Displaying all 13 publications

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  1. Sararaks S, Jamaluddin R
    Med J Malaysia, 1999 Sep;54(3):310-9.
    PMID: 11045056
    Motivation, especially on the relationship of remuneration of government doctors to it, has long been an issue of concern. This study sought to elucidate the demotivating factors in service and the perceived discrepancy in income. It was conducted amongst doctors serving in the Ministry of Health, Negeri Sembilan, using self-administered questionnaires. Factors considered demotivating were remuneration, workload and recognition given. Career development, promotion prospects, issues with superiors, resources and patient attitudes were other factors identified. On average, respondents expect an income of 1.63 times more than their current drawn salary and 87.2% cited rewards as a recommendation to improve their satisfaction in service. In-service training was desired by almost all. Though the medical profession has traditionally been viewed as altruistic in nature, doctors in service are voicing out their views and perception, and they should be heard.
    Matched MeSH terms: National Health Programs/economics*
  2. Lim TO, Lim YN, Wong HS, Ahmad G, Singam TS, Morad Z, et al.
    Med J Malaysia, 1999 Dec;54(4):442-52.
    PMID: 11072461
    We determine the cost effectiveness of centre and home haemodialysis (HD), continuous ambulatory peritoneal dialysis (CAPD) and intermittent peritoneal dialysis (IPD) treatment in the Ministry of Health (MOH) programme. The viewpoint taken for this evaluation is that of MOH. Cost categories identified were capital cost, dialysis operational cost, medical cost and general hospital cost. Cost estimates were mostly based on actual resource utilisation. Life years saved were estimated based on Dialysis Registry data on 2480 HD and 732 CAPD patients. Overall, the cost-effectiveness ratio (CER) of centre HD was RM21620/life year saved. Those of home HD, CAPD and IPD were RM23375, RM30469 and RM36016 respectively. Sensitivity analyses did not change the ranking of the CER. We conclude the MOH dialysis programme was cost-effective, and among the various dialysis modalities centre HD was the most cost-effective.
    Matched MeSH terms: National Health Programs/economics*
  3. Loo CY, Kandiah M, Arumugam G, Goh PP, John E, Gurusami B, et al.
    Int Ophthalmol, 2004 Mar;25(2):81-7.
    PMID: 15290886
    PURPOSE: To determine the cost efficiency and to compare the cost effectiveness of conventional extracapsular cataract surgery (ECCE) and phacoemulsification at three hospitals of the Malaysian Ministry of Health (MOH).

    METHODS: Patient demography, pre-operative visual acuity, intra-operative complications, post-operative complications and post-operative visual acuity were recorded for two hundred and forty seven of the 400 patients who underwent cataract surgery during a 2-week period. The cost of surgery, which included capital, staff and overhead, and patient care consumable costs were assessed prospectively in 8 randomly sampled patients over a 3-month period. Cost efficiency refers to cost per cataract surgery. Cost effectiveness refers to cost per successful cataract surgery. This is estimated by the ratio of cost efficiency to the proportion of successful cataract surgery. Successful surgery was defined as best-corrected visual acuity (BCVA) of better than 6/12 at 3 months post-operatively.

    RESULTS: Proportion of patients who had post-operative visual acuity of 6/12 or better was higher in phacoemulsification group (94%) than in the ECCE group (81%). Conventional extracapsular cataract surgery with intraocular lens implant costs RM3442 (USD 905.79) and phacoemulsification with intraocular lens implant costs RM4288 (USD 1128.42).

    DISCUSSION: There was no significant difference in cost effectiveness between ECCE and phacoemulsification. The cost of cataract surgery in the MOH hospital was found to be high due to the high overhead costs.

    Matched MeSH terms: National Health Programs/economics*
  4. Azimatun Noor A, Saperi S, Aljunid SM
    Public Health, 2019 Oct;175:129-137.
    PMID: 31473369 DOI: 10.1016/j.puhe.2019.07.008
    OBJECTIVES: Currently, Malaysia faces great challenges in allocating adequate resources for healthcare services using a tax-based system. Therefore, Malaysia has no choice but to reform its healthcare financing system. The objective of this study is to assess Malaysian household willingness to pay and acceptance levels to the proposed National Health Financing Scheme.

    STUDY DESIGN: This is a cross-sectional study.

    METHODS: In total, 774 households from four states in Malaysia completed face-to-face interviews. A validated structured questionnaire was used, which was composed of a combination of open-ended questions, bidding games and contingent valuation methods regarding the participants' willingness to pay.

    RESULTS: The study found that the majority of households supported the establishment of the National Health Financing Scheme, and half proposed that a government body should manage the scheme. Most (87.5%) of the households were willing to contribute 0.5-1% of their salaries to the scheme through monthly deductions. Over three-quarters (76.6%) were willing to contribute to a higher level scheme (1-2%) to gain access to both public and private healthcare basic services. Willingness to pay for the National Health Financing Scheme was significantly higher among younger persons, females, those located in rural areas, those with a higher income and those with an illness.

    CONCLUSION: There is a high level of acceptance for the National Health Financing Scheme in the Malaysian community, and they are willing to pay for a scheme organised by a government body. However, acceptance and willingness to pay are strongly linked to household socio-economic status. Policymakers should initiate plans to establish the National Health Financing Scheme to provide the necessary financing for a sustainable health system.

    Matched MeSH terms: National Health Programs/economics*
  5. Thatte U, Hussain S, de Rosas-Valera M, Malik MA
    Value Health, 2009 Nov-Dec;12 Suppl 3:S18-25.
    PMID: 20586975 DOI: 10.1111/j.1524-4733.2009.00622.x
    This paper discusses national programs implemented in India, Pakistan, Malaysia, and Philippines to generate and apply evidence in making informed policy decisions on the approval, pricing, reimbursement and financing of medicines, diagnostics, and medical devices.
    Matched MeSH terms: National Health Programs/economics
  6. Elamin EI, Ibrahim MI, Sulaiman SA, Muttalif AR
    Pharm World Sci, 2008 Jun;30(3):281-6.
    PMID: 18204974 DOI: 10.1007/s11096-007-9185-0
    OBJECTIVE: To assess the costs incurred by the public health services and patients as a result of tuberculosis (TB) treatment. Setting The study was conducted in a government hospital located in the northern region of Malaysia.

    METHOD: Retrospective data were collected from medical records and the patients were observed until the completion of their medication. A pharmacoeconomic evaluation was applied to calculate direct and indirect costs.

    MAIN OUTCOME MEASURE: Direct and indirect costs of tuberculosis treatment in a government health institution.

    RESULTS: Two hundred and one tuberculosis patients were included in the study. Different regimens with various durations of treatments were used. The direct medical and non-medical costs as well as indirect costs were calculated and were found to be as follows: US$61.44 for anti-tuberculosis drugs and supplies, US$28.63 for X-ray examinations, US$28.53 for laboratory tests, US$20.03 for healthcare staff time, US$4.28 for hospitalisation, US$43.20 for overhead costs, US$608.11 for transportation and meals and US$118.78 for time away from work. The cost to the patients constitutes approximately 80% of the total cost of the treatment.

    CONCLUSION: The cost of treating the illness of tuberculosis per patient was US$916.4. The cost of anti-tuberculosis drugs constituted the highest proportion of the cost to the public health services (31.7%) while the cost to the patient constituted the major proportion of the total cost of the illness (79.4%).

    Matched MeSH terms: National Health Programs/economics
  7. Cheng IK
    Perit Dial Int, 1996;16 Suppl 1:S381-5.
    PMID: 8728228
    The socioeconomic status of Asian countries is diverse, and government reimbursement policies for treatment of patients suffering from end-stage renal disease (ESRD) vary greatly from one country to another. Both of these factors have a major impact not only on the choice of treatment for ESRD but also on the utilization of peritoneal dialysis (PD) in this region. Based on the data collected from 11 representative Asian countries, several observations can be made. First, the treatment rates for ESRD in these countries correlated closely with their gross domestic product (GDP) per capita income. Second, the PD utilization rate appeared to have a biphasic relationship with the GDP per capita income and treatment rate, in that countries with the highest and the lowest treatment rates tended to have lower PD utilization rates, whereas countries with modest treatment rates tended to have higher PD utilization rates. The reason for low PD utilization in countries with the highest treatment rates differs from that in countries with low treatment rates. In the former, because of full government reimbursement, there is little physician incentive to introduce PD as an alternative form of ESRD treatment to in-center hemodialysis (HD), whereas in the latter, the complete lack of government reimbursement prevents the introduction of PD as a form of treatment. This pattern is likely to change in the future because, of the 11 countries surveyed, all except Thailand have recorded a growth rate which is higher for PD than HD over the last three years. The rate of utilization of different PD systems varies greatly among different Asian countries. Automated PD has yet to gain popularity in Asia. Conventional straight-line systems remain the dominant PD systems in use in Hong Kong, Korea, Thailand, and the Philippines, while in Malaysia and Singapore UV germicidal connection devices are most popular. However, in all these countries there has been a progressive shift over the last three years from the straight-line systems with or without germicidal connection devices to the disconnect systems. In China and India, where PD has been introduced only recently, the disconnect systems are used almost exclusively. The disconnect systems are also the most popular systems in use in Japan and Taiwan. As data concerning the cost-effectiveness of different PD systems becomes available, it is likely that trend towards a more liberal use of disconnect systems will continue in the future. The usage of low calcium peritoneal dialysate and the average number of daily CAPD exchanges also vary among the Asian countries. Low calcium peritoneal dialysate has been introduced only in Japan, Hong Kong, and Singapore, with the highest utilization rate (90%) recorded in Singapore. The Philippines had the lowest average number of daily peritoneal exchanges (6L) among the countries surveyed, followed by Hong Kong (6.4L), China and Indonesia (7L), and the rest (8L). The use of a lower number of exchanges was introduced in some countries, initially, mainly as a cost-saving measure based on the assumption that Asians are of small body build. The justification for the continued use of a lower number of exchanges among Asian patients is debatable, but is supported by the acceptable, long-term clinical outcome of patients given this form of dialysis prescription. It is suggested that long-term prospective studies on dialysis adequacy and clinical outcome should be done in different ethnic groups in Asia to see if the similar guidelines with regard to dialysis adequacy can be applied uniformly to Orientals and Caucasians.
    Matched MeSH terms: National Health Programs/economics*
  8. Almualm Y, Alkaff SE, Aljunid S, Alsagoff SS
    Glob J Health Sci, 2013 May 14;5(5):1-10.
    PMID: 23985101 DOI: 10.5539/gjhs.v5n5p1
    This study was carried out to determine the level of support towards the proposed National Health Insurance scheme among Malaysian patients attending specialist clinics at the National University of Malaysia Medical centre and its influencing factors. The cross sectional study was carried out from July-October 2012. 260 patients were selected using multistage sampling method. 71.2% of respondents supported the proposed National Health insurance scheme. 61.4% of respondents are willing to pay up to RM240 per year to join the National Health Insurance and 76.6% of respondents are of the view that enrollment in NHI should be made compulsory. Knowledge had a positive influence on respondent's support towards National Health Insurance. National Health Insurance when implemented in Malaysia can be used to raise funds for health care financing, increase access to health services and achieve the desired health status. More efforts should be taken to promote the scheme and educate the public in order to achieve higher support towards the proposed National Health Insurance. The cost to enroll in NHI as well as services to be included under the scheme should be duly considered.
    Matched MeSH terms: National Health Programs/economics
  9. Othman GQ, Ibrahim MI, Raja'a YA
    East Mediterr Health J, 2012 Apr;18(4):393-8.
    PMID: 22768704
    This study determined the costs associated with tuberculosis (TB) diagnosis and treatment for the public health services and patients in Sana'a, Yemen. Data were collected prospectively from 320 pulmonary and extrapulmonary TB patients (160 each) who were followed until completion of treatment. Direct medical and nonmedical costs and indirect costs were calculated. The proportionate cost to the patients for pulmonary TB and extrapulmonary TB was 76.1% arid 89.4% respectively of the total for treatment. The mean cost to patients for pulmonary and extrapulmonary TB treatment was US$ 108.4 and US$ 328.0 respectively. The mean cost per patient to the health services for pulmonary and extrapulmonary TB treatment was US$ 34.0 and US$ 38.8 respectively. For pulmonary and extrapulmonary TB, drug treatment represented 59.3% and 77.9% respectively of the total cost to the health services. The greatest proportionate cost to patients for pulmonary TB treatment was time away from work (67.5% of the total cost), and for extrapulmonary TB was laboratory and X-ray costs (55.5%) followed by transportation (28.6%).
    Matched MeSH terms: National Health Programs/economics
  10. Wong ZY, Alrasheedy AA, Hassali MA, Saleem F
    Res Social Adm Pharm, 2016 04 20;12(5):807-10.
    PMID: 27157864 DOI: 10.1016/j.sapharm.2016.04.002
    Matched MeSH terms: National Health Programs/economics
  11. Kananatu K
    Asia Pac J Public Health, 2002;14(1):23-8.
    PMID: 12597514
    This paper presents an overview of the Malaysian healthcare system and its method of financing. The development of the healthcare delivery system in Malaysia is commendable. However, the strength and weaknesses of the public healthcare system and the financing problems encountered are also discussed. Cost of healthcare and funding of both the public and private sectors were also revealed. One must optimise the advantages of operating a health financing scheme which is affordable and controllable which contribute towards cost-containment and quality assurance. Thus, there is a need for the establishment of a National Healthcare Financing, a mechanism to sustain the healthcare delivery network and operate it as a viable option. A model of the National Health Financing Scheme (NHFS) was proposed.
    Matched MeSH terms: National Health Programs/economics*
  12. Chan PW, Abdel-Latif ME
    Acta Paediatr, 2003 Apr;92(4):481-5.
    PMID: 12801117
    Respiratory syncytial virus (RSV) chest infection is a common cause of hospitalization in the very young child. The aim of this study was to determine the direct cost of resource utilization in the treatment of children hospitalized with RSV chest infection and the potential cost-savings with passive immunization for high-risk infants. An audit of the hospital resource consumption and its costs was performed for 216 children aged < 24 mo admitted with RSV chest infection between 1995 and 1997. The cost-saving potential of passive immunization using monoclonal RSV antibodies during the RSV season was determined by assuming an 0.55 efficacy in hospitalization reduction when administered to "high-risk" infants according to the guidelines outlined by the American Academy of Pediatrics (AAP). The hospital treatment cost of 1064 bed-days amounted to USD 64 277.70. Each child occupied a median of 4.0 bed-days at a median cost of USD 169.99 (IQ1 128.08, IQ3 248.47). Children, who were ex-premature or with an underlying illness were more likely to have a longer hospital stay, higher treatment costs and need for intensive care. Ten (42%) of 24 ex-premature infants fulfilled the recommended criteria for passive immunization. Its use resulted in an incremental cost of USD 31.39 to a potential cost saving of USD 0.91 per infant for each hospital day saved.

    CONCLUSION: Ex-prematurity and the presence of an underlying illness results in escalation of the direct treatment cost of RSV chest infection. Current guidelines for use of passive RSV immunization do not appear to be cost-effective if adopted for Malaysian infants.

    Matched MeSH terms: National Health Programs/economics
  13. Leporowski A, Godman B, Kurdi A, MacBride-Stewart S, Ryan M, Hurding S, et al.
    Expert Rev Pharmacoecon Outcomes Res, 2018 Dec;18(6):655-666.
    PMID: 30014725 DOI: 10.1080/14737167.2018.1501558
    BACKGROUND: Prescribing of lipid-lowering agents (LLAs) has increased worldwide including in Scotland with increasing prevalence of coronary heart disease, and higher dose statins have been advocated in recent years. There have also been initiatives to encourage prescribing of generic versus patented statins to save costs without compromising care. There is a need to document these initiatives and outcomes to provide future direction.

    METHOD: Assessment of utilization (items dispensed) and expenditure of key LLAs (mainly statins) between 2001 and 2015 in Scotland alongside initiatives.

    RESULTS: Multiple interventions over the years have increased international nonproprietary name prescribing (99% for statins) and preferential prescribing of generic versus patented statins, and reduced inappropriate prescribing of ezetimibe. This resulted in a 50% reduction in expenditure of LLAs between 2001 and 2015 despite a 412% increase in utilization, increased prescribing of higher dose statins (71% in 2015) especially atorvastatin following generic availability, and reduced prescribing of ezetimibe (reduced by 72% between 2010 and 2015). As a result, the quality of prescribing has improved.

    CONCLUSION: Generic availability coupled with multiple measures has resulted in appreciable shifts in statin prescribing behavior and reduced ezetimibe prescribing, resulting in improvements in both the quality and efficiency of prescribing.

    Matched MeSH terms: National Health Programs/economics
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