Introduction: Subcutaneous once-weekly semaglutide (Sema-OW) (0.5, 1.0 mg) has been available in Malaysia since 2020, but is currently not listed in the MOH Medicines Formulary. MOH clinicians prescribe Sema-OW for limited patient numbers, on a “named patient basis” following a closely regulated application process, permitting use once multilevel approval is obtained. Our study aims to report on the glycemic and weight-lowering outcomes of SemaOW in a real-world MOH clinical setting. Methodology: A retrospective, single-arm, observational study was conducted in Hospital Putrajaya and Hospital Kuala Lumpur. The study population comprised adults with type 2 diabetes mellitus (T2DM) treated with Sema-OW for at least 6 months with hemoglobin A1c (HbA1c) and weight parameters available in their medical records. The primary endpoint was HbA1c change at 6 months. The secondary endpoints were the changes in HbA1c and weight from baseline to 12 months, proportion of patients achieving HbA1c <7%, and different levels of HbA1c reduction in 6 and 12 months (<0.5, 0.5–<1.0, 1–<2, ≥2%). Changes in concomitant glucose-lowering medications were additionally observed. Results: The cohort comprised 45 patients, with a mean age and disease duration of 53.3 and 16.3 years, respectively. Baseline mean weight was 100.3 kg, and body mass index (BMI) was 36.8 kg/m², with 88% in the obese BMI category. Baseline HbA1c was 7.9%, and HbA1c reduction was 0.74% at 6 months and 0.84% at 12 months. The proportions of patients achieving HbA1c reduction of <0.5, 0.5–<1.0, 1.0– <2.0, and ≥2.0% were 8.9, 26.7, 26.7, and 8.9%, respectively. The mean weight reduction from baseline was 4.93 kg at 6 months and 6.73 kg at 12 months. Concomitant insulin therapy was observed in 44%, with 31% reduction in total daily insulin requirement at the end of the study, along with simplification of insulin regimens. Conclusion Combination therapy with Sema-OW improved glycemic control with weight loss and enabled treatment deintensification in people with T2DM in Malaysian public tertiary diabetes care.
semaglutide ; Hospitals, Public ; Diabetes Mellitus

Introduction: Hypoglycemia, a frequent and potentially life-threatening consequence of anti-diabetic therapy, remains a major barrier to optimal glycemic control. Effective inpatient management depends on frontline staff knowledge and preparedness; thus, knowledge gaps may compromise patient safety. This audit evaluated staff knowledge of hypoglycemia management in a district hospital in Malaysia to identify areas for improvement. Methodology: A cross-sectional audit was conducted among healthcare staff in a district hospital. A structured, modified questionnaire based on the Malaysian MEMS Inpatient Glycemic Guidelines was used. The 10-item questionnaire assessed definition, initial and subsequent management, reassessment, escalation, and documentation, yielding scores from 0 to 10. Descriptive statistics were used for analysis. Conclusion Despite high overall knowledge, critical gaps remain in reassessment, drug-related risks, and stepwise management, warranting targeted education, protocol reinforcement, and re-audit to enhance patient safety.
Hospitals, District ; Hypoglycemia

Introduction: Semaglutide has shown clinically meaningful effects on weight and glycemic control in randomized trials, but realworld evidence from Malaysian public healthcare settings remains limited. Local data are particularly relevant because access to glucagon-like peptide-1 receptor agonists may be influenced by cost and availability. We evaluated the realworld effectiveness of once-weekly semaglutide in adults with obesity and type 2 diabetes mellitus (T2DM) managed in routine clinical practice at a Malaysian district hospital. Methodology: We conducted a retrospective observational study of adults with obesity and T2DM treated with once-weekly semaglutide at a single district hospital. Demographic, anthropometric, metabolic, and cardiovascular parameters were collected at baseline and follow-up. The primary outcomes were percentage weight change and the proportions of patients achieving at least 5% and at least 10% weight loss. Secondary outcomes included changes in body mass index (BMI), glycated hemoglobin A1c (HbA1c), blood pressure, lipid parameters, and insulin requirements. Paired analyses were performed to compare pre-treatment and post-treatment values. Results: Eight patients were included (mean age 45 years; 63% women; 88% Malay). All had T2DM and hypertension, while most had dyslipidemia. Mean baseline weight was 116.0 ± 22.7 kg, and mean BMI was 43.5 ± 9.0 kg/m². After a mean treatment duration of 23 months, mean weight decreased to 102.9 ± 23.8 kg, representing a mean reduction of 13.1 kg or 11.5%. Six patients (75%) achieved at least 5% weight loss, and four (50%) achieved at least 10% weight loss. Mean BMI decreased to 38.4 ± 8.4 kg/m². Mean HbA1c improved from 8.9 ± 1.9% to 6.3 ± 0.9%. Systolic and diastolic blood pressure declined from 153 ± 22 to 134 ± 17 mmHg and from 91 ± 17 to 82 ± 10 mmHg, respectively. Total cholesterol, low-density lipoprotein cholesterol, and triglycerides also improved. Among insulin-treated patients, all discontinued insulin during follow-up. No treatment discontinuations due to adverse effects were recorded. Conclusion In this small real-world cohort, semaglutide was associated with meaningful weight loss, improved glycemic control, favorable cardiometabolic changes, and successful insulin deintensification. These findings support its use in routine obesity-diabetes care, although larger prospective studies are needed.
Adult ; semaglutide ; Diabetes Mellitus, Type 2 ; Hospitals, District ; Obesity

BACKGROUND

PhilHealth serves as the Philippines’ national health insurance provider and is central to implementing the Universal Health Care (UHC) Law. Despite this, existing gaps and ongoing challenges in claims and financial management systems continue to affect public healthcare facilities’ operations and sustainability.

This article examined the effectiveness and challenges of PhilHealth’s claims and financial management systems in public healthcare facilities, focusing on accreditation, claims processing, reimbursements, and financial governance.

A qualitative multiple-case study design was employed in Quezon City and the provinces of La Union, Sorsogon, Leyte, and Bukidnon, with data collected from 2022 to 2023. Prior to data collection, a certificate of exemption was granted by the Department of Health – Single Joint Research Ethics Board (DOH-SJREB). Data were collected through key informant interviews with healthcare facility heads, claims processors, and PhilHealth personnel, supplemented by document reviews and facility observations. Thematic analysis was employed to examine the implementation of national health insurance policies at the facility level.

Accreditation standards are uniformly defined, yet compliance varies widely, directly influencing reimbursement outcomes. Facilities with compliance gaps often face provisional accreditation, downgrades, or suspension, resulting in reduced revenue. Although the Universal Health Care (UHC) Law guarantees patient access to PhilHealth benefits, the efficiency of claims processing remains uneven and highly dependent on administrative capacity, staffing adequacy, and digital infrastructure. Systemic inefficiencies at both PhilHealth and facility levels contribute to delays and claim denials. Reimbursements are further constrained by outdated case rate ceilings, inconsistent financial practices, inadequate recordkeeping, weak information systems, and poor storage conditions—particularly in lower-level hospitals and rural health units.

Reforms in claims processing workflows, information system integration, and financial management capacities are crucial to enhance reimbursement efficiency. Strengthening these systems is fundamental for supporting sustainable, equitable, and high-quality healthcare delivery in the public sector within the Universal Health Care (UHC) framework.

The advances of modern medicine have inadvertently led to a globally ageing population plagued primarily with non-communicable diseases. In addition to traditional medical approaches, nature-based therapy is becoming an increasingly attractive option, with its potential to holistically address physical and mental facets of health and well-being, and to complement 'preventive' and 'population health' strategies, both of which form the bedrock of sustainable healthcare. However, at present, there is vast heterogeneity in the implementation of nature-based therapy, limiting its widespread and sustainable use. The aim of this review is to practically examine and provide a focussed summary of the current evidence with a view to identifying existing gaps and limitations, and to propose directions for future research and implementation within the healthcare setting.
Humans ; Singapore ; Tertiary Care Centers ; Hospitals, Public ; Delivery of Health Care ; Nature ; Complementary Therapies/methods* ; Medicine, Traditional/methods*

PURPOSE

This study assessed the relationship between the levels of intrapersonal and interpersonal skills among ward nurses in selected public hospitals in Manila City in order to address the limited research on how these soft-skill domains interact and influence nurse–patient interactions in the Philippine public health context.

A descriptive–correlational design was employed to determine the relationship between nurses' intrapersonal and interpersonal skills. The study was conducted in three government-funded public hospitals in Manila that were chosen through purposive sampling based on patient volume and accessibility. The sample (N=122) consisted of Filipino nurses working in clinical wards for at least six months to two years and employed in three public hospitals in Metro Manila. Data was collected using an adopted and validated tool via online and face-to-face questionnaires. Multivariate Analysis of Covariance and Pearson Correlation were used to test the hypotheses.

The analysis revealed that there is very high correlation between the intrapersonal and interpersonal skills of the respondents as revealed by the null hypothesis (p-value = < 0.001 and R= 0.930). However, profile variables such as age, type of ward, and number of years employed as ward nurse showed no significant correlation on either intrapersonal skills or interpersonal skills of the respondents. However, analysis revealed that there is a significant relationship between sex and both intrapersonal skills (p = 0.002) and interpersonal skills (p = 0.004).

Intrapersonal and interpersonal skills were distinct yet critical competencies in nurse–patient interactions. Results suggested the need for targeted training and gender-sensitive interventions to strengthen these skills. These findings provided a basis for healthcare institutions to design development programs and for future research to expand on soft-skill dynamics in nursing.

Background: Burnout is a pressing concern among Emergency Ward (EW) nurses, stemming from the intense demands of their profession, including long hours, exposure to traumatic events, and the need for quick decision-making. This issue not only affects nurses' well-being but also has repercussions for patient care and the healthcare system. Objective: This study aimed to investigate the association between effort-reward and work-life imbalance on burnout among EW nurses in a public hospital. Methods: The study was a cross-sectional analytical study conducted from February to May 2022 involving 32 EW nurses employed at Public Hospital I.A. Moeis Hospital in Samarinda City, Indonesia. The research employed several instruments for data collection through stratified random sampling. Chi square and logistic regression analysis were performed to assess the factors contributing to burnout among EW nurses, including effort-reward imbalance, worklife balance, namely monotonous work, self-efficacy, communication among healthcare professionals, and workload. Result: There was positive correlation between effort-reward and work-life imbalance on burnout among EW nurses. The multivariate test results showed that workload, self-efficacy, communication, and monotonous work had higher risk of developing burnout in EW nurses. Conclusion In this study, we found that effort-reward and work-life imbalance were significantly associated with burnout in EW nurses in a public hospital. The development of comprehensive assessment of burnout among EW nurses and its early intervention should be warranted.
Burnout, Psychological ; Emergency Ward ; Emergency Service, Hospital ; Nurses ; Hospitals, Public

Objective: To investigate the current situation of job involvement of nurses in military hospitals in Henan Province and analyze the influencing factors, so as to provide reference for improving the level of job involvement of military nurses. Methods: In February 2022, the employed nurses of 4 military hospitals in Henan Province were investigated by convenient sampling method. A total of 663 questionnaires were collected, including 632 valid questionnaires, with an effective recovery rate of 95.32%. The self-designed questionnaire was used to investigate the basic information of nurses, the Job Involvement Scale was used to investigate the job involvement of nurses, the Emotional Labor Scale for Nurses was used to investigate nurses' emotions, and the Work-Family Conflict Scale was used to investigate the work-family conflict of nurses. Independent sample t-test and univariate analysis of variance were used to compare the job involvement of military employed nurses with different demographic characteristics, Pearson correlation analysis was used to explore the correlation between emotional labor, work-family conflict and job involvement, and hierarchical regression analysis was used to explore the impact of relevant variables on the job involvement of military employed nurses. Results: The total average score of job involvement of military employed nurses was (3.68±1.13), and the scores of vitality, dedication and focus were (3.64±1.15), (3.74±1.25) and (3.67±1.21) respectively. The total score of emotional labor of nurses was 33-80 (62.95±8.12), with an average score of (3.93±0.51). The total score of work-family conflict was 18-94 (55.16±13.53), with an average score of (3.06±0.75). Professional emotional regulation, patient-centered emotional inhibition and standardized emotional play were positively related to the job involvement (r=0.46, 0.41, 0.22, P<0.01). Time-based conflict, stress-based conflict and behavior-based conflict had negative correlation with the job involvement (r=-0.12, -0.23, -0.20, P<0.01). In hierarchical regression analysis, after controlling demographic variables, emotional labor and work-family conflict accounted for 17.2% and 4.2% of the variation of job involvement. Conclusion: The job involvement of military employed nurses tends to be at a moderate level. Emotional labor and work-family conflict can significantly affect their job involvement.
United States ; Humans ; Hospitals, Military ; Family Conflict ; Surveys and Questionnaires ; Regression Analysis ; Nurses ; Job Satisfaction

Endoscopy, Gastrointestinal ; Anesthesia ; Surveys and Questionnaires ; Anesthesiology ; Hospitals, Public ; China ; Endoscopy

OBJECTIVE: The national requirements for the fund management of scientific research projects are becoming more stringent, so that it is convenient to carry out scientific research work and can strengthen the regulation of scientific research reagent procurement, so this study explores the standardization of the whole process of the procurement of scientific research reagent supplies in hospitals and new modes of management. METHODS: By exploring the implementation of the centralized procurement management platform, we engage in full process supervision before, during, and after the event. RESULTS: Introduction of centralized procurement management platform for scientific research reagent supplies can normalize the procurement process, ensure the quality of procurement and improve the procurement efficiency on the basis of ensuring the quality of scientific research. CONCLUSIONS The new model of centralized procurement of full process management based on one-stop service for scientific research reagent supplies is an important part of improving the fine scale management of public hospitals, and it is of great significance in improving the level of scientific research in China and avoiding scientific research corruption.
Indicators and Reagents ; Hospitals, Public ; China