1.Descriptive Analysis of Type 2 Diabetes Mellitus Patients Using Data From Hospital Information System
Malaysian Journal of Medicine and Health Sciences 2020;16(No.1):94-99
Electronic medical records from hospital information system (HIS) offer a major potential for secondary
data analysis which can improve the efficiency of healthcare delivery. This study describes an initiative to use HIS
data to explore the level of diabetic care in patients with T2DM in a hospital-based outpatient clinic, the advantages
and challenges in utilising HIS data. Methods: Patients age of 18 and above who received any diabetes medication
in 2013 were retrospectively identified from HIS of Serdang Hospital. Demographic characteristics, anti-diabetic
agent (ADA) dispensed, and glycaemic measures were quantified. Data was extracted using structured query language (SQL) and descriptive statistical analyses were conducted using Stata Version 12. Results: Prevalence of T2DM
patients in the hospital was 7.5%. Male had slightly higher prevalence and patient at age of 61-70 years old. About
62% of patients were prescribed with metformin and 5% of newer combination of oral hypoglycemic agent. In prescribing pattern, stratification by age group, showed that patient age 41 to 70 years received mostly monotherapy,
whilst 61.1% continue their regime for the year. Only 18% obtained good glycaemic control. Conclusion: Hospital
Information system is a critical instrument in providing data as a platform in diabetic care in an outpatient care.
Moving forward, steps to improve HIS should be taken to seize its potential as a tool to increase the efficiency of
healthcare delivery.
2.Socioeconomic Status Affecting Inequity of Healthcare Utilisation in Malaysia
Nurul Salwana Abu Bakar ; Adilius Manual ; Jabrullah Ab Hamid
Malaysian Journal of Medical Sciences 2019;26(4):79-85
Background: Equity is one of the important aspects of universal health coverage. Variation
in socioeconomic status (SES) has been proved to contribute discrepancies in the use of healthcare
services. This study aimed to assess equity for inpatient, outpatient and dental care utilisation by
household SES over time.
Methods: This study used five series of National Health and Morbidity Survey data from
1986 to 2015. Healthcare utilisation for inpatient, outpatient and dental care were analysed. SES
was grouped based on household expenditure variables accounting for total number of adults and
children in the household using consumption per adult equivalents approach. The determination
of healthcare utilisation across the SES segments was measured using concentration index.
Results: The overall distribution of inpatient utilisation tended towards the pro-poor,
although only data from 1996 (P-value = 0.017) and 2006 (P-value = 0.021) were statistically
significant (P < 0.05). Out-patient care showed changing trends from initially being pro-rich in
1986 (P < 0.05), then gradually switching to pro-poor in 2015 (P < 0.05). Dental care utilisation
was significantly pro-rich throughout the survey period (P < 0.05). Public providers mostly showed
significantly pro-poor trends for both in- and out-patient care (P < 0.05). Private providers,
meanwhile, constantly showed a significantly pro-rich (P < 0.05) trend of utilisation.
Conclusion: Total health utilisation was close to being equal across SES throughout the
years. However, this overall effect exhibited inequities as the effect of pro-rich utilisation in the
private sector negated the pro-poor utilisation in the public sector. Strategies to improve equity
should be consistent by increasing accessibility to the private sectors, which has been primarily
dominated by the richest population.