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Background: This research aims to assess the perceptions of the staff working in emergency departments in Selangor, Malaysia, regarding the adoption of lean management and identify the factors that affect their perceptions. Methods: A cross-sectional study using the Lean in Healthcare Questionnaire was conducted with 251 respondents, which consisted of doctors, nurses and medical assistants employed in three selected hospitals. Results: One-way analysis of variance (ANOVA) showed a significant difference in every domain score in accordance with the occupation category. For the domain process, a significant negative correlation was found between age and domain score (r = – 0.195, p = 0.002). In particular, nurses had better perceptions of lean adoption compared with others (odds ratio [OR] = 2.44, p < 0.004). The odds of having a better perception decreased by 6.3% as the age increased (p < 0.008). Conclusions: The findings revealed that age and occupation appeared to be determinants of lean adoption perceptions among emergency department personnel. Specifically, older employees tend to have negative perceptions, while nurses have more positive perceptions. However, further research is needed to understand perceptions of lean adoption better and develop guidelines for implementing lean principles in healthcare settings. [ABSTRACT FROM AUTHOR]

Background and objectives: While influenza circulates year-round in Malaysia, research data on its incidence is scarce. Yet, this information is vital to the improvement of public health through evidence-based policies. In this cross-sectional study, we aimed to determine the trends and financial costs of influenza. Methods: Data for the years 2016 through 2018 were gathered retrospectively from several sources. These were existing Ministry of Health (MOH) influenza sentinel sites data, two teaching hospitals, and two private medical institutions in the Klang Valley, Malaysia. Expert consensus determined the final estimates of burden for laboratory-confirmed influenza-like illness (ILI) and severe acute respiratory infection (SARI). Economic burden was estimated separately using secondary data supplemented by MOH casemix costing. Results: Altogether, data for 11,652 cases of ILI and 5,764 cases of SARI were extracted. The influenza B subtype was found to be predominant in 2016, while influenza A was more prevalent in 2017 and 2018. The distribution timeline revealed that the highest frequency of cases occurred in March and April of all three years. The costs of influenza amounted to MYR 310.9 million over the full three-year period. Conclusions: The study provides valuable insights into the dynamic landscape of influenza in Malaysia. The findings reveal a consistent year-round presence of influenza with irregular seasonal peaks, including a notable influenza A epidemic in 2017 and consistent surges in influenza B incidence during March across three years. These findings underscore the significance of continuous monitoring influenza subtypes for informed healthcare strategies as well as advocate for the integration of influenza vaccination into Malaysia's national immunization program, enhancing overall pandemic preparedness. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Malaysia's rapid economic growth and rising living costs have affected the lives of lower-income B40. This population group acquire less than 3,855 Malaysian Ringgit (892.26 US Dollars) per month. This study aims to determine the health status, quality of life (QOL) and needs of B40 women in an urban and rural area in Malaysia. MATERIALS AND METHODS: A total of 300 B40 women from Beranang (Selangor) and Kuala Lumpur (KL), Malaysia, participated in a cross-sectional study concerning their needs, health status, and QOL using semi-guided instruments. Bivariate and multivariate analyses identified QOL and health status factors. RESULTS: Rural (OR=10.68; 95% CI=1.85-61.10) and poor urban participants (OR=8.54; 95% CI 2.36-15.62), with the higher income households were healthier. Government hospital patients in Beranang were healthier (OR=9.52; 95% CI=2.64-24.10). Staying alone (OR = 8.33; 95% CI=2.94-25.00) and non-recipient of government aid, Bantuan Sara Hidup (BSH) (OR=3.85; 95% CI=1.10-13.43) was associated with poor health status among KL poor B40 women. B40 women's QOL was predicted by marriage (OR=14.28; 95% CI=1.81-24.54), not staying alone (OR=2.04; 95% CI=1.13-5.88), recipient of BSH (OR = 28.83; 95% CI=10.11- 71.13), and absence of an underlying disease (OR=5.90; 95% CI=1.26-33.93). Meanwhile, the odds of meeting B40 women needs was associated with lower ages (40-49 years) (OR=21.00; 95% CI 2.25-34.56), absence of an underlying diseases (OR=32.10; 95% CI 4.62-124.56), recipient of BSH (OR=30.49; 95% 5.92-64.01), and married status (OR=19.61; 95% CI 1.42-27.15). CONCLUSION: B40 women's QOL, health status, and ability to meet basic needs in Beranang and KL are diverse. Policymakers and relevant authorities should consider these factors to improve the QOL and health status of B40 women and women-headed households in Malaysia. [ABSTRACT FROM AUTHOR]

Introduction: This study investigates the treatment beliefs in heart failure using the Beliefs about Medicines Questionnaire (BMQ) translated in Malaysian language. The research is cross-sectional BMQ based study done in four tertiary hospitals in Pahang and Selangor, Malaysia. Methods: The study used a non-experimental, quantitative design. Simple random sampling method was used in a pilot study which covered the medical and cardio clinics in two tertiary and secondary hospitals. The overall data was collected for four weeks from these hospitals. The total number of respondents in this pilot study was 200 who are diagnosed with heart failure. SPSS version 25.0 was used to analyses the data. Results: The overall BMQ scale consisted of 18 items. BMQ translated into Malay language by using back- to back translation procedure by experts in their fields. The results of the exploratory factor analysis (EFA) found that all 18 items were accepted due to factor loading being greater than 0.6. As a result, for local use, this instrument needs to rearrange the items measuring the construct into their respective components accordingly before proceeding with data collection in the field. Conclusion: It can be concluded that for local content, this instrument needs to rearrange the items measuring the construct into their respective components accordingly before proceeding with data collection practically. [ABSTRACT FROM AUTHOR]

Background: Malaysia is an upper middle income country that provides subsidized healthcare to ensure universal coverage to its citizens. The challenge of escalating health care cost occurs in most countries, including Malaysia due to increase in disease prevalence, which induced an escalation in drug expenditure. In 2009, the Ministry of Health has allocated up to Malaysian Ringgit (MYR) 1.402 billion (approximately USD 390 million) on subsidised drugs. This study was conducted to measure patients' willingness to pay (WTP) for treatment of chronic condition or acute illnesses, in an urbanized population. Methods: A cross-sectional study, through face-to-face interview was conducted in an urban state in 2012-2013. Systematic random sampling of 324 patients was selected from a list of patients attending ten public primary cares with Family Medicine Specialist service. Patients were asked using a bidding technique of maximum amount (in MYR) if they are WTP for chronic or acute illnesses. Results: Patients are mostly young, female, of lower education and lower income. A total of 234 respondents (72.2%) were not willing to pay for drug charges. WTP for drugs either for chronic or acute illness were at low at median of MYR10 per visit (USD 3.8). Bivariate analysis showed that lower numbers of dependent children (≤3), higher personal and household income are associated with WTP. Multivariate analysis showed only number of dependent children (≤3) as significant (p = 0.009; 95% CI 1.27-5.44) predictor to drugs' WTP. Conclusion: The result indicates that primary care patients have low WTP for drugs, either for chronic condition or acute illness. Citizens are comfortable in the comfort zone whereby health services are highly subsidized through universal coverage. Hence, there is a resistance to pay for drugs. [ABSTRACT FROM AUTHOR]

Background: The HPV vaccine was introduced to Malaysian national immunization programme in 2010. The current implementation age of HPV vaccination in Malaysian is at the age of 13 years school girls, given according to a 3 doses protocol which may complicate implementation and compliance. Aim of the study is to determine the cost-effectiveness of HPV vaccination regime comparing twice versus thrice HPV vaccinations dose regime among adolescent girls in Malaysia.Methods: A Markov cohort model reflecting the natural history of HPV infection accounting for oncogenic and low-risk HPV was adapted for 13 year old Malaysian girls cohort (n = 274,050). Transition probabilities, utilities values, epidemiological and cost data were sourced from published literature and local data. Vaccine effectiveness was based on overall efficacy reported from 3-doses clinical trials, with the assumption that the 2-doses is non-inferior to the 3-doses allowing overall efficacy to be inferred from the 3-doses immunogenicity data. Price parity and life-long protection were assumed. The payer perspective was adopted, with appropriate discounting for costs (3 %) and outcomes (3 %). One way sensitivity analysis was conducted. The sensitivity analysis on cost of vaccine, vaccine coverage and discount rate with a 2-doses protocol was performed.Result: The 3-doses and 2-doses regimes showed same number of Cervical Cancers averted (361 cases); QALYs saved at 7,732,266. However, the lifetime protection under the 2-doses regime, showed a significant cost-savings of RM 36, 722,700 compared to the 3-doses scheme. The MOH Malaysia could vaccinate 137,025 more girls in this country using saving 2-doses regime vaccination programme. The model predicted that 2-doses HPV vaccination schemes can avoid additional 180 Cervical Cancers and 63 deaths compare to 3-doses.Conclusion: A 2-doses HPV vaccination scheme may enable Malaysian women to be protected at a lower cost than that achievable under a 3-doses scheme, while avoiding the same number of Cervical Cancer cases and deaths. Using the saving money with 2-doses, more Cervical Cancers and deaths can be avoided. [ABSTRACT FROM AUTHOR]