Implications of Dual Practice on Cataract Surgery Waiting Time and Rescheduling: The Case of Malaysia

Fun, Weng Hong; Tan, Ee Hong; Sararaks, Sondi; Md.Sharif, Shakirah; Rahim, Iqbal Ab; Jawahir, Suhana; Eow, Vivien Han Ying; Sibert, Raoul Muhammad Yusof; Fadzil, Malindawati Mohd; Mahmud, Siti Haniza

doi:10.3390/healthcare9060653

Cited by 6 publications

(13 citation statements)

References 29 publications

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“…The FPP Service is regulated for the number of specialist engagements with patients, amount of incomes, time spent, and the number of patients treated [ 30 , 32 ]. In general, FPP specialists’ engagements with FPP inpatients should not be more than two times per day except in certain circumstances such as on patient request or for emergency cases.…”

Section: Methodsmentioning

confidence: 99%

“…They are only allowed to consult or treat FPP patients after completing the necessary care for public patients. Any surgical procedure for FPP patients must be performed after working hours [ 30 , 32 ], except for emergencies and certain cases after consideration and permission from the Director of the Hospital [ 30 ]. For outpatient clinics, FPP specialists can treat no more than 30% of FPP patients out of the total outpatients at a particular time.…”

Section: Methodsmentioning

confidence: 99%

“…The public healthcare sector is funded predominantly through general taxation in co-existence with a market-driven private health sector that consists of mostly physician-owned clinics and hospitals [ 31 ]. All citizens in the country are entitled to a range of subsidized healthcare services, including both inpatient and outpatient care in the public system with nominal user charges [ 32 ]. The total expenditure on health (TEH) in Malaysia between 1997 to 2019 ranged from 3.04% to 4.30% of the Gross Domestic Product (GDP).…”

Section: Introductionmentioning

confidence: 99%

“…Financial incentives play an important role in influencing individuals’ choice of workplace and have always been applied to address workforce shortage in healthcare worldwide [ 3 , 39 ]. While public sector health workforce under MOH receive fixed monthly salaries according to a salary scale with bands that vary by professional classification and grade, their counterparts in the private sector are mainly remunerated through fee-for-service payments [ 32 , 40 ]. On top of the fixed monthly salaries, they are entitled to specific allowances which make up approximately 20% and 50% of the total gross salary of non-specialists and specialists, respectively [ 40 ].…”

Section: Introductionmentioning

confidence: 99%

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Specialists’ Dual Practice within Public Hospital Setting: Evidence from Malaysia

et al. 2022

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In line with the commitment of the Malaysian government and Ministry of Health to prevent the brain drain of specialists from public hospitals, they have been permitted to perform dual practice within the public hospital setting (DPH) since 2007. DPH allowed them to hold jobs in both public and private practices within the same public hospitals that they are affiliated to, permitting these specialists to treat public and private patients. Nevertheless, the information regarding DPH in Southeast Asia region is still limited. This narrative review provides insight into the implementation of DPH in Malaysia. It highlights that DPH has been well-governed and regulated by the MOH while serving as a means to retain specialists in the public healthcare system by providing them with opportunities to obtain additional income. Such a policy has also reduced the financial burden of the government in subsidizing healthcare. However, as in other countries with similar policies, multiple challenges have arisen from the implementation of DPH in Malaysia despite its positive achievements and potentials. This paper concludes that proactive governance, monitoring, and regulation are key to ensure the success of DPH.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Specialists’ Dual Practice within Public Hospital Setting: Evidence from Malaysia

et al. 2022

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“…For example, in 2014, the average waiting time for a cardiology intervention in the Canary Islands was 257 days, while in La Rioja it was only 35 days. These delays in access to healthcare services affect patients’ health [ 7 ] as well as the quality of the healthcare service, and consequently patient satisfaction [ 8 , 9 ]. In Spain, Law 14/1986 granted the autonomous communities complete authority regarding their individual healthcare systems [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Patient Satisfaction through the Effect of Healthcare Spending on Waiting Times for Consultations and Operations

et al. 2022

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In recent years, public authorities have invested large amounts of public money in trying to reduce waiting times for consultations and operations with the aim of improving the quality of the healthcare system. Our research aims to analyze the effect of these investments on patient satisfaction through the mediating relationship of waiting times for consultations and operations, as well as from a gender perspective. By studying a series of key indicators of the Spanish healthcare system and applying partial least squares structural equation modelling (PLS-SEM), the findings show that the model explains 12.10% of the variance in consultant waiting times, 51.90% in operation waiting times, and 27.00% in patient satisfaction. We found that increased public spending leads to increased patient satisfaction by reducing waiting times. However, no gender-based differences were found. The results provide exciting implications for theory and practice, indicating how policymakers can orient their strategies towards improving patient satisfaction.

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Pushing the envelope: the feasibility of using a mailed contrast sensitivity test to prioritise cataract waiting lists

Bianchi,

Reddingius,

Rathore

et al. 2024

Eye

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Background Cataract waiting lists are growing globally. Pragmatic, cost-effective methods are required to prioritise the most urgent cases. Here we investigate the feasibility of using a third-party pen-and-paper contrast sensitivity, CS, test (SpotChecksTM), delivered by mail, and performed by patients at home unsupervised, to flag eyes requiring surgery. Methods Pen-and-paper CS tests were mailed to 233 people waiting for a cataract assessment, along with a prepaid return envelope (cross-sectional study). Response rates were tabulated (stratified by age, sex and socioeconomic status), and test scores analysed to see how well the home tests predicted which eyes were listed subsequently for surgery. A subset of patients (N = 39) also underwent in-person follow-up testing, to confirm the accuracy of the home data. Results Forty-six percent of patients responded (216 eyes). No gross differences were observed between respondents and non-respondents, either in terms of age, sex, socioeconomic status, or geographic location (all P > 0.05). The home-test CS scores predicted which eyes were subsequently listed for surgery, with an AUROC {±CI95%} of 0.69 {0.61–0.76}. Predictive performance was further-improved when machine learning was used to combine CS scores with letter acuity, extracted from patients’ medical records (AUROC {±CI95%} = 0.77 {0.70–0.83}). Among 39 patients who underwent follow-up testing, home CS scores were correlated with various measures made in clinic: biometry signal-to-noise (P = 0.032), LogMAR acuity, Pelli-Robson CS and SpotChecks CS (all P < 0.001). Conclusions Mailing patients pen-and-paper CS tests may be a feasible, 'low-tech' way of prioritising patients on cataract waiting lists.

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Implications of Dual Practice on Cataract Surgery Waiting Time and Rescheduling: The Case of Malaysia

Cited by 6 publications

References 29 publications

Specialists’ Dual Practice within Public Hospital Setting: Evidence from Malaysia

Specialists’ Dual Practice within Public Hospital Setting: Evidence from Malaysia

Analysis of Patient Satisfaction through the Effect of Healthcare Spending on Waiting Times for Consultations and Operations

Pushing the envelope: the feasibility of using a mailed contrast sensitivity test to prioritise cataract waiting lists

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