatment availability and practice in terms of intravenous thrombolysis and endovascular therapy. With the advent of successful endovascular therapy stroke trials over the past decade, the pressure to revise and advance acute stroke management has greatly intensified. Southeast Asian patients exhibit unique stroke features, such as increased susceptibility to intracranial atherosclerosis and higher prevalence of intracranial haemorrhage, likely secondary to modified vascular risk factors from differing dietary and lifestyle habits. Accordingly, the practice of acute endovascular stroke interventions needs to take into account these considerations. Acute stroke care systems in Southeast Asia also face a unique challenge of huge stroke burden against a background of ageing population, differing political landscape and healthcare systems in these countries. Building on existing published data, further complemented by multi-national interaction and collaboration over the past few years, the current state of acute stroke care systems with existing endovascular therapy services in Southeast Asian countries are consolidated and analysed in this review. The challenges facing acute stroke care strategies in this region are discussed.
    Matched MeSH terms: Delivery of Health Care/statistics & numerical data
  3. Saokaew S, Sugimoto T, Kamae I, Pratoomsoot C, Chaiyakunapruk N
    PLoS One, 2015;10(11):e0141993.
    PMID: 26560127 DOI: 10.1371/journal.pone.0141993
    Health technology assessment (HTA) has been continuously used for value-based healthcare decisions over the last decade. Healthcare databases represent an important source of information for HTA, which has seen a surge in use in Western countries. Although HTA agencies have been established in Asia-Pacific region, application and understanding of healthcare databases for HTA is rather limited. Thus, we reviewed existing databases to assess their potential for HTA in Thailand where HTA has been used officially and Japan where HTA is going to be officially introduced.
    Matched MeSH terms: Delivery of Health Care/statistics & numerical data*
  4. Boey CC, Goh KL
    J Gastroenterol Hepatol, 2001 Feb;16(2):154-9.
    PMID: 11207895
    AIM: To look at the predictors of health-care consultation for recurrent abdominal pain among urban schoolchildren in Malaysia.

    METHODS: Recurrent abdominal pain was defined as at least three episodes of abdominal pain, severe enough to affect a child's activities over a period longer than 3 months. A health-care consulter was defined as a child who had been brought to see a doctor regarding recurrent abdominal pain at least once in the past year. Children aged between 9 and 15 years were randomly chosen from schools in the city of Petaling Jaya, given questionnaires to fill in and interviewed to determine whether they fulfilled the above criteria for having symptoms of recurrent abdominal pain and for being a consulter. Bivariate analysis and multiple logistic regression analysis were performed on the data obtained.

    RESULTS: One hundred and forty-three (9.61%) children fulfilled the criteria for recurrent abdominal pain out of a total of 1488 schoolchildren interviewed. There were 65 (45.5%) consulters and 78 (54.5%) non-consulters. Among the consulters, the male to female ratio was 1:1.4, while among the non-consulters, the ratio was 1:1.1. On bivariate analysis, the Chinese had a significantly lower likelihood to consult a doctor (P = 0.02), while the other two races did not show any increase in consultation (Malays, P = 0.08; Indians, P = 0.21). Among those with severe pain, there was a significantly higher prevalence of consulters (P < 0.01). Furthermore, those whose sleep was interrupted by abdominal pain were more likely to consult (P < 0.01). Children who had consulted a doctor were more likely to be missing school because of abdominal pain (P < 0.01). Following multiple logistic regression analysis, ethnicity was no longer a significant predictor.

    CONCLUSIONS: Approximately 45.5% of schoolchildren with recurrent abdominal pain in an urban setting were brought to see a doctor. Predictors of recent health-care consultation were school absence, pain severity and interruption of sleep caused by abdominal pain.

    Matched MeSH terms: Delivery of Health Care/statistics & numerical data*
  5. Malhotra R, Bautista MAC, Müller AM, Aw S, Koh GCH, Theng YL, et al.
    Gerontologist, 2019 05 17;59(3):401-410.
    PMID: 30517628 DOI: 10.1093/geront/gny160
    The juxtaposition of a young city-state showing relative maturity as a rapidly aging society suffuses the population aging narrative in Singapore and places the "little red dot" on the spotlight of international aging. We first describe population aging in Singapore, including the characteristic events that shaped this demographic transition. We then detail the health care and socioeconomic ramifications of the rapid and significant shift to an aging society, followed by an overview of the main aging research areas in Singapore, including selected population-based data sets and the main thrust of leading aging research centers/institutes. After presenting established aging policies and programs, we also discuss current and emerging policy issues surrounding population aging in Singapore. We aim to contribute to the international aging literature by describing Singapore's position and extensive experience in managing the challenges and maximizing the potential of an aging population. We hope that similar graying populations in the region will find the material as a rich source of information and learning opportunities. Ultimately, we aspire to encourage transformative collaborations-locally, regionally, and internationally-and provide valuable insights for policy and practice.
    Matched MeSH terms: Delivery of Health Care/statistics & numerical data
  6. Nordin J, Solís L, Prévot J, Mahlaoui N, Chapel H, Sánchez-Ramón S, et al.
    Front Immunol, 2021;12:780140.
    PMID: 34868053 DOI: 10.3389/fimmu.2021.780140
    A global gold standard framework for primary immunodeficiency (PID) care, structured around six principles, was published in 2014. To measure the implementation status of these principles IPOPI developed the PID Life Index in 2020, an interactive tool aggregating national PID data. This development was combined with a revision of the principles to consider advances in the field of health and science as well as political developments since 2014. The revision resulted in the following six principles: PID diagnosis, treatments, universal health coverage, specialised centres, national patient organisations and registries for PIDs. A questionnaire corresponding to these principles was sent out to IPOPI's national member organisations and to countries in which IPOPI had medical contacts, and data was gathered from 60 countries. The data demonstrates that, regardless of global scientific progress on PIDs with a growing number of diagnostic tools and better treatment options becoming available, the accessibility and affordability of these remains uneven throughout the world. It is not only visible between regions, but also between countries within the same region. One of the most urgent needs is medical education. In countries without immunologists, patients with PID suffer the risk of remaining undiagnosed or misdiagnosed, resulting in health implications or even death. Many countries also lack the infrastructure needed to carry out more advanced diagnostic tests and perform treatments such as hematopoietic stem cell transplantation or gene therapy. The incapacity to secure appropriate diagnosis and treatments affects the PID environment negatively in these countries. Availability and affordability also remain key issues, as diagnosis and treatments require coverage/reimbursement to ensure that patients with PID can access them in practice, not only in theory. This is still not the case in many countries of the world according to the PID Life Index. Although some countries do perform better than others, to date no country has fully implemented the PID principles of care, confirming the long way ahead to ensure an optimal environment for patients with PID in every country.
    Matched MeSH terms: Delivery of Health Care/statistics & numerical data*
  7. Baker SR, Foster Page L, Thomson WM, Broomhead T, Bekes K, Benson PE, et al.
    J Dent Res, 2018 09;97(10):1129-1136.
    PMID: 29608864 DOI: 10.1177/0022034518767401
    Much research on children's oral health has focused on proximal determinants at the expense of distal (upstream) factors. Yet, such upstream factors-the so-called structural determinants of health-play a crucial role. Children's lives, and in turn their health, are shaped by politics, economic forces, and social and public policies. The aim of this study was to examine the relationship between children's clinical (number of decayed, missing, and filled teeth) and self-reported oral health (oral health-related quality of life) and 4 key structural determinants (governance, macroeconomic policy, public policy, and social policy) as outlined in the World Health Organization's Commission for Social Determinants of Health framework. Secondary data analyses were carried out using subnational epidemiological samples of 8- to 15-y-olds in 11 countries ( N = 6,648): Australia (372), New Zealand (three samples; 352, 202, 429), Brunei (423), Cambodia (423), Hong Kong (542), Malaysia (439), Thailand (261, 506), United Kingdom (88, 374), Germany (1498), Mexico (335), and Brazil (404). The results indicated that the type of political regime, amount of governance (e.g., rule of law, accountability), gross domestic product per capita, employment ratio, income inequality, type of welfare regime, human development index, government expenditure on health, and out-of-pocket (private) health expenditure by citizens were all associated with children's oral health. The structural determinants accounted for between 5% and 21% of the variance in children's oral health quality-of-life scores. These findings bring attention to the upstream or structural determinants as an understudied area but one that could reap huge rewards for public health dentistry research and the oral health inequalities policy agenda.
    Matched MeSH terms: Delivery of Health Care/statistics & numerical data
  8. Naing C, Kai YC, Yi CH, Yee NS, Yi LM, Jun LX, et al.
    Int Health, 2013 Sep;5(3):217-22.
    PMID: 24159624 DOI: 10.1093/inthealth/iht019
    BACKGROUND: This study aimed to determine knowledge of medication use, to investigate the treatment-seeking pattern and to identify factors affecting the use of public health clinics among the study population.

    METHODS: A survey was conducted in Mantin Town of Malaysia using a structured questionnaire based on a literature review. Households were recruited through a three-stage sampling technique.

    RESULTS: Of 183 respondents (mean age 44.6 [±16.9] years; 115 [62.8%] women), 157 (85.8%) did not know about the term 'generic name' and 159 (86.9%) were not sure about the difference in price between a generic medicine and a branded medicine. The majority sought healthcare from the public health clinics (102/183; 55.7%). In the multivariate analysis, higher education level of respondents (p = 0.028), good quality of services in public health clinics (p = 0.001) and short distances between their residences and the public health clinics (p<0.001) were the significant variables for predicting the use of a public health clinic.

    CONCLUSION: This study highlights that health education on the use of generic drugs needs to be scaled up. These findings are important to the health policy makers who may need to consider addressing factors such as quality of care and physical distance to the clinic in the design and implementation of health facilities and the selection of the catchment areas.
    Matched MeSH terms: Delivery of Health Care/statistics & numerical data*
  9. Choo WY, Hairi NN, Sooryanarayana R, Yunus RM, Hairi FM, Ismail N, et al.
    BMJ Open, 2016 05 25;6(5):e011057.
    PMID: 27225651 DOI: 10.1136/bmjopen-2016-011057
    INTRODUCTION: Despite being now recognised as a global health concern, there is still an inadequate amount of research into elder mistreatment, especially in low and middle-income regions. The purpose of this paper is to report on the design and methodology of a population-based cohort study on elder mistreatment among the older Malaysian population. The study aims at gathering data and evidence to estimate the prevalence and incidence of elder mistreatment, identify its individual, familial and social determinants, and quantify its health consequences.

    METHODS AND ANALYSIS: This is a community-based prospective cohort study using randomly selected households from the national census. A multistage sampling method was employed to obtain a total of 2496 older adults living in the rural Kuala Pilah district. The study is divided into two phases: cross-sectional study (baseline), and a longitudinal follow-up study at the third and fifth years. Elder mistreatment was measured using instrument derived from the previous literature and modified Conflict Tactic Scales. Outcomes of elder mistreatment include mortality, physical function, mental health, quality of life and health utilisation. Logistic regression models are used to examine the relationship between risk factors and abuse estimates. Cox proportional hazard regression will be used to estimate risk of mortality associated with abuse. Associated annual rate of hospitalisation and health visit frequency, and reporting of abuse, will be estimated using Poisson regression.

    ETHICS AND DISSEMINATION: The study has been approved by the Medical Ethics Committee of the University of Malaya Medical Center (MEC Ref 902.2) and the Malaysian National Medical Research Register (NMRR-12-1444-11726). Written consent was obtained from all respondents prior to baseline assessment and subsequent follow-up. Findings will be disseminated to local stakeholders via forums with community leaders, and health and social welfare departments, and published in appropriate scientific journals and presented at conferences.

    Matched MeSH terms: Delivery of Health Care/statistics & numerical data
  10. Elmonem MA, Belanger-Quintana A, Bordugo A, Boruah R, Cortès-Saladelafont E, Endrakanti M, et al.
    Mol Genet Metab, 2020 11;131(3):285-288.
    PMID: 33004274 DOI: 10.1016/j.ymgme.2020.09.004
    Quantitative estimates for the global impact of COVID-19 on the diagnosis and management of patients with inborn errors of metabolism (IEM) are lacking. We collected relevant data from 16 specialized medical centers treating IEM patients in Europe, Asia and Africa. The median decline of reported IEM related services in March 1st-May 31st 2020 compared to the same period in 2019 were as high as 60-80% with a profound impact on patient management and care for this vulnerable patient group. More representative data along with outcome data and guidelines for managing IEM disorders under such extraordinary circumstances are needed.
    Matched MeSH terms: Delivery of Health Care/statistics & numerical data*
  11. Mohd Salleh NA, Fairbairn N, Nolan S, Barrios R, Shoveller J, Richardson L, et al.
    HIV Med, 2019 10;20(9):606-614.
    PMID: 31359615 DOI: 10.1111/hiv.12777
    OBJECTIVES: We sought to examine the association between dispensation of methadone maintenance therapy (MMT) and antiretroviral therapy (ART) at the same facility, across multiple low-barrier dispensing outlets, and achieving optimal adherence to ART among people who use illicit drugs (PWUD).

    METHODS: We used data from the AIDS Care Cohort to Evaluate Exposure to Survival Services (ACCESS) study, a long-running study of a community-recruited cohort of HIV-positive PWUD, linked to comprehensive HIV clinical records in Vancouver, Canada, a setting of no-cost, universal access to HIV care. The longitudinal relationship between MMT-ART dispensation at the same facility and the odds of ≥ 95% ART adherence was analysed using multivariable generalized linear mixed-effects modelling. We conducted a further analysis using a marginal structural mode with inverse probability of treatment weights as a sensitivity analysis.

    RESULTS: This study included data on 1690 interviews of 345 ART- and MMT-exposed participants carried out between June 2012 and December 2017. In the final multivariable model, MMT-ART dispensation, compared with nondispensation at the same facility, was associated with greater odds of achieving ≥ 95% adherence [adjusted odds ratio (AOR) 1.56; 95% confidence interval (CI) 1.26-1.96]. A marginal structural model estimated a 1.48 (95% CI 1.15-1.80) greater odds of ≥ 95% adherence among participants who reported MMT-ART dispensation at the same facility compared with those who did not.

    CONCLUSIONS: The odds of achieving optimal adherence to ART were 56% higher during periods in which MMT and ART medications were dispensed at the same facility, in a low-barrier setting. Our findings highlight the need to consider a simpler integrated approach with medication dispensation at the same facility in low-threshold settings.

    Matched MeSH terms: Delivery of Health Care/statistics & numerical data*
  12. Alyousefi NA, Mahdy MA, Mahmud R, Lim YA
    PLoS One, 2011;6(7):e22044.
    PMID: 21789210 DOI: 10.1371/journal.pone.0022044
    BACKGROUND: Intestinal protozoan diseases in Yemen are a significant health problem with prevalence ranging from 18% to 27%. The present study is a cross-sectional study aimed at determining the factors associated with the high prevalence of intestinal protozoan infections among patients seeking health care in Sana'a City, the capital of Yemen.

    METHODOLOGY/PRINCIPAL FINDINGS: Stool samples were collected from 503 patients aged between 1 and 80 years old; 219 were males and 284 females. Biodata were collected via pretested standard questionnaire. Faecal samples were processed and examined for (oo)cysts or ova using a wet mount preparation after formal-ether concentration technique. Cryptosporidium oocysts were detected using the Ziehl-Neelsen staining technique. The overall prevalence of intestinal protozoan infections was 30.9%. Infection rates of Giardia duodenalis, Entamoeba histolytica/dispar and Cryptosporidium were 17.7%, 17.1% and 1%, respectively. Other parasites detected included Ascaris lumbricoides (2.4%), Schistosoma mansoni (0.3%), Hymenolepis nana (1.4%) and Enterobius vermicularis (0.4%). Multivariate analysis using forward stepwise logistic regression based on intestinal protozoan infections showed that contact with animals (OR = 1.748, 95% CI = 1.168-2.617) and taking bath less than twice a week (OR = 1.820, 95% CI = 1.192-2.779) were significant risk factors of protozoan infections.

    CONCLUSIONS/SIGNIFICANCE: This present study indicated that intestinal protozoan infections are still a public health problem in Yemen, with Giardia and Entamoeba infections being most common. Statistical analysis indicated that low personal hygiene and contact with animals were important predictors for intestinal protozoan infections. As highlighted in this study, in order to effectively reduce these infections, a multi-sectoral effort is needed. Preventive measures should include good hygienic practices, good animal husbandry practices, heightened provision of educational health programs, health services in all governorates including rural areas. Furthermore, it is also essential to find radical solutions to the recent water crises in Yemen.

    Matched MeSH terms: Delivery of Health Care/statistics & numerical data
  13. Pang J, Chan DC, Hu M, Muir LA, Kwok S, Charng MJ, et al.
    J Clin Lipidol, 2019 01 25;13(2):287-300.
    PMID: 30797720 DOI: 10.1016/j.jacl.2019.01.009
    BACKGROUND: There is a lack of information on the health care of familial hypercholesterolemia (FH).

    OBJECTIVE: The objective of this study was to compare the health care of FH in countries of the Asia-Pacific region and Southern Hemisphere.

    METHODS: A series of questionnaires were completed by key opinion leaders from selected specialist centers in 12 countries concerning aspects of the care of FH, including screening, diagnosis, risk assessment, treatment, teaching/training, and research; the United Kingdom (UK) was used as the international benchmark.

    RESULTS: The estimated percentage of patients diagnosed with the condition was low (overall <3%) in all countries, compared with ∼15% in the UK. Underdetection of FH was associated with government expenditure on health care (ϰ = 0.667, P health care system (ϰ = 0.571-0.800, P care for FH, particularly in less economically developed countries. Wider implementation of primary and pediatric care, telehealth services, patient support groups, education/training programs, research activities, and health technology assessments are needed to improve the care of patients with FH in these countries.

    Matched MeSH terms: Delivery of Health Care/statistics & numerical data*
  14. Bick J, Culbert G, Al-Darraji HA, Koh C, Pillai V, Kamarulzaman A, et al.
    Int J Prison Health, 2016 12 19;12(4):253-269.
    PMID: 27921633 DOI: 10.1108/IJPH-06-2016-0017
    Purpose Criminalization of drug use in Malaysia has concentrated people who inject drugs (PWID) and people living with HIV into prisons where health services are minimal and HIV-related mortality is high. Few studies have comprehensively assessed the complex health needs of this population. The paper aims to discuss these issues. Design/methodology/approach From October 2012 through March 2013, 221 sequentially selected HIV-infected male prisoners underwent a comprehensive health assessment that included a structured history, physical examination, and clinically indicated diagnostic studies. Findings Participants were mostly PWID (83.7 percent) and diagnosed with HIV while incarcerated (66.9 percent). Prevalence of hepatitis C virus (90.4 percent), untreated syphilis (8.1 percent), active (13.1 percent), and latent (81.2 percent) tuberculosis infection was several fold higher than non-prisoner Malaysian adults, as was tobacco use (71.9 percent) and heavy drinking (30.8 percent). Most (89.5 percent) were aware of their HIV status before the current incarceration, yet few had been engaged previously in HIV care, including pre-incarceration CD4 monitoring (24.7 percent) or prescribed antiretroviral therapy (ART) (16.7 percent). Despite most (73.7 percent) meeting Malaysia's criteria for ART (CD4 <350 cells/ μL), less than half (48.4 percent) ultimately received it. Nearly one-quarter (22.8 percent) of those with AIDS (<200 cells/ μL) did not receive ART. Originality/value Drug addiction and communicable disease comorbidity, which interact negatively and synergistically with HIV and pose serious public health threats, are highly prevalent in HIV-infected prisoners. Interventions to address the critical shortage of healthcare providers and large gaps in treatment for HIV and other co-morbid conditions are urgently needed to meet the health needs of HIV-infected Malaysian prisoners, most of whom will soon transition to the community.
    Matched MeSH terms: Delivery of Health Care/statistics & numerical data*
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