Healthcare Services In Malaysia Research Articles

Mental Healthcare Needs and Experiences of LGBT+ Individuals in Malaysia: Utility, Enablers, and Barriers.

Access to mental healthcare is undoubtedly of major importance for LGBT+ people worldwide, given the high prevalence of mental health difficulties due to minority stress exposures. This study drew mixed-method survey data from the community-based KAMI Survey (n = 696) to examine the enablers, barriers, and unmet needs experiences of LGBT+ individuals in accessing mental healthcare services in Malaysia. First, we present findings from a series of descriptive analyses for sociodemographic differences in unmet needs for mental healthcare, barriers, and satisfaction levels with different types of mental healthcare. Next, we conducted an inductive thematic analysis of open-text comments (n = 273), with relevance drawn to Andersen's Behavioural Model of Healthcare. More than a quarter (29.5%) reported an unmet need for mental healthcare, and some groups (younger, asexual or queer, or participants living in non-major cities) reported higher unmet needs. More than three-fifths (60.5%) reported not knowing where to find culturally safe mental health professionals. The thematic analysis uncovered key contextual (e.g., mental health practitioners' stance, stigma, collaborative client-care) and individual (e.g., positive expectation of mental health services and anticipated stigma) attributes that influence healthcare experiences. Participants also identified resources that facilitate healthcare utilisation, such as affordability, availability of suitable professionals, and geographical considerations. The implications of our findings for the mental healthcare practices in Malaysia were outlined.

Blockchain-Based Electronic Health Records: Revolutionizing healthcare in Malaysia

Introduction: Despite the government's continuous efforts since the 1990s, the public healthcare sector of Malaysia still faces issues related to system deployment and technology adoption. As a result, the nationwide health information exchange remains as not fully established, hampering the Malaysian aspirations of health service provision for citizens. The government long to establish health information exchange, enabling blockchain technology-based applications. This paper aims to review the government's digitalization initiatives and describe the provision of blockchain Electronic Health Records for healthcare services in Malaysia. Methodology: A review of the scholarly databases Scopus, Web of Science, and Google Scholar, along with the grey literature from the Malaysian government, was conducted. In addition, health-related government websites have been searched for information until the end of March 2023. Results: There were 55 documents yielded from the database, and a grey literature search was retained for content analysis. Discussion: The major barrier that could push back governments' efforts is user resistance, particularly from medical professionals. Besides, Regulatory reform is needed to facilitate blockchain provision for healthcare data management. Technical issues directly associated with the system and vendor are worth addressing. Conclusion: Malaysia has a progressive vision towards healthcare digitalization aimed at 2030. To be able to successfully achieve this target then it is essential to implement appropriate strategies. User readiness assessment calls for research, while system-related issues regarding; hardware, software, and vendor needs to be properly planned. Patients' ownership of medical data is to be allowed by law. Currently this information strictly belongs to hospitals and health partitioners therefore data management is physician centric.

Dementia awareness among elderly at risk for developing mild cognitive impairment: a cross sectional study at a university-based primary care clinic.

The number of people living with dementia in Malaysia is expected to increase with the nation's growing elderly population and increased lifespan. The lack of public awareness of dementia is partly compounded by low personal health literacy, while scarce research on local patient awareness further impacts the execution of optimised healthcare services in Malaysia. Patients with chronic disease have an elevated risk of developing mild cognitive impairment (MCI). This study aimed to assess the level of awareness of basic knowledge on dementia among the elderly, especially those at risk of developing mild cognitive impairment and its associated factors. A total of 207 elderly patients aged 60years and above with chronic diseases attending a university-based primary care clinic were recruited via a systematic randomised sampling method from the clinic patient attendance registry. Respondents were assessed using self-administered online questionnaires distributed via mobile devices. The questionnaire assessed awareness, i.e. ability to correctly answer a self-reported questionnaire on basic dementia knowledge; (adapted from Northern Ireland Life and Times Survey 2010), risk of MCI; (using Towards Useful Aging (TUA)-WELLNESS screening questionnaire) and help-seeking behaviour. Bivariate analysis was used to determine factors associated with dementia awareness. The response rate was 77.1%, with the majority of participants were females, Chinese and had secondary school education. 39.1% of participants were categorised as high risk of developing MCI. The majority (92.8%) had low dementia awareness and had never shared their concerns regarding dementia (93.2%) nor had any discussion (87.0%) on cognitive impairment with their physicians. Three factors had an association with total dementia awareness score, i.e., younger age group, higher risk of MCI and presence of cardiovascular diseases have significantly lower awareness score (p < 0.05). Awareness of dementia is low among elderly patients with potentially high risk of developing MCI. Efforts to improve awareness on dementia should focus on primary care doctors engaging with at-risk elderly patients to initiate discussion regarding dementia risk while managing modifiable risk factors i.e. hypertension control, diabetes, dyslipidaemia and obesity.

An Analysis of The Rights to Health and The Traditional &amp; Complementary Medicine (TCM) Healthcare Services in Malaysia

An Analysis of The Rights to Health and The Traditional &amp; Complementary Medicine (TCM) Healthcare Services in Malaysia

THE LEVEL OF INDONESIA'S PATIENT'S CONFIDENCE TOWARD PRIVATE HOSPITAL IN MALAYSIA

To examine the level of Indonesia ‘s patients’ confidence toward private hospitals in Malaysia. The under present literature regarding confidence in the healthcare context has motivated the researcher to research in this area. This study employed the purposive sampling technique. The Questionnaire was distributed to 537 patients from Indonesia who visited private hospitals in Penang, Kuala Lumpur, and Melaka at least for the second times visit. This is a descriptive study that assesses the high or low level of Indonesia patient’s confidence toward the healthcare service provided by the private hospitals in Malaysia. This study utilized SPSS 26 version as a data analysis tool. After analysing the data, it reveals that Indonesia’s patients had high confidence in the healthcare service delivered by Malaysia’s Private hospitals. From six items that as are the reflection of patients’ confidence, the feeling of comfort, familiarity, trust, and satisfaction are among the highest factors that determine the confidence of patients from Indonesia. In addition, all the items’ scales of patient’s confidence have adequate reliability. It is highly suggested for Malaysia’s private hospital to provide high value on quality of healthcare service and develop a good relationship with the patients from Indonesia to boost the confidence of the patients to use the healthcare services in Malaysia. This study expected can give a valuable contribution to the development of patient’s confidence in medical tourism and the national healthcare context.

Evaluating the sustainability of non-communicable diseases programs in Malaysia

BackgroundThe substantial rise in non-communicable diseases (NCDs) over the last two decades poses a major concern to the healthcare services in Malaysia. This study aimed to evaluate the sustainability of the current NCDs programs and identify the challenges and factors impeding the sustainability of the NCDs program implemented under the National Strategic Plan.MethodsThis study applied the mixed-method approach using the Program Sustainability Assessment Tool (PSAT) to assess the eight domains for program sustainability combined with 5 open-ended questions. The survey was administered to key leaders from the district health offices in Malaysia. The mean score for each sustainability domain and the overall mean sustainability score were determined. Descriptive statistics and thematic analysis were conducted using Statistical Package for the Social Sciences (SPSS) version 25 and NVivo version 12, respectively.ResultsA total of 80 key leaders responded to the survey. Overall seven domains scored an average of ≥ 4 with an overall mean sustainability score of 4.2. The highest domain mean scores were 4.5 (communications) and 4.4 (organizational capacity). The lowest mean score domain was 3.8 (funding stability). The open-ended responses revealed challenges faced by department heads, including implementation difficulties, factors impeding the planning of the NCDs program for sustainability, lack of financial resources, lack of human resources, and support for staff training which are largely consistent with the scores of each domain.ConclusionThe sustainability factors affecting the NCDs program in Malaysia are qualitatively similar to other countries. For greater sustainability capacity, we should work towards strong leadership, strengthening funding stability, and incorporating evidence-based public health strategies in the implementation of the NCDs program.

Equity in Out-of-Pocket Payments for Healthcare Services: Evidence from Malaysia.

Background: Out-of-pocket (OOP) payments are an inequitable mechanism for health financing as their high share of total health expenditures poses a risk of catastrophic healthcare expenditures. This study aimed to assess the distribution and progressivity of OOP payments made by Malaysian households for various group of healthcare services. Methods: This study utilized data from the Malaysian Household Expenditure Survey (HES) between 2014 and 2015, which involved 14,473 households. Distribution and progressivity of OOP payments were measured through their proportion of household consumption, a concentration curves plot and the Kakwani Progressivity Index (KPI). Results: The mean proportion of Malaysian OOP payments for healthcare of household consumption was 1.65%. The proportion increased across households’ consumption quintiles, from 1.03% made by the poorest 20% to 1.86% by the richest 20%. The OOP payments in Malaysia were progressive with a positive KPI of 0.0910. The OOP payments made for hospital-based services were the most progressive (KPI 0.1756), followed by medical products, appliances and equipment (KPI 0.1192), pharmaceuticals (0.0925) and outpatient-based services (KPI 0.0394) as the least progressive. Conclusions: Overall, the OOP payments for healthcare services in Malaysia were progressive and equitable as they were more concentrated among the richer households.

PSYCHOMETRIC EVALUATION OF FLOOD DISASTER MANAGEMENT QUESTIONNAIRE: CONFIRMATORY FACTOR ANALYSIS AND ITEM RESPONSE THEORY ANALYSIS

Flood disaster is the commonest natural disaster with huge impact on healthcare services in Malaysia. The FloodDMQ-BM© questionnaire was developed as a tool to assess the knowledge, attitude, and practice of healthcare providers regarding patient management during a flood disaster. We aim to further validate the FloodDMQ-BM© questionnaire by using Confirmatory Factor Analysis (CFA) and Item Response Theory (IRT).This cross-sectional study involved doctors, nurses and paramedics working in the Emergency Department of Hospital Universiti Sains Malaysia, Hospital Raja Perempuan Zainab II and Hospital Kuala Krai. Respondents were required to complete the FloodDMQ-BM© questionnaire. The responses were analysed by using CFA and IRT to establish its validity and reliability. A total of 215 respondents participated in this study. CFA analysis with Maximum Likelihood Robust as the estimation method, on the attitude and practice components resulted in good factor loadings (&gt;0.5) in nearly all items and excellent model fit indices values (CFI = 0.96-0.98, TLI = 0.95-0.96, SRMR = 0.04-0.05, RMSEA = 0.07). Meanwhile, IRT analysis on the knowledge section showed a good two-way marginal fit based on S-X2, and a good model fit with RMSEA of 0.08. Based on the 2PL model by using the IRT assessment of the knowledge section, one item in the knowledge section (K3) was removed (chi-squared residual &gt;4) resulting in improved model fit. The included items had well-standardized loadings (&gt;0.3) and marginal reliability of 0. 651.Our results confirmed that the FloodDMQ-BM© questionnaire displayed valid and reliable psychometric properties.

The Need of Muslim Chaplain In Hospital-Based Services in Malaysia: A Scoping Review of Literature

Introduction: The roles of Muslim chaplain within the boundary of healthcare services in Malaysia should be brought into highlight as they can facilitate the provision of spiritual services for clients with various spiritual and cultural needs. Nonetheless, less attention has been paid to the collaboration between the Muslim chaplain and the healthcare professionals in the Malaysian healthcare settings. This paper provides a scoping review on the articles that can provide insight on the need for Muslim chaplain in the hospital-based services for Malaysia setting based on the expertise the chaplain can provide. Methods: A literature search was done with the keywords including chaplain* OR clergy* AND Muslim* AND hospital* via databases such as Web of Science, SCOPUS, MEDLINE (Proquest), CINAHL and Google scholar, A total of 15 articles has been reviewed and were included in this article to address the aim of this paper and they were limited to English and published within 2011 till 2021. Discussion: This review paper highlighted a discussion on the emerging need of Muslim chaplaincy in the 21st century, and their scope of practice in Hospital-based services as seen in the literature. This is followed by the issues on spiritual struggles among those admitted to hospitals. Conclusion: This paper thus provides recommendations for recruitment of Muslim chaplains, the need for training and future empirical work on the benefits of spiritual services provided by chaplaincy services for the sick.

Bridging Financial Barrier: A Development of Hybrid Takaful Model towards Quality Mental Health Care Services In Malaysia

Covering family’s members with family takaful is a necessary act in today’s environment if the financial risks are to be guarded particularly who are facing with mental health illness. This is due to fact that the cost of mental health services has always been a great barrier to accessing care for people with metal health problems and usually required series of consultations by the expert. Mental health illness becomes one of the major illnesses in Malaysia aside from heart disease that lead for seriously attention among takaful operators to include the mental health treatment in their family takaful premiums due to the worrying number of people suffering from mental health illness. Malaysia is still way behind in offering coverage for mental health illness with only AIA Malaysia and Etiqa Malaysia offers such a policy in the current market and there are huge potential in this product. Consequently, the objective of this paper is to propose a hybrid takaful model for mental health disorders in Malaysia particularly among the lower group of income due to the financial barriers. This paper uses a qualitative approach by analyzing the related document and past literature in achieving the current objective. The outcome from this study concluded that mental health takaful is needed in the Malaysia’s market in improving the mental health assessment in the country where the higher level of collaborative effort among the communities as well as governmental and NGOs is mandatory in combating this issue.

A Reliability Study of the Malay Version of the Malaysian Ministry of Health's Adolescent Client Satisfaction Questionnaire among Adolescents Attending Health Clinics in Northeastern Malaysia.

BackgroundThe need for client feedback in assessing healthcare services is widely recognized. However, little is known about the satisfaction of adolescent clients utilizing healthcare services in Malaysia. To the best of our knowledge, there is no validated instrument to measure the satisfaction of adolescent clients attending health clinics in Malaysia. This cross-sectional study aimed to determine the reliability of the Malay version of the Malaysian Ministry of Health’s Adolescent Client Satisfaction Questionnaire among adolescents attending health clinics in northeastern Malaysia.MethodsA cross-sectional study was conducted in January 2019 among adolescents aged 10–19 years attending four designated health clinics in the northeastern state of Peninsular Malaysia. The test for Cronbach’s α was performed to determine the internal consistency reliability.ResultsThere were a total of 85 adolescent clients involved in this study. The mean age of respondents was 15.6 years. The majority of respondents were female, Malay, students, and had attained a secondary level of education. The mean total satisfaction score was 78.35. The internal consistency reliability according to the Cronbach’s α of the domain was 0.854, which is considered highly reliable. The corrected item-total correlation for the domain was acceptable as it was ≥0.4.ConclusionThe Malay version of the Malaysian Ministry of Health’s Adolescent Client Satisfaction Questionnaire has excellent internal consistency reliability. Therefore, it may be recommended as a tool to measure the satisfaction level among adolescents attending health clinics in Malaysia.

Predicting Nurses Burnout through Quality of Work Life and Psychological Empowerment: A Study Towards Sustainable Healthcare Services in Malaysia

The nursing profession is a much-demanded profession that requires the individual capacity to work under intense physical and emotional dynamics in the workplace. Work related factors cause burnout and need attention from scholars and professionals to reduce the effects of the burnout among nursing staff. This study aimed to examine the meditational role of psychological empowerment and work-life quality on the burnout experiences of nursing staff in Malaysia. This study investigated a sample of 432 nursing staff from 10 registered hospitals in the Selangor area that have been listed on the Malaysian Health Tourism Council (MHTC) website. The responses collected via a self-reported questionnaire, and the data was analyzed using partial least square regression structural equation modelling (PLS-SEM). The findings statistically support the argument that the provision of quality of work-life (adequate and fair compensation, constitution in the work organization, safe and healthy working conditions, social integration in the work organization, social relevance of work-life, and work and life span) could promote psychological empowerment among nurses. Psychological empowerment statistically resulted in reducing the burnout effects by mediating the effect of work-life quality (QWL) on burnout. This study contributes to the literature that QWL factors need to be studied separately, and its affects on psychological empowerment, and how psychological empowerment permits curtails the effects of the burnout among nursing staff providing the services to health tourists. This study also provided important implications for the management staff of the nursing industry to initiate the management of burnout with the provision of psychological employment. The present study contributed to the current literature of burnout management through the psychological empowerment provided by the factors of the quality of work life.

Modeling Nurse Time for School Health Service using System Dynamics

One of the national primary health care services in Malaysia is school health care. This care is very crucial as it ensures that, countrywide, the health of students from the age of five to fifteen is in a good condition. In Malaysia, nurses hold a major responsibility for delivering the school health service. However, there is no solid research investigating the nursing time required to deliver school health services. This paper presents a system dynamics model representing the specific school health services delivered by nurses. System Dynamics is a computer-aided approach to policy analysis and design. In this paper, the system dynamics model are represented by several causal loop diagrams which covers all the school health activities and is able to determine the projected total nurse time required in delivering the service. The baseline simulation result of the nurse time required for delivering school health services is about 1080000 hours in year 2030, which is equivalent to 680 full time equivalent (FTE) nurses. Furthermore, various what-if analyses are tested with the model, as it is important for policy makers to investigate various scenarios for an effective decision-making process. In other words, the theme of the study is to understand the implication of the changes in school population size and the modification of certain activities in the school health program on the nurse time spent delivering school health service by developing a dedicated forecasting system dynamics model for school health. The time horizon for the forecasting is from 2018 until 2030.

Breaking down the barriers: Understanding migrant workers' access to healthcare in Malaysia.

BackgroundMalaysia is widely credited to have achieved universal health coverage for citizens. However, the accessibility of healthcare services to migrant workers is questionable. Recently, medical fees for foreigners at public facilities were substantially increased. Mandatory health insurance only covers public hospital admissions and excludes undocumented migrants. This study explores barriers to healthcare access faced by documented and undocumented migrant workers in Malaysia.MethodsWe use qualitative data from 17 in-depth interviews conducted with key informants from civil society organisations, trade unions, academia, medical professionals, as well as migrant workers and their representatives. We interviewed doctors working in public hospitals and private clinics frequented by migrants. Data were analysed using thematic analysis.ResultsWe found that healthcare services in Malaysia are often inaccessible to migrant workers. Complex access barriers were identified, many beyond the control of the health sector. Major themes include affordability and financial constraints, the need for legal documents like valid passports and work permits, language barriers, discrimination and xenophobia, physical inaccessibility and employer-related barriers. Our study suggests that government mandated insurance for migrant workers is insufficient in view of the recent increase in medical fees. The perceived close working relationship between the ministries of health and immigration effectively excludes undocumented migrants from access to public healthcare facilities. Language barriers may affect the quality of care received by migrant workers, by inadvertently resulting in medical errors, while preventing them from giving truly informed consent.ConclusionsWe propose instituting migrant-friendly health services at public facilities. We also suggest implementing a comprehensive health insurance to enable healthcare access and financial risk protection for all migrant workers. Non-health sector solutions include the formation of a multi-stakeholder migration management body towards a comprehensive national policy on labour migration which includes health.

Level of Satisfaction on Service Quality Dimensions Based on SERVQUAL Model Among Patients Attending 1 Malaysia Clinic in Kota Bharu, Malaysia

Implemented in 2010, 1 Malaysia Clinic (1MC) is the latest innovation in public primary healthcare services in Malaysia to serve the urban population. This study aimed to assess the level of satisfaction and its associated factors using the SERVQUAL (SERV-service, QUAL-quality) instrument. We also sought to compare the difference of mean score between expectation and perception of SERVQUAL dimension among patients attending 1MC in Kota Bharu district, Malaysia. This cross-sectional study included all nine 1MCs in the Kota Bharu district, Malaysia, and used the validated SERVQUAL questionnaire from Ministry of Health, Malaysia. The primary data was collected in January 2017. The sample size was proportionate to the average daily patient attendance for each clinic, and a simple random sampling method was applied to reduced selection bias. Satisfaction level was determined by the mean gap score of expectation and perception of the SERVQUAL dimension. A total of 386 patients were involved in this study (184 male and 202 female). Most were from the low socioeconomic group. Less than half of the patients were satisfied with the clinic services. The tangible dimension (service quality (SQ) gap: -0.25) was the most critical dimension among all five SQ dimensions assessed. The factors included low education level (adjusted odds ratio (adj. OR) 1.87; 95% confidence interval (CI): 1.06, 2.67; p = 0.024), monthly household income less than RM 3000 (adj. OR 2.97; 95% CI: 1.72, 5.51; p < 0.001), and frequency 3 3 visits (adj. OR 2.23; 95% CI: 1.44, 3.45; p < 0.001) had significant association with high level of satisfaction. 1MC has achieved its objective to increase the accessibility of health services among the low-income population in urban settings. However, most patients were not satisfied with certain parts of the services. Thus, proper evaluation of the service gap is required for improvement of the service.

Patients Loyalty Framework towards Healthcare Services in Malaysia

The goal of this research is to determine the components that compel the healthcare stakeholders to become loyal towards the system. With extensive literature study of previously completed work, six crucial variables has been finalized. Hence, these variables will be justified to uphold loyal patients in healthcare. The findings highlighted the importance of loyalty in medical care. The factors leading to loyalty are identified and the relationship between the distinguished variable and loyalty is reconfirmed as prior documented studies.

Public private partnership (PPP) facilities management for healthcare services in Malaysia

Purpose The purpose of this paper is to investigate the challenges associated with the delivery of facilities management (FM) under public–private partnership (PPP) for healthcare services in Malaysia. Design/methodology/approach A questionnaire survey has been administrated to PPP practitioners in Malaysia. The study has adopted reliability and descriptive method for analysis. Findings This research resulted in a series of 14 challenges that have to be faced in the implementation of PPP FM for healthcare services in Malaysia. Inadequate specific PPP risk management model is identified as the most significant challenge followed by the difficulty in reaching agreements and project complexity. Originality/value This study is considered the first study that identifies and assesses the challenges of PPP within the Malaysian context. The findings will provide a more informed basis for decision-making process, especially for the FM bidders.

Issues in healthcare services in Malaysia as experienced by Japanese retirees.

BackgroundWorldwide, international retirement migration is growing in its popularity and Japanese retirees choose Malaysia as their most preferred destination. This study examines the pertinent issues related to healthcare services as experienced by Japanese retirees in this country.Methods and resultsFrom January to March 2015, we conducted focus group discussions with 30 Japanese retirees who live in Kuala Lumpur and Ipoh. Guided by the social-ecological model, we discovered seven pertinent themes: ‘language barriers’,’healthcare decisions’, ‘medical check-ups’,‘healthcare insurance’, ‘nursing and palliative care’, ‘trust and distrust of healthcare services’, and ‘word-of-mouth information’.DiscussionWe identified seven pertinent issues related to healthcare services among Japanese retirees in Malaysia, of which four are especially important. These issues are explained as integrated themes within the social-ecological model. Language barriers prohibit them from having difficulty accessing to healthcare in Malaysia, but lack of will to improve their language skills exist among them. For that reason, they rely heavily on word-of-mouth information when seeking for healthcare. As a consequence, some develop feelings of trust and distrust of healthcare services. In addition, we have identified the needs for provide nursing and palliative care among Japanese retirees in Malaysia.ConclusionBased on the magnitude of the discussion, we concluded that there are four crucial healthcare issues among Japanese retirees; ‘language barriers’, ‘trust and distrust of healthcare services’, ‘word-of-mouth information’ and ‘nursing and palliative care’. We propose that further dialogue by healthcare stakeholders should be carried out to improve further the healthcare service provisions for Japanese retirees in Malaysia.

The Influence of Leadership Style on Job Satisfaction among Nurses

Nurses roles and responsibilities contribute to the quality improvement of health care services in Malaysia. Previous research has shown that leaders play an important role in enhancing job satisfaction among the nurses. Indeed, the transformational and transactional leadership was found to be the most efficient influence among the leadership style in attaining job satisfaction. The objective of this study is to investigate the transformational and transactional leadership styles that might contribute to the job satisfaction among nurses. Survey questionnaires were used in this study as a main method for data collection. Results indicated that the transformational have more contribution towards job satisfaction compare to transactional leadership style. Based on the results, this study also includes the recommendation of future research that might be relevant to be further explored.

Health care delivery in Malaysia: changes, challenges and champions.

Since 1957, there has been major reorganization of health care services in Malaysia. This article assesses the changes and challenges in health care delivery in Malaysia and how the management in health care processes has evolved over the years including equitable health care and health care financing. The health care service in Malaysia is changing towards wellness service as opposed to illness service. The Malaysian Ministry of Health (MOH), being the main provider of health services, may need to manage and mobilize better health care services by providing better health care financing mechanisms. It is recommended that partnership between public and private sectors with the extension of traditional medicine complementing western medicine in medical therapy continues in the delivery of health care.