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Is Dual Policy an Overarching Strategy for Medicine Price Controls in Malaysia?

Choon WY, Lee K

Asia Pac J Public Health, 2020 05;32(4):215-216.
PMID: 32500785 DOI: 10.1177/1010539520920526
Matched MeSH terms: Cost Control*
Fulltext Structuring quality education by proposing physical infrastructure of a medical school

Ashfaq Akram, Muhammad Zahedi Daud, Md Gapar Md Joha, Rizwan Farzana, Rahmatullah Khan

Education in Medicine Journal, 2016;8(3):75-87.
MyJurnal

Due to cost containment considerations, it is common to have medical schools being
located in buildings or campuses built for some other purposes. These buildings are converted into
medical schools which often compromising the functional architectural aspects. Objectives: The
paper examines, explores and proposes an architectural concept of a purpose-built medical school. The
architectural design proposed is sensitive to the values and norms of many schools around the globe.
Methods: An Internet search and personal communication were conducted, focusing on the concepts
of the functionality of medical school. It emphasises on general design of the main building, keeping
in mind the various kinds of teaching, learning and assessment activities. We examined lecture hall,
pre-clinical laboratory, skill laboratory, general facilities of Objective Structured Practical Examination
(OSPE) and Objective Structured Clinical Examination (OSCE). Results: We present hypothetical
structural designs based on built-functions concepts. For example, for the better vision of students
around a demonstration table, an inclined floor surface is proposed. The concept is as illustrated by
anatomy dissection area built inclined upward from the cadaver table. It inevitably provides a better
visual access to the students around the table. Other teaching and learning areas are also illustrated
wherever appropriate in the text. Conclusion: The paper is hypothetical and explores innovative
structural designs of modern medical schools. While most are built to meet the demands of current
technology, it cannot however completely replace face-to-face teaching and learning processes.
Research in architectural designs of education buildings and facilities may be further developed into a
new research niche of medical education.

Matched MeSH terms: Cost Control
Health sector reform: ethical issues and challenges

Suleiman AB

Med J Malaysia, 2000 Aug;55 Suppl B:5-8.
PMID: 11125522
Matched MeSH terms: Cost Control
Fulltext Clinical Pathway as a Strategy in Improving Healthcare Quality and Cost Containment

Anizal, I., Saperi, S., Aljundi, M.

Medicine & Health, 2008;3(2):239-246.
MyJurnal

The increasing health care cost and public awareness on the delivery of high quality services has forced healthcare service providers to look into the healthcare delivery system. Clinical Pathway (CP) has been introduced in many hospitals and has been accepted as a beneficial tool in assisting healthcare organizations worldwide. Further, the CP also provides consistently high quality and coordinates services with minimum resources. It is proven to be a beneficial tool in other countries. CP is recently being introduced into the Malaysian healthcare system. The aim of this article was to high-light the benefits of CP in improving healthcare quality and controlling the medical cost. The relevant articles have been reviewed. The majority of literature reviewed con-cluded that there were positive effects in implementing CP. The CP was found to be significant in reducing length of stay and medical cost. The introduction of evidence based medicine, clinical outcomes, clinical audit, multidisciplinary communication, teamwork and care planning were also improved by CP. The challenges for healthcare providers and healthcare managers are to participate and be fully committed in path-way development and implementation in order to improve healthcare quality and cost control.

Matched MeSH terms: Cost Control
Fulltext SEM-PLS analysis of inhibiting factors of cost performance for large construction projects in Malaysia: perspective of clients and consultants

Memon AH, Rahman IA

ScientificWorldJournal, 2014;2014:165158.
PMID: 24693227 DOI: 10.1155/2014/165158

This study uncovered inhibiting factors to cost performance in large construction projects of Malaysia. Questionnaire survey was conducted among clients and consultants involved in large construction projects. In the questionnaire, a total of 35 inhibiting factors grouped in 7 categories were presented to the respondents for rating significant level of each factor. A total of 300 questionnaire forms were distributed. Only 144 completed sets were received and analysed using advanced multivariate statistical software of Structural Equation Modelling (SmartPLS v2). The analysis involved three iteration processes where several of the factors were deleted in order to make the model acceptable. The result of the analysis found that R(2) value of the model is 0.422 which indicates that the developed model has a substantial impact on cost performance. Based on the final form of the model, contractor's site management category is the most prominent in exhibiting effect on cost performance of large construction projects. This finding is validated using advanced techniques of power analysis. This vigorous multivariate analysis has explicitly found the significant category which consists of several causative factors to poor cost performance in large construction projects. This will benefit all parties involved in construction projects for controlling cost overrun.

Matched MeSH terms: Cost Control
Public health care provisions: access and equity

Bin Juni MH

Soc Sci Med, 1996 Sep;43(5):759-68.
PMID: 8870140

Within the current exercise of reforming the health care system, underlying all issues, is the reassessment of the role of government. It is a government's responsibility and concern that the health sector be accessible and equitable to the population, and more important that the health sector be more efficient and affordable. Many governments in the world attempt to provide universal health care services to their population through public health care provisions. This paper reviews and analyses the experience of the Malaysian health system, focusing on the performance of the system in relation to access and equity. The performance of the Malaysian health system has been impressive. At minimum cost it has achieved virtually accessible and equitable health care to the entire population. This is evident by analysing almost all the commonly used indicators. These clearly show that when matched to comparable countries, health outcome is even better than predicted value.

Matched MeSH terms: Cost Control
Fulltext Characteristics and outcome of high-cost ICU patients

Aung YN, Nur AM, Ismail A, Aljunid SM

Clinicoecon Outcomes Res, 2019;11:505-513.
PMID: 31447570 DOI: 10.2147/CEOR.S209108

Purpose: Care at ICUs is expensive and variable depending on the type of care that the patients received. Knowing the characteristics of the patient and his or her disease is always useful for improving health services and cost containment.
Patients and methods: An observational study was conducted at four different intensive care units of an academic medical institution. Demographic characteristics, disease-management casemix information, cost and outcome of the high costing decile, and the rest of the cases were compared.
Results: A total of 3,220 discharges were included in the study. The high-cost group contributed 35.4% of the ICU stays and 38.8% of the total ICU expenditure. Diseases of the central nervous system had higher odds to be in the top decile of costly patients whereas the cardiovascular system was more likely to be in the non-high cost category. The high-cost patients were more likely to have death as an outcome (19.2% vs 9.3%; p<0.001). The most common conditions that were in the high-cost groups were craniotomy, other ear, nose, mouth, and throat operations, simple respiratory system operations, complex intestinal operations, and septicemia. These five diagnostic groups made up 43% of the high-cost decile.
Conclusion: High-cost patients utilized almost 40% of the ICU cost although they were only 10% of the ICU patients. The chances of admission to the ICU increased with older age and severity level of the disease. Central nervous system diseases were the major problem of patients aged 46-69 years old. In addition to cost reduction strategies at the treatment level, detailed analysis of these cases was needed to explore and identify pre-event stage prevention strategies.

Matched MeSH terms: Cost Control
Achieving cost-efficient management of drug supply via economic order quantity and minimum-maximum stock level

Dewi EK, Dahlui M, Chalidyanto D, Rochmah TN

Expert Rev Pharmacoecon Outcomes Res, 2020 Jun;20(3):289-294.
PMID: 31203686 DOI: 10.1080/14737167.2019.1633308

BACKGROUND: A good drug inventory planning system is important for an efficient budgeting, procurement, and cost control of drugs. When stagnant drugs in the inventory are too much, wastage due to expired and spoiled drugs could occur. These will not only cause loss of income but could also jeopardize healthcare service delivery.
RESEARCH DESIGN AND METHODS: This study aimed to determine the most efficient and effective management of stagnant and shortage drugs by comparing three pharmacy logistic methods; the economic order quantity (EOQ), minimum-maximum stock level (MMSL), and the traditional consumption of drug inventory, at RA Basoeni Hospital, Mojokerto. Drug inventory was analyzed to calculate the opportunity loss, opportunity cost, and proportions of both stagnant and shortage drugs.
RESULTS: We found that EOQ and MMSL performed best for control of stagnant drugs and shortage drugs, respectively. Both methods had proved as effective pharmacy logistic planning. In addition, EOQ produced the lowest opportunity cost for stagnant drugs besides the lowest opportunity loss for shortage drugs.
CONCLUSION: The study concluded that EOQ is the most effective and efficient method to manage stagnant and shortage drugs at hospital pharmacy.

Matched MeSH terms: Cost Control