Introduction: This study looks at the patient’s perspective to determine the Catastrophic Health Expenditure (CHE) level and the possible factors which can be associated with CHE in cancer patients. Methods: This cross sectional study was done in National Cancer Institute, Malaysia with 206 patients sampled using the multilevel sampling method and data collected from interview with patients using a validated questionnaire. The CHE definition used in this study is when the monthly health expenditure exceeds more than 10% of the monthly household income. Results: This study showed a CHE level of 26.2%. CHE was higher in Indian ethnicity (P = 0.017), single marital status (P = 0.019), poverty income (P < 0.001), small household size (P = 0.006) and without Guarantee Letter (GL) (P = 0.002) groups. The significant predicting factors were poverty income aOR 5.60 (95% CI: 2.34 – 13.39), home distance near to hospital aOR 4.12 (95% CI: 1.74 – 9.76), small household size aOR 4.59 (95% CI: 1.07 – 19.72) and lack of Guarantee Letter aOR 3.21 (95% CI: 1.24 – 8.30). Conclusion: The information from this paper can be used by policy makers to formulate better strategies in terms of health financing so that high risk for CHE cancer patients groups can be protected under a better health financing system.

Introduction: Risk factors for Parkinson’s disease (PD) fall into three broad categories, namely environmental, genetic, and lifestyle factors. Identifying environmental factors that increase the risk of PD would allow these exposure to be reduced and the disease prevented while facilitating experimental investigation of mechanisms and intervention options. Thus, the aim of this review is to summarise the current evidence on the role of environmental factors in the development of PD. Methods: All original articles published between 2018 and 2022 and written in English were searched from three databases, i.e., PubMed, Scopus Web of Science (WoS), using combination of primary keyword (PD and its MeSH and synonyms), and two secondary keywords; (“environment*”) and risk (factor*). Result: After a thorough screening process, nineteen articles were included in this scoping review. The environmental risk factors examined in the included studies fell into five categories: a) pesticide exposure, b) heavy metals and organic solvent exposure, c) drug abuse and d) air pollution and e) source of water. Conclusions In summary, PD is a complex neurological disorder for which there are several environmental risk factors involved. Identifying and reducing exposure to these environmental factors could have a significant impact on the future occurrence of the disease.

Pengenalan: Aduan dalam sistem rawatan kesihatan adalah aduan yang dibuat oleh pesakit atau saudara-mara pesakit kerana pelbagai alasan seperti kualiti perkhidmatan yang buruk atau harapan yang tidak dipenuhi. Terdapat beberapa kajian yang dilakukan untuk mengukur berlakunya aduan hospital tetapi tidak ada yang dilakukan di Hospital Sultan Ismail Johor Bahru dan kajian yang sangat terhad melihat faktor-faktor yang berkaitan dengannya dan dengan tuntutan pampasan. Kajian ini bertujuan untuk mengenal pasti aduan di Hospital Sultan Ismail Johor Bahru dan faktor-faktor yang berkaitan dengannya dan dengan tuntutan pampasan. Metodologi: Kajian ini menggunakan kaedah keratan lintang (cross sectional study). Data diambil dari jumlah aduan terkumpul oleh Jawatankuasa Pengurusan Aduan Hospital Sultan Ismail Johor Bahru bermula dari 1 Januari 2009 sehingga 31 Disember 2016. Hasil Kajian: Hasil kajian mendapati terdapat 304 data aduan dengan prevalens 0.13 per 1000 kedatangan pesakit. Seramai 16.7% pengadu telah membuat tuntutan pampasan. Kebanyakan pengadu adalah terdiri daripada lelaki (51.5%) dengan (67.4%) adalah berbangsa Melayu. Sejumlah (46.2%) aduan adalah berkaitan pengurusan klinikal, (61.4 %) aduan dibuat terhadap perkhidmatan doktor manakala (12.1%) aduan adalah berkaitan mortaliti dan (11.4%) berkaitan morbiditi. Kajian ini juga mendapati terdapat hubungan di antara bangsa, jenis aduan dan faktor penyakit dengan tuntutan pampasan. Kesimpulan Aduan berkaitan pengurusan klinikal dan faktor penyakit mempunyai hubungan signifikan dengan pengadu yang menuntut pampasan. Oleh itu, aduan ini harus disiasat secara menyeluruh untuk mengetahui apa yang perlu dilakukan atau diperbaiki supaya kejadian tidak berulang pada masa akan dating.

Introduction: Influenza outbreak causes high economic burden to Malaysia and other countries in South East Asia. Scientists have found a relatively new way to detect influenza outbreaks early thus reducing the burden of disease by early intervention. This new technology is a social network information system which uses Facebook or Twitter data to detect potential influenza cases. Such system is good to be developed by the Malaysian government as it can detect influenza outbreaks three weeks earlier than the normal pathway. However, to implement this we require good evidence that the development will be accepted by potential users. Objective: This study was looking at the acceptance towards using social network information system among public health workers. Materials and Method: This study was done on 205 Malaysian One Health University Network (MyOHUN) members through email and physical survey. Results: Results show that 62.4% public health workers accepted the use technology. The acceptance was shown to be associated with performance expectancy (p<0.05). However, unlike the very famous Unified Theory of Acceptance and Use of Technology (UTAUT) model, the acceptance of social network information system was not associated with effort expectancy, social factors, facilitating conditions and socio-demographic factors. Therefore, it is suggested that social network information system be developed by the authorities in Malaysia, and be developed in a way that the system could strongly increase performance in detection of outbreak earlier than the current normal pathways. As such the system to be accepted and used, it must be sensitive, specific and be able to detect influenza outbreak early Conclusion: The development of social network information system is feasible as it is highly accepted and it’s potential to improve early detection of influenza outbreak.

Using pulmonary tuberculosis (pTB) as an example of a vaccine-preventable disease (VPD), we aimed to gather evidence on the economic impact of treating a case or managing an outbreak of a VPD. A scoping review was conducted. Online databases (MEDLINE and Google Scholar) were used to collate published studies from the year 2015 to 2019 on the management cost of one case or an outbreak of pTB. Keywords used were cost, treatment, outbreak, pulmonary tuberculosis, tuberculosis, economic, economic evaluation. A total of 29 studies were analysed. The costs of pTB treatment for individual patient were higher in high-income countries compared to middle-income and low-income countries. A case of pTB can result in household catastrophic health expenditure; while an outbreak can overwhelm the health system’s capacity, and disrupts the economy of a country. Therefore, accessibility of vaccines especially in low-income countries must be ensured. Also, vaccine-hesitant individuals must reconsider their stance on vaccination.

Introduction Thalassemia disease is a serious health problem as it gives psychosocial burden not only to the patients but also to the patients’ ecosystem. Among the difficulties faced by patients are psychosocial problems, especially in the process patients’ growth and development. Therefore, this study examines what factors can influenced the psychosocial of Thalassemic patients.. Methods A cross-sectional study was carried out among 161 of Thalasemia Major children at Women and Children Hospital, Likas and Keningau District Hospital, Sabah from February to April 2013. The validated PedsQL 4.0 Generic Core Scale and Social Support questionnaire has been used. Results The results showed that the overall psychosocial score was 68.50 (SP 15.18) with the lowest average school psychosocial score of 58.38 (SP 17.82). Only gender factor showed a significant relationship with psychosocial score of emotional function. There is no significant relationship noted between other sociodemographic factors with overall psychosocial scores or with the psychosocial scores of each function. In relation to subscale social support factors, there was a significant relationship between the psychosocial scores of each function and overall with social support factors of parents, close friends, classmates and teachers. The results of linear regression multivariate analysis suggest that social support factors from classmates is a significant factor in the psychosocial impact of Thalassemia Major pediatric patients. Conclusions In conclusion, social support factors primarily from peers are very important in influencing the psychosocial of Thalassemia Major children in overcoming their life's functionality like other normal children

Health care services are not often accessible and available for all people in one country due to multiple reasons such asthe geographical barrier, affordability, etc. The aim of this study was to analyse willingness to pay (WTP) for healthcareservices user fees among Malaysian population and determine its’ influencing factors. Structured interviews wereconducted involving 774 households in 4 states represents Peninsular Malaysia. Validated questionnaires with openended, followed by bidding games were applied to elicit maximum amount of WTP. The study was analysed descriptivelyand with multivariate regression method to adjust for potential confounding factors. More than half of respondents WTPmore than current fee for the government clinic outpatient registration fee with mean MYR3.76 (SD2.71). Majority ofrespondents not WTP more than usual for private clinic simple outpatient treatment charges with the mean MYR38.76(SD5.45). Factors that were found to have significant associations with WTP for both government and private clinic wereincome and having health insurance. Community willing to pay for healthcare services user fees and charges but atcertain amount. The healthcare services user fees and charges can be increased up to community WTP level to avoidfrom catastrophic expenditure.

Background: The availability of obesity specific quality of life measurement tool is limited. The Malay version of Impact of Weight on Quality of Life-Lite is an obesity specific quality of life questionnaire which has been translated for use in Malaysia. The aim of this study is to evaluate the validity and reliability of this tool to measure quality of life among different body mass index (BMI) groups.Methods: One hundred and twenty subjects with different BMI categories attending an outpatient government clinic participated in this study. The translated Malay version of IWQOL-Lite was used for assessment. The validity of this questionnaire was examined using content validity, criterion validity and construct validity. Reliability analyses used in this study were internal consistencies and test-retest reliability. Results: The Malay version of IWQOL-Lite showed good psychometric properties whereby the content validity was sufficient as measured by expert panels. The mean score of all IWQOL-Lite domains were able to discriminate between different BMI groups. Good internal consistency was demonstrated by Cronbach alpha of 0.936. Test-retest reliability ranged from 0.828 to 0.932. The physical function score (IWQOL-Lite) correlated positively with Physical Component Summary of Short Form-36 questionnaire. Exploratory factor analysis found that the questions loaded on five domains. Conclusion: The results suggest that the Malay version of IWQOL-Lite is a valid and reliable tool to measure quality of life among obese and overweight subjects in Malaysia.

Introduction: An economic analysis was performed to estimate the annual cost of diabetes mellitus to Malaysia. Methods: We combined published data and clinical pathways to estimate cost of follow-up and complications, then calculated the overall national cost. Costs consisted of diabetes follow-up and complications costs. Results: Patient follow-up was estimated at RM459 per year. Complications cost were RM42,362 per patient per year for nephropathy, RM4,817 for myocardial infarction, RM5,345 for stroke, RM3,880 for heart failure, RM5,519 for foot amputation, RM479 for retinopathy and RM4,812 for cataract extraction. Conclusion: Overall, we estimated the total cost of diabetes as RM2.04 billion per year for year 2011 (both public and private sector). Of this, RM1.40 billion per year was incurred by the government. Despite some limitations, we believe our study provides insight to the actual cost of diabetes to the country. The high cost to the nation highlights the importance of primary and secondary prevention.
Diabetes Mellitus ; Health Care Costs ; Health Expenditures

The quality of education is one of the controversial topics and vital issues that requires more emphases from researchers due to the current challenges in education at the university level. Involvement and participation from the studentis essential to implement quality assurance and to reach for academic accreditation. The aim of this study is to assess knowledge, attitudes, and practices (KAP) of students towards TQM in education and its influencing factorsatHigh Institute of Health Sciences (HIHS) in Sana'a, Yemen. A cross-sectional study using a self-administered questionnaire was conducted in 2016. A total of 208 students from second and third study levels in HIHS had participated from 268 students were observed (study population). Descriptive statistics, chi-square, and one-way ANOVA were used to determine the association between students’ KAP towards TQM in education with its influencing factors. Mean age of the students were 22.44(SD±2.027) year old. Majority of HIHS students were male 135 (64.9%) and 108 (51.9%) were from the third studying level. The highest students' KAP scores were 53.4%, 65.4%, and 41.3% for good knowledge, good attitudes, and moderate practices respectively. Education Department was found to be significantly associated with students' knowledge and practices with p<0.05. In addition, the means of knowledge, attitudes, and practices were higher among pharmacy, radiology, and physiotherapy students respectively than laboratory students. Students' practices were found to be significantly associated with management, academic, and material factors with p<0.001. HIHS students were observed to have good knowledge, good attitudes, and moderate practices towards TQM.​