04/19/23

HEALTHCARE REFORMS IN HEALTHCARE REFORMS IN MALAYSIAMALAYSIA

DR RIDZWAN BAKAR MBBS FRCP(LON)

PresidentAssociation of Private Hospitals, Malaysia

e-mail: aphm@po.jaring.mye-mail: aphm@po.jaring.myhttp://www.hospitals-malaysia.orghttp://www.hospitals-malaysia.org

23 million people Dual system of health

delivery: public vs private

Public: 127 hospitals

32,000 beds Private: 224 hospitals

9,547 beds Doctors: public 8,723

private 6,780

STRENGTH OR WEAKNESS? 88.5% of the population is within 5km of a public

health clinic or private practitioner dual system of healthcare delivery (public/private) almost total government subsidy for all services in

public hospitals infant mortality rate: 7.9 per 1,000 livebirths (1998) maternal mortality rate:0.2 per 1,000 livebirths (1998) healthcare expenses: 4% of G.D.P.

FACTORS INFLUENCING GLOBAL TRENDS IN HEALTHCARE

Emphasis on patient empowerment & responsibility

shift to the wellness paradigm redressing of social inequities awareness of human rights the consumerism movement concern/awareness to the eco-

systems & environs

Vision 2020 “By the year 2020, Malaysia is to be a united

nation with a confident Malaysian Society infused by strong moral and ethical values, living in a society that is democratic, liberal and tolerant, caring, economically just and equitable, progressive and prosperous, and in full possession of an economy that is competitive dynamic, robust and resilient”

Vision for Health Malaysia is to be a nation of healthy

individuals, families and communities, through a health system that is equitable, affordable, efficient, technologically appropriate, environmentally adaptable and consumer- friendly, with emphasis on quality, innovation, health promotion and respect for human dignity, and which promotes individual responsibility and community participation towards an enhanced quality of life.

GOALS OF THE VISION FOR HEALTH focus on wellness focus on the person informed person self-help care provided at home or near to home seamless care tailored services effective, efficient, affordable services

Some major healthcare reforms….Some major healthcare reforms….

SMART PARTNERSHIP

Necessary to maximise the utilisation of resources between private and public sectors

4 vital elements: shared vision

agreement and commitment

building on strengths

actions to overcome weaknesses

SMART PARTNERSHIP

Some examples:

annual dialogues, meetings and seminars joint consultative panel meetings patient referrals to private sector facilities/services engagement of private specialists to public hospitals establishment of accreditation standards

"Malaysia's Telehealth initiative is not just about point-to-point teleconsultation. It incorporates the full spectrum of multimedia technologies to bring about benefits to all players in the health sector. It will transform the healthcare services and shape new relationships between people and their healthcare providers.”

-Minister of Health,Malaysia.

TELEHEALTH IN MALAYSIATELEHEALTH IN MALAYSIA

TELEHEALTH FLAGSHIP APPLICATIONSTELEHEALTH FLAGSHIP APPLICATIONS the technology enabler to realise the Vision for Health part of the government-funded Multimedia Super

Corridor(MSC) the integration of ICT and medical technology to

deliver healthcare empowering the individual, family and community to

manage their health

The Telemedicine Flagship Applications The Mass Customised/Personalised Health

Information and Education Project

(MCPHIE) Lifetime Health Plans Project Continuing Medical Education

(CME) Project Teleconsultation Project

AccessTELECONSULTATION

Medical RecordsLIFETIME HEALTH

RECORDS

Consumer HealthInformation

MCPHIE

Provider HealthInformation

CME

Consumer Healthcare System Provider

HEALTHCARE FINANCING

The universal issues:• How to mobilise sufficient funds• How to allocate• How to control costs

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2 possible Malaysian models:

medical savings account social health insurance

HEALTHCARE FINANCING

MEDICAL SAVINGS ACCOUNT

2 essential components: -a compulsory personal fund with balances

-back-up insurance scheme

HEALTHCARE FINANCING

SOCIAL INSURANCE

- contribution to a centralised health fund by employers and employees

- government contributes on behalf of civil servants and marginalised groups

- community-rated

"Change is inevitable - "Change is inevitable - except from a vending machine."except from a vending machine."

-- Robert C. Gallagher