Morbidity and Process of Care in Urban Malaysian General Practice

The Impact of Payment System

C. L. Teng, Syed Mohamed Al-Junid Syed Junid, Molly Cheah, K. C. Leong, S. K. Kwa

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: The majority of primary care consultations in Malaysia occur in the general practice clinics. To date, there is no comprehensive documentation of the morbidity and practice activities in this setting. Objectives: We reported the reasons for encounter, diagnoses and process of care in urban general practice and the influence of payment system on the morbidity and practice activities. Methods: 115 clinics in Kuala Lumpur, Ipoh and Penang participated in this study. General practitioners in these clinics completed a 2-page questionnaire for each of the 30 consecutive patients. The questionnaire requested for the following information: demographic data, reasons for encounter, important physical findings, diagnoses, investigations ordered, outpatient procedures performed, medical certificate given, medication prescribed and referral made. The morbidity (reasons for encounter and diagnoses) was coded using ICPC-2 and the medication data was coded using MIMS Classification Index. Results: During 3481 encounters, 5300 RFEs (152 RFEs per 100 encounters) and 3342 diagnoses (96 diagnoses per 100 encounters) were recorded. The majority of the RFEs and diagnoses are in the following ICPC Chapters: Respiratory, General and unspecified, Digestive, Neurological, Musculoskeletal and Skin. The frequencies of selected aspects of the process of care (rate per 100 encounters) were: laboratory investigations 14.7, outpatient procedures 2.4, sick certification 26.9, referral 2.4, and medication prescription 244. Consultation for chronic diseases and acute infections were influenced more by demographic variables (age, employment) rather than payment system. Cash-paying patients were more likely to receive laboratory investigations and injections. Conclusion: This study demonstrated the breadth of clinical care in the general practice. Relatively fewer patients consulted specifically for preventive care and treatment of chronic diseases. The frequencies of outpatient procedures and referrals appeared to be low. Payment system results in important differences in patient mix and influences some types of practice activities.

Original languageEnglish
Pages (from-to)365-374
Number of pages10
JournalMedical Journal of Malaysia
Volume58
Issue number3
Publication statusPublished - Aug 2003

Fingerprint

General Practice
Morbidity
Referral and Consultation
Outpatients
Chronic Disease
Demography
Preventive Medicine
Malaysia
Certification
Documentation
General Practitioners
Prescriptions
Primary Health Care
Skin
Injections
Infection
Surveys and Questionnaires

Keywords

  • Family practice
  • Morbidity
  • Payment
  • Practice patterns

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Morbidity and Process of Care in Urban Malaysian General Practice : The Impact of Payment System. / Teng, C. L.; Syed Junid, Syed Mohamed Al-Junid; Cheah, Molly; Leong, K. C.; Kwa, S. K.

In: Medical Journal of Malaysia, Vol. 58, No. 3, 08.2003, p. 365-374.

Research output: Contribution to journalArticle

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