Faizah A, Kamilah D, Sivasampu S, Tahrani PK, …...Under the Medical Act 1971, all doctors who...
1
INTRODUCTION Clinical Research Centre, 3rd Floor, MMA Building, 124, Jalan Pahang, 53000 Kuala Lumpur. Contact No.: 03-40439300; [email protected] OBJECTIVE METHODOLOGY CONCLUSION RESULT ACKNOWLEDGEMENT REFERENCES DISCUSSION There is strong evidence that health workforce of a country is positively associated with its health outcomes.[1]Currently, there is paucity of evidence on the total practising medical doctors and specialists in Malaysia. This is due to the existence of dual sector health practices in the country. In 2011, it was estimated that 36,607 doctors were licensed; 25,845 in public and 10762 in the private sector.[2] However, this number reflects the total doctors licensed and includes those working in administrative and research institutes. In addition, house officers also have been included in this total. Under the Medical Act 1971, all doctors who practise in Malaysia should be registered under the Malaysian Medical Council. The Act was amended in 2012 to make it compulsory for specialists to be registered under the National Specialist Register (NSR). The NSR was established to ensure that doctors designed as specialists are gazetted, credentialed and competent to practise the expected higher level of care in their respective fields. However, the Act has yet to be enforced. The primary aim is to examine the distribution of specialists in Malaysian Hospitals by specialties, sector and also by geographical location. Secondary data was obtained from the National Healthcare Establishment and Workforce Survey (NHEWS) which was conducted by Healthcare Statistic Unit, Clinical Research Centre. It has been conducted from 2009 to 2011. The survey population was constructed from multiple sources of Medical Development Division for the MOH hospitals and the Private Medical Practice Control Division for the private hospitals. It is a cross sectional survey. Three hundred and thirty seven hospitals were included. From the database of the survey, we specifically looked at distribution and demographics of clinical specialists in Malaysian hospitals. This maldistribution needs to be addressed in future manpower planning for equitable human resource for health. We also need to examine the successes and failures of previously implemented policies and work towards a national policy that provides equitable access of care with a narrower gap in between regions. Most importantly, we need to identify the push and pull factors that drive our specialist towards private practice and the urban areas and address those weaknesses. • The response rate has increased over the three year period; 100% for both MOH and university hospitals, and from 59% to 64% for private hospitals. • The top five specialties in Malaysia were General Medicine, General Surgery, Obstetrics and Gynaecology (O&G), Anaesthesiology and Paediatrics (Figure 2). • There were more specialists in private sector especially in the top three specialties; Medicine, Surgery and O&G. Whereas the number of specialists were higher in MOH for the discipline of anaesthesiology (Figure 3). • There was a disproportionate distribution amongst specialists across regions. The density was heavily distributed towards West Coast Peninsular Malaysia (Table 1). Other studies around the region including Thailand and Indonesia have demonstrated similar findings on inequity. [3] • In 2010, there were more male specialist compared to female specialist, 63.7% and 36.3% respectively. • Limitations of our study: We have not included specialists who work exclusively in a non-hospital setting for e.g. Paediatricians who practice in their respective specialist clinics might not be captured in our study. We would like to thank the Ministry of Health for funding and the Director General of Health, Malaysia for granting permission to publish this poster. We would like to express appreciation to Medical Development Division and Private Medical Practice Control Division. 1. The Economic Planning Unit, Prime Minister’s Department. 100th Malaysian Plan 2011-2015 2. Ono T, Lafortune G, Schoenstein M. Health workforce planning in OECD countries: a review of 26 projection models from 18 countries. OECD Publishing, 2013. 3. Meliala A, Hort K, Trisnantoro L. Addressing the unequal geographic distribution of specialist doctors in Indonesia: The role of the private sector and effectiveness of current regulations. Social Science & Medicine. 2013. 4. National Healthcare Establishment and W orkforce Statistics (Hospital) 2008-09, Clinical Research Centre, Kuala Lumpur. 2010 5. National Healthcare Establishment and Workforce Statistics (Hospital) 2010, Clinical Research Centre, Kuala Lumpur. 2012 6. National Healthcare Establishment and Workforce Statistics (Hospital) 2011, Clinical Research Centre, Kuala Lumpur. 2013 Medicine, n(%) Surgery, n(%) O&G, n(%) Anaesthesiology, n(%) Paediatrics, n(%) MOH 561 (42.2) 350 (39.9) 274 (35.2) 327 (48.1) 293 (45.8) Private 579 (45.6) 430 (49.0) 459 (59.0) 295 (43.4) 293 (45.8) University 130 (10.3) 97 (11.1) 45 (5.8) 58 (8.5) 54 (8.4) Total 1270 877 778 680 640 Table 1: Distribution of Specialists in Malaysian Hospitals by Region, 2010 Region Total population Medicine Surgery O&G Anaesthesiology Paediatrics Number Per 10,000 population Number Per 10,000 population Number Per 10,000 population Number Per 10,000 population Number Per 10,000 population West Coast Peninsular Malaysia 18507445 1033 0.56 708 0.38 635 0.34 554 0.30 523 0.28 East Coast Peninsular Malaysia 4076395 112 0.27 88 0.22 62 0.15 64 0.16 60 0.15 Sabah 3279155 59 0.18 33 0.10 38 0.12 27 0.08 23 0.07 Sarawak 2471140 66 0.27 48 0.19 43 0.17 35 0.14 34 0.14 Faizah A, Kamilah D, Sivasampu S, Tahrani PK, Kasturi M National Clinical Research Centre, Kuala Lumpur, Malaysia Corresponding Author : Dr. Sheamini S, Healthcare Statistics Unit, National Clinical Research Centre. Tel : 03-40439300; Email : [email protected] Figure 1: Total Number of Specialist in Malaysian Hospitals by Sector from 2009 to 2011 Figure 2: Distribution of Specialists in Malaysian Hospitals by Speciality in 2010 Figure 3: Distribution of Specialists in Top Five Specialties by Sector in Malaysian Hospitals, 2010
Transcript of Faizah A, Kamilah D, Sivasampu S, Tahrani PK, …...Under the Medical Act 1971, all doctors who...
INTRODUCTION
Clinical Research Centre, 3rd Floor, MMA Building, 124, Jalan Pahang, 53000 Kuala Lumpur. Contact No.: 03-40439300; [email protected]
OBJECTIVE
METHODOLOGY
CONCLUSION
RESULT
ACKNOWLEDGEMENT
REFERENCES
DISCUSSION
There is strong evidence that health workforce of a country is positively associated with its health outcomes.[1]Currently, there is paucity of evidence on the total practising medical doctors and specialists in Malaysia. This is due to the existence of dual sector health practices in the country. In 2011, it was estimated that 36,607 doctors were licensed; 25,845 in public and 10762 in the private sector.[2] However, this number reflects the total doctors licensed and includes those working in administrative and research institutes. In addition, house officers also have been included in this total.
Under the Medical Act 1971, all doctors who practise in Malaysia should be registered under the Malaysian Medical Council. The Act was amended in 2012 to make it compulsory for specialists to be registered under the National Specialist Register (NSR). The NSR was established to ensure that doctors designed as specialists are gazetted, credentialed and competent to practise the expected higher level of care in their respective fields. However, the Act has yet to be enforced.
The primary aim is to examine the distribution of specialists in Malaysian Hospitals by specialties, sector and also by geographical location.
Secondary data was obtained from the National Healthcare Establishment and Workforce Survey (NHEWS) which was conducted by Healthcare Statistic Unit, Clinical Research Centre. It has been conducted from 2009 to 2011. The survey population was constructed from multiple sources of Medical Development Division for the MOH hospitals and the Private Medical Practice Control Division for the private hospitals. It is a cross sectional survey. Three hundred and thirty seven hospitals were included. From the database of the survey, we specifically looked at distribution and demographics of clinical specialists in Malaysian hospitals.
This maldistribution needs to be addressed in future manpower planning for equitable human resource for health. We also need to examine the successes and failures of previously implemented policies and work towards a national policy that provides equitable access of care with a narrower gap in between regions. Most importantly, we need to identify the push and pull factors that drive our specialist towards private practice and the urban areas and address those weaknesses.
• The response rate has increased over the three year period; 100% for both MOH and university hospitals, and from 59% to 64% for private hospitals.
• The top five specialties in Malaysia were General Medicine, General Surgery, Obstetrics and Gynaecology (O&G), Anaesthesiology and Paediatrics (Figure 2).
• There were more specialists in private sector especially in the top three specialties; Medicine, Surgery and O&G. Whereas the number of specialists were higher in MOH for the discipline of anaesthesiology (Figure 3).
• There was a disproportionate distribution amongst specialists across regions. The density was heavily distributed towards West Coast Peninsular Malaysia (Table 1). Other studies around the region including Thailand and Indonesia have demonstrated similar findings on inequity.[3]
• In 2010, there were more male specialist compared to female specialist, 63.7% and 36.3% respectively.
• Limitations of our study: We have not included specialists who work exclusively in a non-hospital setting for e.g. Paediatricians who practice in their respective specialist clinics might not be captured in our study. We would like to thank the Ministry of Health for funding and the Director General
of Health, Malaysia for granting permission to publish this poster. We would like to express appreciation to Medical Development Division and Private Medical Practice Control Division.
1. The Economic Planning Unit, Prime Minister’s Department. 100th Malaysian Plan 2011-2015 2. Ono T, Lafortune G, Schoenstein M. Health workforce planning in OECD countries: a review of 26 projection models from 18 countries.
OECD Publishing, 2013.3. Meliala A, Hort K, Trisnantoro L. Addressing the unequal geographic distribution of specialist doctors in Indonesia: The role of the private
sector and effectiveness of current regulations. Social Science & Medicine. 2013.4. National Healthcare Establishment and W orkforce Statistics (Hospital) 2008-09, Clinical Research Centre, Kuala Lumpur. 20105. National Healthcare Establishment and Workforce Statistics (Hospital) 2010, Clinical Research Centre, Kuala Lumpur. 20126. National Healthcare Establishment and Workforce Statistics (Hospital) 2011, Clinical Research Centre, Kuala Lumpur. 2013
Medicine, n(%) Surgery, n(%) O&G, n(%) Anaesthesiology, n(%) Paediatrics, n(%)
MOH 561 (42.2) 350 (39.9) 274 (35.2) 327 (48.1) 293 (45.8)
Private 579 (45.6) 430 (49.0) 459 (59.0) 295 (43.4) 293 (45.8)
University 130 (10.3) 97 (11.1) 45 (5.8) 58 (8.5) 54 (8.4)
Total 1270 877 778 680 640
Table 1: Distribution of Specialists in Malaysian Hospitals by Region, 2010
RegionTotal
population
Medicine Surgery O&G Anaesthesiology Paediatrics
NumberPer 10,000 population
NumberPer 10,000 population
NumberPer 10,000 population
NumberPer 10,000 population
NumberPer 10,000 population
West Coast Peninsular Malaysia
18507445 1033 0.56 708 0.38 635 0.34 554 0.30 523 0.28
East Coast Peninsular Malaysia
4076395 112 0.27 88 0.22 62 0.15 64 0.16 60 0.15
Sabah 3279155 59 0.18 33 0.10 38 0.12 27 0.08 23 0.07
Sarawak 2471140 66 0.27 48 0.19 43 0.17 35 0.14 34 0.14
Faizah A, Kamilah D, Sivasampu S, Tahrani PK, Kasturi MNational Clinical Research Centre, Kuala Lumpur, Malaysia
Corresponding Author : Dr. Sheamini S, Healthcare Statistics Unit, National Clinical Research Centre. Tel : 03-40439300; Email : [email protected]
Figure 1: Total Number of Specialist in Malaysian Hospitals by Sector from 2009 to 2011
Figure 2: Distribution of Specialists in Malaysian Hospitals by Speciality in 2010
Figure 3: Distribution of Specialists in Top Five Specialties by Sector in Malaysian Hospitals, 2010
