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National Healthcare Establishments & Workforce Statistics Hospitals 2010

Home : Publications : National Healthcare Establishments & Workforce Statistics Hospitals 2010
This second NHEWS technical report aims to review current status and capture consistent data regarding characteristics of both public and private healthcare establishments and services in Malaysia in the year 2010. The information gathered in the second year can now be compared to the first year to further improve quality and benchmark ourselves with international standards. Seven specialist services which were identified as priority fields under the 10th Malaysia Plan were reported in 2010. This includes Obstetrics, Paediatrics, Anaesthesiology, Emergency Medicine, General Surgery, Psychiatry, and Oncology.

 

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  • Preface   (PDF | HTML)
  • Acknowledgements    (PDF | HTML)
  • Chapter 1 | Overview On Hospitals and Specialists Services In Malaysia   (PDF | HTML)
  • Chapter 2 | Hospital Services In Malaysia    (PDF | HTML)
  • Chapter 3 | Maternity Services In Malaysian Hospitals and Maternity Homes   (PDF | HTML)
  • Chapter 4 | Paediatric Specialist Services In Malaysian Hospitals   (PDF | HTML)
  • Chapter 5 | Surgical Services In Malaysian Hospitals   (PDF | HTML)
  • Chapter 6 | Emergency and Trauma Services In Malaysian Hospitals   (PDF | HTML)
  • Chapter 7 | Anaesthesiology Services In Malaysian Hospitals    (PDF | HTML)
  • Chapter 8 | Oncology Services In Malaysian Hospitals   (PDF | HTML)
  • Chapter 9 | Psychiatric Services In Malaysian Hospitals   (PDF | HTML)
  • Appendices   (PDF | HTML)


This second NHEWS technical report aims to review current status and capture consistent data regarding characteristics of both public and private healthcare establishments and services in Malaysia in the year 2010. The information gathered in the second year can now be compared to the first year to further improve quality and benchmark ourselves with international standards. Seven specialist services which were identified as priority fields under the 10th Malaysia Plan were reported in 2010. This includes Obstetrics, Paediatrics, Anaesthesiology, Emergency Medicine, General Surgery, Psychiatry, and Oncology.

Unlike our previous report, the 2010 report has information pertaining to each chapter and has further refined our fundamental variables. This is a result of active steps taken to improve the consistency of the data overtime. We have also analysed the data in a categorised manner according to specialist and non specialist hospitals. For the first time, we were able to report hospital efficiency markers that are crucial for policy makers. Reporting methods were also manipulated according to chapters instead of using a standard denominator for all the fields.

A total of 337 hospitals provided acute curative services in Malaysia in 2010 with 0.12 hospitals per 10,000 population. There have been no major changes in the concentration of hospitals in the different states when compared to our last report. For the purpose of this survey carried out in 2010, we have also included maternity homes in our sampling frame as these centers share the responsibility and workload of providing obstetrics services in the country. This year, we have also managed to capture the absolute number of practicing physicians in hospitals according to different specialties. Data recorded was painstakingly verified and matched against data from the National Specialist Registry, Medical Development Division and Training Management Division of MOH and many other reliable sources.

As mentioned earlier, we have included 22 maternity homes together with the 315 hospitals that provide obstetrics services for the purpose of this survey. Similar to what was done last year, data on facilities, activities and workforce was documented and analysed. Now that we can compare with last year’s findings, we can report an upward trending, an overall increase in the rate of Caesarean sections with a notable decline in vaginal deliveries. This trend is somewhat worrying. When the instrumental deliveries category was introduced in the 2010 survey, we noted a sharp differential, with private hospitals performing five-fold more such procedures than public hospitals.

Due to the rather comprehensive paediatrics chapter in this year’s report, we were compelled to compare recent data we had collected against that of the established paediatric norms in the country. This comparison was then used to identify many areas of need and to highlight the workforce shortages faced by the paediatric community. Arising from this, a preliminary workforce estimates and supply projections data was compiled based on the projected needs of the country and the current number of medical officers, trainees and specialists.

At first glance of our anaesthesiology chapter, the number of ICUs in the private sector may appear to be more than the numbers found in the public sector. However, on closer examination, the public hospitals have provided for a bigger number of cases with a higher level of ICU care when compared with those of the private sector. The anaesthesiologist to population and surgeon ratio was also below ideal international standards in both sectors.

Emergency medicine and trauma services are widely available in most hospitals in the country. However, varied practices in implementing these services in both private and public hospitals have resulted in different reporting arrangements. The lack of uniformity proved to be a major limitation in reporting this chapter. Despite the extensive availability of service, Malaysia still has inadequate numbers of emergency services and prehospital care to cater to the needs of the population. More often than not, this will result in overcrowding of emergency centers, especially those in the public sector, already hard pressed to cope with the rising trend in admissions. There were 93 emergency physicians practicing in the public hospitals in 2010 with no similar expertise available in the private hospitals.

For the first time, we are able to report on common procedures that were performed in general surgery. This includes appendicectomies, laparotomies, inguinal hernia surgeries, cholecystectomies and thyroidectomies. We also noted that a higher percentage of these surgeries were done as open procedures and that the percentage that was performed as laparoscopic procedures was still minimal with the exception of cholecystectomies. We were also able to report that there was a wide variation of practices pertaining to these procedures that were noted between sectors and between those performed in different states. In tandem with the Ministry of Health’s policy to quantify quality and performance indicators, we were able to capture variables such as elective operating hours for each facility and to analyse it based on the number of surgeons in the country. Another important indicator that was recorded was the perioperative mortality.

In 2010, psychiatric services was introduced as a new chapter in our survey in line with the Ministry’s approach to address the burgeoning challenges of mental health issues in Malaysia. We strived to document facilities providing psychiatric services and to capture some crucial activities concerning the field of psychiatry in both the private and public hospitals. We found considerably varied distribution of psychiatrists across the states. Any shortfalls in the availability of resources for providing mental health services that has been highlighted in our write-up will need to be addressed.

Oncology services in Malaysia have become increasingly important with cancer having been identified as one of the leading causes of death in MOH hospitals each year. However, there were only 55 hospitals providing oncology services in 2010, of which 31 were from public sector hospitals and 27 from private. These oncology centers were mainly found in the West Coast of Peninsular Malaysia. In this survey, we did not capture the workload of oncology as we were more focused on reporting the availability of facilities, workforce and the oncology devices instead. However, as a point of interest, we note that there was a mismatch between workforce personnel, especially radiation therapists, and the limited number of oncology devices in the service.

Important imaging devices such as CT and MRI scanners were again recorded and analysed in this year’s report. We have also included PET scanners as it is another integral form of imaging. Other devices such as ventilators and ECT machines are discussed in the respective chapters.

In our appendices, we have also included the number of specialists available in the various specialties and subspecialties other than the 7 fields mentioned above (Appendices 4 and 5).

In summary, it is obvious that many aspects of healthcare establishments and the services being delivered in the country are still inadequate, especially with regard to the workforce mismatch between availability and need in different areas.


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