Displaying publications 81 - 100 of 2927 in total

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  1. Management of schizophrenia in Sarawak Mental Hospital, 1959
    SCHMIDT KE
    J Ment Sci, 1961 Jan;107:157-60.
    PMID: 13748028
    Matched MeSH terms: Hospitals, Psychiatric*
  2. A six-year review of tubal sterilization at a district hospital (1981-1986)
    Sivalingam N, Bhagat S, Pereira R
    Family Physician, 1989;1:23-27.
    Matched MeSH terms: Hospitals; Hospitals, District
  3. Hysterosalpingogram in the diagnosis of tuboperitoneal abnormalities in female infertility: Experience at the General Hospital, Kota Bharu
    Sathyamoorthy P, Abdul Rahman MA
    Family Physician, 1994;6:9-11.
    Matched MeSH terms: Hospitals; Hospitals, General
  4. Fulltext The Promise for Reducing Healthcare Cost with Predictive Model: An Analysis with Quantized Evaluation Metric on Readmission
    Teo K, Yong CW, Muhamad F, Mohafez H, Hasikin K, Xia K, et al.
    J Healthc Eng, 2021;2021:9208138.
    PMID: 34765104 DOI: 10.1155/2021/9208138
    Quality of care data has gained transparency captured through various measurements and reporting. Readmission measure is especially related to unfavorable patient outcomes that directly bends the curve of healthcare cost. Under the Hospital Readmission Reduction Program, payments to hospitals were reduced for those with excessive 30-day rehospitalization rates. These penalties have intensified efforts from hospital stakeholders to implement strategies to reduce readmission rates. One of the key strategies is the deployment of predictive analytics stratified by patient population. The recent research in readmission model is focused on making its prediction more accurate. As cost-saving improvements through artificial intelligent-based health solutions are expected, the broad economic impact of such digital tool remains unknown. Meanwhile, reducing readmission rate is associated with increased operating expenses due to targeted interventions. The increase in operating margin can surpass native readmission cost. In this paper, we propose a quantized evaluation metric to provide a methodological mean in assessing whether a predictive model represents cost-effective way of delivering healthcare. Herein, we evaluate the impact machine learning has had on transitional care and readmission with proposed metric. The final model was estimated to produce net healthcare savings at over $1 million given a 50% rate of successfully preventing a readmission.
    Matched MeSH terms: Hospitals*
  5. Fulltext A comparison between antibiotic utilisation in public and private community healthcare in Malaysia
    Lim AH, Ab Rahman N, Nasarudin SNS, Velvanathan T, Fong MCC, Mohamad Yahaya AH, et al.
    BMC Public Health, 2024 Jan 03;24(1):79.
    PMID: 38172715 DOI: 10.1186/s12889-023-17579-3
    BACKGROUND: There are two parallel systems in Malaysian primary healthcare services: government funded public primary care and privately-owned practices. While there have been several studies evaluating antibiotic utilisation in Malaysian public healthcare, there is a lack of literature on the use of antibiotics in the private sector. There is a dire need to evaluate the more recent performance of public vs. private community healthcare in Malaysia. As such, this study aimed at measuring and comparing the utilisation of antibiotics in the public and private community healthcare sectors of Malaysia in 2018-2021.

    METHODS: This study was a retrospective analysis of antibiotic utilisation in Malaysian primary care for the period of 1 January 2018 until 31 December 2021 using the nationwide pharmaceutical procurement and sales data from public and private health sectors. Rates of antibiotic utilisation were reported as Defined Daily Doses per 1000 inhabitants per day (DID) and stratified by antibiotic classes. The secondary analysis included proportions of AWaRe antibiotic category use for each sector and proportion of antibiotic utilisation for both sectors.

    RESULTS: The overall national antibiotic utilisation for 2018 was 6.14 DID, increasing slightly to 6.56 DID in 2019, before decreasing to 4.54 DID in 2020 and 4.17 DID in 2021. Private primary care antibiotic utilisation was almost ten times higher than in public primary care in 2021. The public sector had fewer (four) antibiotic molecules constituting 90% of the total antibiotic utilisation as compared to the private sector (eight). Use of Access antibiotics in the public sector was consistently above 90%, while use of Access category antibiotics by the private sector ranged from 64.2 to 68.3%. Although use of Watch antibiotics in the private sector decreased over the years, the use of Reserve and 'Not Recommended' antibiotics increased slightly over the years.

    CONCLUSION: Antibiotic consumption in the private community healthcare sector in Malaysia is much higher than in the public sector. These findings highlight the need for more rigorous interventions targeting both private prescribers and the public with improvement strategies focusing on reducing inappropriate and unnecessary prescribing.

    Matched MeSH terms: Hospitals, Public; Hospitals, Private
  6. Rotavirus infection in paediatric community-acquired acute gastroenteritis: a retrospective cross-sectional study in a private hospital in Malaysia
    Adele, Tan Guat Kean
    Malaysian Journal of Paediatrics and Child Health, 2007;15(1):7-15.
    MyJurnal
    Objectives: 1) To establish the incidence of rotavirus infection in paediatric patients admitted to a private hospital in Malaysia with a diagnosis of community-acquired acute gastroenteritis. 2) To determine whether patients with rotaviral acute gastroenteritis have greater disease severity. Design Retrospective cross-sectional study. Setting An urban private hospital in Malaysia. Participants All paediatric patients with a discharge diagnosis of acute gastroenteritis (AGE) admitted to the hospital between September 2005 and March 2006. A total of 261 patients were included in the study. Results Rotavirus infection contributed to 54% of paediatric hospital admissions with discharge diagnoses of acute gastroenteritis. 74% of children with rotavirus infection were aged 5 years and below. This study demonstrated that patients with rotaviral gastroenteritis had greater disease severity, as measured by two indicators. Firstly, the average length of hospital stay was longer in patients who were rotavirus positive (5.14 days) compared to those who were rotavirus negative (4.81 days). These results were statistically significant (p
    Matched MeSH terms: Hospitals, Pediatric; Hospitals, Urban; Hospitals, Private
  7. Fulltext Rethinking health care commercialization: evidence from Malaysia
    Nwagbara VC, Rasiah R
    Global Health, 2015;11:44.
    PMID: 26582159 DOI: 10.1186/s12992-015-0131-y
    Against the backdrop of systemic inefficiency in the public health care system and the theoretical claims that markets result in performance and efficiency improvement, developing countries' governments have been rapidly commercializing health care delivery. This paper seeks to determine whether commercialization through an expansion in private hospitals has led to performance improvements in public hospitals.
    Matched MeSH terms: Hospitals, Public/economics; Hospitals, Public/standards*; Hospitals, Private/economics; Hospitals, Private/standards*
  8. Fulltext The pattern of death related to trauma cases presented to the emergency department of a tertiary university hospital
    Nik Ab Rahman NH, Mohd Hussain H
    Med J Malaysia, 2013 Apr;68(2):148-52.
    PMID: 23629562 MyJurnal
    Trauma is an ever increasing problem and it is the leading cause of morbidity and mortality in the under 40s age group. The main purpose of this study is to determine the pattern of death related to trauma cases presenting to the emergency department (ED) of a university hospital. This was a retrospective analysis of 75 consecutive trauma case records at a university hospital for a one year period. The most common cause of deaths is motor vehicle crashes. The mean score for the injury severity score (ISS) and revised trauma score (RTS) on arrival to the ED among the succumbed patients were 27.8 (s.d 8.6) and 5.7 (s.d 1.1) respectively. 58.7% of deaths occurred within 48 hours after the admission. Less than 50% of studied patients were still alive beyond 45 hours post admission and less than 10% still alive beyond 11 days. Our analysis also showed that 28% (n=21) and 56% (n=41) of the studied sample had a probability of survival between 50% to 75% and more than 75% respectively upon arrival based on the initial vital signs in the ED and the trauma and injury severity score (TRISS) methodology. Overall, we observed similar injury mechanisms, demographics and causes of death compare to other studies. The figures from this study, mandate further exploration of preventive issues and management improvements that should be applied not only to the current trauma system, but also to the health care system in general.
    Matched MeSH terms: Hospitals, University*
  9. Fulltext Epidemiology of psoriasis in Malaysia: a hospital based study
    Sinniah B, Saraswathy Devi S, Prashant BS
    Med J Malaysia, 2010 Jun;65(2):112-4.
    PMID: 23756793 MyJurnal
    BACKGROUND: Psoriasis is a complex chronic inflammatory skin disease with a worldwide distribution.
    OBJECTIVE: To determine the prevalence of psoriasis according to age, gender and ethnicity among outpatients attending the dermatology clinic in Hospital Tengku Ampuan Rahimah, Klang Malaysia.
    STUDY POPULATION: All outpatients attending the specialist clinic of the dermatology department in Hospital Tengku Ampuan Rahimah, Klang, Malaysia from January 2003 to December 2005.
    METHODS: This is a retrospective descriptive study of all outpatients who attended the specialist clinic from January 2003 to December 2005 and diagnosed for psoriasis. The study population consisted of patients of all ages, both gender and different ethnic groups (Malay, Chinese, Indians and foreign workers) living in the Klang Valley and the surrounding areas.
    RESULTS: A total of 5607 patients were examined during a period of three years and 9.5% were found to be suffering with psoriasis. It was more common in males (11.6%) than in females (7.2%). Patients within the 40-60 year age group had the highest (17.2%) rate and were lower in the younger age group including those aged over 60 years (8.1%). With regards to ethnicity, it was more common in Indians followed by Malays, Chinese and migrant foreign workers respectively. The study indicates that psoriasis is common in Malaysia and its distribution varies with age, ethnicity and gender.

    Study site: dermatology department in Hospital Tengku Ampuan Rahimah,
    Matched MeSH terms: Hospitals; Hospitals, General
  10. Fulltext Rising caesarean section rates in public hospitals in Malaysia 2006
    Ravindran J
    Med J Malaysia, 2008 Dec;63(5):434-5.
    PMID: 19803313 MyJurnal
    The caesarean section rate in Malaysian public hospitals has increased to 15.7% from 10.5% in the year 2000. There are inter-state variations in the rate ranging from a high of 25.4% in Melaka to 10.9% in Sabah. The West Coast states generally had a higher caesarean section rate than the East Coast states as well as East Malaysia. It would be prudent for Malaysia to implement stringent caesarean audits to ensure that rising caesarean section rates are kept in check.
    Matched MeSH terms: Hospitals, Public/statistics & numerical data*
  11. The journey of a teaching hospital to become a learning organisation
    Rowley SD
    Aust Health Rev, 2006 May;30(2):232-40.
    PMID: 16646772
    This paper describes how an acute tertiary referral hospital moved away from a "culture of blame", using change management principles aligned with the concept of the learning organisation. I outline the process of change, and describe its outcomes. The result is summarised as an improvement in desired attributes of the organisation's culture, as evidenced by consistent improvement in the results of a proprietary staff survey. I conclude that the concept of the learning organisation is a useful one for hospitals that seek to improve the organisational culture.
    Matched MeSH terms: Hospitals, Teaching/organization & administration*
  12. Fulltext Draft Genome Sequences of Four Nosocomial Methicillin-Resistant Staphylococcus aureus (MRSA) Strains (PPUKM-261-2009, PPUKM-332-2009, PPUKM-377-2009, and PPUKM-775-2009) Representative of Dominant MRSA Pulsotypes Circulating in a Malaysian University Teaching Hospital
    Neoh HM, Mohamed-Hussein ZA, Tan XE, B Raja Abd Rahman RM, Hussin S, Mohamad Zin N, et al.
    Genome Announc, 2013 Jan;1(1).
    PMID: 23405328 DOI: 10.1128/genomeA.00103-12
    Here, we report the draft genome sequences of four nosocomial methicillin-resistant Staphylococcus aureus strains (PPUKM-261-2009, PPUKM-332-2009, PPUKM-377-2009, and PPUKM-775-2009) isolated from a university teaching hospital in Malaysia. Three of the strains belong to sequence type 239 (ST239), which has been associated with sustained hospital epidemics worldwide.
    Matched MeSH terms: Hospitals, Teaching; Hospitals, University
  13. Mammographic image quality and exposure in South East Asia
    Ng KH, DeWerd LA, Schmidt RC
    Australas Phys Eng Sci Med, 2000 Dec;23(4):135-7.
    PMID: 11376538
    Generally there is a significant delay before optimized performance of mammography is fully realized in the developing countries. To evaluate the status of mammographic performance, a survey of mammographic image quality and exposure was performed in nine hospitals from four selected South East Asian countries. The entrance exposure on the surface of the American College of Radiology (ACR) mammographic phantom (ACR-RMI model 156) was made using both thermoluminescent dosimeters (TLDs) and an ionization chamber. The TLDs were mailed from the University of Wisconsin Radiation Calibration Laboratory (UWRCL) to the cooperating hospitals. The surveyed hospitals processed the images and returned them to the UWRCL for subsequent evaluation of the image quality of the mammographic phantom. Machine-specific data, technique factors and sensitometric data were also obtained. At 28 kVp, the mean entrance exposure is 0.91 R (0.46 to 2.6 R), mean glandular dose is 1.61 mGy (0.90 to 4.15 mGy), mean optical density is 1.37 (0.66 to 2.30), mean total phantom image score is 9.1(4-12). Only three of the nine hospitals tested achieved an acceptable score above the minimum 10. Results for 25 and 30 kVp showed similar trend. The variation between the ion chamber measurements and TLD measurements ranged from 4 to 24%. There is a wide variation in the image quality and entrance exposure among hospitals in South East Asia. There is a need for a quality assurance program. The factors that cause low score in the phantom images must be corrected. Calibration and the use of appropriate ionization chambers for mammography is important.
    Matched MeSH terms: Hospitals/statistics & numerical data
  14. Sarawak General Hospital--Kuching, Malaysia
    Yong L
    J Hosp Supply Process Distrib, 1984 Nov-Dec;2(6):52-4.
    PMID: 10269457
    Matched MeSH terms: Hospitals, Teaching*
  15. Hospital service quality: a managerial challenge
    Rose RC, Uli J, Abdul M, Ng KL
    Int J Health Care Qual Assur Inc Leadersh Health Serv, 2004;17(2-3):146-59.
    PMID: 15301271
    While much is known generally about predictions of customer-perceived service quality, their application to health services is rarer. No attempt has been made to examine the impact of social support and patient education on overall service quality perception. Together with six quality dimensions identified from the literature, this study seeks to provide a more holistic comprehension of hospital service quality prediction. Although 79 percent of variation is explained, other than technical quality the impact of the remaining factors on quality perception is far from constant, and socio-economic variables further complicate unpredictability. Contrary to established beliefs, the cost factor was found to be insignificant. Hence, to manage service quality effectively, the test lies in how well healthcare providers know the customers they serve. It is not only crucial in a globalized environment, where trans-national patient mobility is increasingly the norm, but also within homogeneous societies that appear to converge culturally.
    Matched MeSH terms: Hospitals/standards*
  16. Fulltext Evaluating the effect of chlorpheniramine on patch test reactions amongst eczema patients sensitised to nickel
    Shafinaz, S., Chan, L.C., Adawiyah, J., Norazirah, M.N.
    Medicine & Health, 2018;13(1):71-76.
    MyJurnal
    Discontinuing antihistamines for patch testing (PT) in allergic contact dermatitis (ACD) is more conventional than evidence based. Data suggests that non-sedating antihistamines do not interfere with PT. Investigating the effects of sedating antihistamines are more relevant as these are recommended for eczema. We aimed to evaluate the effect of chlorpheniramine on PT, to determine the prevalence of nickel sensitization and common sensitizing allergens. An open labeled cohort study was conducted at two dermatology clinics. Patients indicated for PT underwent standard protocol where antihistamines were discontinued. Patients sensitised to nickel were subjected to a second nickel PT while taking chlorpheniramine. Results were evaluated using the North American Contact Dermatitis Research Group (NACDRG) score, a Mexameter measured erythema and pruritus was assessed using a visual analogue score. A total 82 patients were recruited, 28 (34.1%) were sensitised to nickel. The mean age was 40 ± 17.7 years with 22(26.8%) males and 60 (73.2%) females. Indications for PT included suspected ACD (57.3%), hand and feet eczema (34.1%) and severe eczema with suspected superimposed ACD (6.1%). The commonest sensitizing allergens were methyldibromoglutaronitrile (40.2%) nickel sulphate (34.1%), potassium dichromate (29.3%) and formaldehyde (24.4%). A second PT was performed on 23 patients. There was no difference in the NACDRG score with chlorpheniramine or without chlorpheniramine (p=0.968). Pruritus score was reduced by 1.39 ± 2.9, p=0.031 with chlorpheniramine. The degree of erythema was 611.46 ± 21.59 with chlorpheniramine versus 613.87 ± 27.5 without chlorpheniramine, p=0.671. Chlorpheniramine did not affect PT based on clinical and objective scorings. It has the additional benefit of reducing test-induced itch.
    Study site: Dermatology clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur and Hospital Pulau Pinang, Malaysia
    Matched MeSH terms: Hospitals, General; Hospitals, University
  17. Fulltext Doctors perception towards implementation of hospital accreditation in state hospitals
    Halim, A., Roslan, J.G.
    Malaysian Journal of Public Health Medicine, 2002;2(1):47-49.
    MyJurnal
    The Ministry of Health had instructed all state hospitals to go for Accreditation. Accreditation is considered to be a more appropriate tool forquality assurance in a hospital setting than ISO 9000.The objective of this research was to study doctors perception towards the implementation of Accreditation in state hospital. Self-administered questionnaires were sent through mail to doctors in eight clinical departments of all state hospitals. From 832 questionnaires sent, 297 responded (36%),i.e. 84 specialists and 2/2 medical officers. The study showed that 69% doctors knew that their hospital was implementing Accreditation. There were more clinical specialist (9I%) who were involved in accreditation as compared to Medical Ojicers (73%). 83% of doctors believed that accreditation can assist in assuring quality in their hospital. Those who do not, thought that quality can be assured stajfing was adequate (67%) and accreditation does not assess patient care
    (33%). The study also showed that 7I% of doctors knew that their hospital was implementing MS ISO 9000. A 77% of doctors believed that ISO 9000 can assist in assuring quality in their hospital. Those who do not, thought that quality can onhi be assured Jstajfng was adequate (27%) and ISO 9000 was only meant for industry (8%). In conclusion, doctors believed that Accreditation and MS ISO 9000 can assist in assuring quality in their hospitals. Amongst, those who do not, majority thought that quality can only be assured staffing was adequate.
    Matched MeSH terms: Hospitals; Hospitals, State
  18. Fulltext Work-related stress and coping: a survey on medical and surgical nurses in a Malaysian teaching hospital
    Emilia, Z.A., Noor Hassim, I.
    Malaysian Journal of Community Health, 2007;13(1):55-66.
    MyJurnal
    Background: A cross-sectional study on work-related stressors among nurses in a public teaching hospital had also attempted to explore functions of coping strategies in determining stress.
    Materials and Methods: A structured bilingual questionnaire (English-Malay) on symptoms and sources of stress, and coping style measure was disseminated to medical and surgical nurses working in a teaching hospital in Kuala Lumpur. Socio demographic information and stress management methods were inquired. Frequency in workplace stressors were assessed using Nursing Stress Scale. Stress symptoms and home-life stressors were evaluated using Personal Stress Inventory. Measurement of coping strategies was performed using Coping Orientation for Problems Experienced questionnaire.
    Results: A total of 181 questionnaires were disseminated and 151 (83.4%) were satisfactorily completed by nurses. It was found that the prevalence of work-related stress among medical and surgical nurses was 49.3% (N=74/150). Analysis of dichotomized outcome (between Stress and No stress group) illustrated high workload (t-value=4.122; p
    Matched MeSH terms: Hospitals, Public; Hospitals, Teaching
  19. Geospatial and clinical analyses on pediatric related road traffic injury in Malaysia
    Rahman NH, Rainis R, Noor SH, Syed Mohamad SM
    World J Emerg Med, 2016;7(3):213-20.
    PMID: 27547282 DOI: 10.5847/wjem.j.1920-8642.2016.03.009
    BACKGROUND: The main aim of this study is to utilize the geographical information system (GIS) software and perform the spatial analysis in relation to clinical data for road traffic injury (RTI) pediatric cases attending the emergency department.
    METHODS: The study sample included pediatric patients (age less than 18 years) with road-related injuries within a district in Malaysia who attended emergency departments of two tertiary hospitals within the district. In addition to injury, pre-hospital care and outcome data, the coordinate of the locations were obtained by the ambulance paramedics by using portable handheld GPS unit brand Garmin(®) model GPS 72 H. The data was transferred into the excel format which in turn underwent GIS analysis by using ARCGIS(®) (by ESRI) software version 10.1 licensed to the study institution.
    RESULTS: A total of 102 (24.8%) of all motor vehicle crash (MVC) victims involved the pediatric age group (age 18 years and below). The mean (SD) age of the pediatric victims was 14.30 years (SD 3.830). Male comprised of 68 (66.7%) of the cases. Motorcyclists [88 (88.0%)] were the most common type of victims involved. Interestingly, the majority of the severely injured victims [75 (73%)] sustained the RTI on roads with maximum speed limit of 60 km/hour. The mean (SD) length of hospital stay was 7.83 days (5.59).
    CONCLUSION: The pediatric related road traffic injury in Malaysia causes significant health and social burden in the country. This study showed both important clinical and geographical factors that need to be taken into consideration for future preventive action.
    KEYWORDS: Geographical information system; Geospatial; Injury; Pediatric; Road safety
    Matched MeSH terms: Hospitals, General; Hospitals, University
  20. Treatment of institutional neurosis
    Khuan TC
    Med J Malaysia, 1979 Mar;33(3):209-15.
    PMID: 522724
    Matched MeSH terms: Hospitals, Psychiatric*
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