NATIONAL MEDICAL CARE STATISTICS 2010 EDITED BY : LIM KK, SIVASAMPU S, GOH PP, HISHAM AN MINISTRY OF HEALiTH MALAYSIA NATIONAL MEDICAL CARE STATISTICS 2010 National Medical Care Statistics 2010 October 2012 © Ministry of Health Malaysia Published by: The National Healthcare Statistics Initiative (NHSI) Clinical Research Centre, Ministry of Health 3rd Floor, MMA House 124, Jalan Pahang 53000 Kuala Lumpur Malaysia Tel. : (603) 40439300 / 400 Fax : (603) 40439500 e-mail : [email protected] Website : http://www.crc.gov.my/nhsi This report is copyrighted. Reproduction and dissemination of this report in part or in whole for research, educational or other non-commercial purposes are authorised without any prior written permission from the copyright holders provided the source is fully acknowledged. Suggested citation is Clinical Research Centre. National Medical Care Statistics 2010. Kuala Lumpur 2012. Funding: The National Healthcare Statistics Initiative is funded by a grant from the Ministry of Health Malaysia (MRG Grant No. NMRR-09-842-4718) ISSN 2289-1811 9 7722 89 1810 08 Please note that there is the potential for minor corrections of data in this report. Please check the online version at www.crc.gov.my for any amendments NATIONAL MEDICAL CARE STATISTICS 2010 PREFACE With over 800 Klinik Kesihatan (public health clinics) and 5,000 private primary care clinics in Malaysia, primary care serves as the first point of contact for many of the health needs of Malaysia’s estimated 28 million population. Despite its importance in community healthcare, there has been little information available on the primary care setting. This vacuum poses a great challenge to the coordination of health services, collaboration between public and private sector, policy planning and implementation. It is only with the successful launch of the National Healthcare Establishment and Workforce Survey (NHEWS) Primary Care report in 2009, that we now have some credible demographic data of primary care facilities available in the country. Two reports (Year 2009 and 2010) derived from the annual survey have also been published. The next step forward would be to look at the data on disease burden and treatment modalities used in the primary care setting. It is with this objective that the National Medical Care Survey (NMCS) was carried out to fill the information gap as it explores the morbidity pattern and treatment being given in the primary care setting. Thus, I am convinced that this maiden report will be a very useful reference for many stakeholders of the healthcare sector, including the general public, practitioners, policy makers as well as the industry. In addition, I hope that this report will create more awareness on the importance of primary care in safeguarding the health of the population and that this would later translate into more support for the development of primary care in Malaysia. Last but not least, it is my pleasure to convey my appreciation to all the participants of the survey and the staff from Healthcare Statistics Unit, Clinical Research Centre who have contributed towards the successful completion of the first National Medical Care Statistics (NMCS) 2010. I sincerely hope that the primary care practitioners, particularly those from the private sector, would continue to render us your support in the coming NMCS survey. Thank you. ………………………………… Dato’ Sri Dr. Hasan Abdul Rahman Director General of Health, Malaysia i NATIONAL MEDICAL CARE STATISTICS 2010 CONTENTS PREFACE ................................................................................................................................. i TABLE OF CONTENTS .................................................................................................................... ii LIST OF TABLES ......................................................................................................................... iii ACKNOWLEDGEMENTS .................................................................................................................. iv NATIONAL MEDICAL CARE SURVEY 2010 PROJECT TEAM ............................................................................... v ABBREVIATIONS .......................................................................................................................... vi CHAPTER 1 : INTRODUCTION ........................................................................................................... 1 1.1 : About National Healthcare Statistics Initiative (NHSI) ........................................................................ 2 1.2 : About National Medical Care Survey (NMCS) ............................................................................... 2 1.3 : Objectives ................................................................................................................ 2 General Objectives ........................................................................................................ 2 Specific Objectives ........................................................................................................ 2 CHAPTER 2 : METHODOLOGY .......................................................................................................... 3 2.1 : Survey Tool ............................................................................................................... 3 2.2 : Sampling Frame & Recruitment Strategy ................................................................................... 3 2.3 : Study Period .............................................................................................................. 5 2.4 : Data Collection ............................................................................................................ 5 2.5 : Data Entry & Data Cleaning ................................................................................................ 5 2.6 : Identification of Private Primary Care Clinics ................................................................................ 5 2.7 : Data Coding .............................................................................................................. 6 2.8 : Data Analysis ............................................................................................................. 6 2.9 : Limitations of the Study ................................................................................................... 6 CHAPTER 3 : THE RESPONSE RATE .................................................................................................... 7 CHAPTER 4 : THE ENCOUNTERS ....................................................................................................... 9 CHAPTER 5 : THE REASONS FOR ENCOUNTER ........................................................................................13 CHAPTER 6 : MANAGEMENT OF MORBIDITY ..........................................................................................17 6.1 : Prescribed Medication .................................................................................................... 17 ATC Classification ........................................................................................................17 Types of Drugs Prescribed ................................................................................................ 17 6.2 : Continuity of Care ........................................................................................................ 26 APPENDIX 1 : PARTICIPANTS OF NMCS 2010 ......................................................................................... 27 Public/Ministry of Health ................................................................................................. 27 Private .................................................................................................................. 29 APPENDIX 2 : NMCS 2010 SURVEY FORM .............................................................................................37 ii NATIONAL MEDICAL CARE STATISTICS 2010 LIST OF TABLES Table 1.1 : Healthcare surveys under the NHSI ........................................................................................ 1 Table 3.1 : Number of respondent public and private clinics ........................................................................... 7 Table 4.1 : Characteristic of encounters by age group in NMCS 2010 .................................................................10 Table 4.2 : Characteristic of encounters by sector, sex, nationality and ethnicity in NMCS 2010 ........................................ 11 Table 4.3 : Characteristic of encounters by source of payment in NMCS 2010 ........................................................ 11 Table 5.1 : Number of patients’ reasons for encounter in NMCS 2010 ................................................................ 13 Table 5.2 : Reasons for encounter by ICPC-2 chapter in NMCS 2010, in descending order ............................................ 14 Table 5.3 : Top 50 reasons for encounter in NMCS 2010, in descending order ........................................................ 15 Table 6.1 : Distribution of prescribed medications by ATC level 1 in NMCS 2010, in descending order ................................. 18 Table 6.2 : Distribution of prescribed medications by ATC level 2 in NMCS 2010, in descending order ................................. 19 Table 6.3 : Top 100 most prescribed medications in NMCS 2010, in descending order ............................................... 22 Table 6.4 : Follow up proposed by primary