Design & Health 8 TH WORLD CONGRESS AND EXHIBITION Kuala Lumpur, 27 June 1 July 2012 Policy and Framework on Healthcare Facilities in Malaysia Othman Warijo 1, A Rahim Mohamed 2, 1 Ministry of Health Malaysia and 2 Cyberjaya University College of Medical Sciences
ABOUT MALAYSIA Location: South East Asia Population: 28 million Total area: 329,847 sq km Ethnic groups: - Malay 54 % - Chinese 25% - Indian 7.5% - Other ethnic groups 13.5% Capital city: Kuala Lumpur Federal Government Administrative Centre: Putrajaya Language: Malay (official) English (widely spoken) Climate: Tropics Temperature: 21 to 33 ⁰ C
Health Vision Health System Consumer centered Equitable Affordable Efficient Technologically appropriate Environmentally adaptable Innovative Emphasis Caring, Professionalism & Teamwork Respect for human dignity Community participation Empower the people Take individual responsibility & positive action for their health Appreciate health as a valuable asset Attain their full potential in health 3
Healthcare Service Provision Public Ministry of Health hospital, clinics, health offices Ministry of Higher Learning hospital Ministry of Defence hospital Dept of Occupational Safety and Health Local Authority Anti-Narcotic Agency rehab centre, clinics Social Security Organisation Hospital General Practice clinics Dental clinics Specialist clinics Maternity homes Day-care centres Pharmacy Pathology labs Hemodialysis centres Chemotherapy centres Home Care Nursing T&CM practice centres Private Nongovernment Organisations Ambulance service Emergency care Community care 4
Healthcare Facilities (2010) Public (Ministry of Health) Hospital 131 Health Clinic 2833 Mobile Health Clinic 165 1Malaysia Clinic 53 1Malaysia Mobile Clinic 3 Dental Clinic 34 Mobile Dental Chair 25 Special Medical Institution 6 Flying Doctor Station 13 Public (Non-MoH) Hospital 8 Private Hospital 217 Maternity Home 22 Nursing Home 12 Hospice Centre 3 Ambulatory Care Centre 36 Hemodialysis Centre 191 Community Mental Health Centre Medical Clinic 6442 Dental Clinic 1512 1 5
Healthcare Facilities (2010) 1.Network of hospitals (Norm 2 bed/1000 population, 37,793 beds) i. State Hospitals ii. District Hospitals iii. Special Medical Institution Rehabilitation, National Heart Institute, National Cancer Institute. Private Hosp - 217 with 13,186 beds 14 State Hospitals + HKL (45 services) 42 Hospitals with specialists 75 Hospitals (Visiting Specialists) 6
Healthcare Facilities (2010) 2. Health Clinics (2,833 Health & Community Clinics) Type 1- Attendance > 1000 patients/day 2-500-1000 patients/day 3-300-500 patients/day 4-150-300 patients/day 5-50-150 patients/day 6- Less than 50 patients/day PRIVATE CLINICS 6442 7
Health Facilities in a District DISTRICT HEALTH OFFICE (Total No: 141) DISTRICT HOSPITAL HEALTH CLINIC (20-40,000 populations) OUTREACH TEAMS COMMUNITY CLINIC (2-4,000 pop) * Dec 2006 8
Primary Health Care: A Comprehensive and Deconcentrated system 1960 Mother & child Family planning Outpatient Mother & child Family planning Outpatient Environmental School 1980 Environmental School Dental Pharmacy Lab 2000 Mother & Child Family Planning Outpatient Environmental School Dental Pharmacy Lab Child with Special Need Reproductive Clinic HEALTH CLINICS No. : 2833* Elderly Clinic Diabetes Clinic Coverage: 20,000 pop Adolescent Clinic Occupational Health Emergency Care Rehabilitation 9 Mother & Child Family Planning Outpatient Environmental School Dental Pharmacy Lab Children with Special Need Reproductive Health Elderly Health Diabetes Care Adolescent Health Occupational Health Emergency Care Rehabilitation Hypertension Care Rehabilitation Services Needle/Syringe Exchange Methadone Maintenance Therapy HIV/STI service PLKN/DTS/ Prison Health Services 2010 9
The Rural Health Teams MOBILE TEAM RURAL HEALTH STAFF FLYING DOCTOR SERVICE VILLAGE HEALTH TEAM Courtesy from Sarawak State Health Dept 10
New Facilities (1Malaysia concept) 11
Malaysian Healthcare Scenarios Public Healthcare Facility Development Need to juggle between - limited fund vs competing needs - quantity vs quality
Health Clinic Modification Health Screening Combating NCD: Comprehensive health screening Self-assessment 13
Health Clinic Modification Improving Diabetes Care Combating NCD: Resource Centre Fundus Camera 14
Health Clinic Modification Segregating infectious cases: Triaging Infection/Fever Clinic Coughing Corner 15
Health Clinic Modification Managing Waiting Time: Information Counter Appointment System Express line Express Dispensing system Extending service hour 16
Hospital Design Initiatives Design Revolution - started in 6 th MP (2001 2005) - adoption of UK Nucleus Hospital Design - compliance to international standards No more standard plans since 6 th MP - unique requirements / needs - site difference - social, cultural differences 17
Hospital Design Initiatives Design Revolution: Computerisation Isolation room Centralised medical gas Flooring Pneumatic tube 18
Hospital Design Initiatives Design Revolution: Therapeutic Garden Patient cubicle/room Nurse call system Visitor s lounge Visitor s lodge 19
Optimizing Utilization Health clinics: Extended operation time After office-hours (up to 9:30 pm) Open early (7:30 am) Lunch-time service Pre-hospital care Common registration counter Common consultation rooms Common Patient Resource Centre Hospitals: Extending surgical operating hours Extending surgical operating day (Saturday) Extending hours for outpatient clinics 3 shifts hemodialysis service Drive-through dispensing 20
CONCLUSIONS To cope with never-ending demands and needs: Considering both health/policy need and client s demand Focus on optimal utilization of space and equipment Towards reducing/balancing development and operating cost 21
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