National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 National Healthcare Establishment and Workforce Statistics (Hospital) 2012-2013 January 2015 ©Ministry of Health Malaysia Published by: The National Healthcare Statistics Initiative (NHSI) National Clinical Research Centre Ministry of Health 3rd Floor, MMA House 124, Jalan Pahang 53000 Kuala Lumpur Malaysia Tel Fax E-mail Website : (603) 40439300/400 : (603) 40439500 : hsu@crc.gov.my : http://www.crc.gov.my/nhsi/ This report is copyrighted Reproduction and dissemination of its contents- in part or in whole, for research, educational or non-commercial purposes is authorised without any prior written permission; provided the source is fully acknowledged The suggested citation is ‘National Clinical Research Centre National Healthcare Establishment & Workforce Statistics (Hospital) 2012-2013 Kuala Lumpur 2015’ This report is also available electronically on the website of the National Healthcare Statistics Initiative at: http://www.crc.gov.my/nhsi/ Funding: The National Healthcare Statistics Initiative was funded by a grant from the Ministry of Health Malaysia (MRG Grant No NMRR-09-842-4718) Please note that there is potential for minor corrections of data in this report Please check the online version at http://www.crc.gov.my/nhsi/ for any amendments We welcome any suggestions or further enquiries Please contact us via the channels stated above National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 CONTENTS ACKNOWLEDGEMENTS iv ABOUT NATIONAL HEALTHCARE ESTABLISHMENT AND WORKFORCE SURVEY (NHEWS) – HOSPITAL v MEMBERS OF NHEWS (HOSPITAL) PROJECT TEAM vii MEMBERS OF NHEWS (HOSPITAL) EXPERT PANEL viii SUMMARY OF STUDY PROCESS ix STUDY METHODOLOGY x CONSORT DIAGRAM Consort Diagram NHEWS 2012 (Acute Curative Hospitals) xviii Consort Diagram NHEWS 2013 (Acute Curative Hospitals) xix SURVEY RESPONSE RATE xx ABBREVIATIONS & SYMBOLS xxi EXECUTIVE SUMMARY CHAPTER | HOSPITAL FACILITIES IN MALAYSIA Table 1.1 Acute Curative Hospitals Table 1.1 Categories of Acute Curative Hospitals 10 Table 1.2 Total Inpatient Beds 12 Table 1.2.1 Inpatient Beds in Specialist Hospitals 14 Table 1.2.2 Inpatient Beds in Non-specialist Hospitals 16 Table 1.2.3 Inpatient Beds in Maternity Centres 18 CHAPTER | HOSPITAL MEDICAL DEVICE IN MALAYSIA 22 Table 2.1 Mammogram Machines 26 Table 2.2 Total Mammography and Screening Mammography Performed 28 Table 2.3 Estimated Screening Mammography Performed for Women Aged 40-74 Years, 2012 30 Table 2.4 Estimated Screening Mammography Performed for Women Aged 40-74 Years, 2013 31 CHAPTER | HOSPITAL ACTIVITIES IN MALAYSIA 34 Table 3.1 Hospital Admissions, and Rate of Admissions per Day 36 Table 3.2 Average Length of Stay (ALOS), Bed Occupancy Rate (BOR) and Turnover Interval (TOI) 38 Table 3.3 Average Length of Stay (ALOS) by Categories of Acute Curative Hospitals 40 Table 3.4 Bed Occupancy Rate (BOR) by Categories of Acute Curative Hospitals 42 Table 3.5 Turnover Interval (TOI) by Categories of Acute Curative Hospitals 44 Table 3.6 Emergency Department Visits, General Outpatient Department Visits and Specialist Clinic Visits 46 Table 3.7 Public Specialist Clinic Visits (Medicine, General Surgery, Orthopaedics and Obstetrics & Gynaecology) 48 Table 3.8 Public Specialist Clinic Visits (Paediatrics, Otorhinolaryngology (ENT), Ophthalmology, Psychiatry and Oncology) 49 i National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 CHAPTER | HOSPITAL HEALTH WORKFORCE IN MALAYSIA 52 Table 4.1 Medical Practitioners 54 Table 4.1.1 Specialists and Medical Officers 56 Table 4.1.2 Internal Medicine Specialists 58 Table 4.1.3 Cardiologists, Respiratory Medicine Specialists and Nephrologists 60 Table 4.1.4 Endocrinologists, Neurologists and Rheumatologists 62 Table 4.1.5 Gastroenterologists, Hepatologists and Clinical Haematologists 64 Table 4.1.6 Geriatricians, Infectious Disease Specialists and Dermatologists 66 Table 4.1.7 General Surgeons 68 Table 4.1.8 Colorectal Surgeons, Hepatobiliary Surgeons and Urologists 70 Table 4.1.9 Vascular Surgeons, Cardiothoracic Surgeons and Neurosurgeons 72 Table 4.1.10 Breast & Endocrine Surgeons and Breast Surgeons 74 Table 4.1.11 Plastic & Reconstructive Surgeons and Paediatric Surgeons 76 Table 4.1.12 Obstetricians & Gynaecologists and Paediatricians 78 Table 4.1.13 Emergency Medicine Specialists and Anaesthesiologists 80 Table 4.1.14 Ophthalmologists and Otorhinolaryngologists 82 Table 4.1.15 Orthopaedic Surgeons, Sports Medicine Specialists and Rehabilitation Medicine Specialists 84 Table 4.1.16 Psychiatrists and Oncologists 86 Table 4.1.17 Radiologists and Nuclear Medicine Specialists 88 Table 4.1.18 Pathologists and Forensic Pathologists 90 Table 4.2 Staff Nurses and Staff Nurses with Post-Basic Training 92 Table 4.3 Assistant Medical Officers (AMO) and Assistant Medical Officers with PostBasic Training 94 Table 4.4 Radiographers and Radiographers with Post-Basic Training in Mammography / Computer Tomography (CT) Scan 96 APPENDICES APPENDIX | DEFINITION OF NHEWS (HOSPITAL) TERMINOLOGY 100 APPENDIX | PARTICIPANTS OF NHEWS (HOSPITAL) Participants of NHEWS (Hospital) 2012 105 Hospital Sector: Public/ Ministry Of Health 105 Hospital Sector: Public/ Ministry Of Health/Psychiatric Institution 107 Hospital Sector: Public/ University 108 Hospital Sector: Public/ Ministry of Defence 108 Hospital Sector: Private 109 Participants of NHEWS (Hospital) 2013 112 Hospital Sector: Public/ Ministry Of Health 112 Hospital Sector: Public/ Ministry Of Health/Psychiatric Institution 114 Hospital Sector: Public/ University 114 Hospital Sector: Public/ Ministry of Defence 114 Hospital Sector: Private 115 ii National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 APPENDIX | MALAYSIAN POPULATION, 2010-2013 119 Table A3.1 Total Population in Malaysia by State, 2010-2013 119 Table A3.2 Female Population in Malaysia by State 2010, 2011, 2013 119 Table A3.3 Female Population (aged 50-69 years old) in Malaysia by State, 2012-2013 120 Table A3.4 Female Population (aged 40-74 years old) in Malaysia by State, 2012-2013 120 Table A3.5 Female Population (aged 40-44 years old) in Malaysia by State, 2012-2013 121 Table A3.6 Female Population (aged 45-49 years old) in Malaysia by State, 2012-2013 121 Table A3.7 Female Population (aged 50-54 years old) in Malaysia by State, 2012-2013 122 Table A3.8 Female Population (aged 55-59 years old) in Malaysia by State, 2012-2013 122 Table A3.9 Female Population (aged 60-64 years old) in Malaysia by State, 2012-2013 123 Table A3.10 Female Population (aged 65-69 years old) in Malaysia by State, 2012-2013 123 Table A3.11 Female Population (aged 70-74 years old) in Malaysia by State, 2012-2013 124 Table A3.12 Paediatric (0-14 years old) Population in Malaysia by State, 2010, 2011, 2013 124 Table A3.13 Geriatric (60 years old and above) Population in Malaysia by State, 2010, 2011, 2013 125 APPENDIX | DATA QUALITY STATEMENT 126 APPENDIX | SURVEY PROFILE & RESPONSE RATE ANALYSIS 130 Table A5.1 Survey Profile of NHEWS (Hospital) 2012 & 2013: Public Hospitals 130 Table A5.2 Survey Profile of NHEWS (Hospital) 2012 & 2013: Private Hospitals 131 Table A5.3 Response Rate of NHEWS (Hospital) 2011, 2012 & 2013 132 iii National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 ACKNOWLEDGEMENTS The National Healthcare Statistics Initiative team would like to thank the Director General of Health Malaysia for his continuous support towards this survey and permission to publish the report Also, our sincere appreciation to the following for their participation, assistance, support and contributions: • Deputy Director General of Health (Research and Technical Support), MOH • Deputy Director General of Health (Medical), MOH • Deputy Director General of Health (Public Health), MOH • Director, National Clinical Research Centre (NCRC), National Institutes of Health (NIH) • Director, Medical Development Division, MOH • Director, Medical Practice Division, MOH • Health Informatics Centre, MOH • Private Medical Practice Control Section (National level) • Private Medical Practice Control Unit (State level) • The Association of Private Hospitals of Malaysia (APHM) • All participating Ministry of Health, private, university and Ministry of Defence hospitals which provided or allowed access to their establishment and workforce data • KPJ Healthcare Berhad • Pantai Holdings Berhad • Columbia Asia Sdn Bhd • Ramsay Sime Darby Healthcare Group • Malaysian Medical Council • Training Division, MOH • Members of the NHEWS- Hospital Expert Panel • All medical doctors and support personnel who participated in the NHEWS- Hospital • All those who have supported or contributed to the success of the NHEWS- Hospital and publication of this report Thank you National Healthcare Statistics Initiative (NHSI) Ministry of Health, Malaysia iv National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 ABOUT NATIONAL HEALTHCARE ESTABLISHMENTS AND WORKFORCE STATISTICS (HOSPITAL) Background National Healthcare Establishment and Workforce Statistics (NHEWS) Hospital is an initiative that gathers information on hospitals in the country concerning their services- with emphasis on specialised clinical services, facilities, medical devices, and health workforce The NHEWS survey covers all acute curative hospitals and related specialty services for both public and private sectors (The definition of acute curative care is provided in Appendix 1) However, unlike the NHEWS (Hospital) surveys of previous years (2008/09, 2010, 2011), the current survey reports only acute curative hospitals without distinguishing the specialty services, except when reporting the public hospital specialist clinic visits Further, only one medical device is reported here compared to several devices in the previous reports Besides that, the hospital population frame also has differed between the current and the past NHEWS (Hospital) surveys Revision of inclusion criteria has led to the Ministry of Defence (MOD) hospitals being included in the 2012-2013 survey compared to the previous surveys Objectives General Objective To document the availability and distribution of hospitals/facilities, services, medical devices, and health workforce in the country Specific Objectives • To estimate the number and density (number per population) of hospitals/facilities, services, and health workforce in Malaysia by geographical areas • To map out trends in the number and density of hospitals/facilities, services, and health workforce through consistent and reliable data collection Structure of Report This fourth NHEWS (Hospital) report provides overall statistics on the acute curative hospitals in Malaysia during 2012-2013 It consists of four chapters: • Chapter 1: Hospital Facilities • Chapter 2: Hospital Medical Device (Mammogram Machine) • Chapter 3: Hospital Activities • Chapter 4: Hospital Health Workforce Data prepared for this report has been reviewed by an expert panel of hospital services This review process is identical to that of the previous NHEWS (Hospital) reports Previously, each chapter within the report was written by an expert panel of the respective service Meanwhile for the current report, all chapters were written by members of the NHEWS (Hospital) project team Data will first feature the national picture, and then followed by a drill-down report of sectors within states We have also included data from the 2010/2011 survey in this report; to serve in presenting patterns/ trends within the datasets across multiple time points, wherever the data is available v National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 However, data from the 2010/2011 survey that appears in this report may be dissimilar to data found in the NHEWS (Hospital) 2010 and NHEWS (Hospital) 2011 reports Several reasons contribute to this: • The data may have been corrected following information that we received from the data source providers • Revision of “acute curative care” definition for this current report has led us to reclassify two hospitals that were labelled as “chronic curative care” in the 2011 report as “acute curative care” in the 2012-2013 report These two hospitals were included in all reanalyses of the 2011 survey data presented in this report We did so in order to minimise disharmony among these datasets, and therefore facilitate the three-year comparison • Rerun of non-response analysis of the 2011 survey data to standardise the statistical method to that of the NHEWS (Hospital) 2012-2013 • Revision of calculation method of mean average length of stay (ALOS), mean bed occupancy rate (BOR), and mean turnover interval (TOI) Please refer to study methodology for further details (page xi) • Referring specifically to the doctor workforce data: - Continuing and periodic data cleaning based on updated sources of data verification e.g from the MMC, NSR, and Medical Development Division MOH - The current NHEWS (Hospital) 2012-2013 features only acute curative services, whereas the previous NHEWS (Hospital) featured selected specialty services, which took into account long term care hospitals, therefore included the workforce within these hospitals as well for the count of doctor workforce Thus in this report we present current (2013) and past (2010 & 2011) workforce data that have been standardised to include only doctors working in acute curative hospitals A specific example pertaining to this is the psychiatrist workforce For the NHEWS (Hospital) 2010 & 2011 survey, data included psychiatrists who were working in the psychiatric institutions However in this report we only highlight the 2010 & 2011 data on psychiatrists working in acute curative hospitals The scenario above would have applied to the rehabilitation medicine specialist workforce as well, except that in 2010 & 2011, there were no rehabilitation medicine specialists working in the long term care hospitals being surveyed The NHEWS (Hospital) data was collected based on the needs of our stakeholders Other data users are advised that the inclusion and exclusion criteria, and data definitions used in this report may differ from other sources Any interpretation or comparison should be made with caution The Health Informatics Centre, Ministry of Health Malaysia is the official source of health data in the country Harmonisation of health data for the purpose of international comparisons should preferably be obtained from this official source vi National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 MEMBERS OF NHEWS (HOSPITAL) PROJECT TEAM PRINCIPAL INVESTIGATOR DATUK DR JEYAINDRAN TAN SRI SINNADURAI DR SHEAMINI SIVASAMPU PRINCIPAL CO-INVESTIGATORS DR GOH PIK PIN DATO’ DR NOORAINI BABA CO-INVESTIGATORS DR MD KHADZIR SHEIKH AHMAD MR ZAMANE ABDUL RAHMAN DR LAILI MURNI MOKHTAR PROJECT LIASON OFFICERS DR AFIDAH ALI DR YEO SIEW LIAN PROJECT MANAGERS DR FOO CHEE YOONG DR AIMI NADIAH JAMEL MRS FATIHAH MAHMUD SURVEY COORDINATORS MS KAMILAH DAHIAN MS KASTURI MANOHARAN ASSISTANT SURVEY COORDINATOR MS SITI HASLINA OTHMAN DATA ANALYST DR FOO CHEE YOONG DATABASE DEVELOPER/ ADMINISTRATOR ALTUS SOLUTIONS SDN BHD vii National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 MEMBERS OF THE NHEWS (HOSPITAL) EXPERT PANEL EXPERT PANEL INSTITUTION Datin Dr Nor Akma Yusuf Medical Development Division, Ministry of Health Dr Laili Murni Mokhtar Medical Development Division, Ministry of Health Dr Khalid Ibrahim Hospital Sungai Buloh Matron Rosena Abd Ghani Nursing Division, Ministry of Health Mrs Jasintha Sangarapillai Department of Diagnostic Imaging, Hospital Kuala Lumpur Ms Lim Jew Heang Medical Record Department, Hospital Selayang Tuan Haji Wan Azmi Mohd Medical Assistant Board, Medical Practice Division, Ministry of Health viii National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 Table A3.5 Female Population (40-44 years old) in Malaysia by State, 2012-2013 State 2012 2013 Malaysia 906,900 915,300 Selangor 184,600 191,200 Johor 108,100 109,100 Sabah 93,700 97,000 Sarawak 78,000 79,300 Perak 72,000 70,400 Kedah 63,500 63,400 WP Kuala Lumpur 62,600 60,600 Pulau Pinang 56,700 57,400 Kelantan 47,300 47,000 Pahang 41,100 41,700 Negeri Sembilan 31,000 31,000 Terengganu 29,800 29,800 Melaka 26,900 26,100 Perlis 7,000 6,700 WP Labuan 2,700 2,800 WP Putrajaya 1,800 1,900 Source: Department of Statistics, Malaysia, 2012 & 2013 Used for density calculations in Chapter (Medical Device) only Table A3.6 Female Population (45-49 years old) in Malaysia by State, 2012-2013 2012 2013 Malaysia 816,100 836,900 Selangor 152,300 158,000 Johor 96,000 98,900 Sabah 75,600 78,600 Perak 73,000 73,600 Sarawak 69,100 70,700 Kedah 60,100 61,200 WP Kuala Lumpur 55,100 58,700 Pulau Pinang 50,700 52,100 Kelantan 46,900 47,100 Pahang 40,400 40,200 Negeri Sembilan 30,800 30,800 Terengganu 29,100 29,200 Melaka 25,700 26,600 Perlis 7,300 7,400 WP Labuan 2,300 2,400 WP Putrajaya 1,500 1,600 Source: Department of Statistics, Malaysia, 2012 & 2013 Used for density calculations in Chapter (Medical Device) only 121 APPENDIX 3: MALAYSIAN POPULATION 2010-2013 State National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 Table A3.7 Female Population (50-54 years old) in Malaysia by State, 2012-2013 State 2012 2013 Malaysia 705,600 723,000 Selangor 122,600 127,800 Johor 84,000 85,400 Perak 68,900 69,400 Sarawak 59,700 61,800 Sabah 59,600 62,200 Kedah 54,800 55,500 Pulau Pinang 44,700 45,500 Kelantan 43,100 43,900 WP Kuala Lumpur 42,500 43,700 Pahang 38,100 38,800 Negeri Sembilan 29,500 29,700 Terengganu 26,000 26,700 Melaka 22,200 22,500 Perlis 6,700 6,700 WP Labuan 1,700 1,800 WP Putrajaya 1,500 1,500 Source: Department of Statistics, Malaysia, 2012 & 2013 Used for density calculations in Chapter (Medical Device) only Table A3.8 Female Population (54-59 years old) in Malaysia by State, 2012-2013 State 2012 2013 Malaysia 568,100 594,700 Selangor 92,400 97,800 Johor 69,300 72,500 Perak 61,200 62,700 Sarawak 48,700 50,000 Kedah 46,500 48,400 Sabah 41,500 45,100 Pulau Pinang 38,300 39,500 WP Kuala Lumpur 34,300 36,000 Kelantan 34,200 36,000 Pahang 30,400 32,000 Negeri Sembilan 24,900 26,000 Terengganu 20,000 21,200 Melaka 18,600 19,300 Perlis 5,800 5,900 WP Labuan 1,200 1,200 900 1,100 WP Putrajaya Source: Department of Statistics, Malaysia, 2012 & 2013 Used for density calculations in Chapter (Medical Device) only 122 National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 Table A3.9 Female Population (60-64 years old) in Malaysia by State, 2012-2013 State 2012 2013 Malaysia 442,100 456,100 Selangor 74,400 75,400 Johor 53,200 55,300 Perak 52,800 53,500 Sarawak 37,700 39,200 Kedah 35,500 37,100 Pulau Pinang 31,700 32,500 Sabah 26,600 28,500 Kelantan 26,100 26,800 WP Kuala Lumpur 25,600 26,800 Pahang 24,400 24,800 Negeri Sembilan 18,500 19,500 Melaka 15,600 15,700 Terengganu 14,400 15,000 4,600 4,700 WP Labuan 700 800 WP Putrajaya 300 300 Perlis Source: Department of Statistics, Malaysia, 2012 & 2013 Used for density calculations in Chapter (Medical Device) only Table A3.10 Female Population (65-69 years old) in Malaysia by State, 2012-2013 2012 2013 Malaysia 303,400 326,800 Selangor 47,000 53,200 Perak 37,100 40,300 Johor 35,700 38,600 Sarawak 27,300 28,400 Kedah 23,700 25,300 Pulau Pinang 22,500 24,200 Sabah 19,500 20,100 Kelantan 19,200 20,100 WP Kuala Lumpur 17,600 18,800 Pahang 16,200 17,900 Negeri Sembilan 12,100 13,100 Melaka 10,900 11,900 Terengganu 10,700 10,900 3,200 3,300 WP Labuan 500 500 WP Putrajaya 100 100 Perlis Source: Department of Statistics, Malaysia, 2012 & 2013 Used for density calculations in Chapter (Medical Device) only 123 APPENDIX 3: MALAYSIAN POPULATION 2010-2013 State National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 Table A3.11 Female Population (70-74 years old) in Malaysia by State, 2012-2013 State 2012 2013 Malaysia 214,800 214,200 Selangor 28,600 28,300 Perak 28,400 27,300 Johor 25,700 25,400 Sarawak 19,200 20,300 Kedah 19,000 18,100 Pulau Pinang 16,000 16,100 Sabah 14,200 14,900 Kelantan 13,600 13,800 WP Kuala Lumpur 11,600 12,100 Pahang 11,100 10,700 Negeri Sembilan 9,100 8,900 Terengganu 8,100 8,100 Melaka 7,600 7,500 Perlis 2,400 2,300 WP Labuan 300 300 WP Putrajaya 100 100 Source: Department of Statistics, Malaysia, 2012 & 2013 Used for density calculations in Chapter (Medical Device) only Table A3.12 Paediatric (0-14 years old) Population in Malaysia by State, 2010-2013 State 2010 2011 2013 Malaysia 7,827,907 7,784,600 7,741,300 Perlis 1,372,012 1,378,700 1,391,500 Kedah 1,026,161 922,100 932,400 Pulau Pinang 910,413 907,600 893,000 Perak 626,615 631,900 608,100 Selangor 571,559 564,600 551,900 WP Putrajaya 497,464 535,900 529,200 WP Kuala Lumpur 452,801 448,600 449,200 Negeri Sembilan 370,204 371,200 378,700 Melaka 361,081 359,200 354,700 Johor 334,533 349,900 351,000 Pahang 271,214 276,000 274,000 Terengganu 215,670 215,000 211,600 Kelantan 183,393 710,400 697,100 Sarawak 58,435 61,300 61,300 Sabah 25,064 26,600 27,600 WP Labuan 22,354 25,600 29,800 Source: Department of Statistics, Malaysia, 2010, 2011 & 2013 Used for density calculations in Chapter (Workforce- Doctor) only 124 National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 Table A3.13 Geriatric (60 years old and above) Population in Malaysia by State, 2010-2013 State 2010 2011 2013 Malaysia 2,251,216 2,338,300 2,542,600 Selangor 334,289 347,900 383,900 Perak 280,118 289,100 310,300 Johor 278,028 287,300 311,600 Kedah 184,087 189,700 203,000 Pulau Pinang 159,285 165,900 181,100 Sabah 138,386 150,400 167,700 Kelantan 135,935 140,800 149,300 WP Kuala Lumpur 127,825 132,000 147,000 Pahang 122,719 127,600 138,200 Negeri Sembilan 91,920 96,500 106,600 Melaka 79,422 81,900 87,900 Terengganu 78,058 80,900 87,000 Sarawak 37,844 39,700 236,700 Perlis 25,499 25,900 26,900 3,483 3,700 4,400 981 1,000 1,200 WP Labuan WP Putrajaya APPENDIX 3: MALAYSIAN POPULATION 2010-2013 Source: Department of Statistics, Malaysia, 2010, 2011 & 2013 Used for density calculations in Chapter (Workforce-Doctor) only 125 National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 APPENDIX | DATA QUALITY STATEMENT NHEWS (Hospital) 2012-2013 Quality Statement Dimension Description Data Collector(s): The data was collected by the Health Statistics Unit (HSU) of the National Clinical Research Centre (CRC) Malaysia Collection authority: Under the jurisdiction of the MDD of MOH, public hospitals were directed to participate in this survey and provide access to their available data For private healthcare establishments, legal authorities for the collection of such data by the MOH are provided by (where applicable) the Private Healthcare Facilities and Services Act 1998 and Control of Drugs & Cosmetics Regulation 1984 The relevant regulatory authorities in the MOH are the Medical Practice Division, National Pharmaceutical Control Bureau and Medical Device Bureau respectively They have designated the CRC as their data collection agency Institutional Environment Data Compiler(s): The data was compiled by the same organisation that collected the data Additional information: Statistical confidentiality was maintained by ensuring that the information provided is: - Securely maintained - Used only for statistical purposes - Not inadvertently revealed in any published literature - Used safely as unidentifiable micro-data to support research and analysis Any identified data error will be notified to the public and data user through an online notice published on the organisation website where the report and data are posted All effort will be made to ensure any data error is corrected within working days and be re-released All key data users will be specifically notified through email or telephone Relevance Data topic: The data represents all acute curative hospitals of both public and private sectors within Malaysia for 2012 and 2013 Level of geography: Data is available at national and state level Key Data Items: The key data items produced from this collection include the facilities, medical device, activities and health workforce of the identified hospitals for 2012 and 2013 Numerator/Denominator Source: Numerators and denominators of all the rates, percentages and densities were derived from the same data source and auxiliary sources e.g population census obtained from the Department of Statistics Malaysia (DOS) Additional information: Healthcare establishment and workforce data was collected to assist in evidence based health policy planning and projection The data is a measure of acute curative healthcare establishment characteristic in terms of facilities, activities, medical device and health workforce Key variables have been defined in this survey to assist in data standardisation However, standard international coding or classification was not used, owing to technical limitation 126 National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 Timeliness Data collection: Data was intended to reflect annual hospital statistics The current survey collected data for both years at one point of time However data for each year relates to its own reference period Data availability: Data collection took place in January-April 2014 This was followed by data cleaning, validation, verification and analysis between May-August 2014 The report shall be published with approval from the Ministry of Health, by July of the next calendar year Reference Period: The data reference period is from 1st-Jan-2012 to 31st-Dec-2012 and from 1st-Jan-2013 to 31stDec-2013 Additional information: Updates or revisions of the data may become necessary because new information may become available during the preparation of the report Accuracy Method of Collection: The data was collected using either printed or online survey questionnaires These were distributed to all related healthcare establishments listed under the Ministry of Health and Private Hospital Registry Data Adjustments: The data was adjusted to account for item and/or unit non-responses by using imputation (logical, conditional and regressing) and weighting methods Logical and conditional imputation based on reasonable assumption was used to replace missing data Regression imputation was used for the remaining missing data which had a 5% or less missing rate Despite these efforts, certain variables were found to have a higher missing rate than expected Caution will be needed when interpreting these estimates due to their inaccuracy Percentages of missing values and the imputation status for each variable can be found at Appendix Collection size: All registered acute curative hospitals within the country were included: 345 hospitals in 2012, and 351 hospitals in 2013 Under and over counts: Undercount and over-count of the survey variables will not be known until a post-enumeration survey is conducted to measure how effective the original survey was Additional information: Any sensitive question or topics that may have the potential to cause bias was not collected Manual data cleaning, review and verification with source personnel, and automated data validation were performed to minimize processing errors All hospitals in the country fulfilling the inclusion criteria were accounted for in this survey Coherence Consistency over time: Similar survey methods have been used for this survey in 2009, 2010, and 2011 However, definition of certain health services and key variables has been revised in the present survey to allow for a more practical and reflective interpretation These changes may have affected the value of certain variables collected and, any comparisons with previous years must be treated with caution Numerator/ denominator: The impact of differences between the criteria for numerators and denominators was minor in most cases Data produced from this survey is of cross-sectional nature No time series data was collected Coherence Data collected in this survey is broadly comparable to data of similar nature available from the Health Informatics Centre (HIC) of the Ministry of Health The HIC obtains such data from routine (monthly) data submission by healthcare establishments However, certain data from our survey and from the HIC may not be directly comparable because of differences in definition as well as in inclusion and exclusion criteria Furthermore, additional data have been collected in greater detail in this survey in order to answer specific health policy questions Please refer to the survey questionnaire for more details on the specific survey questions, at our website: www.crc.gov.my/nhsi/survey-form Besides the routine monthly data collected by the HIC, no other similar information or data source are available at the national level 127 APPENDIX 4: DATA QUALITY STATEMENT Additional information: There were no significant changes of the mode of data collection compared to previous years Further, there was no occurrence of substantial local or regional events that that may have had an impact on the data since the last report National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 Interpretability Context: Due to the alterations of certain important definitions in this report, any increasing or decreasing pattern of variable being reported may not reflect the actual situation Specific issues related to this area have been discussed in the write-up of relevant survey chapters Other supporting information: Please refer to the data definition, study methodology, and discussion of limitation of each chapter for further insight Accessibility Contact details: Healthcare Statistics Unit Clinical Research Centre 3rd Floor, MMA House 124 Jalan Pahang 53000 Kuala Lumpur Malaysia Phone: +603-4043 9300 Fax: +603- 4043 9500 Email: hsu@crc.gov.my Website: http://www.crc.gov.my/nhsi Additional information: Custom analysis of anonymised data is available (in spreadsheet format) upon request A printed copy of the report will be mailed to all related hospital administrators upon publication Electronic copy of the report can be downloaded at http://www.crc.gov.my/nhsi In addition, the aforementioned website also has a feature of data visualisation whereby online charting of the data is presented Should it be required, the NHSI team can provide training on analysing and interpreting NHSI data For further information please contact: Name: Health Statistics Unit Telephone Number: +603-40439300 Email Address: hsu@crc.gov.my 128 This page intentionally left blank National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 APPENDIX | SURVEY PROFILE AND RESPONSE RATE ANALYSIS Survey Profile Table A5.1 Outcome Variables, Missing Data and Application of Imputation Methods for the Public Hospitals in the NHEWS (Hospital) 2012-2013 Survey # Outcome variable 2013 Percentage (%) with missing values Imputation Percentage (%) with missing values Imputation Total number of gazetted inpatient beds - - Total number of gazetted functioning inpatient beds - - Total number of inpatient admissions - - Total Inpatient Day (Total Length of Stay) for all discharged patients - - Emergency department visits - - General outpatient department (OPD) visits - - Specialist clinic visits (All) - - Specialist clinic visits (Medicine) - - Specialist clinic visits (General surgery) - - 10 Specialist clinic visits (Orthopaedics) - - 11 Specialist clinic visits (Obstetrics) - - 12 Specialist clinic visits (Gynaecology) - - 13 Specialist clinic visits (Paediatrics) - - 14 Specialist clinic visits (Otorhinolaryngology/ ENT) - - 15 Specialist clinic visits (Ophthalmology) - - 16 Specialist clinic visits (Psychiatry) - - 17 Specialist clinic visits (Oncology) - - 18 Total number of dedicated mammogram machines - - 19 Total number of mammographies performed - - 20 Total number of screening mammographies performed Yes Yes 21 Total number of medical doctors (excluding house officers) - - 22 Total number of staff nurses - - 23 Total number of staff nurses with post-basic training Yes Yes 24 Total number of assistant medical officers - - 25 Total number of assistant medical officers with post-basic training Yes Yes 26 Total number of radiographers - - 27 Total number of radiographers with postbasic training in mammography - - 28 Total number of radiographers with postbasic training in CT scan - - 130 APPENDIX 5:SURVEY PROFILE & RESPONSE RATE ANALYSIS 2012 National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 Table A5.2 Outcome Variables, Missing Data and Application of Imputation Methods for the Private Hospitals in the NHEWS (Hospital) 2012-2013 Survey 2012 # Outcome variable 2013 Percentage (%) with missing values Imputation Percentage (%) with missing values Imputation Total number of gazetted inpatient beds - - Total number of gazetted functioning inpatient beds - - Total number of inpatient admissions - - Total Inpatient Day (Total Length of Stay) for all discharged patients - - Emergency department visits - - General outpatient department (OPD) visits - - Specialist clinic visits (All) Yes Yes Total number of dedicated mammogram machines - - Total number of mammographies performed - - 10 Total number of screening mammographies performed Yes Yes 11 Total number of medical doctors (excluding house officers) - - 12 Total number of staff nurses - - 13 Total number of staff nurses with post-basic training - - 14 Total number of assistant medical officers - - 15 Total number of assistant medical officers with post-basic training - - 16 Total number of radiographers - - 17 Total number of radiographers with postbasic training in mammography - - 18 Total number of radiographers with postbasic training in CT scan - - 131 132 Public Private Total Public Private Total Public Private Total Public Private Total Public Private Total Public Private Total Public Private Total Public Private Total Public Private Total Public Private Total Sector APPENDIX 5:SURVEY PROFILE & RESPONSE RATE ANALYSIS Malaysia Malaysia Malaysia Perlis Perlis Perlis Kedah Kedah Kedah Kedah & Perlis Kedah & Perlis Kedah & Perlis Pulau Pinang Pulau Pinang Pulau Pinang Perak Perak Perak Selangor Selangor Selangor WP Putrajaya WP Putrajaya WP Putrajaya WPKL WPKL WPKL Selangor & WP Putrajaya & WPKL Selangor & WP Putrajaya & WPKL Selangor & WP Putrajaya & WPKL State 135 206 341 na 9 18 10 19 22 28 14 16 30 11 49 60 na 37 41 16 86 102 Population 135 133 268 na 17 10 18 10 16 14 12 26 11 31 42 na 21 25 16 52 68 Respondent 2011 100.00 64.56 78.59 100.00 na 100.00 100.00 88.89 94.44 100.00 88.89 94.74 100.00 45.45 57.14 100.00 75.00 86.67 100.00 63.27 70.00 100.00 na 100.00 100.00 56.76 60.98 100.00 60.47 66.67 % 139 206 345 na 17 10 18 21 27 15 16 31 11 53 64 na 37 42 17 90 107 Population 139 148 287 na 17 10 18 11 17 15 13 28 11 35 46 na 27 32 17 62 79 Respondent 2012 100.00 71.84 83.19 100.00 na 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 52.38 62.96 100.00 81.25 90.32 100.00 66.04 71.88 100.00 na 100.00 100.00 72.97 76.19 100.00 68.89 73.83 % 141 210 351 na 17 10 18 21 27 15 16 31 11 53 64 na 39 44 18 92 110 Population Table A5.3: Number and Percentage of Respondents of the NHEWS (Hospital) Survey by State and Sector, 2011-2013 141 151 292 na 17 10 18 12 18 15 13 28 11 34 45 na 30 35 18 64 82 Respondent 2013 100.00 71.90 83.19 100.00 na 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 57.14 66.67 100.00 81.25 90.32 100.00 64.15 70.31 100.00 na 100.00 100.00 76.92 79.55 100.00 69.57 74.55 % National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 Negeri Sembilan Negeri Sembilan Negeri Sembilan Melaka Melaka Melaka Johor Johor Johor Pahang Pahang Pahang Terengganu Terengganu Terengganu Kelantan Kelantan Kelantan Sarawak Sarawak Sarawak Sabah Sabah Sabah WP Labuan WP Labuan WP Labuan Sabah & WP Labuan Sabah & WP Labuan Sabah & WP Labuan State Public Private Total Public Private Total Public Private Total Public Private Total Public Private Total Public Private Total Public Private Total Public Private Total Public Private Total Public Private Total Sector 15 11 30 41 10 19 10 13 20 12 32 22 27 na 23 28 Population 11 11 17 28 10 18 10 13 20 10 30 22 25 na 23 26 Respondent 2011 100.00 55.56 73.33 100.00 100.00 100.00 100.00 56.67 68.29 100.00 88.89 94.74 100.00 100.00 100.00 100.00 100.00 100.00 100.00 83.33 93.75 100.00 60.00 92.59 100.00 na 100.00 100.00 60.00 92.86 % 16 4 11 28 39 10 19 10 13 20 12 32 22 27 na 23 28 Population 15 4 11 17 28 10 18 10 13 20 29 22 26 na 23 27 Respondent 2012 100.00 88.89 93.75 100.00 100.00 100.00 100.00 60.71 71.79 100.00 88.89 94.74 100.00 100.00 100.00 100.00 100.00 100.00 100.00 75.00 90.63 100.00 80.00 96.30 100.00 na 100.00 100.00 80.00 96.43 % 16 4 11 29 40 10 19 10 13 20 13 33 23 28 na 24 29 Population 15 4 11 17 28 10 18 10 13 20 29 23 27 na 24 28 Respondent 2013 Table A5.3 [continued]: Number and Percentage of Respondents of the NHEWS (Hospital) Survey by State and Sector, 2011-2013 100.00 88.89 93.75 100.00 100.00 100.00 100.00 58.62 70.00 100.00 88.89 94.74 100.00 100.00 100.00 100.00 100.00 100.00 100.00 69.23 87.88 100.00 80.00 96.43 100.00 na 100.00 100.00 80.00 96.55 % National Healthcare Establishment & Workforce Statistics Hospital 2012 -2013 133 This page intentionally left blank