ABSTRACT
@#Introduction: A casemix system measures costs of health service provision that is crucial in the planning and hospital budgeting. The MalaysianDRG casemix system has been implemented since 2010, yet many health professionals were unaware of its importance. To highlight this problem, we estimated the miscalculation of costs in providing treatment, that occurred due to inaccurate clinical documentation and coding error in the MalaysianDRG casemix system. Methods: Using a cross-sectional study design, 226 coded case notes from two healthcare institutions in Malaysia were selected and re-coded. If a difference between codes was observed, the new code would be chosen as the final code. The cases were then re-grouped using the MalaysianDRG casemix system. The cost per case derived from the new and original codes was compared. Then, the outcomes were verified by a casemix expert from the Ministry of Health. Results: Results indicated 61.9% inaccurate clinical documentation and 25.2% coding error. The difference in costs of treatment provision, due to inaccurate clinical documentation was RM227,657 and RM 68,216 for coding error. Using paired t-test analysis, differences between mean (SD) cost per case of the original vs. new codes due to inaccurate clinical documentation [RM10,208.19(12273) vs. RM11,244.53(13785.27), p<0.05], and coding error [RM10,208.19(12273.04) vs. RM11,215.52(13798.03) p<0.05] were statistically significant. These results raised important questions regarding costly financial implications arising from inaccurate clinical documentation and coding error in the MalaysianDRG casemix system. Conclusion: To achieve the full benefit of the MalaysianDRG casemix system, the quality and accuracy of its data must first be established.
ABSTRACT
@#Introduction: The Ministry of Health (MOH) implemented the MalaysianDRG casemix system in 2010, and two national target indicators on the accuracy and completeness of clinical documentation were introduced to measure its performance. This study aims to show the trend of casemix performance in MOH hospitals and to explore the challenges in meeting these targets. Methods: The study design was sequential explanatory mixed-method design. First, a cross-sectional study described the trend of casemix performance in five MOH hospitals in Malaysia. Second, a single holistic case study of the hospital with the lowest casemix system performance was conducted to explore the perceptions of clinicians regarding the MalaysianDRG casemix and the challenges pertaining to clinical documentation. Purposive sampling was employed, and the case study data collection was carried out using in-depth-interviews, observation, and document reviews. Results: Two hospitals achieved the target in the accuracy of clinical documentation for the main condition (≥90%). For completeness in clinical documentation, four out of five MOH hospitals performed below the target (≤ 60%). Thematic analysis of the data found poor commitment of clinicians towards casemix and a multitude of obstacles in performing clinical documentations. Conclusion: After a decade of its implementation, the performance of the MalaysianDRG casemix system in MOH hospitals is still moderate due to inaccurate and incomplete clinical documentations. The study findings may be used to spread awareness and devise tailored solutions to assist clinicians in paving the way towards future excellence in MalaysianDRG casemix system.
ABSTRACT
@#Introduction: Eating out has always been associated with increasing cases of food poisoning. These problems can be minimized through mobile applications and technology development. A mobile application called MyWarung© was developed to provide an alternative, improved tool for improving food poisoning knowledge and preventive behaviour. Methods: This cross-sectional study aims to assess the feasibility and acceptance of the MyWarung© application for consumers in Terengganu. The 50 consumers were selected based on the inclusion and exclusion criteria using convenience non-probability sampling. The data were collected through a questionnaire that included three components: socio-demographic, feasible (6 components) and acceptable (7 components). The scoring above 80.0% indicates an acceptable, while lower than 80.0% show unacceptable for both feasibility and acceptability sections. SPSS 22.0 has analyzed the data. Results: The results showed excellent feasibility with a median score of 27.5 (IQR 6.0) out of 30.0, and acceptance with 32.0 (IQR 7.0) out of 35.0. Majority of the respondents agreed that the app is easy to use (94.0%), easy to understand (88.0%), attractive (84.0%), catchy (88.0%), provides more information (96.0%), efficient (96.0%), knowledge improvement (96.0%), beneficial (100.0%), useful application (88.0%), and recommend to the other people (84.0%). The overall result showed that most respondents agreed that MyWarung© application was feasible and acceptable with 90.0% and 86.0% feasibility and acceptability rate. Conclusion: The MyWarung© application among consumers can be highly feasible and acceptable in preventing food poisoning during dining out.
ABSTRACT
Leptospirosis has been reported as an endemic in most tropical countries. Among high risk occupations, leptospirosis includes workers in agriculture and domestic animal industries. Environmental hygiene in the wet market has established a link between the presence of rodents with probability of leptospirosis infection. This study was aimed to compare the level of knowledge, attitude and preventive practice against leptospirosis between healthy Malaysian and non-Malaysian wet market workers in selected wet markets in urban areas of Selangor. A cross-sectional study in the determined area was conducted with the participation of 147 respondents. The respondents were randomly chosen from the list provided by the state agency that regulates these markets. A self-administered bilingual validated questionnaire (English and Bahasa Melayu) was distributed to the selected respondents. There were 68 (48.3%) Malaysian respondents and 79 (53.7%) non-Malaysian respondents. The majority of them were males, who attained formal education and were less than 40 years old. Meanwhile, the respondents earned less than RM3000. Among the Malaysian respondents, 80.9% were aware of leptospirosis as compared to 17.7% of the non-Malaysian colleagues (p < 0.05). All items of knowledge showed that the Malaysian respondents scored higher as compared to non-Malaysian respondents. On attitude towards infection prevention, most Malaysian respondents had a positive attitude, while most non-Malaysian respondents had undecided perception on the majority of crucial attitude items. In practicing preventive measures, there was a marked significant difference in proportion between Malaysian and non-Malaysian respondents for items on "Specific Protection and Isolation at Source." There was a significant gap on knowledge, attitude and preventive practice among Malaysian workers as compared to non-Malaysian workers. Therefore, it was highly recommended the health promotion implementation should also provide specific focus on non-Malaysian workers.
Subject(s)
Health Knowledge, Attitudes, Practice , Leptospirosis , Adult , Animals , Cross-Sectional Studies , Female , Humans , Malaysia , Male , Surveys and QuestionnairesABSTRACT
Background@#The 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. @*Methods@#A 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. @*Results@#There 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. @*Conclusion@#The 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.
ABSTRACT
@#The flood disaster in Kelantan in 2014 had resulted in substantial health implications including increased cases of communicable diseases. There was a lack of community preparedness including customized health educations in the prevention and control of flood-related communicable diseases in the affected areas. The research was aimed to evaluate the effectiveness of community-based health education modules on flood-related communicable diseases among communities in Kelantan. Health education modules focusing on major food-related diseases were developed. A non-randomized community-controlled trial using the modules were conducted. Outcomes were assessed on knowledge, attitude and preventive practice scores to flood-related communicable diseases using a pre-validated questionnaire. Independent t test was used to compare mean scores between the intervention community (Tumpat) and the control community (Bachok) at 1-month post intervention. One-way independent ANOVA test was done to compare score differences at baseline (pre), post 1-month and post 2-month from repeated surveys among random samples within the intervention community. There were significant improvements in all knowledge components from 9.4% to 52.6% with 10% increment in attitude scores toward preventing behaviours on flood-related communicable diseases. When compared against the control community at one-month post-intervention, there were significantly higher knowledge on types of diseases, symptoms and risk factors as well as practice scores of drinking safe water and protective habits. This research demonstrated that community-based health education is effective in improving relevant knowledge, attitude and preventive practices among affected communities as part of their preparedness toward communicable diseases related to flood.
ABSTRACT
Abstract@#Introduction: Parents of a disabled child might require extra basic needs which most of the time are unmet due to several factors. Thus, understanding the unmet needs could help the respective institution to provide and prioritise the needs required. Methods: A cross-sectional study was conducted between September to December 2013 to determine the proportion of unmet needs among parents of children with disabilities at support institutions in Kelantan, Malaysia. Biological parents of disabled children aged between 2 to 18 years old were included in the study. A 35item validated Malay version of the Family Needs Survey was used in this study. A scoring of 4-point Likert scale was used; the prevalence of unmet needs was determined based on the proportion of those who scored “3” from each domain. Results: A total of 226 parents were involved in the present study. The mean age of parents and children were 44.6 (8.99) and 10.2 (4.85) years old respectively. The most common type of disabilities was learning disability (n=151, 66.8%). The unmet need for information has the highest prevalence (97.8%), followed by the unmet need for social support (93.8%). Conclusion: Parents with disabled children require information to guide them in managing their children. Findings from this study may better enable policymakers to devote resources in assisting parents, and service providers in designing appropriate interventions in fulfilling the unmet needs of these parents.
ABSTRACT
@#The article introduces readers to the Master of Public Health and Doctor of Public Health programmes, offered by the Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia. The programme vision, structure and accomplishments over the decade are presented to provide an understanding of the programme. It is hoped that this professional programme will continue to flourish and produce new generations of public health medicine specialist equipped with the necessary knowledge and skills to make significant contribution towards improving the health of the population.
ABSTRACT
AIM: To explore the experiences of women with severe maternal morbidity and their perception of the quality of health care. BACKGROUND: The exploration of factors associated with severe maternal morbidity has emerged as an alternative strategy in reducing maternal mortality. This approach is useful for the evaluation and improvement of maternal health services. DESIGN: Included a comprehensive search, appraisal of reports of qualitative studies, the classification of studies and the synthesis of findings. DATA SOURCES: A literature search was conducted through nine databases for articles published between January 1980 and August 2013. REVIEW METHODS: The quality of included studies was assessed with a modified Critical Appraisal Skills Program tool. The synthesis applied a meta-ethnographic approach. It involved (1) identifying and comparing the findings; (2) creating a parsimonious thematic structure and (3) searching for disconfirming data. RESULTS: Nine studies published between 2005 and 2012, involving 292 women with severe maternal morbidity, were included. Three key themes were identified: 'provision of care', 'severe maternal morbidity' and 'health care seeking behavior'. Barriers to the access and utilization of heath care services were identified. CONCLUSION: The findings appear to suggest that mental and physical health outcomes of women who experienced severe maternal morbidity were poor. There is a need to identify the persistence and severity of these outcomes over a longer period of time. More realistic and less biased information may be obtained in community-based interviews. The impact of potential negative fetal outcomes would be a strong influencing factor for the women. These findings may help to increase awareness of the non-physical components of severe maternal morbidity and provide guidance for professionals regarding preventive measures.
