ABSTRACT
@#Introduction: Primary health care plays an important role in healthcare systems. In Malaysia, One (1) Malaysia Clinic (now known as Community Clinic since 2018) was established in 2010 aims to increase healthcare services accessibility within the poor urban population. The aim was to look at the effectiveness of One (1) Malaysia Clinic as a new form of public primary health clinic by looking at expectations and perceptions of the quality of the provided services by the patients. Method: It applied a cross sectional study involving nine clinics in of the busiest district in Kelantan namely, Kota Bharu district. 386 respondents which were Malaysian citizen, 18 years old and above were involved in this study. The survey used Malay validated SERVQUAL questionnaire. The Service Quality (SQ) gap was calculated. Result: The empathy dimension obtained the highest expectation and perception score, while the tangible dimension has the lowest expectation and perception score. In all SERVQUAL dimension, the expectations and perceptions of the service provided was significantly different with P < 0.001. The most critical dimension identified was tangible dimension as it has the largest negative SQ gap score. Conclusion: Negative gaps for all SERVQUAL dimensions and individual items indicated that provided services at One (1) Malaysia Clinic still could not fulfilled the patient’s expectation. A continuous improvement program is needed especially on tangible dimension in delivering a quality healthcare services.
ABSTRACT
@#Introduction: Proper distribution of human resources is an important factor ensuring high-quality performance and sustained service quality. The aim of this study was determining the workload pressure among medical officers in health clinics (HCs) in Kelantan. Method: A record review survey was conducted between January and April 2019 using human resources data for 2018 involving HCs in Kelantan. It included all the HCs in Kelantan and excluded community clinics. Workload pressure was determined using a tool known as Workload Indicator of Staffing Needs, developed by World Health Organization. A high workload pressure was defined as a ratio between required and acquired medical officers of less than 1. The data were presented descriptively using as frequencies and percentages. Results: All 85 HCs in Kelantan were involved in the study; 90% (9/10) of the Kelantan districts recorded high workload pressure. Moreover, 68.2% (58/85) HCs had high workload pressure. Tanah Merah, Tumpat, Pasir Mas, and Kota Bharu had the most HCs with high workload pressure, and most such HCs were found in areas with a high-density population, requiring huge coverage. Conclusion: The Kelantan State Health Department should develop better human resource distribution strategies to ensure the sustainability of quality care in HCs.
ABSTRACT
Objectives: 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
Methods: 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
Results: 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 visits [adj. OR 2.23; 95% CI: 1.44, 3.45; p < 0.001] had significant association with high level of satisfaction
Conclusion: 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