hospital - Clinical Research Centre

Transcription

MINISTRY OF HEALTH MALAYSIA
NCRC/HSU/2013.1
EDITED BY:
Sivasampu S, Arunah C
Kamilah D, Fatihah M
Goh PP, Hisham AN
NATIONAL HEALTHCARE
E S TA B L I S H M E N T &
WORKFORCE STATISTICS
HOSPITAL
2 0 1 1
N AT I O N A L H E A LT H C A R E S TAT I S T I C S I N I T I AT I V E
NATIONAL HEALTHCARE ESTABLISHMENT & WORKFORCE STATISTICS 2011
HOSPITAL
National Healthcare Establishment and Workforce Statistics (Hospital) 2011
September 2013
©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
: [email protected]
: 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 authorized 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) 2011. Kuala Lumpur 2013.’
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.
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Contents
ACKNOWLEDGEMENTS
vi
ABOUT NATIONAL HEALTHCARE ESTABLISHMENT AND WORKFORCE SURVEY (NHEWS) – HOSPITAL
vii
MEMBERS OF NHEWS (HOSPITAL) PROJECT TEAM
viii
MEMBERS OF NHEWS (HOSPITAL) EXPERT PANELS
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SUMMARY OF STUDY PROCESS
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STUDY METHODOLOGY
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CONSORT DIAGRAM
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Consort Diagram NHEWS 2011 (Acute Curative Hospitals)
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Consort Diagram NHEWS 2011 (Maternity Services)
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Consort Diagram NHEWS 2011 (General Surgery Services)
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Consort Diagram NHEWS 2011 (Oncology Services)
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Consort Diagram NHEWS 2011 (Psychiatry Services)
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Consort Diagram NHEWS 2011 (Ophthalmology Services)
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ABBREVIATIONS
xxv
SYMBOLS
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CHAPTER 1 | OVERVIEW OF HOSPITALS AND SPECIALISTS SERVICES IN MALAYSIA
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CHAPTER 2 | ACUTE CURATIVE HOSPITAL SERVICES IN MALAYSIA
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Table 2.1 Hospitals Providing Acute Curative Care
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Table 2.2 Types of Hospitals Establishment Providing Acute Curative Care
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Table 2.3 Different Types of Private Hospital’s Entrepreneurship
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Table 2.4 Inpatient beds
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Table 2.5 Operating theatre (OT), Operating Rooms (ORs) and Functioning ORs
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Table 2.6 Doctors and Patients Admission
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Table 2.7 Average Length of Stay (ALOS), Bed Occupancy Rate (BOR), and Turnover Interval (TOI)
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Table 2.8 Average Length of Stay (ALOS) by Acute Hospital Type
14
Table 2.9 Bed Occupancy Rate (BOR)
15
Table 2.10 Turnover Interval (TOI) by Acute Hospital Type
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Table 2.11 Hospital Doctors, Staff Nurses (with and without Post Basic Training)
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Table 2.12 Community Nurses and Assistant Nurses
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Table 2.13 Assistant Medical Officers (AMO)
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Table 2.14 Pharmacists, Physiotherapists, Occupational Therapists, and Dieticians
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Table 2.15 Medical Record Officers and Medical Social Officers
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Table 2.16 Computed Tomography (CT) Scanners and Rate of CT scan Procedures
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Table 2.17 Magnetic Resonance Imaging (MRI) and Rate of MRI Procedures
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Table 2.18 Positron Emission Tomography (PET) and Rate of PET Procedures
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CHAPTER 3 | MATERNITY SERVICES IN MALAYSIAN HOSPITALS AND MATERNITY HOMES
Table 3.1 Hospitals Providing Maternity Services
Table 3.2 Functioning Delivery Beds
Table 3.3 Dedicated OT Facilities and Functioning ORs
Table 3.4 Functional Obstetric High Dependency Unit (HDU) Beds
Table 3.5 Total Deliveries
Table 3.6 Spontaneous Vertex Deliveries (SVD)
Table 3.7 Vaginal Breech Deliveries
Table 3.8 Instrumental Deliveries using Vacuum
Table 3.9 Instrumental Deliveries using Forceps
Table 3.10 Caesarean Surgeries
Table 3.11 Lower Segment Caesarean Section (LSCS), Caesarean Hysterectomy and Hysterotomy
Table 3.12 Multiple Pregnancies Deliveries
Table 3.13 Eclampsia
Table 3.14 Post Partum Haemorrhage (PPH)
Table 3.15 Newborns Delivered & Admitted to Paediatrics, NICU & SCN
Table 3.16 Obstetrics & Gynaecology (O&G) Specialists and Medical Officers
Table 3.17 Staff Nurses and Community Nurses in O&G services
Table 3.18 Staff Nurses with Midwifery and Community Nurses (Public Hospitals Obstetric Ward)
Table 3.19 Staff Nurses with Midwifery and Community Nurses (Public Hospitals Labour Ward)
Table 3.20 Staff Nurses with Midwifery and Community Nurses (Public Hospitals Obstetric HDU)
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CHAPTER 4 | SURGICAL SERVICES IN MALAYSIAN HOSPITALS
Table 4.1 Hospitals Providing General Surgery Services
Table 4.2 Total Surgeons, Operation Theatre (OT) and Theatre Scrub Nurses
Table 4.3 Dedicated Emergency/Trauma Theatres (Public Hospitals)
Table 4.4 General Surgeons and Total Elective Operating Hours (Public Hospitals)
Table 4.5 Elective Cases in General Surgery (Public Hospitals)
Table 4.6 Emergency Cases in General Surgery (Public Hospitals)
Table 4.7 Mastectomies
Table 4.8 Total, Open and Laparoscopic Inguinal Hernia Surgeries
Table 4.9 Total, Open and Laparoscopic Cholecystectomies
Table 4.10 OGDS Scopes and OGDS Cases by Surgical and Medical Specialists (Public Hospitals)
Table 4.11 OGDS Scopes and OGDS Cases (Private Hospitals)
Table 4.12 Colonoscopes and Colonoscopy Cases by Surgical and Medical Specialists (Public Hospitals)
Table 4.13 Colonoscopes and Colonoscopy Cases (Private Hospitals)
Table 4.14 ERCP Scopes and ERCP Cases by Surgical and Medical Specialists (Public Hospitals)
Table 4.15 ERCP Scopes and ERCP Cases (Private Hospitals)
Table 4.16 OGDS Scopes, Colonoscopes and ERCP Scopes
Table 4.17 Theatre Scrub Nurses
Table 4.18 General Surgeons and Anaesthesiologists
Table 4.19 Breast Surgeons, Breast and Endocrine Surgeons
Table 4.20 Vascular Surgeons, Hepatobiliary Surgeons, and Colorectal Surgeons
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CHAPTER 5 | ONCOLOGY SERVICES IN MALAYSIAN HOSPITALS
Table 5.1 Hospitals Providing Oncology Services
Table 5.2 Hospitals Providing Oncology Services (with and without Oncologist)
Table 5.3 Clean Room for Reconstitution of Cytotoxic Drugs
Table 5.4 Hospitals Providing Cytotoxic Drug Reconstitution (CDR) Services
Table 5.5 Chemotherapy Day Care Services, Chemotherapy Beds and Chairs
Table 5.6 Oncologists
Table 5.7 Oncology Trained Nurses, Radiation Therapists and Physicists
Table 5.8 Megavoltage Machines, Brachytherapy Machines and Simulators
Table 5.9 Physics Equipment and Treatment Planning System Devices
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Table 5.10 Equipment Capable of Carrying Out Intensity Modulated Radiotherapy (IMR), Image Guided Radiotherapy (IGRT) & Stereotactic Procedure
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CHAPTER 6 | PSYCHIATRIC SERVICES IN MALAYSIAN HOSPITALS
Table 6.1 Hospitals Providing Psychiatry Services
Table 6.2 Inpatient Dedicated Beds and Functioning Inpatient Dedicated Beds
Table 6.3 Inpatient Psychiatry Admissions, Dedicated Beds and Mean Bed Occupancy Rate
Table 6.4 Follow up Outpatient Visits, New Cases and Referrals from Wards or Emergency Department
Table 6.5 Community Psychiatric and Psychiatric Rehabilitation Services (Public Hospital)
Table 6.6 Hospital Visits with Patients below 18 Years Old and above 60 Years Old
Table 6.7 Methadone Replacement Therapy (MRT) Services & Total MRT Patients (Public Hospital)
Table 6.8 ECT Machines and Procedures
Table 6.9 Psychiatrists
Table 6.10 Clinical Psychologists
Table 6.11 Counsellors in Psychiatry Services (Full Time and Common User)
Table 6.12 Medical Social Workers in Psychiatry Services (Full Time and Common User) (Public Hospital)
Table 6.13 Nurses in Psychiatry
Table 6.14 Assistant Medical Officers in Psychiatry Service (Public Hospital)
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CHAPTER 7 | OPHTHALMOLOGY SERVICES IN MALAYSIAN HOSPITALS
Table 7.1 Hospitals Providing Ophthalmology Services
Table 7.2 Dedicated Ophthalmology Operating Rooms (ORs) (Public Hospitals)
Table 7.3 Ophthalmology Elective Operating Hours (Public Hospitals)
Table 7.4 Cataract Surgery (Day care and Inpatient)
Table 7.5 Glaucoma Surgery (with and without Implant)
Table 7.6 Vitreoretinal Surgeries
Table 7.7 Ophthalmologists
Table 7.8 Optometrists
Table 7.9 Assistant Medical Officers (AMOs) in Ophthalmology Services (Public Hospital)
Table 7.10 Nurses in Ophthalmology Services (Public Hospital)
Table 7.11 Ophthalmology Devices
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APPENDICES
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APPENDIX 1 | LIST OF DEFINITIONS
Chapter 2 : Hospital
Chapter 3 : Obstetrics
Chapter 4 : General Surgery
Chapter 5 : Oncology
Chapter 6 : Psychiatry
Chapter 7 : Ophthalmology
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APPENDIX 2 | PARTICIPANTS FOR NHEWS (HOSPITAL) 2011
Hospital Sector: Public/ Ministry Of Health
Hospital Sector: Public/ Ministry Of Health/Psychiatric Institution
Hospital Sector: Public/ University
Hospital Sector: Public/ Jabatan Kemajuan Orang Asli
Hospital Sector: Private
Hospital Sector: Private/ Maternity Homes
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APPENDIX 3 | MALAYSIAN POPULATION, 2011
Table A3.1 Total Population by State, Malaysia 2011
Table A3.2 Total Population of Females by State, Malaysia 2011
Table A3.3 Number of Live Births by State, Malaysia 2011
Table A3.4 Total Population Under 19 Years Old by State, Malaysia 2011
Table A3.5 Total Population above 60 Years Old by State, Malaysia 2011
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APPENDIX 4 | DATA QUALITY STATEMENT
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APPENDIX 5 | SURVEY PROFILES & RESPONSE RATE
Chapter 2: Hospital Services in Malaysia
Chapter 3: Maternity Services in Malaysian Hospitals and Maternity Homes
Chapter 4: Surgical Services in Malaysian Hospitals
Chapter 5: Oncology Services in Malaysian Hospitals
Chapter 6: Psychiatric Services in Malaysian Hospitals
Chapter 7: Ophthalmology Services In Malaysian Hospitals
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APPENDIX 6 | MEDICAL SUBSPECIALTIES
Table A6.1 Anaesthesiologists, Emergency Medicine Specialists and Paediatricians
Table A6.2 Internal Medicine and Infectious Diseases Specialists
Table A6.3 Nephrologists and Endocrinologists
Table A6.4 Cardiologists and Respiratory Medicine Specialists
Table A6.5 Hepatologists and Gastroenterologists
Table A6.6 Clinical Haematologists
Table A6.7 Neurologists and Rheumatologists
Table A6.8 Geriatric Medicine Specialists
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APPENDIX 7 | OTHER SPECIALTIES IN MEDICINE
Table A7.1 Cardiothoracic and Paediatric Surgeons
Table A7.2 Plastic and Reconstructive Surgeons
Table A7.3 Neurosurgery and Urology Specialists
Table A7.4 Orthopaedic Surgeons and Sport Medicine Specialists
Table A7.5 Radiologists and Nuclear Medicine Specialists
Table A7.6 Pathologists and Forensic Pathologists
Table A7.7 Rehabilitation Medicine Specialists and Otorhinolaryngologists
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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 public, private and university hospitals which provided or allowed access to their establishment and workforce data.
• KPJ Healthcare Berhad
• Pantai Holdings Berhad
• Columbia Asia Sdn Bhd
• Malaysian Medical Council, Association of Private Hospitals of Malaysia, Obstetrical & Gynaecological Society of Malaysia, Malaysian
Psychiatric Association, Malaysian Oncological Society
• Head of Clinical Services, MOH
• Members of NHEWS (Hospital) Expert Panels
• 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
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ABOUT NATIONAL HEALTHCARE ESTABLISHMENT AND WORKFORCE SURVEY (NHEWS) – HOSPITAL
Background
The National Healthcare Establishment and Workforce Survey (NHEWS) – Hospital is an initiative to gather information on the Hospital establishment
and specialty clinical services, facilities, workforce and the medical devices available in the country. This survey covers all acute curative hospitals
and related specialty services within the public and private settings.
The rationale for this survey was to gather the relevant information that would be important for the country to develop an accurate and robust
capacity for evaluating, monitoring and implementing its healthcare policies.
Objectives
General Objective
To document the availability and distribution of the healthcare facilities, services, workforce and devices in the country.
Specific Objectives
• To estimate the number and density of hospital or related healthcare establishments and specialty service in Malaysia by geographical area
• To establish trends in these services through continuous, consistent and reliable data collection
The NHSI data was collected based on the key user needs for local health service research. Other users should understand that the inclusion and
exclusion criteria, service and data definitions used in this report may differ from other sources. Therefore, 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. Harmonization
of health data for the purpose of International comparisons should preferably be obtained from this official source.
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MEMBERS OF NHEWS (HOSPITAL) PROJECT TEAM
PRINCIPAL INVESTIGATOR
PRINCIPAL CO-INVESTIGATORS
DATUK DR. NOOR HISHAM ABDULLAH
DR. SHEAMINI SIVASAMPU
DR. GOH PIK PIN
DATO’ DR. NOORAINI BABA
CO-INVESTIGATORS
DR. MD KHADZIR SHEIKH AHMAD
MR. ZAMANE ABDUL RAHMAN
PROJECT LIASON OFFICERS
DR. LAILI MURNI MOKHTAR
DR. AFIDAH ALI
DR. TAHRANI PERIANA KOVINDEAR
PROJECT MANAGERS
DR. ARUNAH CHANDRAN
DR. FOO CHEE YOONG (JAN 2013 – PRESENT)
MS. FAIZAH AHMAD
SURVEY COORDINATORS
MS. KAMILAH DAHIAN
MRS. FATIHAH MAHMUD
STATISTICIAN
MS. LENA YEAP LAY LING
DATABASE DEVELOPER/ADMINISTRATOR
ALTUS SOLUTIONS SDN. BHD.
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MEMBERS OF NHEWS (HOSPITAL) EXPERT PANELS
HOSPITAL SERVICES
EXPERT PANEL
INSTITUTION
Datin Dr. Nor Akma Yusuf
Medical Development Division, Ministry of Health
Dato’ Dr. Hjh. Juita Ghazalie
Hospital Sultanah Bahiyah, Alor Setar
Dr. Siti Zaleha Mohd Salleh
Hospital Selayang
Dr. Laili Murni Mokhtar Medical Development Division, Ministry of Health
Dr. Khalid Ibrahim
Hospital Sungai Buloh
Dr. Farique Rizal Abd Hamid
Matron Hjh. Rosena Abdul Ghani
Nursing Division, Ministry of Health
Dr. Sheamini Sivasampu
National Clinical Research Centre, Ministry of Health
Mrs. Fatihah Mahmud
MATERNITY SERVICES
EXPERT PANEL
INSTITUTION
Dr. Ravichandran Jeganathan
Hospital Sultanah Aminah, Johor Bahru
Dato’ Dr. Ravindran Jegasothy
Hospital Kuala Lumpur
Dr. Sharmini Diana Parampalam
Hospital Seberang Jaya
Dr. Shamala Devi Karalasingam
Dr. Arunah Chandran
Ms. Faizah Ahmad
SURGICAL SERVICES
EXPERT PANEL
INSTITUTION
Dato’ (Mr.) Abdul Jamil Abdullah
Hospital Sultanah Nur Zahirah
Mr. Andrew Gunn Kean Beng
Dato’ (Mr.) Wan Khamizar Wan Khazim
Dato’ (Mr.) Jiffre Din
Hospital Tengku Ampuan Afzan, Kuantan
Dato’ (Mr) Mohamed Yusof Abd. Wahab
Hospital Tengku Ampuan Rahimah, Klang
Mr. Tan Wee Jin
Hospital Pulau Pinang
Mr. Nik Azim Nik Abdullah
Hospital Umum Sarawak
Mr. Yan Yang Wai
Hospital Raja Permaisuri Bainun, Ipoh
Mr. Chuah Jitt Aun
Hospital Queen Elizabeth, Kota Kinabalu
Mr. Clement Edward Thaumanavar
Hospital Tuanku Fauziah, Kangar
Mr. Nik Mohamad Shukri Nik Yahya
Hospital Raja Perempuan Zainab II, Kota Bharu
Ms. Jasiah Zakaria
Hospital Tuanku Jaafar, Seremban
Dr. Tahrani Periana Kovindear
Ms. Faizah Ahmad
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ONCOLOGY SERVICES
EXPERT PANEL
INSTITUTION
Dr. Gerard Lim Chin Chye
Assoc. Prof. (Clinical) Dato’ Dr. Fuad Ismail
Universiti Kebangsaan Malaysia Medical Center
Dr. Nellie Cheah
Dr. Nik Muhd. Aslan Abdullah
Universiti Kebangsaan Malaysia Medical Center
Dr. Lau Kah Liew
Mdm. Lim Yeok Siew
Hospital Ampang
Dr. Hafizah Zaharah Ahmad
Mdm. Sarah Lee Abdullah
Dr. Foo Chee Yoong
Ms. Kamilah Dahian
PSYCHIATRY SERVICES
EXPERT PANEL
INSTITUTION
Dr. Toh Chin Lee
Hospital Selayang
Dr. Lim Chong Hum
Hospital Ampang
Dr. Khairuddin Abdul Wahab
Hospital Melaka
Dr. Azizul Awaluddin
Hospital Putrajaya
Dr. Siti Nor Aizah Ahmad
Dr. Chee Kok Yoon
Dr. Rahima Dahlan @ Mohd Shafie
Hospital Kajang
Dr. Ong Lieh Yan
Hospital Bahagia, Ulu Kinta
Mrs. Fatihah Mahmud
OPHTHALMOLOGY SERVICES
EXPERT PANEL
INSTITUTION
Dr. Elias Hussien
Hospital Selayang
Dr. Anusiah K. Selvaathurai
Hospital Melaka
Dr. Mariam Ismail
Hospital Selayang
Dr. Chandramalar T. Santhirathelagan
Dr. Norlaila Talib
Hospital Serdang
Dr. Thayanithi K. Sandragasu
Dr. Arunah Chandran
Ms. Kamilah Dahian
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SUMMARY OF STUDY PROCESS
CRF Development and Pilot Test
Survey Population
Hospital Induction and CRF Distribution
Q
U
E
Data Collection and Data Entry
R
I
Data Cleaning, Verification and Standardisation
E
S
Data Analysis
Report / Manuscript Writing
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STUDY METHODOLOGY
Survey Population Framework Development
To determine the total hospitals and related healthcare establishment population, we first matched the records of the hospitals in the existing National
Healthcare Establishment and Workforce Survey (NHEWS) Hospital database against the independent databases of the Private Medical Practice Control
Division (private hospitals), and Medical Development Division, MOH (public hospitals). Both, the matched and unmatched records were then reviewed by
the NHEWS team. Verification was conducted by contacting each unmatched site to confirm their operational status and establishment details as of 31st
December 2011.These processes were performed for both the private and public hospital list.All verified changes were updated to our database (Figure 1).
Figure 1 Process of Determining the Total Hospitals, Maternity Homes and Psychiatry Institutions Population
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The NHEWS 2011 survey collected data from all related healthcare establishments in Malaysia that fulfilled the criteria and definition relevant to
the specific survey as shown below:
Table 1 Inclusion and Exclusion Criteria of the Respective Surveys
Survey
Inclusion criteria
Exclusion criteria
Acute Curative Hospital
All general and specialized hospital providing ● Aboriginals (Orang Asli) Hospital
acute curative care
● Military hospitals
● Hospital units of institution, such as prison hospitals
● NGO hospitals
● Long term care hospitals e.g. rehabilitation and palliative care,
nursing homes, leprosy centres and psychiatric institutions
General Surgery Services
Ophthalmology Services
Maternity Services
All hospitals providing general surgical services
All hospitals providing ophthalmology services
All hospitals providing maternity services.
● Hospitals that were non-operational in 2011
Independent, stand-alone general surgery centres
Independent, stand-alone eye clinics or day surgery centre
Public health clinics that conduct deliveries
Psychiatry Services
All maternity homes
All hospitals providing psychiatry services.
Stand alone psychiatric clinics
Oncology Services
All public psychiatric institutions
All hospitals providing basic oncology services
Table 2 Definition of Specialty Services
Service
Definition
Remarks
General Surgical Services Services provided by permanent/ resident ● Include general, breast & endocrine, upper gastrointestinal,
colorectal, vascular, hepatobilliary, trauma and thoracic
or visiting general surgeons with procedures
surgeries
performed within the establishment
● Exclude paediatric, plastic, urology, neurosurgery and
cardiothoracic surgeries
Ophthalmology Services
Obstetric Services
Psychiatry Services
Oncology Services
Services provided by permanent/ resident or visiting
ophthalmologist with procedures performed within
the establishment
Not specified
Services headed by a permanent/ resident
psychiatrists
Services provided by permanent/ resident and Exclude services provided by haematologists and paediatric
visiting medical or clinical oncologists, surgeons oncologists
or respiratory physicians with a special interest
in oncology, including hospitals that deliver basic
chemotherapies
Note: List of data definitions used in this survey are included in Appendix 1.
The total number of the establishments (included and excluded) in the study is summarised in Table 3.
Table 3 Summary of Total Number of Healthcare Establishment by Category
Hospitals by Sector Category of Healthcare Establishment
Public
Private
Acute Curative Hospitals
Total Number
in the Population
Ministry of Health
University
Aboriginals
Psychiatric Institutions
Acute Curative Hospitals (General)
Single Specialty
Maternity Homes
Note: Hospitals excluded from the study are available in Consort Diagram NHEWS Hospital 2011.
Details of hospitals that participated in NHEWS hospital survey are available in Appendix 2.
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3
1
4
124
11
70
Number of Hospitals
Included in the Study
131
3
0
4
124
11
70
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Survey Structure
NHEWS 2011 comprised one main and 5 sub-surveys (Figure 2). The Acute Curative Hospitals survey was the main survey that provided
the population framework. Maternity homes and psychiatric institutions were included only for the specific service surveys. General Surgical,
Ophthalmology and Oncology surveys were conducted using a specific subset of the total hospital population that provides for the specific services.
NHEWS 2011
General Surgery
Services Survey
General Surgery
Services Survey
(n=166)
(Hospitals)
Psychiatry
Services Survey
Psychiatry
Services Survey
(n=90)
(Hospitals)
Opthalmology
Services Survey
Maternity
Services Survey
(n=317)
(Hospitals)
Opthalmology
Services Survey
(n=98)
(Hospitals)
Oncology
Services Survey
Maternity Services
Survey
Acute Curative Hospitals
Survey (n=339)
Oncology
Services Survey
(n=98)
(Hospitals)
Figure 2 NHEWS (Hospital) 2011 Survey Structure
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Maternity
Services Survey
(n=26)
(Maternity Homes)
Psychiatry
Services
Survey (n=4)
(Psychiatric
Institutions)
HOSPITAL
Case Report Form (CRF) Development and Pilot Testing
The CRF was developed by the NHEWS project team with input from the respective NHEWS expert panels. Separate sets of CRFs were developed
for the public and private sector because of their different practices and administrative structures.
Variables were grouped by sections based on their establishment details, facilities, activities and services, workforce and medical device. Two
different types of CRF were developed, Printed and Online. English and Malay versions of the CRF were available for the main hospital survey.
However, only the English version of CRF was used for the specialty services survey. This is to cater for the English literacy among the respondents
for the specialty services; they were most likely to be doctors or nurses and they would not have problems understanding the the CRF in English.
Definitions of services were stated at the beginning of the general surgery, ophthalmology and oncology survey forms to ensure a more accurate
and consistent response since these services are generally poorly defined.
Suitable respondents for certain specialty services were selected from the responding establishment to improve on the reliability of the data.
These included obstetrics, general surgery and psychiatry service survey. This was based on our experiences from the two previous cycles where,
general support staff had shown difficulty in understanding the survey content and providing reliable answers.
Additional feature of historical consistency references was available for respondents who submitted an online CRF upon request. This was
designed to assist in the consistency of data.
A process of verification was incorporated into the CRF: Information on the person who coordinates or completes the survey was first obtained.
This was followed by a verification of the information by the CEO or the relevant Department heads and with their signature incorporated.
Specified text boxes were provided for each question on both of the survey forms. The online forms had incorporated automated validation rules
that applied directly at time of data entry. No data could be submitted if it did not pass the validation rules. Units of certain answers (e.g. in days,
%) were also specified. Answers marked “to be auto calculated” required no input from the respondent.
Lists of the definition of terms and specialty code (for workforce list) were provided at the end of each survey form, and arranged by sections.
The CRFs were pilot-tested with the Person-In-Charge (PIC) of the respective services. Revisions and improvements were then made to the form
accordingly. Lists of definitions used in this survey are included in Appendix 1 of this report.
CRF Distribution
Induction of MOH hospitals was undertaken by briefing the hospital directors or representatives first.
The following documents were distributed to them and in their respective hospitals:
● Survey instruction manual
● An endorsement letter from the State Health Directors (for public hospital) or Association of Private Hospital Malaysia (APHM)
● Username and password access details for electronic CRF
● NHEWS 2010 hospital report
The induction session began with a presentation by a NHEWS hospital team member with a brief overview on the project and the aims of the
survey. This was followed by a demonstration on how to fill in the paper and electronic CRFs. Hospitals that were not represented at the induction
meeting were contacted and briefed later by phone and the survey instrument sets were delivered to them by post.
For private hospitals, the induction was done by sending a compilation of self-explanatory documents to the hospital’s highest authority e.g. CEO.
An endorsement letter by the Association of Private Hospitals Malaysia (APHM) was attached. Follow-up calls were made to each private hospital
to ensure the documents were received.
Hospital representatives were given 2 weeks to complete and submit CRFs. Non responders after this period were contacted and reminded, and
their progress monitored.
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Data Collection
Respondents had the option to choose between two modes of data submission which included:
1. Paper data submission via hardcopy Case Report Form (Printed CRF)
2. Electronic data submission via web application (eCRF)
The processed datasets of the list of doctors for each hospital were pre-uploaded to the online eCRFs to minimize the need for manual data
entry. These datasets were obtained from record matches on the doctor workforce from the previous year’s NHEWS survey against the databases
of Malaysian Medical Council, National Specialist Register (NSR) and Medical Development Division (MDD). The edited list was then sent to the
corresponding heads of services in the MOH or other related authorized personnel for verification.
Data Entry
Data from paper submissions were checked manually and reviewed for their completeness and logical consistency before data entry by trained
members. Data entry through eCRF was submitted directly into the NHEWS database and monitored in real-time basis. Quality of data entry
was constantly checked and maintained by several built-in features such as a compulsory data checking function, consistency checks, auto
calculations and auto default data from the previous year’s survey. Activities performed in the database were recorded by a built-in tracking
system. Historical consistency check was used for repeated variables.
Data Processing
Data cleaning was performed in parallel with data entry and based on the results of edit checks. An edit check is a checking procedure for tracing
doubtful data being entered. The editing was performed by NHEWS team members who were familiar with hospital settings. Any queries were
then attended to by contacting the data entry personnel or any authorised representative at the participant’s site to seek further clarification or
verification.
Exploratory data analysis was performed before database locking to ensure that the data was acceptable for analysis. Data duplication, range and
consistency checks were done to detect outliers and data that deviated; these procedures were undertaken with the source data providers. In cases
where the data was not verifiable with the source, cross checks were done against other sources such as the Health Information Management
System Reports, Malaysian Medical Council Doctor Database, professional societies, National Specialist Register and Registry Central Surveys.
Statistical and Estimation Procedures
NHEWS uses the census of all hospitals and related establishments from the Medical Development Division and the Private Healthcare Registration
and Enforcement Unit (CKAPS) to derive its estimates of the total facility, devices, activity and workforce of related healthcare services within the
country. As participation is voluntary, non-response was anticipated and two sources of non-response were accounted for:
Unit non-response – occured as a result of the healthcare establishment not responding to the survey.
Item non-response – occured as some respondents returned partially completed survey forms.
A survey unit will be considered as non-response if the item non-response exceeds 50% of the total questions.
Imputation techniques were used to account for item non-response and weighting for unit non-response.
Imputation: Estimating Item Non-Response
The imputation process consists of 2 stages. First, the missing values are imputed with reasonable assumptions (Logical/ Conditional Imputation).
For example, hospitals without CT scans will have zero CT imaging performed. Similarly, it is assumed that centres without operating microscopes
do not perform any cataract surgery.
The remaining missing values after logical and conditional imputation is further accessed for its suitability of other imputation techniques.
Regression imputation is used in cases where the proportion of missing values is less than 5% of the total. One fundamental assumption of
missing data imputation is that respondent and non-respondent share similar characteristics.
Weighting: Estimating Unit Non-Response
Each survey unit will be assigned a weight in order to provide a population estimate of each variable while compensating for the missing
value of unit non-response. The weight is calculated by dividing the population number to respondent number in a stratified manner based on
characteristics that are known for the whole population. These characteristic variables include state, sector, and year of establishment, type of
establishment, bed and staff strength, obtained from the above mentioned census. Each chapter of non-response weight is calculated separately
as different health services differ in terms of their non-response and overall population characteristics. This procedure also assumes similar
characteristics of both respondents and non-respondents.
xvi
HOSPITAL
Estimates of the Total Number of the Device/ Activity/ Facility/ Workforce (T)
Where:
Ti is the number of device/ activity/ facility/ workforce available in the ith facility in the year,
Wi is the calculated weight of the ith facility
Limitation of the Estimating Procedures
NHEWS is a census survey because all in-scope Malaysian Hospitals and related healthcare establishments of study were given the survey forms.
However, because response is not mandatory, there will be a significant level of “respondent-bias” in the data. Because of this non-random
response in our survey, standard errors are not a suitable means of gauging variability.
The fundamental purpose of imputation and weighting is to adjust for bias in the responding units and produce estimates. However, these
procedures can only account for and adjust to known population characteristics. If information for a variable is not known for the whole population,
the adjustment process will not be possible.
Furthermore, as mentioned above, assumptions of the similarity of respondent and non-respondent in terms of their population characteristics
is made when imputation and weighting is used to derive estimates. Thus, if the assumption is wrong i.e. non-respondents are different from
respondents, then the estimates will have a certain degree of bias. The level of bias in the estimates will not be quantifiable without a further study
of the non-respondents.
List of Formula
Facilities, devices, activities and workforce of related healthcare establishment and services are expressed as an absolute count by state, sector
and year.
Turnover interval (TOI) is calculated as:
Where:
B is number of inpatient beds
N is number of inpatient admissions
ALOS is average length of stay
The densities of hospitals and respective healthcare services are calculated as follows:
Number of hospitals and healthcare services details/ 10,000 population =
Number of hospitals and healthcare services details/ million population =
Where:
T is an estimate of the total quantity of the variable available in the country in the year under consideration.
P is the midyear population of Malaysia or the relevant geographic region where the survey was conducted.
xvii
HOSPITAL
For maternity services:
Number of hospitals and healthcare services details/ 10,000 female population =
Where:
P is the midyear female population of Malaysia or the relevant geographic region where the survey was conducted.
Number of hospitals and specialist services details/ 100 deliveries =
Number of hospitals and specialist services details/ 1,000 deliveries =
Where:
P is the total obstetric deliveries of Malaysia or the relevant geographic region where the survey was conducted.
Details of the Malaysian population statistics for 2011 by state are available in Appendix 3.
Data-Set Finalisation and Locking
All processed data were reviewed by the project team and all members of the expert panel to ensure validity and accuracy before the finalization.
The decision to lock the data-set was made by the project team only after the finalization. No further amendments to the data-set were allowed
except for errors supported by valid evidence as determined by the project team and/or expert panel. All amendments of data-set, if any, must be
approved by the co-investigator(s).
Data Security
The NHEWS hospital data collection was authorized under the Private Healthcare Facilities and Services Act 1998. However, participation was
voluntary. Data collected in the NHEWS survey is regulated by the Personal Data Protection Act 2010 where applicable. All information collected
is held in the strictest confidence and according to legal and research ethics guidelines.
Data Quality
A full description of data quality of the data set is contained in Appendix 4.
xviii
HOSPITAL
CONSORT DIAGRAM NHEWS 2011 (ACUTE CURATIVE HOSPITALS(a))
Total number of hospitals in Malaysia
Losses (Closed premise), n = 4
n = 353
1. Establishments ceased operations = 2
a. Multimedic Specialist & Maternity Centre
b. Hope Children Hospital – Farlim
Number of hospitals (operational)
n = 349
2.Establishment changed from Hospital
to Maternity Home =2
a. Pusat Rawatan Mahsuri
b. Klinik Wanita Nara
Excluded, n = 6
Public
Private
n = 138
n = 208
Ministry of Health
Aboriginals (JAKOA)
n = 137
n=1
University
n=3
(b)
1. Zero beds, n = 1
a.Hospital Tuaran
2. Chronic (curative) care(b), n = 5
Excluded, n = 1
Excluded, n = 3
1.Chronic (curative) care(b), n = 1
1. Chronic (curative) care(b), n = 2
a.Columbia Asia Extended
Care Hospital – Shah Alam
a. Hospital Kemajuan Orang Asli
a.Leprosy, n = 1
b. Pudu Specialists Centre
i. Rajah Charles Brooke
Memorial Hospital
2. Fertility centre = 1
a.TMC Women’s Specialist
(Kuantan) Sdn. Bhd.
b. Psychiatry, n = 4
i. Hospital Mesra Bukit Padang
ii. Hospital Bahagia Ulu Kinta
iii.Hospital Permai
iv.Hospital Sentosa
Included
Included
Included
n = 131
n = 205
n=3
Total in-scope hospitals
n = 339
(a) Acute Curative Hospital
ALOS<10 days
Analysis
(b) Chronic Curative Hospital
ALOS≥10 days
Note: List of new hospitals in 2011, n = 8:
Ministry of Health
1. Hospital Queen Elizabeth II
Private
2. Columbia Asia Extended Care Hospital – Seremban
3. Columbia Asia Hospital – Cheras
4. Darul Makmur Medical Centre Sdn Bhd
5. iHeal Medical Centre Kuala Lumpur
6. Pusat Perubatan UniKL-RCMP
7. Bintulu Medical Centre
8. Sethu Medical Centre
Abbreviation: JAKOA – Jabatan Kemajuan Orang Asli (Aboriginals Hospital)
xix
HOSPITAL
CONSORT DIAGRAM NHEWS 2011 (MATERNITY SERVICES)
NHEWS 2011 (Maternity Services)
n = 348
Ministry of Health & University
Private
n = 133
n = 212
Hospital
Hospital
Maternity Centre
Maternity Home
n = 133
n = 119
n = 69
n = 27
Losses, n = 2
Status changed from hospital to
maternity homes
a. Pusat Rawatan Mahsuri
b. Klinik Wanita Nara
Losses, n = 1
Establisments ceased operations
Losses, n = 1
a. Multimedic Specialist &
Maternity Centre
Establishments closed operations
a. Asia Maternity Homes
Excluded, n = 1
Excluded, n = 2
No admissions
a. Helen Ngu Women Hospital
1. Zero beds
a.Joe Medical Centre - Pandan Jaya
b.Joe Medical Centre - Pandan Indah
Included
Included
Included
Included
n = 133
n = 119
n = 65
n = 26
Total In-scope Establishment with Maternity Services
n = 343
Analysis
Note:
List of new private hospitals with maternity services in 2011, n = 2:
1. Pusat Perubatan UniKL-RCMP
2. Darul Makmur Medical Centre
List of new maternity centre in 2011, n = 1:
1. Sethu Medical Centre
xx
HOSPITAL
CONSORT DIAGRAM NHEWS 2011 (GENERAL SURGERY SERVICES)
NHEWS 2011 (General Surgery Services)
n = 169
Private
Public
n = 109
n = 60
Excluded, n = 3
Provide only consultation
a) Klinik Bersalin Yasmin
b) Sentul Medical Centre
c) Hospital Pusrawi SMC
Included
MOH Non-Specialist
Hospital
MOH Specialist
Hospital
University
Hospital
n = 106
n=7
n = 50
n=3
Included
Included
Included
n=7
n = 50
n=3
Total In-scope Establishment with General Surgery Services
n = 166
Analysis
Abbreviation: MOH – Ministry of Health
xxi
HOSPITAL
CONSORT DIAGRAM NHEWS 2011 (ONCOLOGY SERVICES)
NHEWS 2011 (Oncology Services)
n = 58
Private
Public
n = 27
n = 31
MOH Specialist
Hospital
University
Hospital
n = 28
n=3
Included
Included
Included
n = 27
n = 28
n=3
Total In-scope Establishment with Oncology Services
n = 58
Analysis
Note:
List of hospitals included in 2011 survey but not in 2010 survey
due to the difference in the definition of inclusion criteria, n = 3:
1. Hospital Sandakan
2. Hospital Tawau
3. Hospital Selayang
xxii
HOSPITAL
CONSORT DIAGRAM NHEWS 2011 (PSYCHIATRY SERVICES)
NHEWS 2011 (Psychiatry Services)
n = 94
Private
Public
n = 45
n = 49
University
Hospital
MOH Psychiatry
Institution
Acute Curative
Psychiatry Hospital
n=3
n=4
n = 42
Included
Included
Included
Included Hospital
n = 45
n=3
n=4
n = 42
Total In-scope Establishment with Psychiatry Services
n = 94
Analysis
xxiii
HOSPITAL
CONSORT DIAGRAM NHEWS 2011 (OPHTHALMOLOGY SERVICES)
NHEWS 2011 (Ophthalmology Services)
n = 102
Private
Public
n = 63
n = 39
Excluded, n = 3
(a)
Included Specialist Hospital
n = 59
Provide only consultation
a) Perdana Specialist Hospital
b) Kota Bharu Medical Centre
c) Columbia Asia Nusajaya
d) Kuantan Clinical Diagnostic
MOH Specialist
Hospital
University
Hospital
n = 36
n=3
Included
Included
n = 36
n=3
Total In-scope Establishment with Ophthalmology Services
n = 98
Analysis
(a) Have visiting ophthalmologist for consultation, but all the procedures to be carried out are referred to hospitals or clinics.
xxiv
HOSPITAL
ABBREVIATIONS
ALOS
Average Length of Stay
AMO
Assistant Medical Officer
APHM
Association of Private Hospitals Malaysia
BER
Beyond Economic Repair
BOR
Bed Occupancy Rate
CDR
Cytotoxic Drug Reconstitution
CEO
Chief Executive Officer
CKAPS
Cawangan Kawalan Amalan Perubatan Swasta
CRF
Case Report Form
CS
Caesarean Section
CT
Computed Tomography
DOS
Department of Statistics
eCRF
Electronic Case Report Form
ECT
Electroconvulsive Therapy
EOH
Elective Operating Hours
ERCP
Endoscopic Retrograde Cholangio-Pancreatography
GA
General Anaesthesia
HDR
High Dose Radiation
HDU
High Dependency Unit
ICU
Intensive Care Unit
IGRT
Image-Guided Radiotherapy
IMRT
Intensity Modulated Radiotherapy
IOP
Intraocular Pressure
IPH
Institute for Public Health
LA
Local Anaesthesia
LDR
Low Dose Radiation
LSCS
Lower Segment Caesarean Section
MDD
Medical Development Division
MMA
Malaysian Medical Association
MMC
Malaysian Medical Council
MREC
MOH Medical Research and Ethics Committee
MRG
Malaysian Research Grant
MRI
Magnetic Resonance Imaging
NHEWS
National Healthcare Establishment and Workforce Survey
NHSI
National Healthcare Statistics Initiative
NICU
Neonatal Intensive Care Unit
NIH
National Institute of Health
NMRR
National Medical Research Register
NRIG
National Radiotherapy Implementation Group
O&G
Obstetrics and Gynaecology
OECD
Organisation For Economic Co-operation and Development
OGDS
Oesophagogastroduodenoscopy
OR
Operating Room
OT
Operating Theatre
PET
Positron Emission Tomography
PIC
Person In-Charge
xxv
PMP
Per Million Population
PMPCS
Private Medical Practice Control Section
PPH
Post Partum Haemorrhage
QA
Quality Assurance
RT
Radiotherapy
SCN
Special Care Nursery
SDP
Source Data Provider
SRS
Stereotactic Radiotherapy
SVD
Spontaneous Vertex Delivery
TOI
Turn Over Interval
UK
United Kingdom
WP
Wilayah Persekutuan
WPKL
Wilayah Persekutuan Kuala Lumpur
HOSPITAL
SYMBOLS
na
not applicable
-
not available
xxvi
Chapter 1
HOSPITAL
| OVERVIEW OF HOSPITALS AND SPECIALISTS SERVICES IN MALAYSIA
Sivasampu S1*, Foo CY1, Tahrani PK1,Arunah C1, Kamilah D1, Fatihah M1, Faizah A1
1. National Clinical Research Centre, Ministry of Health
* Corresponding author.
Our third NHEWS report aims to provide consistent and reliable data on healthcare establishments, activities, selected devices and the workforce
in the country. In addition, it was to show the trends in those activities. This report consists of six chapters. The first chapter covers the overall
statistics on the acute curative hospitals. The other chapters examine the specific healthcare services:
● Chapter 2 : Acute curative hospital establishment survey
● Chapter 3 : Maternity services survey
● Chapter 4 : General surgical services survey
● Chapter 5 : Oncology services survey
● Chapter 6 : Psychiatry services survey
● Chapter 7 : Ophthalmology services survey
Improved methods of data collection and in project management have contributed to better data quality and response rates. Here is the summary
of those changes:
● Development of different and separate Case Report Forms (CRFs) for public and private establishments to accommodate their different practices and
administrative requirements
● Specified definition of each service to avoid ambiguity of inclusion and exclusion criteria
● Suitable respondents were suggested for both private and public sector for more reliable data collection e.g. the operating theatre manager was
identified as the suitable respondent for the surgical chapter.
● Incorporated two levels of data verification process to improve accuracy of data:
m
First level – verified by Hospital Director/ Department Heads before submission
m
Second level – verified with the relevant personnel of the responding establishment during the review process after submission
● Enhancing electronic data validation for online data submissions
● Redefining channels of distributing survey forms to facilitate the process of reaching the appropriate personnel and to shorten the response
and submission times
No.
Service Survey
Survey Population (n)
Response Rate (%)
1
Acute Curative Hospital
339
77.9%
2
Maternity Service
317
81.4%
3
General Surgery Service
166
85.4%
4
Oncology Service
58
100.0%
5
Psychiatry Service
94
95.7%
6
Ophthalmology Service
98
91.8%
Note: Details of item and unit non-response by chapter are available in Appendix 5.
We felt that the improved productivity and efficiency for 2011 was firstly, due to the above changes and secondly, due to the experience gained
from the two previous reports.
1
1
Summary of response rate by chapter:
Overview on Hospitals and Specialists Services in Malaysia
● Enabling historical consistency checks for repeated variables. Any inconsistent data was verified with source personnel and corrected
accordingly.
HOSPITAL
Here we summarise our key findings of this report:
Acute Curative Hospital Survey
● Overall, 51,076 bed facilities were available in 339 acute curative hospitals; the majority of them were public hospitals (73%).
● The hospital admission rates have increased by 8% for both sectors in 2011. The mean bed occupancy rate (BOR) for private hospitals
(41.9%) was lower than that of public hospitals (59.6%).
● Of the hospital healthcare workforces, most doctors (78%), staff nurses (72.4%) and assistant medical officers (AMO) (98.8%) worked in the
public hospitals.
● The use of Computed Tomography (CT) scanners, Magnetic Resonance Imaging (MRIs) and Positron Emission Tomography (PET) scanners
increased by 14%, 15% and 22% respectively in 2011.
● The number of medical doctors has increased over the past 3 years (2009-2011).
Maternity Services Survey
● Three hundred and seventeen hospitals and 26 maternity homes provided maternity services in 2011. These included 130 Ministry of Health (MOH)
hospitals, 3 public University Hospitals and 184 private hospitals.
● Eighty per cent of deliveries were conducted in public hospitals. The Caesarean section rate in private hospitals (34.7%) was almost twice that of the
public hospitals (19.7%).
● The instrumental delivery rate in the public hospitals (3.2 per 100 deliveries) was less than that in the private hospitals (14.85 per 100 deliveries).
● There were 839 obstetricians and gynaecologists (O&G) of whom 327 (39%) worked in the public sector and 512 (61%) in the private sector.
● The ratio of midwifery-trained nurse to delivery beds in specialist hospitals was 1.6 to 1 per shift.
General Surgical Services Survey
● The majority (64%) of hospitals providing general surgical services were from the private sector (n=106).
● There was a marked increase in the number of mastectomies done (18.6%, n=662) over the two years. The private sector reported an increase of
1,414 to 1,993 (41%) over the 2 year period.
● There was an increased preference for laparoscopic inguinal hernia surgery (11.8%) and laparoscopic cholecystectomy (7.3%) over the same period
of time.
● In 2011, there were 557 general surgeons, 298 in the public and 259 in the private sector. When compared to 2010, there was an increase of 21
surgeons (3.9%) all of whom came from the private sector.
Oncology Services Survey
● There were 58 hospitals providing oncology services in 2011, with a density of 0.02 per 10,000 population
● Only 4 hospitals provided data on selected oncology activities, e.g. chemotherapy and radiotherapy with curative intent (please refer to
relevant chapter).
● A total of 67 oncologists were providing services in the country for 2011, with 68% of them serving in the West Coast of Peninsular Malaysia.
● Core oncology devices including 29 simulators, 36 megavoltage machines and 14 brachytherapy machines were available within the country in 2011.
● There was no significant increase in the overall manpower and facilities from 2010.
2
HOSPITAL
Psychiatry Services Survey
● Twenty percent of hospitals in Malaysia provided psychiatric services of which, 49 were public and 45 were private hospitals.
● The majority of the psychiatric services were carried out in the public hospitals; public hospitals providing 88.7% of out-patient care and
97.1% of the in-patient care.
● Most psychiatrists (79.5%, n=186) were employed by the public sector.
● The availability of allied health personnel in psychiatry was low and limited to few centres.
● Overall inpatient and outpatient electroconvulsive therapy (ECT) had decreased to 14% and 1% respectively for 2011 when compared to
2010.
Ophthalmology Services Survey
● Thirty-six MOH, three Universities, and 59 private hospitals provided ophthalmology services in Malaysia with the Klang Valley and Melaka
having the highest density.
● Fifty-two per cent of the cataract surgeries were performed as day care and 48% as inpatient. The majority (70%) of them being done in the
public sector.
● Most of the vitreoretinal surgeries were performed in public hospitals.
● The ratio of ophthalmologist to population was 1 to 76,923 for 2011.
● The private sector had a higher number of ophthalmological devices with the exception of stand-alone vitrectomy and automated perimetry
devices.
1
Overview on Hospitals and Specialists Services in Malaysia
In our appendices, we have also included the number of specialists available in the various specialties and subspecialties other than the 5 fields
mentioned above (Appendices 6 and 7).
3
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Chapter 2
HOSPITAL
| ACUTE CURATIVE HOSPITAL SERVICES IN MALAYSIA
Sivasampu S1*, Fatihah M1*, Akma NY2, Laili MM2, Khalid I3, Siti ZS4, Juita5, Farique5, Rosena O6
1. National Clinical Research Centre, Ministry of Health 2. Medical Development Division, Ministry of Health 3. Hospital Sungai Buloh, 4. Hospital Selayang 5. Hospital Sultanah Bahiyah,
Alor Setar, 6. Nursing Division, Ministry of Health
Summary: This chapter highlights several issues with regards to hospital efficiency in terms of the underutilisation and/
or overutilization of hospital beds, especially in the public hospitals. This is the first time such information on functioning
beds is available from both, the public and private hospitals. Surprisingly, the private specialist hospitals reported low bed
occupancy rates in 2011. With an increasing number of medical doctors in the public hospitals, there is a need to redistribute
them, taking into account the hospital workload (BOR, admission to doctor ratio) and the hospital type (specialists or non
specialists’ hospitals). This chapter also demonstrates the maldistribution of human resources in the public sector both,
at national and state levels, especially those of nurses and assistant medical officers (AMOs) with post basic training.
Furthermore, the proper allocation of medical devices such as PET scanners need to be looked into since an increase in the
use of these devices has been seen over the past three years.
There were 339 acute curative hospitals in 2011, of which 134 were public and 205 were private hospitals. (Table 2.1) There were 8 new acute
curative hospitals in 2011, but only one was public – the Hospital Queen Elizabeth II (HQEII), a 291-bedded hospital in Sabah. During the same
period, two existing private hospitals were closed and another two more had changed their status from hospital to maternity homes. The hospital
designated for the aborigines and one private hospital with average length of stay (ALOS) of more than 10 days were excluded from this year’s
analysis. This raised the total number of private hospitals from 203 in 2010 to 205 in 2011 (Table 2.1).
The response rate increased from 75% in 2010 to 78%in 2011. The endorsement given by Association of Private Hospitals of Malaysia (APHM)
may have contributed to this increase from the private sector (from 59% to 64%). Many of the non respondents (36.6%) were private maternity
centres.
We have categorised the hospitals into three main types (Table 2.2), namely:
•
Non specialist hospitals
These are hospitals without resident/ permanent specialists. They were seen mainly in the public sector. There was only one hospital in the private sector
that fell into this category.
•
Specialist hospitals
These are hospitals that provide secondary and tertiary care (Appendix 1) and also those who provide services for specific disciplines e.g. the National
Heart Institute and the Tun Hussein Onn Eye Hospitals from the private sector and the Institute of Respiratory Medicine from the public sector.
•
Maternity centres are centres that provide obstetric or delivery services. They were all in the private sector.
Facilities
There were 51,076 inpatient beds in all acute curative hospitals, of which 73% (37,493 beds) were in the public hospitals. A new term of
“functioning bed” was introduced in the present report to address the issue of inpatient beds being non-functioning. Without a precise definition
of `functioning beds’, assessing the bed occupancy rate (BOR) may be an issue because, a hospital with high non-functioning bed may have a
misleadingly low BOR despite actually being crowded. Based on this new definition, we found that only 74% of the beds in public hospitals were
reported as `functioning’ (35,415 beds). In contrast, 90 per cent (12,273 beds) of the private hospital beds were functioning (Table 2.4).
2
In 2011, there were 575 operating rooms in public hospitals of which, 511 were functioning (88.9%). These were mostly concentrated in Wilayah
Persekutuan Kuala Lumpur (WPKL) and with a density of 0.5 per 10,000 population (Table 2.5).
ACUTE CURATIVE HOSPITAL SERVICES IN MALAYSIA
In this report, entrepreneurship refers to ownership of the hospitals (Table 2.3). Most of the private hospitals were incorporated as corporate bodies
(84.9%) followed by sole proprietorship (12.7%), partnership (1.5%) and societies (1.0%).
5
HOSPITAL
Activities
The majority (67.9%) of admissions were to the public hospitals. The ratio of the number of admissions to doctors in public hospitals was 181.9
per doctor per year as compared to 316.4 admissions per doctor per year in the private hospitals (Table 2.6). The overall ALOS in 2011 was 3.3
days in the public hospitals and 2.4 days in the private hospitals (Table 2.7). The ALOS for non specialists and specialists’ public hospitals was
2.82 and 3.88 respectively (Table 2.8).
The mean BOR of the public hospitals had increased from 56.2% to 59.6% over three years. Further analysis showed that the mean BOR of the
public specialist hospitals was 70.7% when compared to 50.0% for the non specialists public hospitals (Table 2.9). This shows that the demand
for specialists care has increased (Table 2.9). We feel that underutilisation of non specialist hospitals needs to be addressed. In contrast, the mean
BOR of the private sector has decreased from 46.6 to 41.9% over the three years. The mean BOR for the private specialist hospitals was 52.0%
and it was 22.9% for the maternity centres.
The mean turn over interval (TOI) for public hospitals was 3.4 days in non specialist hospitals and 2 days in specialist hospitals. Melaka had the
lowest TOI with 0.68 days followed by Terengganu 0.74 days and Kedah 0.94. (Table 2.10)
Health Workforce
There were 16,643 doctors serving in all the hospitals in 2011; a density of 5.8 doctors per 10,000 populations (Table 2.11). Of the total, 12,966
(79%) were employed in the public hospitals. For the purposes of this report, medical doctors include hospital clinical specialists and medical
officers only.
There were 58,780 hospital staff nurses, of which 42,548 were in the public and 16,232 in the private sector. The highest density of staff nurses
with or without post basic training was seen in WPKL (Table 2.11). Out of 18,215 staff nurse with post basic training, 16.2 % were employed in
WPKL (Table 2.11) .
There were 8,712 community nurses working in hospitals in 2011, of which 8,474 (97.3 %) were employed by the public hospitals. However, most
(85.3 %) of the 3,091 assistant nurses worked in the private hospitals. The MOH is in the process of phasing out the assistant nurses in the public
sector. At the same time, it is upgrading the training of community nurses to staff nurses (Table 2.12).
There were 6,064 assistant medical officers (AMOs) (with and without post basic training) working in hospitals in 2011. Most were employed by
the public hospitals (Table 2.13).
There were 2,654 pharmacists in 2011 of which 90% were in the public sector. Of the 845 physiotherapist employed, 63% were in the public
sector. Of the 643 occupational therapist employed, 94% were in the public sector and of the 271 dieticians, 70% were in the public sector (Table
2.14). However, of the 473 medical record officers 57% worked in the private sector. By comparison, only 21 medical social officers (9%) worked
in private sector (Table 2.15).
Medical Devices and Procedures
Over the past three years, the number of Computed Tomography (CT) Scanners and Magnetic Resonance imaging (MRIs) in the country has
decreased by 1.4% (Table 2.16 and Table 2.17). But the number of Positron Emission Tomography (PET) scanners available has remained constant
since 2009 (Table 2.18).
Limitations
1. The BOR and TOI of some private hospitals, especially the maternity centres, may have been under-reported because, the number of admissions was
unrealistically low. This may have skewed some of the overall state figures. The NHEWS team has made attempts to query such data. Corrections and
resubmissions have been made to those who have responded. However the data cannot be corrected for the non-responders.
2. In this survey, hospital units of special institution e.g. prison hospitals, military hospitals and hospitals operated by NGOs were excluded. We felt it was
justified because of their unique nature of practice and the kind of patients being served.
3. Only the national average has been highlighted. This may give a misconception of what is going on in some individual hospitals e.g. states that lie below
average may in fact be doing well.
6
HOSPITAL
Table 2.1 Number and Density of Hospitals Providing Acute Curative Care Services in Malaysia by State and Sector, 2009 – 2011
Year 2009
Year 2010
Year 2011
State
Sector
Per 10,000
Per 10,000
Per 10,000
Number
Number
Number
population
population
population
Malaysia
Public
133
134
134
Malaysia
Private
201
203
205
Malaysia
Total
334
0.12
337
0.12
339
0.12
Perlis
Public
1
1
1
Perlis
Private
na
na
na
na
na
na
Perlis
Total
1
0.04
1
0.04
1
0.04
Kedah
Public
9
9
9
Kedah
Private
11
10
9
Kedah
Total
20
0.1
19
0.10
18
0.09
Kedah & Perlis
Public
10
10
10
Kedah & Perlis
Private
11
10
9
Kedah & Perlis
Total
21
0.1
20
0.09
19
0.09
Pulau Pinang
Public
6
6
6
Pulau Pinang
Private
23
23
22
Pulau Pinang
Total
29
0.18
29
0.19
28
0.18
Perak
Public
14
14
14
Perak
Private
15
15
16
Perak
Total
29
0.12
29
0.12
30
0.13
Selangor & WP Putrajaya
Public
11
12
11
Private
46
48
49
Total
57
0.11
60
0.11
60
0.11
WP Kuala Lumpur
Public
4
4
4
WP Kuala Lumpur
Private
41
37
36
WP Kuala Lumpur
Total
45
0.26
41
0.24
40
0.24
Selangor & WP Putrajaya & WPKL Public
15
16
15
Selangor & WP Putrajaya & WPKL Private
87
85
85
Selangor & WP Putrajaya & WPKL Total
102
0.15
101
0.14
100
0.14
Negeri Sembilan
Public
6
6
6
Negeri Sembilan
Private
6
8
9
Negeri Sembilan
Total
12
0.12
14
0.14
15
0.14
Melaka
Public
3
3
3
Melaka
Private
4
4
4
Melaka
Total
7
0.09
7
0.09
7
0.08
Johor
Public
11
11
11
Johor
Private
29
30
30
Johor
Total
40
0.12
41
0.12
41
0.12
Pahang
Public
10
10
10
Pahang
Private
7
7
9
Pahang
Total
17
0.11
17
0.11
19
0.12
Terengganu
Public
6
6
6
Terengganu
Private
1
1
1
Terengganu
Total
7
0.07
7
0.07
7
0.07
Kelantan
Public
10
10
10
Kelantan
Private
3
3
3
Kelantan
Total
13
0.08
13
0.08
13
0.08
Sabah & WP Labuan
Public
22
22
23
Sabah & WP Labuan
Private
6
5
5
Sabah & WP Labuan
Total
28
0.09
27
0.08
28
0.08
20
20
20
Sarawak
Public
Sarawak
Private
9
12
12
Sarawak
Total
29
0.12
32
0.13
32
0.13
2
Abbreviation: na – not applicable; - – not available
7
HOSPITAL
Table 2.2 Number and Density of Types of Hospitals Establishment Providing Acute Curative Care Services in Malaysia by State & Sector, 2011
State
Sector
Non Specialist
Hospital
No.
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Selangor & WP Putrajaya & WPKL
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
72
1
73
0
0
0
5
0
5
5
0
5
2
0
2
9
0
9
3
0
3
0
0
0
3
0
3
3
0
3
2
0
2
5
1
6
6
0
6
4
0
4
6
0
6
15
0
15
12
0
12
Per 10,000
population
0.03
na
0.00
0.03
0.02
0.01
0.04
0.01
0.00
0.00
0.03
0.02
0.02
0.04
0.04
0.04
0.04
0.05
Hospital
with Tertiary
Services
Per 10,000
No.
population
14
38
52
0.02
1
na
1
0.04
1
1
2
0.01
2
1
3
0.01
1
6
7
0.04
1
3
4
0.02
1
12
13
0.02
1
9
10
0.06
2
21
23
0.03
1
1
2
0.02
1
3
4
0.05
1
2
3
0.01
1
0
1
0.01
1
0
1
0.01
1
0
1
0.01
1
0
1
0.00
1
1
2
0.01
Please refer to Appendix 1 for Tertiary, Secondary and Special Institution definition.
Abbreviation: na – not applicable;
- – not available
8
Specialist Hospital
Hospital with
Special
Secondary
Maternity Centre
Institutions
Services
Per 10,000
Per 10,000
Per 10,000
No.
No.
No.
population
population
population
47
1
0
85
11
70
132
0.05
12
0.00
70
0.02
0
0
0
na
na
na
na
na
na
0
0.00
0
0.00
0
0.00
3
0
0
4
0
4
7
0.04
0
0.00
4
0.02
3
0
0
4
0
4
7
0.03
0
0.00
4
0.02
3
0
0
5
4
7
8
0.05
4
0.03
7
0.04
4
0
0
9
0
4
13
0.05
0
0.00
4
0.02
7
0
0
20
2
15
27
0.05
2
0.00
15
0.03
2
1
0
10
4
13
12
0.07
5
0.03
13
0.08
9
1
0
30
6
28
39
0.05
7
0.01
28
0.04
2
0
0
6
0
2
8
0.08
0
0.00
2
0.02
0
0
0
0
1
0
0
0.00
1
0.01
0
0.00
5
0
0
11
0
16
16
0.05
0
0.00
16
0.05
3
0
0
5
0
4
8
0.05
0
0.00
4
0.03
1
0
0
1
0
0
2
0.02
0
0.00
0
0.00
3
0
0
3
0
0
6
0.04
0
0.00
0
0.00
7
0
0
3
0
2
10
0.03
0
0.00
2
0.01
7
0
0
8
0
3
15
0.06
0
0.00
3
0.01
HOSPITAL
Table 2.3 Number and Density of Different Types of Private Hospital’s Entrepreneurship in Malaysia by State, 2011
Number of Sole Proprietor Partnership
Corporate Body
Hospitals
State
in Private
No.
%
No.
%
No.
%
Sector
Malaysia
205
26
12.68
3
1.46
174
84.88
Perlis
0
0
0
0
Kedah
9
0
0.00
0
0.00
9 100.00
Kedah & Perlis
9
0
0.00
0
0.00
9 100.00
Pulau Pinang
22
2
9.09
0
0.00
19
86.36
Perak
16
2
12.50
0
0.00
14
87.50
49
7
14.29
0
0.00
42
85.71
WP Kuala Lumpur
36
4
11.11
2
5.56
29
80.56
85
11
12.94
2
2.35
71
83.53
Negeri Sembilan
9
0
0.00
0
0.00
9 100.00
Melaka
4
0
0.00
0
0.00
4 100.00
Johor
30
4
13.33
0
0.00
26
86.67
Pahang
9
4
44.44
1
11.11
4
44.44
Terengganu
1
0
0.00
0
0.00
1 100.00
Kelantan
3
0
0.00
0
0.00
3 100.00
Sabah & WP Labuan
5
0
0.00
0
0.00
5 100.00
Sarawak
12
3
25.00
0
0.00
9
75.00
Society
No.
%
2
0
0
0
1
0
0
1
1
0
0
0
0
0
0
0
0
0.98
0.00
0.00
4.55
0.00
0.00
2.78
1.18
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
2
Abbreviation: - – not available
9
HOSPITAL
Table 2.4 Number and Density of Inpatient Beds in Acute Curative Hospital in Malaysia by State and Sector, 2010 and 2011
2010
2011
Functioning
Total Inpatient Beds
Total Inpatient Beds
State
Sector
Inpatient Beds
Per 10,000
Per 10,000
Per 10,000
Number
Number
Number
population
population
population
Malaysia
Public
36,256
37,493
35,415
Malaysia
Private
12,605
13,583
12,273
Malaysia
Total
48,861
17.24
51,076
17.63
47,688
16.46
Perlis
Public
404
404
390
Perlis
Private
na
na
na
na
na
na
Perlis
Total
404
17.45
404
17.01
390
16.42
Kedah
Public
2,350
2,390
2,294
Kedah
Private
542
535
530
Kedah
Total
2,892
14.85
2,925
14.82
2,824
14.31
Kedah & Perlis
Public
2,754
2,794
2,684
Kedah & Perlis
Private
542
535
530
Kedah & Perlis
Total
3,296
15.12
3,329
15.06
3,214
14.54
Pulau Pinang
Public
1,939
1,947
1,947
Pulau Pinang
Private
2,135
2,147
2,041
Pulau Pinang
Total
4,074
26.09
4,094
25.69
3,988
25.03
Perak
Public
3,470
3,580
3,324
Perak
Private
988
974
894
Perak
Total
4,458
18.95
4,554
18.99
4,218
17.59
Public
4,797
4,877
4,391
Private
2,836
3,282
2,962
Total
7,633
13.79
8,159
14.43
7,353
13.01
WP Kuala Lumpur
Public
4,137
4,651
4,075
WP Kuala Lumpur
Private
2,859
2,915
2,454
WP Kuala Lumpur
Total
6,996
41.78
7,566
44.65
6,529
38.53
8,934
9,528
8,466
5,695
6,197
5,416
14,629
20.29
15,725
21.40
13,882
18.89
Negeri Sembilan
Public
1,527
1,527
1,513
Negeri Sembilan
Private
428
512
510
Negeri Sembilan
Total
1,955
19.15
2,039
19.55
2,023
19.40
Melaka
Public
1,006
1,006
1,006
Melaka
Private
690
813
686
Melaka
Total
1,696
20.66
1,819
21.84
1,692
20.31
Johor
Public
3,609
3,634
3,578
Johor
Private
1,111
1,126
1,041
Johor
Total
4,720
14.10
4,760
13.99
4,619
13.58
Pahang
Public
1,907
2,030
1,962
Pahang
Private
204
326
324
Pahang
Total
2,111
14.07
2,356
15.45
2,286
14.99
Terengganu
Public
1,342
1,342
1,342
Terengganu
Private
20
33
33
Terengganu
Total
1,362
13.15
1,375
12.80
1,375
12.80
Kelantan
Public
2,399
2,399
2,399
Kelantan
Private
162
162
162
Kelantan
Total
2,561
16.63
2,561
15.86
2,561
15.86
Sabah & WP Labuan
Public
3,962
4,253
3,884
Sabah & WP Labuan
Private
165
269
173
Sabah & WP Labuan
Total
4,127
12.53
4,522
13.28
4,057
11.91
Sarawak
Public
3,407
3,453
3,310
Sarawak
Private
465
489
463
Sarawak
Total
3,872
15.67
3,942
15.67
3,773
14.99
10
HOSPITAL
Table 2.5 Number and Density of Operating theatre (OT), Operating Rooms (OR) and Functioning Operating Rooms (OR) in Acute Curative
Public Hospitals in Malaysia by State 2011
Operating Theatre (OT)
State
Operating Rooms (OR)
Functioning Operating
Rooms (OR)
Per 10,000
population
Number
Per 10,000
population
Number
Per 10,000
population
178
0.06
575
0.20
511
0.18
Perlis
1
0.04
5
0.21
5
0.21
Kedah
12
0.06
39
0.20
29
0.15
Kedah & Perlis
13
0.06
44
0.20
34
0.15
Pulau Pinang
7
0.04
28
0.18
26
0.16
Perak
19
0.08
37
0.15
31
0.13
18
0.03
105
0.19
99
0.18
WP Kuala Lumpur
12
0.07
85
0.50
78
0.46
30
0.04
190
0.26
177
0.24
Negeri Sembilan
6
0.06
15
0.14
14
0.13
Melaka
4
0.05
13
0.16
12
0.14
Johor
13
0.04
47
0.14
39
0.11
Pahang
16
0.10
36
0.24
30
0.20
8
0.07
17
0.16
15
0.14
Kelantan
15
0.09
36
0.22
33
0.20
Sabah & WP Labuan
27
0.08
57
0.17
53
0.16
Sarawak
20
0.08
55
0.22
47
0.19
Terengganu
2
Malaysia
Number
11
HOSPITAL
Table 2.6 Number and Density of Admissions, Admission to Doctors Ratio and Rate of Patients Admission Per Day in Acute Curative
Hospitals in Malaysia by State and Sector, 2010 and 2011
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Number
2,286,079
959,758
3,245,837
28,808
na
28,808
178,728
51,321
230,049
207,536
51,321
258,857
139,734
142,134
281,868
217,608
75,122
292,730
322,814
246,923
569,737
204,172
146,692
350,864
526,986
393,615
920,601
104,661
44,847
149,508
77,711
53,018
130,729
267,297
116,567
383,864
127,637
18,000
145,637
108,551
2,200
110,751
148,758
12,990
161,748
193,087
12,649
205,736
166,513
37,295
203,808
Admission 2010
Per 10,000 Rate per
population
Day
6,263.2
2,629.5
1,145.56
8,892.7
78.9
na
na
1,244.41
78.9
489.7
140.6
1,181.13
630.3
568.6
140.6
1,187.85
709.2
382.8
389.4
1,805.23
772.2
596.2
205.8
1,244.23
802.0
884.4
676.5
1,029.43
1,560.9
559.4
401.9
2,095.21
961.3
1,443.8
1,078.4
1,277.00
2,522.2
286.7
122.9
1,464.19
409.6
212.9
145.3
1,592.12
358.2
732.3
319.4
1,146.44
1,051.7
349.7
49.3
970.40
399.0
297.4
6.0
1,069.03
303.4
407.6
35.6
1,050.58
443.1
529.0
34.7
624.65
563.7
456.2
102.2
824.77
558.4
12
Ratio to
Doctors
198.7
282.4
217.8
240.1
na
240.1
278.8
450.2
304.7
272.7
450.2
295.8
191.2
343.3
246.2
242.9
293.4
254.1
176.4
275.3
208.9
82.3
181.5
106.7
122.3
230.9
153.1
231.0
332.2
254.3
218.3
323.3
251.4
289.3
455.3
325.3
243.1
281.3
247.3
282.7
200.0
280.4
170.4
302.1
176.6
288.2
186.0
278.8
267.3
220.7
257.3
Number
2,381,244
1,123,350
3,504,594
29,721
na
29,721
186,124
49,375
235,499
215,845
49,375
265,220
140,929
177,300
318,229
224,969
76,839
301,808
333,429
271,525
604,954
205,994
245,936
451,930
539,423
517,461
1,056,884
103,034
69,153
172,187
79,441
52,399
131,840
281,388
98,235
379,623
129,537
18,505
148,042
110,374
2,774
113,148
151,102
14,611
165,713
231,719
12,391
244,110
173,483
34,307
207,790
Admission 2011
Per 10,000 Rate per
population
Day
6,524.0
3,077.7
1,209.97
9,601.6
81.4
na
na
1,251.41
81.4
509.9
135.3
1,193.55
645.2
591.4
135.3
1,199.76
726.6
386.1
485.8
1,996.92
871.9
616.4
210.5
1,258.79
826.9
913.5
743.9
1,070.00
1,657.4
564.4
673.8
2,667.04
1,238.2
1,477.9
1,417.7
1,438.27
2,895.6
282.3
189.5
1,651.04
471.7
217.6
143.6
1,582.71
361.2
770.9
269.1
1,115.95
1,040.1
354.9
50.7
970.89
405.6
302.4
7.6
1,053.52
310.0
414.0
40.0
1,025.96
454.0
634.8
33.9
716.66
668.8
475.3
94.0
825.81
569.3
Ratio to
Doctors
181.9
316.4
210.6
212.3
na
212.3
240.8
411.5
263.7
236.4
411.5
256.7
158.7
419.1
242.7
221.4
284.6
234.7
164.7
277.1
201.4
79.0
319.4
133.8
116.5
295.7
165.6
191.9
467.3
251.4
181.0
284.8
211.6
249.0
363.8
271.2
207.3
250.1
211.8
270.5
231.2
269.4
161.8
332.1
169.4
271.7
169.7
263.6
241.3
188.5
230.6
HOSPITAL
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
2009
3.31
3.17
3.23
3.70
na
3.70
2.90
3.79
3.43
2.98
3.79
3.44
4.09
3.24
3.49
2.80
2.27
2.50
3.47
4.84
4.56
6.14
3.31
3.62
4.06
4.27
4.23
2.90
3.23
3.06
3.14
3.31
3.26
3.09
2.05
2.30
3.13
2.46
2.91
2.94
3.00
2.95
3.21
3.48
3.28
3.63
2.00
3.19
3.24
2.06
2.79
ALOS
2010
3.43
2.76
3.03
3.59
na
3.59
2.95
2.59
2.76
3.02
2.59
2.80
3.70
2.50
2.75
2.88
2.13
2.49
5.10
2.76
3.23
6.01
3.92
4.12
5.33
3.27
3.59
2.95
3.29
3.14
3.20
3.53
3.38
3.00
2.09
2.34
3.13
2.28
2.78
2.81
3.00
2.83
3.25
2.29
3.03
3.44
2.80
3.32
3.27
2.05
2.82
2011
3.31
2.35
2.73
3.40
na
3.40
2.93
2.29
2.61
2.98
2.29
2.65
3.82
2.62
2.88
2.95
2.37
2.64
3.47
2.33
2.54
5.90
2.45
2.80
4.12
2.38
2.65
3.20
2.55
2.81
3.31
2.98
3.12
2.98
1.66
2.01
3.24
1.95
2.63
2.88
3.00
2.90
3.27
2.19
3.02
3.46
2.40
3.27
3.19
3.18
3.19
2009
56.22
46.66
50.57
75.11
na
75.11
56.93
46.74
50.86
58.69
46.74
51.87
68.06
60.46
62.72
46.94
39.31
42.60
57.55
55.50
55.92
66.38
46.94
49.09
59.52
52.31
53.55
51.04
59.77
55.35
64.25
55.64
58.50
65.55
37.85
44.35
63.16
63.57
63.29
60.79
65.00
61.72
70.59
50.41
65.37
52.65
25.17
45.24
40.04
30.83
36.54
BOR
2010
56.62
43.71
48.85
67.40
na
67.40
59.79
40.69
49.74
60.55
40.69
50.62
70.53
49.16
53.58
47.70
42.57
45.05
67.42
41.85
46.96
65.65
39.52
42.07
66.98
40.83
44.97
53.90
63.61
59.45
61.37
59.85
60.50
68.84
35.81
44.67
58.37
58.35
58.36
60.47
90.30
64.73
70.29
59.17
67.72
49.43
53.20
50.13
40.87
38.51
39.99
2011
59.59
41.93
48.91
70.94
na
70.94
58.99
47.15
53.07
60.18
47.15
54.01
73.99
44.76
51.03
57.27
38.92
47.48
69.85
42.87
47.82
64.77
44.97
46.95
68.50
43.76
47.47
55.56
65.69
61.64
74.54
53.11
62.29
66.92
29.51
39.55
58.56
29.00
44.55
66.10
69.04
66.52
73.48
55.69
69.37
54.87
37.83
51.83
41.91
39.02
40.83
2009
3.24
6.34
5.07
1.21
na
1.21
2.38
5.97
4.52
2.27
5.97
4.38
2.16
2.20
2.18
3.43
5.18
4.43
2.82
3.44
3.31
4.39
7.44
7.10
3.17
4.93
4.63
3.93
1.75
2.85
2.62
3.00
2.87
2.01
9.77
7.95
2.06
2.62
2.25
2.33
1.98
2.25
1.48
3.16
1.92
4.11
8.21
5.22
5.67
16.94
9.95
TOI
2010
3.35
12.58
8.91
1.53
na
1.53
2.85
5.21
4.09
2.72
5.21
3.96
1.72
15.98
13.03
3.53
2.98
3.24
2.74
12.23
10.34
4.29
23.78
21.87
3.13
17.26
15.02
3.10
2.99
3.04
2.05
3.87
3.09
1.91
15.71
12.00
2.46
5.04
3.52
1.83
0.32
1.61
1.73
2.00
1.79
4.26
2.66
3.96
6.01
4.81
5.56
2011
2.75
20.96
13.76
1.39
na
1.39
2.34
3.01
2.68
2.25
3.01
2.61
1.64
10.26
8.41
2.62
6.47
4.67
1.66
6.24
5.40
4.05
17.56
16.21
2.30
11.03
9.72
2.68
2.18
2.38
1.22
2.84
2.14
1.71
17.32
13.13
2.64
249.73
119.69
1.65
1.35
1.61
1.57
1.70
1.60
3.22
5.92
3.70
5.03
14.10
8.43
2
State
Table 2.7 Mean of Average Length of Stay (ALOS), Bed Occupancy Rate (BOR), and Turnover Interval (TOI) in Acute Curative Hospitals
in Malaysia by State and Sector, 2009 - 2011
Abbreviation: na – not applicable
13
HOSPITAL
Table 2.8 Mean of Average Length of Stay (ALOS) in Malaysia by Acute Curative Hospital Type, State and Sector, 2011
Non Specialist Hospital
Mean ALOS
Specialist Hospital
Maternity Centre
Public
2.82
3.88
na
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
1.00
2.79
na
na
na
2.48
na
2.48
2.48
na
2.48
4.11
na
4.11
2.66
na
2.66
2.52
na
2.52
na
na
na
2.52
na
2.52
3.17
na
3.17
3.00
na
3.00
2.50
1.00
2.22
2.69
na
2.69
2.82
na
2.82
2.74
na
2.74
3.06
na
3.06
2.78
na
2.78
2.52
2.95
3.40
na
3.40
3.49
2.38
2.84
3.47
2.38
2.90
3.68
3.01
3.15
3.47
2.59
2.87
3.83
2.39
2.68
5.89
2.64
3.03
4.52
2.51
2.84
3.24
2.55
2.72
3.93
2.97
3.17
3.38
2.08
2.56
4.07
2.62
3.30
3.00
3.00
3.00
4.06
2.19
3.26
4.22
2.85
3.89
3.81
2.02
2.86
2.02
2.02
na
na
na
na
2.14
2.14
na
2.14
2.14
na
1.92
1.92
na
1.93
1.93
na
2.23
2.23
na
1.60
1.60
na
2.06
2.06
na
na
na
na
na
na
na
1.46
1.46
na
1.29
1.29
na
na
na
na
na
na
na
1.96
1.96
na
6.67
6.67
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
14
HOSPITAL
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
50.00
0.63
49.22
na
na
na
41.83
na
41.83
41.83
na
41.83
58.16
na
58.16
50.64
na
50.64
43.97
na
43.97
na
na
na
43.97
na
43.97
47.75
na
47.75
69.22
na
69.22
61.52
0.63
50.10
52.17
na
52.17
58.00
na
58.00
71.23
na
71.23
47.70
na
47.70
34.15
na
34.15
Maternity Centre
na
22.89
22.89
na
na
na
na
30.18
30.18
na
30.18
30.18
na
30.70
30.70
na
21.29
21.29
na
30.47
30.47
na
14.29
14.29
na
25.99
25.99
na
na
na
na
na
na
na
14.82
14.82
na
10.99
10.99
na
na
na
na
na
na
na
24.35
24.35
na
38.97
38.97
2
Mean BOR
Specialist Hospital
70.73
51.95
57.85
70.94
na
70.94
80.42
57.33
66.93
78.53
57.33
67.30
81.91
52.57
59.04
69.19
47.73
54.58
79.56
49.52
55.54
64.77
51.79
53.34
74.63
50.61
54.54
63.36
65.69
65.11
85.18
53.11
59.52
71.41
58.83
63.44
68.13
47.00
56.95
82.30
69.04
77.88
76.85
55.69
67.78
68.31
51.32
64.27
53.55
39.04
45.87
Table 2.9 Bed Occupancy Rate (BOR) in Malaysia by Acute Curative Hospital Type, State and Sector, 2011
15
HOSPITAL
Table 2.10 Turnover Interval (TOI) in Malaysia by Acute Curative Hospital Type, State and Sector, 2011
Mean TOI
State
Sector
Specialist Hospital
Malaysia
Public
3.44
1.95
Malaysia
Private
157.80
13.30
Malaysia
Total
5.88
9.73
Perlis
Public
na
1.39
Perlis
Private
na
na
Perlis
Total
na
1.39
Kedah
Public
3.47
0.94
Kedah
Private
na
1.73
Kedah
Total
3.47
1.40
Kedah & Perlis
Public
3.47
1.03
Kedah & Perlis
Private
na
1.73
Kedah & Perlis
Total
3.47
1.40
Pulau Pinang
Public
2.89
1.01
Pulau Pinang
Private
na
13.33
Pulau Pinang
Total
2.89
10.61
Perak
Public
3.07
1.81
Perak
Private
na
5.05
Perak
Total
3.07
4.02
Public
3.21
1.08
Private
na
6.37
Total
3.21
5.31
WP Kuala Lumpur
Public
na
4.05
WP Kuala Lumpur
Private
na
4.16
WP Kuala Lumpur
Total
na
4.15
3.21
2.07
na
5.31
3.21
4.78
Negeri Sembilan
Public
3.49
1.86
Negeri Sembilan
Private
na
2.18
Negeri Sembilan
Total
3.49
2.10
Melaka
Public
1.48
0.68
Melaka
Private
na
2.84
Melaka
Total
1.48
2.41
Johor
Public
2.00
1.47
Johor
Private
157.80
1.53
Johor
Total
31.21
1.51
Pahang
Public
2.86
2.32
Pahang
Private
na
250.72
Pahang
Total
2.86
133.83
Terengganu
Public
2.11
0.74
Terengganu
Private
na
1.35
Terengganu
Total
2.11
0.94
Kelantan
Public
1.69
1.39
Kelantan
Private
na
1.70
Kelantan
Total
1.69
1.53
Sabah & WP Labuan
Public
3.92
1.91
Sabah & WP Labuan
Private
na
2.73
Sabah & WP Labuan
Total
3.92
2.11
Sarawak
Public
5.79
3.88
Sarawak
Private
na
3.56
Sarawak
Total
5.79
3.71
16
Maternity Centre
na
33.75
33.75
na
na
na
na
5.15
5.15
na
5.15
5.15
na
4.73
4.73
na
9.30
9.30
na
6.00
6.00
na
77.84
77.84
na
25.89
25.89
na
na
na
na
na
na
na
17.43
17.43
na
248.75
248.75
na
na
na
na
na
na
na
9.11
9.11
na
45.72
45.72
HOSPITAL
Table 2.11 Number and Density of Hospital Doctors, Staff Nurses with Post Basic Training and without Post Basic Training in Malaysia
by State and Sector, 2011
Staff Nurses with Post Staff Nurses without
Hospital Doctors
Basic Training
Post Basic Training
State
Sector
Per 10,000
Per 10,000
Per 10,000
Number
Number
Number
population
population
population
Malaysia
Public
13,093
14,735
27,813
Malaysia
Private
3,550
3,480
12,752
Malaysia
Total
16,643
5.75
18,215
6.29
40,565
14.01
Perlis
Public
140
175
368
Perlis
Private
0
na
na
na
na
Perlis
Total
140
5.89
175
7.37
368
15.49
Kedah
Public
773
1,122
1,815
Kedah
Private
120
90
424
Kedah
Total
893
4.53
1,212
6.14
2,239
11.35
Kedah & Perlis
Public
913
1,297
2,183
Kedah & Perlis
Private
120
90
424
Kedah & Perlis
Total
1,033
4.67
1,387
6.27
2,607
11.79
Pulau Pinang
Public
888
714
1,346
Pulau Pinang
Private
423
585
1,875
Pulau Pinang
Total
1,311
8.23
1,299
8.15
3,221
20.21
Perak
Public
1,016
1,156
2,522
Perak
Private
270
213
742
Perak
Total
1,286
5.36
1,369
5.71
3,264
13.61
Public
2,024
1,401
3,772
Private
980
757
3,292
Total
3,004
5.31
2,158
3.82
7,064
12.49
WP Kuala Lumpur
Public
2,607
1,959
4,324
WP Kuala Lumpur
Private
770
997
3,374
WP Kuala Lumpur
Total
3,377
19.93
2,956
17.44
7,698
45.43
4,631
3,360
8,096
1,750
1,754
6,666
6,381
8.68
5,114
6.96
14,762
20.09
Negeri Sembilan
Public
537
474
1,044
Negeri Sembilan
Private
148
209
698
Negeri Sembilan
Total
685
6.57
683
6.55
1,742
16.70
Melaka
Public
439
645
579
Melaka
Private
184
105
604
Melaka
Total
623
7.48
750
9.00
1,183
14.20
Johor
Public
1,130
1,374
3,152
Johor
Private
270
300
821
Johor
Total
1,400
4.12
1,674
4.92
3,973
11.68
Pahang
Public
625
985
1,353
Pahang
Private
74
56
201
Pahang
Total
699
4.58
1,041
6.83
1,554
10.19
Terengganu
Public
408
885
1,100
Terengganu
Private
12
1
34
Terengganu
Total
420
3.91
886
8.25
1,134
10.56
Kelantan
Public
934
1,161
1,883
Kelantan
Private
44
43
135
Kelantan
Total
978
6.05
1,204
7.45
2,018
12.49
Sabah & WP Labuan
Public
853
1,562
2,843
Sabah & WP Labuan
Private
73
36
143
Sabah & WP Labuan
Total
926
2.72
1,598
4.69
2,986
8.77
Sarawak
Public
719
1,122
1,712
Sarawak
Private
182
88
409
Sarawak
Total
901
3.58
1,210
4.81
2,121
8.43
2
17
HOSPITAL
Table 2.12 Number and Density of Community Nurses and Assistant Nurses in Malaysia by State and Sector, 2011
Community Nurses
Assistant Nurses
State
Sector
Per 10,000
Per 10,000
Number
Number
population
population
Malaysia
Public
8,474
455
Malaysia
Private
238
2,636
Malaysia
Total
8,712
3.01
3,091
1.07
Perlis
Public
80
11
Perlis
Private
na
na
na
na
Perlis
Total
80
3.37
11
0.46
Kedah
Public
482
16
Kedah
Private
10
127
Kedah
Total
492
2.49
143
0.72
Kedah & Perlis
Public
562
27
Kedah & Perlis
Private
10
127
Kedah & Perlis
Total
572
2.59
154
0.70
Pulau Pinang
Public
334
22
Pulau Pinang
Private
60
577
Pulau Pinang
Total
394
2.47
599
3.76
Perak
Public
661
36
Perak
Private
8
237
Perak
Total
669
2.79
273
1.14
Public
1,282
22
Private
49
473
Total
1,331
2.35
495
0.88
WP Kuala Lumpur
Public
256
15
WP Kuala Lumpur
Private
23
619
WP Kuala Lumpur
Total
279
1.65
634
3.74
1,538
37
72
1,092
1,610
2.19
1,129
1.54
Negeri Sembilan
Public
183
14
Negeri Sembilan
Private
5
60
Negeri Sembilan
Total
188
1.80
74
0.71
Melaka
Public
197
9
Melaka
Private
3
118
Melaka
Total
200
2.40
127
1.52
Johor
Public
567
41
Johor
Private
27
168
Johor
Total
594
1.75
209
0.61
Pahang
Public
534
38
Pahang
Private
10
26
Pahang
Total
544
3.57
64
0.42
Terengganu
Public
386
26
Terengganu
Private
0
25
Terengganu
Total
386
3.59
51
0.47
Kelantan
Public
447
44
Kelantan
Private
6
4
Kelantan
Total
453
2.80
48
0.30
Sabah & WP Labuan
Public
1,585
151
Sabah & WP Labuan
Private
5
67
Sabah & WP Labuan
Total
1,590
4.67
218
0.64
Sarawak
Public
1,480
10
Sarawak
Private
32
135
Sarawak
Total
1,512
6.01
145
0.58
18
HOSPITAL
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
2,451
23
2,474
53
na
53
162
1
163
215
1
216
138
2
140
242
0
242
212
2
214
152
3
155
364
5
369
88
3
91
141
1
142
222
4
226
152
0
152
117
0
117
153
0
153
334
0
334
285
7
292
0.85
na
2.23
0.83
0.98
0.88
1.01
0.38
0.91
0.50
0.87
1.70
0.66
1.00
1.09
0.95
0.98
1.16
1.24
na
1.98
1.39
1.45
1.53
1.15
0.99
1.45
1.09
1.58
1.36
0.91
1.92
1.15
1.18
1.13
1.46
2
3,541
56
3,590
47
na
47
272
2
274
319
2
321
241
3
244
275
0
275
537
21
558
231
15
246
768
36
804
162
3
165
110
3
113
316
0
309
291
2
293
123
0
123
189
1
190
386
0
386
361
6
367
Table 2.13 Number and Density of Assistant Medical Officers (AMO) with Post Basic Training and without Post Basic Training in
Acute Curative Hospitals in Malaysia by State and Sector, 2011
AMO with Post Basic Training
AMO without Post Basic Training
State
Sector
No.
Per 10,000 population
No.
19
HOSPITAL
Table 2.14 Number of Pharmacists, Physiotherapists, Occupational Therapists, and Dieticians in Acute Curative Hospitals in
Malaysia by State and Sector, 2011
Occupational
Pharmacists
Physiotherapists
Dieticians
Therapists
State
Sector
Per 10,000
Per 10,000
Per 10,000
Per 10,000
No.
No.
No.
No.
population
population
population
population
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
2,654
302
2,956
47
na
47
180
3
183
227
3
230
165
28
193
276
13
289
432
75
507
333
121
454
1.02
na
1.98
0.93
1.04
1.21
1.21
0.90
2.68
845
508
1,353
13
na
13
40
18
58
53
18
71
55
69
124
59
27
86
92
121
213
126
121
247
0.47
na
0.55
0.29
0.32
0.78
0.36
0.38
1.46
643
43
686
7
na
7
35
0
35
42
0
42
50
8
58
61
0
61
65
11
76
85
16
101
0.24
na
0.29
0.18
0.19
0.36
0.25
0.13
0.60
271
118
389
4
na
4
14
3
17
18
3
21
13
25
38
24
7
31
44
29
73
57
29
86
0.13
na
0.17
0.09
0.09
0.24
0.13
0.13
0.51
765
-
218
-
150
-
101
-
196
-
242
-
27
-
58
-
961
1.31
460
0.63
177
0.24
159
0.22
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
93
20
113
72
6
78
225
10
235
127
6
133
107
0
107
173
1
174
215
4
219
209
15
224
1.08
0.94
0.69
0.87
1.00
1.08
0.64
0.89
32
45
77
27
15
42
60
51
111
38
11
49
31
0
31
75
4
79
107
4
111
90
22
112
0.74
0.50
0.33
0.32
0.29
0.49
0.33
0.45
31
2
33
24
1
25
47
1
48
28
0
28
24
0
24
45
0
45
80
0
80
61
4
65
0.32
0.30
0.14
0.18
0.22
0.28
0.23
0.26
10
8
18
6
7
13
22
5
27
8
2
10
17
0
17
20
1
21
22
1
23
10
1
11
0.17
0.16
0.08
0.07
0.16
0.13
0.07
0.04
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
20
HOSPITAL
2
Table 2.15 Number and Density of Medical Record Officers and Medical Social Officers in Acute Curative Hospitals in Malaysia by
State and Sector, 2011
Medical Record Officers
Medical Social Officers
State
Sector
Per 10,000
Per 10,000
Number
Number
population
population
Malaysia
Public
330
215
Malaysia
Private
437
21
Malaysia
Total
767
0.26
236
0.08
Perlis
Public
2
1
Perlis
Private
na
na
na
na
Perlis
Total
2
0.08
1
0.04
Kedah
Public
26
7
Kedah
Private
9
0
Kedah
Total
35
0.18
7
0.04
Kedah & Perlis
Public
28
8
Kedah & Perlis
Private
9
0
Kedah & Perlis
Total
37
0.17
8
0.04
Pulau Pinang
Public
14
10
Pulau Pinang
Private
20
13
Pulau Pinang
Total
34
0.21
23
0.14
Perak
Public
34
12
Perak
Private
19
0
Perak
Total
53
0.22
12
0.05
Public
35
27
Private
102
4
Total
137
0.24
31
0.05
WP Kuala Lumpur
Public
40
59
WP Kuala Lumpur
Private
164
2
WP Kuala Lumpur
Total
204
1.20
61
0.36
75
86
266
6
341
0.46
92
0.13
Negeri Sembilan
Public
18
8
Negeri Sembilan
Private
38
0
Negeri Sembilan
Total
56
0.54
8
0.08
Melaka
Public
9
5
Melaka
Private
25
0
Melaka
Total
34
0.41
5
0.06
Johor
Public
29
16
Johor
Private
22
0
Johor
Total
51
0.15
16
0.05
Pahang
Public
18
12
Pahang
Private
10
2
Pahang
Total
28
0.18
14
0.09
Terengganu
Public
16
9
Terengganu
Private
0
0
Terengganu
Total
16
0.15
9
0.08
Kelantan
Public
23
14
Kelantan
Private
3
0
Kelantan
Total
26
0.16
14
0.09
Sabah & WP Labuan
Public
40
20
Sabah & WP Labuan
Private
3
0
Sabah & WP Labuan
Total
43
0.13
20
0.06
Sarawak
Public
26
15
Sarawak
Private
22
0
Sarawak
Total
48
0.19
15
0.06
21
HOSPITAL
Table 2.16 Number and Density of Computed Tomography (CT) Scanner and Rate of CT Scan Procedure Performed in Acute
Curative Hospitals in Malaysia by State and Sector, 2010 and 2011
CT Scan Machine
CT Scan Procedure Performed
2010
2011
2010
2011
State
Sector
Per 10,000
Per 10,000
No.
PMP No.
PMP
No.
No.
Population
Population
Malaysia
Public
53
52
- 267,278
- 333,739
Malaysia
Private
92
91
- 217,553
- 219,097
Malaysia
Total
145
5.12 143
4.94 484,831
171.11 552,836
190.87
Perlis
Public
1
0
1,902
0
Perlis
Private
na
na
na
na
na
na
na
na
Perlis
Total
1
4.32
0
0.00
1,902
82.16
0
0.00
Kedah
Public
3
3
17,914
19,557
Kedah
Private
4
4
9,362
8,615
Kedah
Total
7
3.59
7
3.55
27,276
140.04
28,172
142.78
Kedah & Perlis
Public
4
3
19,816
19,557
Kedah & Perlis
Private
4
4
9,362
8,615
Kedah & Perlis
Total
8
3.67
7
3.17
29,178
133.89
28,172
127.44
Pulau Pinang
Public
2
2
24,615
26,681
Pulau Pinang
Private
10
11
40,888
36,308
Pulau Pinang
Total
12
7.69
13
8.16
65,503
419.51
62,989
395.26
Perak
Public
3
3
22,565
26,864
Perak
Private
7
6
13,009
11,172
Perak
Total
10
4.25
9
3.75
35,574
151.21
38,036
158.64
Public
10
11
45,030
51,927
Private
17
18
48,196
48,936
Total
27
4.88
29
5.13
93,226
168.45 100,863
178.40
WP Kuala Lumpur
Public
11
10
44,115
76,626
WP Kuala Lumpur
Private
15
15
27,331
41,301
WP Kuala Lumpur
Total
26
15.53
25
14.75
71,446
426.65 117,927
695.94
21
21
89,145
- 128,553
32
33
75,527
90,237
53
7.35
54
7.35 164,672
228.42 218,790
297.74
Negeri Sembilan
Public
1
1
10,984
13,862
Negeri Sembilan
Private
8
6
10,328
10,749
Negeri Sembilan
Total
9
8.81
7
6.71
21,312
208.72
24,611
235.99
Melaka
Public
1
1
9,506
10,612
Melaka
Private
4
4
16,451
16,772
Melaka
Total
5
6.09
5
6.00
25,957
316.12
27,384
328.74
Johor
Public
5
4
30,333
35,126
Johor
Private
10
10
30,125
22,385
Johor
Total
15
4.48
14
4.12
60,458
180.56
57,511
169.06
Pahang
Public
2
2
10,467
12,152
Pahang
Private
2
3
2,870
2,934
4
2.67
5
3.28
13,337
88.87
15,086
98.94
Pahang
Total
Terengganu
Public
1
1
4,297
5,173
Terengganu
Private
1
1
95
190
Terengganu
Total
2
1.93
2
1.86
4,392
42.39
5,363
49.93
Kelantan
Public
4
4
12,718
12,920
Kelantan
Private
1
1
903
1,115
Kelantan
Total
5
3.25
5
3.10
13,621
88.47
14,035
86.89
Sabah & WP Labuan
Public
4
5
12,318
19,044
Sabah & WP Labuan
Private
3
3
8,643
6,313
Sabah & WP Labuan
Total
7
2.13
8
2.35
20,961
63.64
25,357
74.44
Sarawak
Public
5
5
20,514
23,195
Sarawak
Private
10
9
9,352
12,307
Sarawak
Total
15
6.07
14
5.56
29,866
120.86
35,502
141.09
Abbreviation: na – not applicable; - – not available; PMP – per million population
22
HOSPITAL
2
Table 2.17 Number and Density of Magnetic Resonance Imaging (MRI) and Rate of MRI Procedure Performed in Acute Curative
MRI Machine
MRI Procedure Performed
2010
2011
2010
2011
State
Sector
Per 10,000
Per 10,000
No. PMP
No.
PMP
No.
No.
Population
Population
Malaysia
Public
31
30
47,875
52,739
Malaysia
Private
76
75
- 122,135
- 142,985
Malaysia
Total
107
3.78
105
3.63 170,010
60.00 195,724
67.57
Perlis
Public
1
0
532
0
Perlis
Private
na
na
na
na
na
na
na
na
Perlis
Total
1
4.32
0
0.00
532
22.98
0
0.00
Kedah
Public
2
1
2,617
1,702
Kedah
Private
4
4
5,331
4,807
Kedah
Total
6
3.08
5
2.53
7,948
40.81
6,509
32.99
Kedah & Perlis
Public
3
1
3,149
1,702
Kedah & Perlis
Private
4
4
5,331
4,807
Kedah & Perlis
Total
7
3.21
5
2.26
8,480
38.91
6,509
29.44
Pulau Pinang
Public
2
2
4,111
4,237
Pulau Pinang
Private
7
8
18,905
26,035
Pulau Pinang
Total
9
5.76
10
6.28
23,016
147.41
30,272
189.96
Perak
Public
2
1
1,789
2,611
Perak
Private
5
4
7,255
6,567
Perak
Total
7
2.98
5
2.09
9,044
38.44
9,178
38.28
Public
5
5
6,115
6,609
Private
18
18
31,645
34,528
Total
23
4.16
23
4.07
37,760
68.23
41,137
72.76
WP Kuala Lumpur
Public
6
7
17,180
17,947
WP Kuala Lumpur
Private
17
14
20,301
30,219
WP Kuala Lumpur
Total
23 13.73
21 12.39
37,481
223.82
48,166
284.25
11
12
23,295
24,556
35
32
51,946
64,747
46
6.38
44
5.99
75,241
104.37
89,303
121.53
Negeri Sembilan
Public
1
1
1,925
2,016
Negeri Sembilan
Private
5
4
3,481
4,794
Negeri Sembilan
Total
6
5.88
5
4.79
5,406
52.94
6,810
65.30
Melaka
Public
1
1
1,643
1,537
Melaka
Private
3
3
7,301
8,872
Melaka
Total
4
4.87
4
4.80
8,944
108.93
10,409
124.96
Johor
Public
3
2
3,161
3,743
Johor
Private
7
8
15,490
13,178
Johor
Total
10
2.99
10
2.94
18,651
55.70
16,921
49.74
Pahang
Public
2
2
1,709
1,650
Pahang
Private
2
3
2,004
2,051
4
2.67
5
3.28
3,713
24.74
3,701
24.27
Pahang
Total
Terengganu
Public
1
1
945
1,162
Terengganu
Private
0
0
0
0
Terengganu
Total
1
0.97
1
0.93
945
9.12
1,162
10.82
Kelantan
Public
2
3
2,125
1,728
Kelantan
Private
1
1
637
796
Kelantan
Total
3
1.95
4
2.48
2,762
17.94
2,524
15.63
Sabah & WP Labuan
Public
1
2
1,359
4,335
Sabah & WP Labuan
Private
2
2
4,072
3,671
Sabah & WP Labuan
Total
3
0.91
4
1.17
5,431
16.49
8,006
23.50
Sarawak
Public
2
2
2,664
3,462
Sarawak
Private
5
6
5,713
7,467
Sarawak
Total
7
2.83
8
3.18
8,377
33.90
10,929
43.43
23
HOSPITAL
Table 2.18 Number and Density of Positron Emission Tomography (PET) and Rate of PET Procedure Performed in Acute Curative
PET MACHINE
PET PROCEDURE PERFORMED
2010
2011
2010
2011
State
Sector
PER 10,000
PER 10,000
NO. PMP
NO.
PMP
NO.
NO.
POPULATION
POPULATION
Malaysia
Public
2
2
1,133
1,343
Malaysia
Private
6
6
1,015
1,278
Malaysia
Total
8 0.28
8
0.28
2,148
0.76
2,621
0.90
Perlis
Public
0
0
0
0
Perlis
Private
na
na
na
na
na
na
na
na
Perlis
Total
0 0.00
0
0.00
0
0.00
0
0.00
Kedah
Public
0
0
0
0
Kedah
Private
0
0
0
0
Kedah
Total
0 0.00
0
0.00
0
0.00
0
0.00
Kedah & Perlis
Public
0
0
0
0
Kedah & Perlis
Private
0
0
0
0
Kedah & Perlis
Total
0 0.00
0
0.00
0
0.00
0
0.00
Pulau Pinang
Public
1
1
307
469
Pulau Pinang
Private
3
- 3
232
480
Pulau Pinang
Total
4 2.56
4
2.51
539
3.45
949
5.96
Perak
Public
0
0
0
0
Perak
Private
0
0
0
0
Perak
Total
0 0.00
0
0.00
0
0.00
0
0.00
Public
1
1
826
874
Private
2
2
713
584
Total
3 0.54
3
0.53
1,539
2.78
1,458
2.58
WP Kuala Lumpur
Public
0
0
0
0
WP Kuala Lumpur
Private
1
1
70
214
WP Kuala Lumpur
Total
1 0.60
1
0.59
70
0.42
214
1.26
1
1
826
874
3
3
783
798
4 0.55
4
0.54
1,609
2.23
1,672
2.28
Negeri Sembilan
Public
0
0
0
0
Negeri Sembilan
Private
0
0
0
0
Negeri Sembilan
Total
0 0.00
0
0.00
0
0.00
0
0.00
Melaka
Public
0
0
0
0
Melaka
Private
0
0
0
0
Melaka
Total
0 0.00
0
0.00
0
0.00
0
0.00
Johor
Public
0
0
0
0
Johor
Private
0
0
0
0
Johor
Total
0 0.00
0
0.00
0
0.00
0
0.00
Pahang
Public
0
0
0
0
Pahang
Private
0
0
0
0
0 0.00
0
0.00
0
0.00
0
0.00
Pahang
Total
Terengganu
Public
0
0
0
0
Terengganu
Private
0
0
0
0
Terengganu
Total
0 0.00
0
0.00
0
0.00
0
0.00
Kelantan
Public
0
0
0
0
Kelantan
Private
0
0
0
0
Kelantan
Total
0 0.00
0
0.00
0
0.00
0
0.00
Sabah & WP Labuan
Public
0
0
0
0
Sabah & WP Labuan
Private
0
0
0
0
Sabah & WP Labuan
Total
0 0.00
0
0.00
0
0.00
0
0.00
Sarawak
Public
0
0
0
0
Sarawak
Private
0
0
0
0
Sarawak
Total
0 0.00
0
0.00
0
0.00
0
0.00
24
Chapter 3
HOSPITAL
| MATERNITY SERVICES IN MALAYSIAN HOSPITALS AND MATERNITY HOMES
Ravichandran J1, Ravindran J2, Parampalam SD3, Shamala K4, Arunah C4*, Faizah A4*
1. Hospital Sultanah Aminah, Johor Bahru, 2. Hospital Kuala Lumpur, 3. Hospital Seberang Jaya, 4. National Clinical Research Centre, Ministry of Health
Summary: There were 839 Obstetrics and Gynaecology (O&G) specialists working with medical officers and nurses
providing maternity services in 317 hospitals and 26 maternity homes in 2011. The Caesarean section rate for 2011 was
23.76 per 100 live births. This was lower than the average rate across OECD countries which had a rate of 25.8 per 100
live births. The ratio of specialist to total deliveries in the public sector was 1:1,265 as compared to 1:202 in the private
sector. In specialist hospitals, the ratio of midwifery trained nurses to delivery beds was 1.6 to 1 per shift. The ratio
of midwifery trained nurse to delivery in these labour rooms was 1 per 100. The ratio of eclampsia to delivery in East
Malaysia was 1.75 times more than that of Peninsular Malaysia. In addition to providing care for the mother, the staff of
the maternity services in the public sector also looked after 83% of newborns during the mother’s stay in the hospital.
This survey was conducted in all hospitals that received patients and provided specialist, nursing and midwifery care for women in labour and
for women soon after childbirth. Facilities that did not conduct inpatient deliveries such as the delivery centres in health clinics were excluded. In
addition, five hospitals from the Ministry of Defence were excluded.
There were 317 hospitals providing maternity services. These included 130 Ministry of Health (MOH) facilities, three University Hospitals and 184
private hospitals (Table 3.1). The response rate in this survey was 81.4%; 100% from the public sector and 67.9% from the private sector. This
was higher than in the 2010 survey which had a response rate of 74.9%. The improved response rate was contributed entirely from the private
sector.
Facilities
Wilayah Persekutuan Kuala Lumpur (WPKL) recorded the highest density of maternity services at 0.20 per 10,000 population, followed by Pulau
Pinang at 0.14 per 10,000 population and Sarawak, Perak, Negeri Sembilan and Pahang at 0.12 per 10,000 population. The hospitals with lowest
density of maternity services were in Perlis (0.04 per 10,000 population), followed by Melaka and Terengganu, both at 0.07 per 10,000 population
(Table 3.1).
Seven states (WPKL, Pulau Pinang, Perak, Negeri Sembilan, Pahang, Sarawak and Johor) were at or above the national average of 0.11 per
10,000 population. These were also the states that had higher private sector providers (Table 3.1).
Nationwide, 30 public hospitals had a dedicated high dependency unit (HDU) within the O&G Department. There were 103 obstetrics HDU beds in
these public hospitals. The national public hospital average of obstetrics HDU beds was 0.25 per 1,000 deliveries. Kelantan had the lowest number
of HDU beds (0.03 beds per 1,000 deliveries), followed by Selangor and WP Putrajaya, Sabah and WP Labuan (0.12). In contrast to the previous
report, every state in Malaysia had access to a dedicated obstetrics HDU (Table 3.4).
Activities
A total of 517,081 deliveries were reported from both public and private hospitals in 2011. Of these, 413,657 (80%) deliveries were from the public
sector and 103,424 (20%) from the private sector. This did not include home deliveries, maternity home deliveries and deliveries in transit (Table 3.5).
Kelantan had the highest rate of deliveries at 231 per 10,000 population followed by WPKL (224 per 10,000) and Terengganu (198 per 10,000).
Pulau Pinang had the lowest rate of deliveries at 154 per 10,000 population. All the states registered proportionally higher deliveries in public
hospitals (Table 3.5).
25
3
Of the 56 public hospitals with O&G specialists, only 33 had dedicated maternity operation theatres (OT) with 47 operating rooms that were
functioning. This translates to 0.11 dedicated OTs per 1,000 deliveries. This was an improvement when compared to 2010 which had a rate of
0.07 per 1,000 deliveries (Table 3.3).
MATERNITY SERVICES IN MALAYSIAN HOSPITALS AND MATERNITY HOMES
A total of 1,310 delivery beds were available nationwide, of which 774 (59.1%) were in the public sector and the remaining 536 (40.9%) in the
private sector. In terms of workload, there were 1.87 delivery beds per 1,000 deliveries in the public sector whereas there were 5.18 beds per
1,000 deliveries in the private side. The national average was 2.53 delivery beds per 1,000 deliveries (Table 3.2).
HOSPITAL
Of the total deliveries in Malaysia, 368,010 were spontaneous vertex deliveries (SVD). Sabah and Kelantan recorded the highest ratio of SVD
with 894.59 and 845.37 deliveries per 1,000 live births respectively. Selangor and WP Putrajaya had the lowest density of SVDs (641 per 1,000
deliveries) (Table 3.6). There were 1,823 vaginal breech deliveries in the public sector when compared to 175 breech deliveries in the private
sector (Table 3.7).
Five per cent (26,040) of the total deliveries were instrumental deliveries, almost all using vacuum. About 2.9% and 13.7% of all deliveries were
conducted using vacuum in the public and private sector, respectively (Table 3.8). Only 0.5% of all deliveries were conducted using forceps; 0.4%
of deliveries in the public sector and 1% of deliveries in the private sector (Table 3.9).
There were a total of 117,526 Caesarean sections (CS) in 2011. This accounted for 22.7% of all deliveries captured in this survey, which is
marginally higher than the rate reported (22.1%) in 2010. We had a national CS rate of 23.76 per 100 live births. This was lower than the rate
across the Organisation for Economic Co-operation and Development (OECD) countries which had an average rate of 25.8 per 100 live births
(Table 3.10).
Almost all states recorded a higher number of Caesarean sections when compared to the previous year. A total of 35,897 (34.71 per 100
deliveries) of CS were performed in the private sector and 81,629 (19.73 per 100 deliveries) CS were recorded in public hospitals. The states
with the lowest CS rates were Kelantan at 14.66 per 100 deliveries, followed by Terengganu at 14.74 per 100 deliveries. WPKL had the highest
Caesarean section rate (32.48 per 100 deliveries), followed by Pulau Pinang (29.26 per 100 deliveries). In the private sector, Sabah had the
highest CS rate (51.27 per 100 deliveries) with Terengganu having the lowest (19.43 per 100 deliveries). In the public sector, WPKL had the
highest CS rate at 29.5 per 100 deliveries while Sabah recorded the lowest (13.31 per 100 deliveries) (Table 3.10). About 76% of all CS in the
public sector were emergency surgeries (Table 3.10).
A total of 4,008 deliveries (0.78 per 100 deliveries) were from multiple pregnancies, of which 3,284 deliveries (82%) were in public hospitals
(Table 3.12). There were 490 eclampsia cases reported, a rate of 0.95 cases per 1,000 deliveries. Sabah had the highest incidence per 1,000
deliveries (1.82) whereas Pahang had the lowest with 0.19 cases per 1,000 deliveries. The ratio of eclampsia to delivery in East Malaysia was
1.75 times more than that of Peninsular Malaysia (Table 3.13).
A total of 12,662 cases of post partum haemorrhage (PPH) were reported nationwide, a rate of 2.5%. Perlis had the highest PPH rate of 14.7%
followed by Pulau Pinang at 4.4%. The lowest rate was in Sarawak at 0.9%, followed by Terengganu at 1.3% (Table 3.14). There were 166
recorded cases of Caesarean hysterectomies in public hospitals in this survey, a rate of 0.04% (Table 3.11). Further details of such surgeries
performed in public hospitals are shown in Table 3.11.
In addition to caring for mothers, the obstetrics fraternity also provided care for 83% of newborns in the public sector. (Table 3.15)
Human Workforce
There were 839 obstetricians and gynaecologists identified in this survey, of whom 327 (39%) worked in the public sector and 512 (61%) in
the private sector. This equated to 5.96 specialists per 100,000 female population. This is low when compared to the OECD standards of 26.8
specialists per 100,000 female population. The ratio of specialists to total deliveries in the public sector was 1:1,265 as compared to the private
sector which was 1:202 (Table 3.16).
In 2011, 5,901 staff nurses and 3,280 community nurses worked in the O&G services in both public and private hospitals (Table 3.17). Of these,
1,689 staff nurses with midwifery training and 1,312 community nurses worked in public specialist hospitals (Table 3.18). In contrast, 1,216 staff
nurses with midwifery training and 814 community nurses worked in labour wards in public specialist hospitals. Only 60% of nurses in the labour
ward in public specialist hospitals were staff nurses with midwifery training. The remaining 40% were community nurses. In specialist hospitals,
the ratio of midwifery trained nurses to delivery beds was 1.6 to per shift. The ratio of nurse to delivery in these labour rooms was 1:100 per year
(Table 3.19). A total of 110 staff nurses with midwifery training and 50 community nurses worked in public specialist hospital HDUs. The ratio of
nurses with midwifery to functional obstetrics HDU bed per shift was 0.5:1 (Table 3.20).
Maternity Homes
Of the 26 maternity homes, 10 or 38.5% responded to the survey. They accounted for 1,823 deliveries. Seven vacuum and 7 forceps deliveries.
There were 2 specialists, 20 medical officers, 29 staff nurses, 20 nurses with midwifery training, 12 community nurses and 53 clinic assistants
serving these homes.
26
HOSPITAL
Limitations
1. Estimation of total deliveries conducted within all inpatient establishments was not possible due to the poor response rate from maternity
homes and, as a result, we were unable to capture the total deliveries conducted in all inpatient establishments in the country.
2. Changes in the definitions of the relevant variables limited our efforts to study trends in the data over the years
3
3. Lack of comprehensive national and international norms for obstetrics services restricted international comparisons
27
HOSPITAL
Table 3.1 Number, Density and Percentage of Hospitals Providing Maternity Services in Malaysia by State and Sector, 2010 and 2011
Year 2010
State
Sector
Total Hospitals Providing
Maternity Services
No.
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
133
182
315
1
na
1
9
10
19
10
10
20
6
17
23
14
14
28
12
45
57
3
32
35
15
77
92
6
6
12
3
3
6
11
28
39
10
7
17
6
1
7
10
3
13
22
5
27
20
11
31
% of
Per 10,000
facilities
population
by Sector
42.20
57.80
0.11
100.00
100.00
na
na
0.04
100.00
47.40
52.60
0.10
100.00
50.00
50.00
0.09
100.00
26.10
73.90
0.15
100.00
50.00
50.00
0.12
100.00
21.10
78.90
0.10
100.00
8.60
91.40
0.21
100.00
16.30
83.70
0.13
100.00
50.00
50.00
0.12
100.00
50.00
50.00
0.07
100.00
28.20
71.80
0.12
100.00
58.80
41.20
0.11
100.00
85.70
14.30
0.07
100.00
76.90
23.10
0.08
100.00
81.50
18.50
0.08
100.00
64.50
35.50
0.13
100.00
28
Year 2011
Hospitals
Providing
Total Hospitals Providing
Maternity
Maternity Services
with
Specialists
% Per
% of
Per 10,000
No. Maternity No.
facilities
population
Hospital
by Sector
53
39.80 133
42
182
100.00 184
58
235
74.60 317
0.11
100
1
100.00
1
100
na
na
na
na
na
1
100.00
1
0.04
100
4
44.40
9
50
10
100.00
9
50
14
73.70 18
0.09
100
5
50.00 10
52.6
10
100.00
9
47.4
15
75.00 19
0.09
100
3
50.00
6
26.1
17
100.00 17
73.9
20
87.00 23
0.14
100
5
35.70 14
48.3
14
100.00 15
51.7
19
67.90 29
0.12
100
8
66.70 12
20.7
45
100.00 46
79.3
53
93.00 58
0.10
100
3
100.00
3
8.8
32
100.00 31
91.2
35
100.00 34
0.20
100
11
73.30 15
16.3
77
100.00 77
83.7
88
95.70 92
0.13
100
2
33.30
6
50
6
100.00
6
50
8
66.70 12
0.12
100
1
33.30
3
50
3
100.00
3
50
4
66.70
6
0.07
100
6
54.50 11
28.2
28
100.00 28
71.8
34
87.20 39
0.11
100
3
30.00 10
52.6
7
100.00
9
47.4
10
58.80 19
0.12
100
2
33.30
6
85.7
1
100.00
1
14.3
3
42.90
7
0.07
100
4
40.00 10
76.9
3
100.00
3
23.1
7
53.80 13
0.08
100
5
22.70 22
81.5
5
100.00
5
18.5
10
37.00 27
0.08
100
6
30.00 20
64.5
11
100.00 11
35.5
17
54.80 31
0.12
100
Hospitals
Providing
Maternity with
Specialists
% Per
No. Maternity
Hospital
56
42.10
184
100.00
240
75.70
1
100.00
na
na
1
100.00
4
44.40
9
100.00
13
72.20
5
50.00
9
100.00
14
73.70
3
50.00
17
100.00
20
87.00
5
35.70
15
100.00
20
69.00
8
66.70
46
100.00
54
93.10
3
100.00
31
100.00
34
100.00
11
73.30
77
100.00
88
95.70
3
50.00
6
100.00
9
75.00
1
33.30
3
100.00
4
66.70
6
54.50
28
100.00
34
87.20
3
30.00
9
100.00
12
63.20
2
33.30
1
100.00
3
42.90
4
40.00
3
100.00
7
53.80
6
27.30
5
100.00
11
40.70
7
35.00
11
100.00
18
58.10
HOSPITAL
Table 3.2 Number, Density and Percentage of Functioning Delivery Beds in Malaysia by State and Sector, 2011
Functioning Delivery Beds
Sector
No. % of Beds by sector
Delivery Beds per
1,000 Deliveries
Malaysia
Public
774
59.10
1.87
Malaysia
Private
536
40.90
5.18
Malaysia
Total
1,310
100.00
2.53
Perlis
Public
6
100.00
1.46
Perlis
Private
na
na
na
Perlis
Total
6
100.00
1.46
Kedah
Public
51
64.60
1.68
Kedah
Private
28
35.40
4.63
Kedah
Total
79
100.00
2.17
Kedah & Perlis
Public
57
67.10
1.66
Kedah & Perlis
Private
28
32.90
4.63
Kedah & Perlis
Total
85
100.00
2.10
Pulau Pinang
Public
33
36.30
2.32
Pulau Pinang
Private
58
63.70
5.61
Pulau Pinang
Total
91
100.00
3.70
Perak
Public
74
67.90
2.41
Perak
Private
Perak
Total
35
32.10
4.66
109
100.00
2.85
Public
85
35.40
1.30
Private
155
64.60
4.79
Total
240
100.00
2.45
WP Kuala Lumpur
Public
42
32.30
1.72
WP Kuala Lumpur
Private
88
67.70
6.47
WP Kuala Lumpur
Total
130
100.00
3.42
127
34.30
1.41
243
65.70
5.29
370
100.00
2.72
32
64.00
2.34
Negeri Sembilan
Public
Negeri Sembilan
Private
18
36.00
3.34
Negeri Sembilan
Total
50
100.00
2.62
Melaka
Public
20
54.10
1.77
Melaka
Private
17
45.90
5.02
Melaka
Total
37
100.00
2.51
Johor
Public
89
55.60
1.92
Johor
Private
71
44.40
6.00
Johor
Total
160
100.00
2.74
Pahang
Public
52
71.20
2.25
Pahang
Private
21
28.80
8.08
Pahang
Total
73
100.00
2.84
Terengganu
Public
35
92.10
1.67
Terengganu
Private
Terengganu
Total
3
7.90
9.46
38
100.00
1.79
Kelantan
Public
72
87.80
2.09
Kelantan
Private
10
12.20
3.65
Kelantan
Total
82
100.00
2.20
Sabah & WP Labuan
Public
107
92.20
1.90
Sabah & WP Labuan
Private
9
7.80
3.01
Sabah & WP Labuan
Total
116
100.00
1.96
Sarawak
Public
76
76.80
2.00
Sarawak
Private
23
23.20
5.30
Sarawak
Total
99
100.00
2.34
3
State
29
HOSPITAL
Table 3.3 Number and Density of Hospital with Dedicated Maternity Operating Theatre (OT) Facilities and Functioning Maternity
Operating Room (OR) in Public Hospitals in Malaysia by State, 2011
State
Malaysia
Perlis
2011
Dedicated OT Facilities
No. Per 1,000 Deliveries
33
0.08
0
0.00
Functioning Operating Room (OR)
47
0.11
0
0.00
Kedah
2
0.07
4
0.13
Kedah & Perlis
Pulau Pinang
Perak
WP Kuala Lumpur
Negeri Sembilan
Melaka
Johor
Pahang
Terengganu
Kelantan
Sabah & WP Labuan
Sarawak
2
2
4
5
3
8
1
1
1
2
1
3
2
6
0.06
0.14
0.13
0.08
0.12
0.09
0.07
0.09
0.02
0.09
0.05
0.09
0.04
0.16
4
2
6
7
7
14
1
1
1
3
1
3
3
8
0.12
0.14
0.20
0.11
0.29
0.16
0.07
0.09
0.02
0.13
0.05
0.09
0.05
0.21
Table 3.4 Number and Density of Functional Obstetrics High Dependency Unit (HDU) Beds within O&G Department in Public Hospitals
in Malaysia by State, 2010 and 2011
2010
2011
State
Functional HDU Beds
within O&G Department
Hospital with HDU within
O&G Department
Functional HDU Beds
within O&G Department
No.
Per 1,000
Deliveries
No.
Per 1,000
Deliveries
No.
Per 1,000
Deliveries
106
0.27
30
0.07
103
0.25
Perlis
2
0.51
1
0.24
2
0.49
Kedah
7
0.24
2
0.07
7
0.23
Kedah & Perlis
9
0.27
3
0.09
9
0.26
Pulau Pinang
8
0.57
1
0.07
4
0.28
Perak
8
0.27
2
0.07
10
0.33
13
0.21
3
0.05
8
0.12
WP Kuala Lumpur
15
0.64
3
0.12
16
0.66
Malaysia
28
0.33
6
0.07
24
0.27
Negeri Sembilan
2
0.15
1
0.07
2
0.15
Melaka
0
0.00
1
0.09
2
0.18
Johor
24
0.53
4
0.09
24
0.52
Pahang
8
0.36
2
0.09
8
0.35
Terengganu
3
0.15
1
0.05
2
0.10
Kelantan
2
0.06
1
0.03
1
0.03
Sabah & WP Labuan
8
0.15
4
0.07
7
0.12
Sarawak
6
0.17
4
0.11
10
0.26
30
HOSPITAL
3
Table 3.5 Number, Density and Percentage of Total Deliveries in Malaysia by State and Sector, 2010 and 2011
Year 2010
Year 2011
% of
% of
State
Sector
No Of Per 10,000
No Of Per 10,000
Deliveries
Deliveries
Deliveries population
Deliveries population
by Sector
by Sector
Malaysia
Public
396,836
77.70
413,657
80.00
Malaysia
Private
114,098
22.30
103,424
20.00
Malaysia
Total
510,934
180.32
100.00
517,081
178.52
100.00
Perlis
Public
3,949
100.00
4,100
100.00
Perlis
Private
na
na
na
na
na
na
Perlis
Total
3,949
170.58
100.00
4,100
172.63
100.00
Kedah
Public
29,397
85.60
30,338
83.40
Kedah
Private
4,955
14.40
6,051
16.60
Kedah
Total
34,352
176.37
100.00
36,389
184.43
100.00
Kedah & Perlis
Public
33,346
87.10
34,438
85.10
Kedah & Perlis
Private
4,955
12.90
6,051
14.90
Kedah & Perlis
Total
38,301
175.76
100.00
40,489
183.16
100.00
Pulau Pinang
Public
14,013
55.30
14,251
57.90
Pulau Pinang
Private
11,332
44.70
10,342
42.10
Pulau Pinang
Total
25,345
162.32
100.00
24,593
154.32
100.00
Perak
Public
29,741
75.90
30,763
80.40
Perak
Private
9,424
24.10
7,505
19.60
Perak
Total
39,165
166.47
100.00
38,268
159.61
100.00
Public
61,061
59.60
65,604
67.00
Private
41,310
40.40
32,333
33.00
Total
102,371
184.97
100.00
97,937
173.22
100.00
WP Kuala Lumpur
Public
23,260
60.70
24,376
64.20
WP Kuala Lumpur
Private
15,041
39.30
13,611
35.80
WP Kuala Lumpur
Total
38,301
228.72
100.00
37,987
224.18
100.00
84,321
59.90
89,980
66.20
56,351
40.10
45,944
33.80
140,672
195.13
100.00
135,924
184.97
100.00
Negeri Sembilan
Public
13,297
76.20
13,668
71.70
Negeri Sembilan
Private
4,143
23.80
5,384
28.30
Negeri Sembilan
Total
17,440
170.80
100.00
19,052
182.68
100.00
Melaka
Public
10,585
77.20
11,334
77.00
Melaka
Private
3,129
22.80
3,385
23.00
Melaka
Total
13,714
167.02
100.00
14,719
176.70
100.00
Johor
Public
45,560
79.90
46,481
79.70
Johor
Private
11,447
20.10
11,831
20.30
Johor
Total
57,007
170.26
100.00
58,312
171.42
100.00
Pahang
Public
22,302
87.70
23,092
89.90
Pahang
Private
3,126
12.30
2,598
10.10
Pahang
Total
25,428
169.43
100.00
25,690
168.48
100.00
Terengganu
Public
20,510
98.40
20,968
98.50
Terengganu
Private
333
1.60
317
1.50
Terengganu
Total
20,843
201.19
100.00
21,285
198.18
100.00
Kelantan
Public
33,381
94.10
34,485
92.60
Kelantan
Private
2,100
5.90
2,738
7.40
Kelantan
Total
35,481
230.46
100.00
37,223
230.45
100.00
Sabah & WP Labuan
Public
53,646
94.80
56,238
95.00
Sabah & WP Labuan
Private
2,949
5.20
2,990
5.00
173.88
100.00
Sabah & WP Labuan
Total
56,595
171.83
100.00
59,228
Sarawak
Public
36,134
88.30
37,959
89.70
Sarawak
Private
4,809
11.70
4,339
10.30
Sarawak
Total
40,943
165.69
100.00
42,298
168.10
100.00
31
HOSPITAL
Table 3.6 Number and Density of Spontaneous Vertex Deliveries (SVD) in Malaysia by State and Sector, 2010 and 2011
Spontaneous Vertex Deliveries (SVD)
2010
2011
State
Sector
Per 100
Per 1,000
Per 100
Per 1,000
No.
No.
Deliveries Live Birth
Malaysia
Public
305,930
77.09
316,273
76.46
Malaysia
Private
59,417
52.08
51,737
50.02
Malaysia
Total
365,347
71.51
685.86
368,010
71.17
744.05
Perlis
Public
2,899
73.41
2,926
71.37
Perlis
Private
na
na
na
na
na
na
Perlis
Total
2,899
73.41
662.58
2,926
71.37
725.16
Kedah
Public
21,678
73.74
21,759
71.72
Kedah
Private
1,886
38.06
2,102
34.74
Kedah
Total
23,564
68.60
643.53
23,861
65.57
685.35
Kedah & Perlis
Public
24,577
73.70
24,685
71.68
Kedah & Perlis
Private
1,886
38.06
2,102
34.74
Kedah & Perlis
Total
26,463
69.09
645.56
26,787
66.16
689.48
Pulau Pinang
Public
10,318
73.63
10,240
71.85
Pulau Pinang
Private
6,723
59.33
5,404
52.25
Pulau Pinang
Total
17,041
67.24
695.15
15,644
63.61
719.36
Perak
Public
21,608
72.65
22,217
72.22
Perak
Private
4,167
44.22
3,243
43.21
Perak
Total
25,775
65.81
689.03
25,460
66.53
698.55
Public
44,150
72.30
46,710
71.20
Private
20,862
50.50
16,463
50.92
Total
65,012
63.51
567.47
63,173
64.50
641.23
WP Kuala Lumpur
Public
15,171
65.22
16,062
65.89
WP Kuala Lumpur
Private
8,308
55.24
6,504
47.78
WP Kuala Lumpur
Total
23,479
61.30
834.56
22,566
59.40
775.25
59,321
70.35
62,772
69.76
29,170
51.76
22,967
49.99
88,491
62.91
620.13
85,739
63.08
671.79
Negeri Sembilan
Public
10,085
75.84
10,542
77.13
Negeri Sembilan
Private
2,294
55.37
2,868
53.27
Negeri Sembilan
Total
12,379
70.98
658.87
13,410
70.39
783.39
Melaka
Public
8,027
75.83
8,296
73.20
Melaka
Private
989
31.61
1,330
39.29
Melaka
Total
9,016
65.74
566.00
9,626
65.40
710.25
Johor
Public
35,133
77.11
35,885
77.20
Johor
Private
6,192
54.09
6,402
54.11
Johor
Total
41,325
72.49
667.14
42,287
72.52
748.80
Pahang
Public
17,040
76.41
17,551
76.00
Pahang
Private
2,313
73.99
1,841
70.86
Pahang
Total
19,353
76.11
720.40
19,392
75.48
741.09
Terengganu
Public
17,675
86.18
17,683
84.33
Terengganu
Private
288
86.49
146
46.06
Terengganu
Total
17,963
86.18
777.53
17,829
83.76
742.38
Kelantan
Public
28,342
84.90
28,810
83.54
Kelantan
Private
1,753
83.48
2,138
78.09
Kelantan
Total
30,095
84.82
849.88
30,948
83.14
845.37
Sabah & WP Labuan
Public
44,678
83.28
47,256
84.03
Sabah & WP Labuan
Private
1,202
40.76
1,058
35.38
Sabah & WP Labuan
Total
45,880
81.07
780.85
48,314
81.57
894.59
Public
29,126
80.61
30,336
79.92
Sarawak
Sarawak
Private
2,440
50.74
2,238
51.58
Sarawak
Total
31,566
77.10
683.11
32,574
77.01
775.83
32
HOSPITAL
Table 3.7 Number and Density of Vaginal Breech Deliveries in Malaysia by State and Sector, 2010 and 2011
Vaginal Breech Deliveries
2010
2011
State
Sector
Per 100
Per 1,000
Per 100
No.
No.
Deliveries
Malaysia
Public
2,246
0.57
1,823
0.44
Malaysia
Private
157
0.14
175
0.17
Malaysia
Total
2,403
0.47
4.51
1,998
0.39
Perlis
Public
22
0.56
28
0.68
Perlis
Private
na
na
na
na
na
Perlis
Total
22
0.56
5.03
28
0.68
Kedah
Public
178
0.61
168
0.55
Kedah
Private
16
0.32
24
0.40
Kedah
Total
194
0.56
5.30
192
0.53
Kedah & Perlis
Public
200
0.60
196
0.57
Kedah & Perlis
Private
16
0.32
24
0.40
Kedah & Perlis
Total
216
0.56
5.27
220
0.54
Pulau Pinang
Public
65
0.46
68
0.48
Pulau Pinang
Private
19
0.17
15
0.15
Pulau Pinang
Total
84
0.33
3.43
83
0.34
Perak
Public
163
0.55
88
0.29
Perak
Private
6
0.06
3
0.04
Perak
Total
169
0.43
4.52
91
0.24
Public
292
0.48
284
0.43
Private
34
0.08
49
0.15
Total
326
0.32
2.85
333
0.34
WP Kuala Lumpur
Public
201
0.86
138
0.57
WP Kuala Lumpur
Private
36
0.24
42
0.31
WP Kuala Lumpur
Total
237
0.62
8.42
180
0.47
493
0.58
422
0.47
70
0.12
91
0.20
563
0.40
3.95
513
0.38
Negeri Sembilan
Public
136
1.02
45
0.33
Negeri Sembilan
Private
3
0.07
2
0.04
Negeri Sembilan
Total
139
0.80
7.40
47
0.25
Melaka
Public
46
0.43
27
0.24
Melaka
Private
1
0.03
3
0.09
Melaka
Total
47
0.34
2.95
30
0.20
Johor
Public
326
0.72
251
0.54
Johor
Private
35
0.31
22
0.19
Johor
Total
361
0.63
5.83
273
0.47
Pahang
Public
100
0.45
95
0.41
Pahang
Private
3
0.10
5
0.19
Pahang
Total
103
0.41
3.83
100
0.39
Terengganu
Public
86
0.42
94
0.45
Terengganu
Private
1
0.30
0
0.00
Terengganu
Total
87
0.42
3.77
94
0.44
Kelantan
Public
218
0.65
201
0.58
Kelantan
Private
2
0.10
8
0.29
Kelantan
Total
220
0.62
6.21
209
0.56
Sabah & WP Labuan
Public
227
0.42
212
0.38
Sabah & WP Labuan
Private
0
0.00
0
0.00
Sabah & WP Labuan
Total
227
0.40
3.86
212
0.36
Public
186
0.51
124
0.33
Sarawak
Sarawak
Private
1
0.02
2
0.05
Sarawak
Total
187
0.46
4.05
126
0.30
3
Per 1,000
Live Birth
4.04
na
6.94
5.52
5.66
3.82
2.50
3.38
6.18
4.02
2.75
2.21
4.83
3.82
3.91
5.71
3.93
3.00
33
HOSPITAL
Table 3.8 Number and Density of Instrumental Deliveries using Vacuum in Malaysia by State and Sector, 2010 and 2011
Instrumental Deliveries using Vacuum
2010
2011
State
Sector
Per 100
Per 1,000
Per 100
Per 1,000
No.
No.
Malaysia
Public
11,182
2.82
11,832
2.86
Malaysia
Private
15,458
13.55
14,208
13.74
Malaysia
Total
26,640
5.21
50.01
26,040
5.04
52.65
Perlis
Public
149
3.77
110
2.68
Perlis
Private
na
na
na
na
na
na
Perlis
Total
149
3.77
34.05
110
2.68
27.26
Kedah
Public
1,174
3.99
1,063
3.50
Kedah
Private
1,042
21.03
1,334
22.05
Kedah
Total
2,216
6.45
60.52
2,397
6.59
68.85
Kedah & Perlis
Public
1,323
3.97
1,173
3.41
Kedah & Perlis
Private
1,042
21.03
1,334
22.05
Kedah & Perlis
Total
2,365
6.17
57.69
2,507
6.19
64.53
Pulau Pinang
Public
243
1.73
200
1.40
Pulau Pinang
Private
1,550
13.68
1,460
14.12
Pulau Pinang
Total
1,793
7.07
73.14
1,660
6.75
76.33
Perak
Public
350
1.18
194
0.63
Perak
Private
1,935
20.53
1,533
20.43
Perak
Total
2,285
5.83
61.08
1,727
4.51
47.38
Public
2,332
3.82
3,212
4.90
Private
6,371
15.42
5,134
15.88
Total
8,703
8.50
75.97
8,346
8.52
84.72
WP Kuala Lumpur
Public
851
3.66
880
3.61
WP Kuala Lumpur
Private
1,519
10.10
1,534
11.27
WP Kuala Lumpur
Total
2,370
6.19
84.24
2,414
6.35
82.93
3,183
3.77
4,092
4.55
7,890
14.00
6,668
14.51
11,073
7.87
77.60
10,760
7.92
84.31
Negeri Sembilan
Public
402
3.02
389
2.85
Negeri Sembilan
Private
741
17.89
1,048
19.47
Negeri Sembilan
Total
1,143
6.55
60.84
1,437
7.54
83.95
Melaka
Public
432
4.08
431
3.80
Melaka
Private
363
11.60
340
10.04
Melaka
Total
795
5.80
49.91
771
5.24
56.89
Johor
Public
1,846
4.05
1,992
4.29
Johor
Private
1,148
10.03
974
8.23
Johor
Total
2,994
5.25
48.33
2,966
5.09
52.52
Pahang
Public
790
3.54
846
3.66
Pahang
Private
102
3.26
86
3.31
Pahang
Total
892
3.51
33.20
932
3.63
35.62
Terengganu
Public
177
0.86
118
0.56
Terengganu
Private
4
1.20
48
15.14
Terengganu
Total
181
0.87
7.84
166
0.78
6.91
Kelantan
Public
271
0.81
370
1.07
Kelantan
Private
85
4.05
94
3.43
Kelantan
Total
356
1.00
10.05
464
1.25
12.67
Sabah & WP Labuan
Public
1,210
2.26
1,146
2.04
Sabah & WP Labuan
Private
375
12.72
379
12.68
28.24
Sabah & WP Labuan
Total
1,585
2.80
26.98
1,525
2.57
Sarawak
Public
955
2.64
881
2.32
Sarawak
Private
223
4.64
244
5.62
Sarawak
Total
1,178
2.88
25.49
1,125
2.66
26.80
34
HOSPITAL
3
Table 3.9 Number and Density of Instrumental Deliveries using Forceps in Malaysia by State and Sector, 2010 and 2011
Instrumental Deliveries using Forceps
2010
2011
State
Sector
Per 100
Per 1,000
Per 100
Per 1,000
No.
No.
Malaysia
Public
1,455
0.37
1,633
0.39
Malaysia
Private
1,339
1.17
1,146
1.11
Malaysia
Total
2,794
0.55
5.25
2,779
0.54
5.62
Perlis
Public
9
0.23
12
0.29
Perlis
Private
na
na
na
na
na
na
Perlis
Total
9
0.23
2.06
12
0.29
2.97
Kedah
Public
71
0.24
53
0.17
Kedah
Private
188
3.79
127
2.10
Kedah
Total
259
0.75
7.07
180
0.49
5.17
Kedah & Perlis
Public
80
0.24
65
0.19
Kedah & Perlis
Private
188
3.79
127
2.10
Kedah & Perlis
Total
268
0.70
6.54
192
0.47
4.94
Pulau Pinang
Public
28
0.20
59
0.41
Pulau Pinang
Private
41
0.36
42
0.41
Pulau Pinang
Total
69
0.27
2.82
101
0.41
4.64
Perak
Public
80
0.27
64
0.21
Perak
Private
118
1.25
83
1.11
Perak
Total
198
0.51
5.29
147
0.38
4.03
Public
597
0.98
515
0.79
Private
328
0.79
212
0.66
Total
925
0.90
8.07
727
0.74
7.38
WP Kuala Lumpur
Public
76
0.33
106
0.43
WP Kuala Lumpur
Private
266
1.77
376
2.76
WP Kuala Lumpur
Total
342
0.89
12.16
482
1.27
16.56
Public
673
0.80
621
0.69
Private
594
1.05
588
1.28
Total
1,267
0.90
8.88
1,209
0.89
9.47
Negeri Sembilan
Public
86
0.65
76
0.56
Negeri Sembilan
Private
32
0.77
20
0.37
Negeri Sembilan
Total
118
0.68
6.28
96
0.50
5.61
Melaka
Public
39
0.37
72
0.64
Melaka
Private
27
0.86
42
1.24
Melaka
Total
66
0.48
4.14
114
0.77
8.41
Johor
Public
172
0.38
323
0.69
Johor
Private
107
0.93
60
0.51
Johor
Total
279
0.49
4.50
383
0.66
6.78
Pahang
Public
10
0.04
34
0.15
Pahang
Private
69
2.21
68
2.62
Pahang
Total
79
0.31
2.94
102
0.40
3.90
Terengganu
Public
33
0.16
37
0.18
Terengganu
Private
2
0.60
0
0.00
Terengganu
Total
35
0.17
1.52
37
0.17
1.54
Kelantan
Public
121
0.36
130
0.38
Kelantan
Private
4
0.19
0
0.00
Kelantan
Total
125
0.35
3.53
130
0.35
3.55
Sabah & WP Labuan
Public
54
0.10
63
0.11
Sabah & WP Labuan
Private
15
0.51
19
0.64
Sabah & WP Labuan
Total
69
0.12
1.17
82
0.14
1.52
Public
79
0.22
89
0.23
Sarawak
Sarawak
Private
142
2.95
97
2.24
Sarawak
Total
221
0.54
4.78
186
0.44
4.43
35
HOSPITAL
Table 3.10 Number and Density of Caesarean Sections in Malaysia by State and Sector, 2010-2011
2010
Total LSCS
State
Sector
Total Caesarean Sections
Per
Per 1,000
Per 100
Per 100 1,000
No.
Live
No.
Deliveries
Deliveries
Live
Birth
Birth
2011
Elective Surgeries
No.
Per 100
Deliveries
4.56
Per
1,000
Live
Birth
Emergency Surgeries
Per
Per 100 1,000
No.
Deliveries
Live
Birth
Malaysia
Public
75,692
19.07
- 81,629
19.73
- 18,869
Malaysia
Private
37,075
32.49
- 35,897
34.71
-
-
-
-
-
-
-
Malaysia
Total
22.07 211.697 117,526
22.73 237.62
-
-
-
-
-
-
Perlis
Public
870
22.03
-
1,019
24.85
-
222
5.41
55.02
797
Perlis
Private
na
na
na
na
na
na
na
na
na
na
na
na
Perlis
Total
22.03 198.841
1,019
24.85 252.54
-
-
-
-
-
-
Kedah
Public
6,454
21.95
-
7,407
24.41
-
1,831
6.04
52.59
5,576
Kedah
Private
1,823
36.79
-
2,455
40.57
-
-
-
-
-
-
-
Kedah
Total
8,277
24.09 226.044
9,862
27.10 283.26
-
-
-
-
-
-
Kedah & Perlis
Public
7,324
21.96
-
8,426
24.47
-
2,053
5.96
52.84
6,373
Kedah & Perlis
Private
1,823
36.79
-
2,455
40.57
-
-
-
-
-
-
-
Kedah & Perlis
Total
9,147
23.88 223.141 10,881
26.87 280.07
-
-
-
-
-
-
Pulau Pinang
Public
3,516
25.09
-
3,784
26.55
-
1,091
7.66
50.17
2,693
Pulau Pinang
Private
2,996
26.44
-
3,411
32.98
-
-
-
-
-
-
-
Pulau Pinang
Total
6,512
25.69 265.644
7,195
29.26 330.85
-
-
-
-
-
-
Perak
Public
7,541
25.36
-
8,197
26.65
-
1,683
5.47
46.18
6,514
Perak
Private
2,784
29.54
-
2,640
35.18
-
-
-
-
-
-
-
Perak
Total
28.32 297.34
-
-
-
-
-
-
112,767
870
10,325
26.36 276.011 10,837
38.15 62,760
19.44 197.52
18.38 160.16
18.51 164.04
18.90 123.83
21.17 178.73
Public
13,602
22.28
- 14,476
22.07
-
3,499
5.33
Private
13,469
32.6
- 10,542
32.60
-
-
-
-
-
-
-
Total
27,071
26.44 236.296 25,018
25.54 253.94
-
-
-
-
-
-
WP Kuala Lumpur
Public
6,972
29.97
-
7,190
29.50
-
1,777
7.29
61.05
5,413
WP Kuala Lumpur
Private
4,904
32.6
-
5,149
37.83
-
-
-
-
-
-
-
WP Kuala Lumpur
Total
32.48 423.90
-
-
-
-
-
-
11,876
31.01 422.134 12,339
35.52 10,977
15.17 126.89
22.21 185.96
Public
20,574
24.4
- 21,666
24.08
-
5,276
5.86
Private
18,373
32.6
- 15,691
34.15
-
-
-
-
-
-
-
Total
38,947
27.69 272.934 37,357
27.48 292.71
-
-
-
-
-
-
Negeri Sembilan
Public
2,543
19.12
-
2,526
18.48
-
804
5.88
46.97
1,722
Negeri Sembilan
Private
1,074
25.92
-
1,430
26.56
-
-
-
-
-
-
-
Negeri Sembilan
Total
3,617
20.74 192.514
3,956
20.76 231.10
-
-
-
-
-
-
Melaka
Public
2,087
19.72
2,511
22.15
-
490
4.32
36.15
2,021
Melaka
Private
1,564
49.98
-
1,663
49.13
-
-
-
-
-
-
-
Melaka
Total
3,651
26.62
229.2
4,174
28.36 307.98
-
-
-
-
-
-
Johor
Public
7,868
17.27
-
7,994
17.20
-
2,245
4.83
39.75
5,749
Johor
Private
3,959
34.59
-
4,095
34.61
Johor
Total
11,827
Pahang
Public
Pahang
Private
Pahang
Total
5,001
Terengganu
Public
2,486
12.12
-
Terengganu
Private
38
11.41
Terengganu
Total
2,524
Kelantan
Public
4,483
13.43
-
Kelantan
Private
428
20.38
Kelantan
Total
4,911
Sabah & WP Labuan
Public
7,209
13.44
Sabah & WP Labuan
Private
1,380
Sabah & WP Labuan
Total
8,589
Sarawak
Public
5,699
Sarawak
Private
Sarawak
Total
-
41.34 16,390
16.73 111.42
18.22 128.42
12.60 100.60
17.83 149.12
12.37 101.80
-
-
-
-
-
-
-
20.75 190.932 12,089
20.73 214.07
-
-
-
-
-
-
4,362
19.56
-
4,660
20.18
-
1,017
4.40
38.87
3,643
639
20.44
-
601
23.13
-
-
-
-
-
-
19.67 186.158
5,261
20.48 201.06
-
-
-
-
-
-
3,015
14.38
-
726
3.46
30.23
2,289
10.92
95.31
-
123
38.80
-
-
-
-
-
-
-
12.11 109.251
3,138
14.74 130.66
-
-
-
-
-
-
4,960
14.38
-
801
2.32
21.88
4,159
-
498
18.19
-
-
-
-
-
-
-
13.84 138.686
5,458
14.66 149.09
-
-
-
-
-
-
-
7,485
13.31
-
1,373
2.44
25.42
6,112
46.8
-
1,533
51.27
-
-
-
-
-
-
-
15.18
146.18
9,018
15.23 166.98
-
-
-
-
-
-
15.77
-
6,405
16.87
-
1,310
3.45
31.20
5,095
2,017
41.94
-
1,757
40.49
-
-
-
-
-
-
-
7,716
18.85 166.978
8,162
19.30 194.40
-
-
-
-
-
-
36
15.78 139.22
-
12.06 113.61
10.87 113.17
13.42 121.35
HOSPITAL
Table 3.11 Number and Density of Lower Segment Caesarean Section (LSCS), Caesarean Hysterectomy and Hysterotomy Performed in
Public Hospitals in Malaysia by State, 2010 and 2011
2010
2011
Caesarean
Hysterectomy
LSCS
State
No.
Per 100
Deliveries
75,692
Perlis
Per
1,000
Live
Birth
No.
Per 100
Deliveries
19.07
142.10 233
870
22.03
198.84
Kedah
6,454
21.95
Kedah & Perlis
7,324
21.96
Malaysia
LSCS
Per
1,000
Live
Birth
Caesarean Hysterectomy
No.
Per 100
Deliveries
Per
1,000
Live
Birth
No.
Per 100
Deliveries
Per
1,000
Live
Birth
19.66
164.44 166
0.04
0.34
71
0.02
0.14
1,019
24.85
252.54
4
0.10
0.99
0
0.00
0.00
0.57
7,389
24.36
212.23
35
0.12
1.01
7
0.02
0.20
0.54
8,408
24.41
216.42
39
0.11
1.00
7
0.02
0.18
No.
Per 100
Deliveries
0.06
0.44 81,331
1
0.03
0.23
176.26
21
0.07
178.67
22
0.07
Per
1,000
Live
Birth
Hysterotomy
Pulau Pinang
3,516
25.09
143.43
13
0.09
0.53
3,786
26.57
174.09
5
0.04
0.23
0
0.00
0.00
Perak
7,541
25.36
201.59
27
0.09
0.72
7,985
25.96
219.09
26
0.08
0.71
21
0.07
0.58
13,602
22.28
118.73
37
0.06
0.32 14,476
22.07
146.94
12
0.02
0.12
2
0.00
0.02
Selangor & WP
Putrajaya
6,972
29.97
247.82
12
0.05
0.43
7,190
29.50
247.01
7
0.03
0.24
5
0.02
0.17
Selangor & WP
20,574
Putrajaya & WPKL
WP Kuala Lumpur
24.40
144.18
49
0.06
0.34 21,666
24.08
169.76
19
0.02
0.15
7
0.01
0.06
Negeri Sembilan
19.12
135.35
9
0.07
0.48
18.47
147.45
3
0.02
0.18
0
0.00
0.00
2,543
2,524
2,087
19.72
131.02
2
0.02
0.13
2,511
22.15
185.27
8
0.07
0.59
0
0.00
0.00
7,868
17.27
127.02
19
0.04
0.31
7,982
17.17
141.34
18
0.04
0.32
7
0.02
0.12
Pahang
4,362
19.56
162.37
8
0.04
0.30
4,660
20.18
178.09
10
0.04
0.38
1
0.00
0.04
Terengganu
2,486
12.12
107.61
15
0.07
0.65
3,015
14.38
125.54
4
0.02
0.17
15
0.07
0.63
Kelantan
4,483
13.43
126.60
6
0.02
0.17
4,960
14.38
135.49
9
0.03
0.25
1
0.00
0.03
Sabah & WP Labuan
7,209
13.44
122.69
41
0.08
0.70
7,539
13.41
139.59
15
0.03
0.28
8
0.01
0.15
Sarawak
5,699
15.77
123.33
22
0.06
0.48
6,295
16.58
149.93
10
0.03
0.24
4
0.01
0.10
3
Melaka
Johor
37
HOSPITAL
Table 3.12 Number and Density of Multiple Pregnancies Delivered in Malaysia by State and Sector, 2010 and 2011
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
No.
3,131
732
3,863
23
na
23
247
23
270
270
23
293
101
103
204
208
25
233
514
317
831
289
97
386
803
414
1,217
102
21
123
92
24
116
329
47
376
155
18
173
123
0
123
289
7
296
457
13
470
202
37
239
Multiple Pregnancies Delivered
2010
2011
Per 100 deliveries
No.
Per 100 deliveries
0.79
3,284
0.79
0.64
724
0.70
0.76
4,008
0.78
0.58
31
0.76
na
na
na
0.58
31
0.76
0.84
228
0.75
0.46
28
0.46
0.79
256
0.70
0.81
259
0.75
0.46
28
0.46
0.76
287
0.71
0.72
148
1.04
0.91
75
0.73
0.80
223
0.91
0.70
276
0.90
0.27
33
0.44
0.59
309
0.81
0.84
500
0.76
0.77
195
0.60
0.81
695
0.71
1.24
288
1.18
0.64
124
0.91
1.01
412
1.08
0.95
788
0.88
0.73
319
0.69
0.87
1,107
0.81
0.77
133
0.97
0.51
48
0.89
0.71
181
0.95
0.87
89
0.79
0.77
17
0.50
0.85
106
0.72
0.72
397
0.85
0.41
100
0.85
0.66
497
0.85
0.70
142
0.61
0.58
11
0.42
0.68
153
0.60
0.60
170
0.81
0.00
1
0.32
0.59
171
0.80
0.87
277
0.80
0.33
6
0.22
0.83
283
0.76
0.85
394
0.70
0.44
51
1.71
0.83
445
0.75
0.56
211
0.56
0.77
35
0.81
0.58
246
0.58
38
HOSPITAL
Table 3.13 Number and Density of Eclampsia in Malaysia by State and Sector, 2010 and 2011
Eclampsia
State
Sector
2010
No.
Malaysia
Public
390
0.98
390
Malaysia
Private
150
1.31
100
Malaysia
Total
540
1.06
490
Perlis
Public
5
1.27
5
Perlis
Private
na
na
na
Perlis
Total
5
1.27
5
Kedah
Public
21
0.71
28
Kedah
Private
6
1.21
6
Kedah
Total
27
0.79
34
Kedah & Perlis
Public
26
0.78
33
Kedah & Perlis
Private
6
1.21
6
Kedah & Perlis
Total
32
0.84
39
Pulau Pinang
Public
4
0.29
2
Pulau Pinang
Private
11
0.97
4
Pulau Pinang
Total
15
0.59
6
Perak
Public
11
0.37
24
Perak
Private
0
0.00
1
Perak
Total
11
0.28
25
Public
79
1.29
59
Private
62
1.50
42
Total
141
1.38
101
WP Kuala Lumpur
Public
9
0.39
29
WP Kuala Lumpur
Private
38
2.53
29
WP Kuala Lumpur
Total
47
1.23
58
Public
88
1.04
88
Private
100
1.77
71
Total
188
1.34
159
Negeri Sembilan
Public
7
0.53
14
Negeri Sembilan
Private
0
0.00
0
Negeri Sembilan
Total
7
0.40
14
Melaka
Public
4
0.38
10
Melaka
Private
4
1.28
4
Melaka
Total
8
0.58
14
Johor
Public
42
0.92
36
Johor
Private
0
0.00
3
Johor
Total
42
0.74
39
Pahang
Public
17
0.76
4
Pahang
Private
7
2.24
1
Pahang
Total
24
0.94
5
Terengganu
Public
21
1.02
16
Terengganu
Private
11
33.03
0
Terengganu
Total
32
1.54
16
Kelantan
Public
19
0.57
26
Kelantan
Private
0
0.00
1
Kelantan
Total
19
0.54
27
Sabah & WP Labuan
Public
118
2.20
99
Sabah & WP Labuan
Private
0
0.00
9
Sabah & WP Labuan
Total
118
2.08
108
Sarawak
Public
33
0.91
38
Sarawak
Private
11
2.29
0
Sarawak
Total
44
1.07
38
3
2011
Per 1,000 Deliveries
0.94
0.97
0.95
1.22
na
1.22
0.92
0.99
0.93
0.96
0.99
0.96
0.14
0.39
0.24
0.78
0.13
0.65
0.90
1.30
1.03
1.19
2.13
1.53
0.98
1.55
1.17
1.02
0.00
0.73
0.88
1.18
0.95
0.77
0.25
0.67
0.17
0.38
0.19
0.76
0.00
0.75
0.75
0.37
0.73
1.76
3.01
1.82
1.00
0.00
0.90
39
HOSPITAL
Table 3.14 Number and Density of Post Partum Haemorrhage (PPH) in Malaysia by State and Sector, 2010-2011
2010
2011
Post Partum
Post Partum
Primary PPH
State
Sector
Haemorrhage
Haemorrhage
Per 1,000
Per 1,000
Per 1,000
No
No
No
Deliveries
Deliveries
Deliveries
Malaysia
Public
8,045
20.27 11,843
28.63
10,329
24.97
Malaysia
Private
1,222
10.71
819
7.92
758
7.33
Malaysia
Total
9,267
18.14 12,662
24.49
11,087
21.44
Perlis
Public
39
9.88
602
146.83
542
132.20
Perlis
Private
na
na
na
na
na
na
Perlis
Total
39
9.88
602
146.83
542
132.20
Kedah
Public
253
8.61
786
25.91
611
20.14
Kedah
Private
49
9.89
19
3.14
19
3.14
Kedah
Total
302
8.79
805
22.12
630
17.31
Kedah & Perlis
Public
292
8.76
1,388
40.30
1,153
33.48
Kedah & Perlis
Private
49
9.89
19
3.14
19
3.14
Kedah & Perlis
Total
341
8.90
1,407
34.75
1,172
28.95
Pulau Pinang
Public
568
40.53
1,024
71.85
927
65.05
Pulau Pinang
Private
143
12.62
67
6.48
58
5.61
Pulau Pinang
Total
711
28.05
1,091
44.36
985
40.05
Perak
Public
1,497
50.33
1,451
47.17
1,275
41.45
Perak
Private
156
16.55
101
13.46
95
12.66
Perak
Total
1,653
42.21
1,552
40.56
1,370
35.80
Public
1,662
27.22
2,199
33.52
2,385
36.35
Private
394
9.54
247
7.64
238
7.36
Total
2,056
20.08
2,446
24.98
2,623
26.78
WP Kuala Lumpur
Public
515
22.14
378
15.51
235
9.64
WP Kuala Lumpur
Private
108
7.18
115
8.45
104
7.64
WP Kuala Lumpur
Total
623
16.27
493
12.98
339
8.92
2,177
25.82
2,577
28.64
2,620
29.12
502
8.91
362
7.88
342
7.44
2,679
19.04
2,939
21.62
2,962
21.79
Negeri Sembilan
Public
57
4.29
639
46.75
592
43.31
Negeri Sembilan
Private
90
21.72
76
14.12
76
14.12
Negeri Sembilan
Total
147
8.43
715
37.53
668
35.06
Melaka
Public
26
2.46
497
43.85
452
39.88
Melaka
Private
6
1.92
23
6.79
19
5.61
Melaka
Total
32
2.33
520
35.33
471
32.00
Johor
Public
993
21.80
1,038
22.33
870
18.72
Johor
Private
71
6.20
104
8.79
92
7.78
Johor
Total
1,064
18.66
1,142
19.58
962
16.50
Pahang
Public
355
15.92
512
22.17
424
18.36
Pahang
Private
19
6.08
44
16.94
35
13.47
Pahang
Total
374
14.71
556
21.64
459
17.87
Terengganu
Public
67
3.27
270
12.88
177
8.44
Terengganu
Private
1
3.00
0
0.00
0
0.00
Terengganu
Total
68
3.26
270
12.68
177
8.32
Kelantan
Public
853
25.55
1,115
32.33
701
20.33
Kelantan
Private
6
2.86
4
1.46
3
1.10
Kelantan
Total
859
24.21
1,119
30.06
704
18.91
Sabah & WP Labuan
Public
984
18.34
960
17.07
835
14.85
Sabah & WP Labuan
Private
5
1.70
0
0.00
0
0.00
Sabah & WP Labuan
Total
989
17.48
960
16.21
835
14.10
Sarawak
Public
176
4.87
372
9.80
303
7.98
Sarawak
Private
174
36.18
19
4.38
19
4.38
Sarawak
Total
350
8.55
391
9.24
322
7.61
40
Massive PPH
No
1,927
80
2,007
60
na
60
174
1
175
234
1
235
97
15
112
176
6
182
206
13
219
143
16
159
349
29
378
47
0
47
45
4
49
168
14
182
88
9
97
93
0
93
414
1
415
148
0
148
68
1
69
Per 1,000
Deliveries
4.66
0.77
3.88
14.63
na
14.63
5.74
0.17
4.81
6.79
0.17
5.80
6.81
1.45
4.55
5.72
0.80
4.76
3.14
0.40
2.24
5.87
1.18
4.19
3.88
0.63
2.78
3.44
0.00
2.47
3.97
1.18
3.33
3.61
1.18
3.12
3.81
3.46
3.78
4.44
0.00
4.37
12.01
0.37
11.15
2.63
0.00
2.50
1.79
0.23
1.63
HOSPITAL
Table 3.15 Number of Newborns Delivered and Admitted to Paediatrics, NICU and SCN in Public Hospitals in Malaysia by State, 2010-2011
2010
Newborns Newborns Admitted to
Delivered Paediatrics, NICU & SCN
404,396
70,501
3,973
1,310
29,534
4,171
33,507
5,481
14,117
3,660
29,821
5,526
61,842
10,522
23,599
7,277
85,441
17,799
13,423
1,843
10,675
2,307
50,529
6,006
22,361
6,497
20,548
5,309
33,761
4,227
54,020
8,347
36,193
3,499
Newborns Newborns Admitted to
Delivered Paediatrics, NICU & SCN
413,736
82,980
4,100
1,398
30,338
6,359
34,438
7,757
14,251
3,893
30,763
5,994
65,683
9,802
24,376
5,590
90,059
15,392
13,668
2,499
11,334
3,755
46,481
10,079
23,092
7,685
20,968
6,056
34,485
4,938
56,238
8,300
37,959
6,632
Malaysaia
Perlis
Kedah
Kedah & Perlis
Pulau Pinang
Perak
WP Kuala Lumpur
Negeri Sembilan
Melaka
Johor
Pahang
Terengganu
Kelantan
Sabah & WP Labuan
Sarawak
2011
3
State
41
HOSPITAL
Table 3.16 Number and Density of Obstetrics & Gynaecology (O&G) Specialists and Medical Officers in Malaysia by State and Sector,
2010-2011
2010
2011
O&G Specialist
Medical Officers
O&G Specialist
Medical Officers
State
Sector
Per
Per
Per
Per
No. 100,000
No. 100,000
No. 100,000
No. 100,000
Female
Female
Female
Female
Malaysia
Public
310
643
327
741
5.27
Malaysia
Private
446
92
512
Malaysia
Total
756
5.49
735
5.34
839
5.97
Perlis
Public
5
8
6
13
10.77
Perlis
Private
0
na
na
na
na
na
na
na
Perlis
Total
5
4.25
8
6.80
6
4.97
Kedah
Public
22
41
23
61
6.25
Kedah
Private
16
4
21
Kedah
Total
38
3.95
45
4.68
44
4.51
Kedah & Perlis
Public
27
49
29
74
6.75
Kedah & Perlis
Private
16
4
21
Kedah & Perlis
Total
43
3.98
53
4.91
50
4.56
Pulau Pinang
Public
14
40
16
38
4.78
Pulau Pinang
Private
48
10
52
Pulau Pinang
Total
62
7.96
50
6.42
68
8.56
Perak
Public
24
51
21
59
4.98
Perak
Private
42
0
43
Perak
Total
66
5.66
51
4.38
64
5.40
Public
64
108
61
126
4.62
Private
119
25
139
Total
183
6.84
133
4.97
200
7.33
WP Kuala Lumpur
Public
44
91
57
82
9.88
WP Kuala Lumpur
Private
98
38
102
WP Kuala Lumpur
Total
142
17.26
129
15.68
159
19.17
108
199
118
208
5.85
217
63
241
325
9.29
262
7.49
359
10.09
Negeri Sembilan
Public
10
28
12
40
7.93
Negeri Sembilan
Private
18
0
20
Negeri Sembilan
Total
28
5.69
28
5.69
32
6.35
Melaka
Public
9
31
5
29
7.01
Melaka
Private
18
0
20
Melaka
Total
27
6.61
31
7.59
25
6.04
Johor
Public
27
57
31
70
4.35
Johor
Private
36
2
50
Johor
Total
63
3.99
59
3.73
81
5.04
Pahang
Public
15
27
15
34
4.75
Pahang
Private
7
9
11
Pahang
Total
22
3.12
36
5.11
26
3.63
Terengganu
Public
10
17
11
29
5.51
Terengganu
Private
1
1
2
Terengganu
Total
11
2.17
18
3.55
13
2.47
Kelantan
Public
22
44
24
48
5.97
Kelantan
Private
6
3
5
Kelantan
Total
28
3.66
47
6.14
29
3.61
Sabah & WP Labuan
Public
23
55
22
67
4.10
Sabah & WP Labuan
Private
13
0
17
Sabah & WP Labuan
Total
36
2.26
55
3.46
39
2.39
Sarawak
Public
21
45
23
45
3.71
Sarawak
Private
24
0
30
Sarawak
Total
45
3.76
45
3.76
53
4.37
42
HOSPITAL
Table 3.17 Number and Density of Staff Nurses and Community Nurses in Obstetrics & Gynaecology (O&G) in Malaysia by State and
Sector, 2010-2011
Sector
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 & WP
Putrajaya
Selangor & WP
Putrajaya
Selangor & WP
Putrajaya
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Selangor & WP
Putrajaya & WPKL
Selangor & WP
Putrajaya & WPKL
Selangor & WP
Putrajaya & WPKL
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP
Labuan
Sabah & WP
Labuan
Sabah & WP
Labuan
Sarawak
Sarawak
Sarawak
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Community Nurses
Per
Per 1,000
No. 100,000
Deliveries
Female
2011
Staff Nurses
Per
Per 1,000
No. 100,000
Deliveries
Female
3,914
1,479
5,393
31
na
31
370
55
425
401
55
456
178
136
314
283
93
376
39.16
na
26.34
44.17
42.22
40.29
32.26
9.86
12.96
10.56
7.85
na
7.85
12.59
11.10
12.37
12.03
11.10
11.91
12.70
12.00
12.39
9.52
9.87
9.60
2,528
256
2,784
18
na
18
193
16
209
211
16
227
102
38
140
178
17
195
20.22
na
15.29
21.72
21.02
17.96
16.73
23.34
na
25.68
26.02
25.98
21.90
21.52
7.20
2.92
6.34
7.56
na
7.56
7.71
3.31
6.98
7.69
3.31
7.04
9.40
3.87
7.08
7.44
3.46
6.66
Public
500
-
8.19
455
-
7.45
581
-
8.86
490
-
7.47
Private
516
-
12.49
69
-
1.67
384
-
11.88
53
-
1.64
1,016
37.97
9.92
524
19.58
5.12
965
35.38
9.85
543
19.91
5.54
Public
Private
Total
325
278
603
73.31
13.97
18.48
15.74
76
22
98
11.91
3.27
1.46
2.56
513
254
767
92.45
21.05
18.66
20.19
108
38
146
17.60
4.43
2.79
3.84
Public
825
-
9.78
531
-
6.30 1,094
-
12.16
598
-
6.65
Private
794
-
14.09
91
-
1.61
638
-
13.89
91
-
1.98
1,619
46.28
11.51
622
17.78
4.42 1,732
48.70
12.74
689
19.37
5.07
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
124
47
171
104
59
163
473
185
658
291
27
318
224
5
229
352
14
366
34.75
39.88
41.62
45.14
45.12
47.79
9.33
11.34
9.81
9.83
18.86
11.89
10.38
16.16
11.54
13.05
8.64
12.51
10.92
15.02
10.99
10.54
6.67
10.32
37
3
40
73
4
77
258
26
284
215
9
224
157
2
159
137
6
143
8.13
18.84
17.97
31.80
31.33
18.67
2.78
0.72
2.29
6.90
1.28
5.61
5.66
2.27
4.98
9.64
2.88
8.81
7.65
6.01
7.63
4.10
2.86
4.03
163
60
223
97
77
174
501
153
654
295
39
334
193
1
194
346
10
356
44.22
42.07
40.65
46.69
36.88
44.26
11.93
11.14
11.70
8.56
22.75
11.82
10.78
12.93
11.22
12.77
15.01
13.00
9.20
3.15
9.11
10.03
3.65
9.56
123
11
134
90
1
91
308
38
346
218
9
227
125
0
125
146
3
149
26.57
22.00
21.51
31.73
23.76
18.53
9.00
2.04
7.03
7.94
0.30
6.18
6.63
3.21
5.93
9.44
3.46
8.84
5.96
0.00
5.87
4.23
1.10
4.00
Public
357
-
6.65
315
-
5.87
425
-
7.56
384
-
6.83
Private
24
-
8.14
8
-
2.71
24
-
8.03
25
-
8.36
Total
381
23.95
6.73
323
20.31
5.71
449
27.49
7.58
409
25.04
6.91
Public
Private
Total
302
40
342
28.55
8.36
8.32
8.35
314
36
350
29.22
8.69
7.49
8.55
398
61
459
37.81
10.48
14.06
10.85
358
38
396
32.62
9.43
8.76
9.36
Total
Total
41.99
na
32.31
39.44
38.66
46.95
44.65
10.93 2,978
13.34
302
11.41 3,280
9.51
31
na
na
9.51
31
11.21
234
7.44
20
10.58
254
11.01
265
7.44
20
10.47
285
13.89
134
16.92
40
15.17
174
14.04
229
12.92
26
13.82
255
3
6.37 4,521
2.24 1,380
5.45 5,901
4.56
39
na
na
4.56
39
6.57
340
3.23
45
6.08
385
6.33
379
3.23
45
5.93
424
7.28
198
3.35
175
5.52
373
5.99
432
1.80
97
4.98
529
Community Nurses
Per
Per 1,000
No. 100,000
Deliveries
Female
State
2010
Staff Nurses
Per
Per 1,000
No. 100,000
Deliveries
Female
43
HOSPITAL
Table 3.18 Number and Density of Staff Nurses with Midwifery and Community Nurses in Public Hospitals Obstetric Ward in Malaysia
with Specialist Services by State, 2010-2011
2010
2011
Staff Nurses with Midwifery Staff Nurses with Midwifery
Community Nurses
State
Per
Per
Per
Per 1,000
Per 1,000
Per 1,000
No. 100,000
No. 100,000
No. 100,000
Deliveries
Deliveries
Deliveries
Female
Female
Female
Malaysia
2,743
19.92
6.91
1,689
12.02
4.08
1,312
9.34
3.17
Perlis
27
22.94
6.84
17
14.08
4.15
10
8.29
2.44
Kedah
201
20.89
6.84
127
13.01
4.19
114
11.68
3.76
Kedah & Perlis
228
21.11
6.84
144
13.13
4.18
124
11.31
3.60
Pulau Pinang
115
14.76
8.21
78
9.82
5.47
63
7.93
4.42
Perak
331
28.39
11.13
207
17.47
6.73
99
8.36
3.22
236
8.82
3.86
154
5.65
2.35
227
8.32
3.46
WP Kuala Lumpur
299
36.35
12.85
249
30.01
10.21
92
11.09
3.77
535
15.29
6.34
403
11.33
4.48
319
8.97
3.55
Negeri Sembilan
104
21.13
7.82
72
14.28
5.27
67
13.29
4.90
Melaka
105
25.69
9.92
47
11.36
4.15
41
9.91
3.62
Johor
221
13.98
4.85
175
10.88
3.76
128
7.96
2.75
Pahang
205
29.10
9.19
67
9.37
2.90
94
13.14
4.07
Terengganu
187
36.85
9.12
63
11.97
3.00
66
12.55
3.15
Kelantan
180
23.50
5.39
162
20.14
4.70
54
6.71
1.57
Sabah & WP Labuan
313
19.68
5.83
105
6.43
1.87
122
7.47
2.17
Sarawak
219
18.28
6.06
166
13.67
4.37
135
11.12
3.56
Table 3.19 Number and Density of Staff Nurses with Midwifery and Community Nurses in Public Hospitals Labour Ward in Malaysia
with Specialist Services by State, 2010-2011
2010
State
Staff Nurses with
Midwifery
No.
Malaysia
2011
Staff Nurses with
Midwifery
Per
Per 1,000
100,000
Deliveries
Female
No.
Community Nurses
Per
Per 1,000
100,000
Deliveries
Female
No.
Per
100,000
Female
Per 1,000
Deliveries
2,025
14.70
5.10
1,216
8.65
2.94
814
5.79
1.97
Perlis
20
16.99
5.06
22
18.23
5.37
11
9.11
2.68
Kedah
199
20.68
6.77
90
9.22
2.97
66
6.76
2.18
Kedah & Perlis
219
20.28
6.57
112
10.21
3.25
77
7.02
2.24
Pulau Pinang
102
13.09
7.28
62
7.80
4.35
32
4.03
2.25
Perak
192
16.47
6.46
115
9.71
3.74
62
5.23
2.02
228
8.52
3.73
158
5.79
2.41
197
7.22
3.00
WP Kuala Lumpur
111
13.50
4.77
115
13.86
4.72
16
1.93
0.66
339
9.69
4.02
273
7.68
3.03
213
5.99
2.37
Negeri Sembilan
60
12.19
4.51
35
6.94
2.56
36
7.14
2.63
Melaka
54
13.21
5.10
27
6.53
2.38
26
6.29
2.29
Johor
233
14.74
5.11
155
9.64
3.33
98
6.09
2.11
Pahang
141
20.01
6.32
70
9.78
3.03
53
7.41
2.30
Terengganu
128
25.22
6.24
52
9.88
2.48
31
5.89
1.48
Kelantan
148
19.32
4.43
104
12.93
3.02
33
4.10
0.96
Sabah & WP Labuan
231
14.52
4.31
90
5.51
1.60
66
4.04
1.17
Sarawak
178
14.86
4.93
121
9.97
3.19
87
7.17
2.29
44
HOSPITAL
Table 3.20 Number and Density of Staff Nurses with Midwifery and Community Nurses in Public Hospitals Obstetric HDU in Malaysia
with Specialist Services by State, 2011
2011
Staff Nurses with Midwifery
Community Nurses
State
Per 100,000
Per 1,000
Per 100,000
Per 1,000
No.
No.
Female
Deliveries
Female
Deliveries
Malaysia
Perlis
110
0.78
0.27
50
0.36
0.12
0
0.00
0.00
10
8.29
2.44
Kedah
16
1.64
0.53
22
2.25
0.73
Kedah & Perlis
16
1.46
0.46
32
2.92
0.93
Pulau Pinang
4
0.50
0.28
5
0.63
0.35
Perak
10
0.84
0.33
0
0.00
0.00
16
0.59
0.24
0
0.00
0.00
WP Kuala Lumpur
10
1.21
0.41
0
0.00
0.00
26
0.73
0.29
0
0.00
0.00
Negeri Sembilan
7
1.39
0.51
0
0.00
0.00
Melaka
0
0.00
0.00
0
0.00
0.00
Johor
1.37
0.47
1
0.06
0.02
6
0.84
0.26
0
0.00
0.00
Terengganu
5
0.95
0.24
0
0.00
0.00
Kelantan
0
0.00
0.00
0
0.00
0.00
Sabah & WP Labuan
0
0.00
0.00
0
0.00
0.00
14
1.15
0.37
12
0.99
0.32
3
Sarawak
22
Pahang
45
Chapter 4
HOSPITAL
| SURGICAL SERVICES IN MALAYSIAN HOSPITALS
Abdul JA1, Tahrani PK2*, Faizah A2*, Gunn AKB3, Tan WJ4, Nik ANA5, Clement ET6, Jiffre D7, Nik MSNY8, Yan YW9, Chuah JA10, Wan KWK11, Mohamed
YAB12, Jasiah Z13
1. Hospital Sultanah Zahirah, Kuala Terengganu, 2. National Clinical Research Centre, Ministry of Health, 3. Hospital Sultanah Aminah, Johor Bahru, 4. Hospital Pulau Pinang, 5. Sarawak
General Hospital, 6. Hospital Tuanku Fauziah, Kangar, 7. Hospital Tengku Ampuan Afzan, Kuantan, 8. Hospital Raja Perempuan Zainab II, Kota Bharu, 9. Hospital Raja Permaisuri Bainun,
Ipoh, 10. Hospital Queen Elizabeth, Kota Kinabalu, 11. Hospital Sultanah Bahiyah, Alor Setar, 12. Hospital Tengku Ampuan Rahimah, Klang, 13. Hospital Tuanku Jaafar, Seremban
Summary: The facility, workforce and surgical output has not changed significantly since 2010. The distribution of
hospitals providing general surgical services in 2011 was similar to that of 2010; more than 50% being in the private
sector. The highest density of surgeons was in Wilayah Persekutuan Kuala Lumpur (WPKL) and the lowest in Sabah.
There was an increase in the number of surgeons in private hospitals. However, the number of hours allocated to elective
operations has increased in the public hospitals. There was a marked increase in the number of mastectomies, most
cases being done in the private hospitals. Laparoscopic repairs for inguinal hernias and laparoscopic cholecystectomies
are now preferred to open procedures, both in the public and private sectors. Endoscopic procedures in public hospitals
were done mostly by surgeons when compared to gastroenterologists. However, this increase in laparoscopic surgeries
and endoscopic procedures in the public hospitals also faced the limitation of availability of equipment. This needs to
be looked into for future planning.
General surgical services in this report refers to the general surgery and its subspecialties of breast and endocrine, upper gastrointestinal,
colorectal, vascular, hepatobiliary, trauma and thoracic surgeries only. This survey was undertaken in all Ministry of Health (MOH), University and
private hospitals in Malaysia, irrespective of whether the surgical services were provided by resident or visiting general surgeons. Furthermore,
hospitals with visiting surgeons were included only if elective surgery was performed there. The response rate was 98.3% for public hospitals and
78.3% for private hospitals.
Facilities
There were 166 hospitals providing general surgical services in 2011; 60 were from the public sector, three from the university and 106 from the
private sector. WPKL had the highest density (0.12 per 10,000 populations) and Sabah had the lowest density of 0.03 per 10,000 populations.
Private hospitals made up 64% of the total number of hospitals providing surgical services (Table 4.1).
There were 235 operation theatres (OTs) in Malaysia, 128 (54.5%) in public hospitals and 107 (45.5%) in private hospitals. The highest numbers
were in WPKL with 33 OTs. Perlis had the least with only one OT (Table 4.2).
Activities and Workload
A total of 91,144 surgeries were performed in public hospitals in 2011 of which 49.5% were elective cases and the remaining 50.5% were
emergencies. Of these surgeries, 72,859 or 80% were done under general anaesthesia, 60% being emergency cases. There was an increase of
11.3% in the time allocated for elective operating hours for general surgery from 2010 (Table 4.4, Table 4.5, Table 4.6).
A total of 11,660 inguinal hernia repairs were reported in 2011, with 11.6% being done laparoscopically, an increase of 3% from the 8.6%
reported in the previous year. There was a significant increase of 27.3% in the number of these procedures being done laparoscopically in the
public sector (Table 4.8).
In all, 10,404 cholecystectomies were performed in 2011 with 78.4% being done laparoscopically, a small increase from the 76.7% reported in
the previous year. Of these, 67.5% were performed in private sector. This shows that laparoscopic approach is the preferred method (Table 4.9).
4
Endoscopic services in Malaysia were provided both by surgeons and gastroenterologists. In the public sector, surgeons performed more of
the oesophago-gastroduodenoscopies (OGDS), (45,574 or 71.7%), colonoscopies (24,416 or 78.9%) and endoscopic retrograde cholangiopancreatography (ERCP) cases (3,458 or 69.1%). There were a total of 251 OGDS scopes, 178 Colonoscopes and 134 ERCP scopes done in the
public hospitals. Most of these scopes were being done in the Klang Valley (Selangor, WPKL, WP Putrajaya). The least were in Melaka (Table 4.10,
Table 4.12, Table 4.14, and Table 4.16). In 2011, about a quarter of the scopes were non functional and awaiting repair or replacement in the
public hospitals.
SURGICAL SERVICES IN MALAYSIAN HOSPITALS
A total of 4,228 mastectomies were reported in 2011, an increase of 18.6% (662 cases) from 2010. Most of these were performed in the three
tertiary breast centres i.e. Hospital Putrajaya (n= 83), Hospital Kuala Lumpur (n=135) and University Malaya Medical Centre (n= 220). In the
private sector the increase was from 1,414 to 1,993, an increase of 41% (Table 4.7).
47
HOSPITAL
Workforce
There were a total of 3,708 OT scrub nurses in the country, with 53.3% (1,978) serving the public hospitals. Almost half (44.2%) of them had post
basic training. On the other hand, in the private sector, only 22.1% out of 1,730 OT scrub nurses had post basic training (Table 4.17).
There were 557 (public: 298; private: 259) general surgeons in 2011 as compared to 540 in 2010. This translates to a surgeon to population ratio
of 0.2 per 10,000. There was an increase of 21 surgeons (3.9%) in private sector from 2010. The highest concentration was seen in WPKL (0.66
per 10,000 population) while Terengganu and Sabah had the lowest (0.08 per 10,000 population) (Table 4.18).
Limitation
1. This survey does not reflect the total workload of surgeons as it only captures selected types of surgeries performed.
48
HOSPITAL
Table 4.1 Number and Density of Hospitals Providing General Surgery Services in Malaysia by State and Sector, 2010-2011
2010
2011
State
Sector
Per 10,000
Per 10,000
No.
No.
population
population
Malaysia
Public
60
60
Malaysia
Private
107
106
Malaysia
Total
167
0.06
166
0.06
Perlis
Public
1
1
Perlis
Private
na
na
na
na
Perlis
Total
1
0.04
1
0.04
Kedah
Public
4
4
Kedah
Private
4
5
Kedah
Total
8
0.04
9
0.05
Kedah & Perlis
Public
5
5
Kedah & Perlis
Private
4
5
Kedah & Perlis
Total
9
0.04
10
0.05
Pulau Pinang
Public
4
4
Pulau Pinang
Private
11
10
Pulau Pinang
Total
15
0.10
14
0.09
Perak
Public
5
5
Perak
Private
10
11
Perak
Total
15
0.06
16
0.07
Public
7
7
Private
25
23
Total
32
0.06
30
0.05
WP Kuala Lumpur
Public
3
3
WP Kuala Lumpur
Private
19
18
WP Kuala Lumpur
Total
22
0.13
21
0.12
10
10
44
41
54
0.07
51
0.07
Negeri Sembilan
Public
2
2
Negeri Sembilan
Private
6
6
Negeri Sembilan
Total
8
0.08
8
0.08
Melaka
Public
1
1
Melaka
Private
3
3
Melaka
Total
4
0.05
4
0.05
Johor
Public
7
7
Johor
Private
12
11
Johor
Total
19
0.06
18
0.05
Pahang
Public
2
2
Pahang
Private
3
4
Pahang
Total
5
0.03
6
0.04
Terengganu
Public
3
3
Terengganu
Private
1
1
Terengganu
Total
4
0.04
4
0.04
Kelantan
Public
6
6
Kelantan
Private
2
3
Kelantan
Total
8
0.05
9
0.06
Sabah & WP Labuan
Public
8
8
Sabah & WP Labuan
Private
3
3
Sabah & WP Labuan
Total
11
0.03
11
0.03
Sarawak
Public
7
7
Sarawak
Private
8
8
Sarawak
Total
15
0.06
15
0.06
4
49
HOSPITAL
Table 4.2 Number of Total Surgeons, Operation Theatre (OT) and Theatre Scrub Nurses in Malaysia by State and Sector, 2011
Total
OT
Theatre Scrub Nurses
State
Sector Surgeonsa
No.
No.
No. Per Surgeonsa Per Functioning OT
Malaysia
Public
1,431
128
1,978
1.38
15.45
Malaysia
Private
1,555
107
1,730
1.11
16.17
Malaysia
Total
2,986
235
3,708
1.24
15.78
Perlis
Public
20
1
27
1.35
27.00
Perlis
Private
na
na
na
na
na
Perlis
Total
20
1
27
1.35
27.00
Kedah
Public
85
9
143
1.68
15.89
Kedah
Private
63
5
75
1.19
15.00
Kedah
Total
148
14
218
1.47
15.57
Kedah & Perlis
Public
105
10
170
1.62
17.00
Kedah & Perlis
Private
63
5
75
1.19
15.00
Kedah & Perlis
Total
168
15
245
1.46
16.33
Pulau Pinang
Public
64
7
128
2.00
18.29
Pulau Pinang
Private
184
10
338
1.84
33.80
Pulau Pinang
Total
248
17
466
1.88
27.41
Perak
Public
80
12
181
2.26
15.08
Perak
Private
120
11
133
1.11
12.09
Perak
Total
200
23
314
1.57
13.65
Public
270
16
343
1.27
21.44
Private
416
25
378
0.91
15.12
Total
686
41
721
1.05
17.59
WP Kuala Lumpur
Public
312
16
170
0.54
10.63
WP Kuala Lumpur
Private
325
17
268
0.82
15.76
WP Kuala Lumpur
Total
637
33
438
0.69
13.27
Public
582
32
513
0.88
16.03
Private
741
42
646
0.87
15.38
Total
1,323
74
1,159
0.88
15.66
Negeri Sembilan
Public
44
4
56
1.27
14.00
Negeri Sembilan
Private
58
6
90
1.55
15.00
Negeri Sembilan
Total
102
10
146
1.43
14.60
Melaka
Public
29
3
47
1.62
15.67
Melaka
Private
86
3
108
1.26
36.00
Melaka
Total
115
6
155
1.35
25.83
Johor
Public
120
13
226
1.88
17.38
Johor
Private
135
11
179
1.33
16.27
Johor
Total
255
24
405
1.59
16.88
Pahang
Public
67
11
77
1.15
7.00
Pahang
Private
34
4
41
1.21
10.25
Pahang
Total
101
15
118
1.17
7.87
Terengganu
Public
43
6
81
1.88
13.50
Terengganu
Private
3
1
8
2.67
8.00
Terengganu
Total
46
7
89
1.93
12.71
Kelantan
Public
133
13
108
0.81
8.31
Kelantan
Private
18
3
25
1.39
8.33
Kelantan
Total
151
16
133
0.88
8.31
Sabah & WP Labuan
Public
84
10
206
2.45
20.60
Sabah & WP Labuan
Private
41
3
20
0.49
6.67
Sabah & WP Labuan
Total
125
13
226
1.81
17.38
Sarawak
Public
80
7
185
2.31
26.43
Sarawak
Private
72
8
67
0.93
8.38
Sarawak
Total
152
15
252
1.66
16.80
(a) Surgeons include surgeons, obstetricians & gynaecologists, opthalmologists, orthopedics surgeons and otorhinolaryngologists
50
HOSPITAL
Table 4.3 Number and Density of Dedicated Emergency/ Trauma Theatres in Malaysian Public Hospitals by State, 2010-2011
2010
2011
Dedicated Emergency /
Dedicated Emergency /
State
Sector
Trauma Theatres
Trauma Theatres
Per 10,000
Per 10,000
No.
No.
population
population
Malaysia
Public
55
0.02
57
0.02
Perlis
Public
1
0.04
1
0.04
Kedah
Public
6
0.03
4
0.02
Kedah & Perlis
Public
7
0.03
5
0.02
Pulau Pinang
Public
2
0.01
2
0.01
Perak
Public
5
0.02
5
0.02
Public
7
0.01
7
0.01
WP Kuala Lumpur
Public
4
0.03
5
0.03
Public
11
0.02
12
0.02
Negeri Sembilan
Public
1
0.01
0
0.00
Melaka
Public
2
0.02
3
0.04
Johor
Public
5
0.02
6
0.02
Pahang
Public
4
0.03
2
0.01
Terengganu
Public
2
0.02
3
0.03
Kelantan
Public
1
0.01
1
0.01
Sabah & WP Labuan
Public
8
0.02
9
0.03
Sarawak
Public
7
0.03
9
0.04
Note: Discrepancies in 2010 and 2011 data due to changes in data definition
Definition 2010: A 24 hours operating theatre dedicated for urgent patient intervention. Urgent is defined as acute onset or deterioration of conditions that threaten life, limb or organ survival.
Note: Discrepancies in 2010 and 2011 data due to changes in data definition
Definition 2010: Total hours of elective cases performed within OR time divided by the hours of allocated block time.
Definition 2011: The allocated elective GA/regional block time for general surgery. The times included are from daycare OT and Saturday OT. Locum OT time and time given to specialties outside general
surgery were excluded.
51
4
Table 4.4 Number and Density of General Surgeons and Total Elective Operating Hours in Malaysian Public Hospitals by State,
2010-2011
2010
2011
General
Total Elective Operating
General
Total Elective Operating Hours
State
Surgeons
Hours /Weeks
Surgeons
/Weeks
Ratio to General
Ratio to General
No.
No.
No.
No.
Surgeons
Surgeons
Malaysia
302
1,445
4.78
298
1,609
5.40
Perlis
2
23
11.50
3
23
7.67
Kedah
23
104
4.52
22
145
6.59
Kedah & Perlis
25
127
5.08
25
168
6.72
Pulau Pinang
14
113
8.07
15
123
8.20
Perak
15
144
9.60
16
126
7.88
62
228
3.68
55
275
5.00
WP Kuala Lumpur
56
124
2.21
61
188
3.08
Selangor & WP Putrajaya &
118
352
2.98
116
463
3.99
WPKL
Negeri Sembilan
10
61
6.10
11
61
5.55
Melaka
8
47
5.88
7
47
6.71
Johor
24
117
4.88
25
127
5.08
Pahang
18
81
4.50
13
63
4.85
Terengganu
5
68
13.60
8
86
10.75
Kelantan
26
103
3.96
25
98
3.92
Sabah & WP Labuan
18
128
7.11
20
118
5.90
Sarawak
21
104
4.95
17
129
7.59
Definition 2011: A 24 hours operating theatre dedicated for emergency cases only. OTs dedicated for emergency LSCS and orthopedics were excluded.
HOSPITAL
Table 4.5 Number and Density of Elective Cases in General Surgery in Malaysian Public Hospitals by State, 2011
Total Elective Cases
State
Elective Cases Under GA
Elective Cases Under LA
No.
Per 10,000
population
No.
Per 10,000
population
No.
Per 10,000
population
45,149
15.59
29,525
10.19
15,624
5.39
Perlis
661
27.83
534
22.48
127
5.35
Kedah
2,622
13.29
2,162
10.96
460
2.33
Kedah & Perlis
3,283
14.85
2,696
12.20
587
2.66
Pulau Pinang
2,757
17.30
1,569
9.85
1,188
7.45
Perak
5,656
23.59
3,117
13.00
2,539
10.59
7,829
13.85
5,639
9.97
2,190
3.87
WP Kuala Lumpur
5,314
31.36
3,052
18.01
2,262
13.35
13,143
17.89
8,691
11.83
4,452
6.06
2,016
19.33
1,810
17.36
206
1.98
829
9.95
708
8.50
121
1.45
Johor
4,138
12.16
2,561
7.53
1,577
4.64
Pahang
2,174
14.26
1,621
10.63
553
3.63
Terengganu
2,126
19.80
1,623
15.11
503
4.68
Kelantan
1,866
11.55
1,480
9.16
386
2.39
Sabah & WP Labuan
3,177
9.33
1,810
5.31
1,367
4.01
Sarawak
3,984
15.83
1,839
7.31
2,145
8.52
Malaysia
Negeri Sembilan
Melaka
Abbreviation: GA - general anaesthesia; LA - local anaesthesia
Table 4.6 Number and Density of Emergency Cases in General Surgery in Malaysian Public Hospitals by State, 2011
Total Emergency Cases
State
Emergency Cases
Under GA
Emergency Cases
Under LA
No.
Per 10,000
population
No.
Per 10,000
population
No.
Per 10,000
population
45,995
15.88
43,334
14.96
2,661
0.92
Perlis
718
30.23
709
29.85
9
0.38
Kedah
4,193
21.25
4,189
21.23
4
0.02
Kedah & Perlis
4,911
22.22
4,898
22.16
13
0.06
Pulau Pinang
2,115
13.27
2,088
13.10
27
0.17
Perak
5,129
21.39
4,821
20.11
308
1.28
6,280
11.11
6,063
10.72
217
0.38
WP Kuala Lumpur
5,158
30.44
4,714
27.82
444
2.62
11,438
15.57
10,777
14.67
661
0.90
Negeri Sembilan
1,570
15.05
1,566
15.02
4
0.04
Melaka
2,422
29.08
2,045
24.55
377
4.53
Johor
6,701
19.70
6,129
18.02
572
1.68
Pahang
2,127
13.95
2,117
13.88
10
0.07
Terengganu
2,005
18.67
1,884
17.54
121
1.13
Kelantan
1,713
10.61
1,647
10.20
66
0.41
Sabah & WP Labuan
3,191
9.37
2,829
8.31
362
1.06
Sarawak
2,673
10.62
2,533
10.07
140
0.56
Malaysia
Abbreviation: GA - general anaesthesia; LA - local anaesthesia
52
HOSPITAL
Table 4.7 Number and Density of Mastectomies in Malaysia by State and Sector, 2010-2011
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
No.
2,152
1,414
3,566
20
na
20
105
41
146
125
41
166
174
276
450
132
121
253
342
208
550
625
281
906
967
489
1,456
96
25
121
62
128
190
204
200
404
62
33
95
45
1
46
84
4
88
106
37
143
95
59
154
2011
Per 10,000
population
1.26
na
0.86
0.75
0.76
2.88
1.08
0.99
5.41
2.02
1.18
2.31
1.21
0.63
0.44
0.57
0.43
0.62
No.
2,235
1,993
4,228
21
na
21
136
33
169
157
33
190
127
483
610
164
225
389
319
175
494
575
345
920
894
520
1,414
41
52
93
57
97
154
256
255
511
128
105
233
40
0
40
101
14
115
126
31
157
144
178
322
Per 10,000
population
1.46
na
0.88
0.86
0.86
3.83
1.62
0.87
5.43
1.92
0.89
1.85
1.50
1.53
0.37
0.71
0.46
1.28
4
Sector
2010
State
53
HOSPITAL
Table 4.8 Number and Density of Inguinal Hernia Surgeries in Malaysia by State and Sector, 2010-2011
2010
State
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 &
WP Putrajaya
Selangor &
WP Putrajaya
Selangor &
WP Putrajaya
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Selangor & WP
Putrajaya & WPKL
Selangor & WP
Putrajaya & WPKL
Selangor & WP
Putrajaya & WPKL
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP
Labuan
Sabah & WP
Labuan
Sabah & WP
Labuan
Sarawak
Sarawak
Sarawak
Sector
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Total Inguinal
Hernia Surgeries
Per 10,000
No.
population
7,486
6,634
14,120
4.98
184
na
na
184
7.95
549
310
859
4.41
733
310
1,043
4.79
522
827
1,349
8.64
829
697
1,526
6.49
Open Procedures
6,795
6,108
12,903
157
na
157
515
284
799
672
284
956
441
625
1,066
631
673
1,304
Per 10,000
population
4.55
na
6.78
4.10
4.39
6.83
5.54
No.
2011
Laparoscopic
Total Inguinal
Open Procedures
Procedures
Hernia Surgeries
Per 10,000
Per 10,000
Per 10,000
No.
No.
No.
population
population
population
691
6,472
5,592
524
5,188
4,709
1,215
0.43 11,660
4.03 10,301
3.56
27
101
83
na
na
na
na
na
na
27
1.17
101
4.25
83
3.49
34
410
349
26
256
252
60
0.31
666
3.38
601
3.05
61
511
432
26
256
252
87
0.40
767
3.47
684
3.09
81
376
337
201
1,008
752
282
1.81
1,384
8.68
1,089
6.83
198
694
482
24
420
396
222
0.94
1,114
4.65
878
3.66
Laparoscopic
Procedures
Per 10,000
No.
population
880
478
1,358
0.47
18
na
na
18
0.76
61
4
65
0.33
79
4
83
0.38
39
256
295
1.85
212
24
236
0.98
Public
1,156
-
1,073
-
83
-
1,037
-
939
-
98
-
Private
1,853
-
1,823
-
31
-
820
-
748
-
72
-
Total
3,009
5.44
2,896
5.23
114
0.21
1,857
3.28
1,687
2.98
170
0.30
Public
Private
Total
503
562
1,065
6.36
429
410
839
5.01
74
152
226
1.35
460
549
1,009
5.95
349
514
863
5.09
111
35
146
0.86
Public
1,659
-
1,502
-
157
-
1,497
-
1,288
-
209
-
Private
2,415
-
2,233
-
183
-
1,369
-
1,262
-
107
-
Total
4,074
5.65
3,735
5.18
340
0.47
2,866
3.90
2,550
3.47
316
0.43
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
294
240
534
241
259
500
756
1,216
1,972
366
162
528
381
15
396
532
70
602
5.23
6.09
5.89
3.52
3.82
3.91
253
235
488
241
182
423
749
1,216
1,965
312
160
472
380
15
395
517
70
587
4.78
5.15
5.87
3.14
3.81
3.81
41
5
46
0
76
76
7
0
7
54
1
55
1
0
1
15
0
15
0.45
0.93
0.02
0.37
0.01
0.10
202
209
411
325
272
597
721
1,100
1,821
339
109
448
152
8
160
554
73
627
3.94
7.17
5.35
2.94
1.49
3.88
123
200
323
320
236
556
695
1,067
1,762
287
109
396
152
8
160
543
73
616
3.10
6.67
5.18
2.60
1.49
3.81
79
8
87
5
36
41
26
33
59
52
0
52
0
0
0
11
0
11
0.83
0.49
0.17
0.34
0.00
0.07
Public
548
-
548
-
0
-
606
-
605
-
1
-
Private
103
-
103
-
0
-
82
-
82
-
0
-
Total
651
1.98
651
1.98
0
0.00
688
2.02
687
2.02
1
0.00
Public
Private
Total
625
320
945
3.82
549
312
861
3.48
76
8
84
0.34
495
282
777
3.09
328
272
600
2.38
167
10
177
0.70
54
HOSPITAL
Table 4.9 Number and Density of Cholecystectomies in Malaysia by State and Sector, 2010-2011
2010
Malaysia
Total
Open
Laparoscopic
Total
Open
Laparoscopic
Sector Cholecystectomies Cholecystectomies Cholecystectomies Cholecystectomies Cholecystectomies Cholecystectomies
Public
No.
Per 10,000
population
No.
Per 10,000
population
No.
Per 10,000
population
No.
Per 10,000
population
No.
Per 10,000
population
No.
Per 10,000
population
2,924
-
930
-
1,994
-
3,386
-
1,168
-
2,218
-
-
7,016
-
1,075
-
5,939
-
2.68 10,402
3.59
2,243
0.77
8,157
2.82
Malaysia
Private
6,985
-
1,378
-
5,607
Malaysia
Total
9,909
3.50
2,308
0.81
7,601
Perlis
Public
82
-
15
-
67
-
39
-
9
-
30
-
Perlis
Private
na
na
na
na
na
na
na
na
na
na
na
na
1.26
Perlis
Total
82
3.54
15
0.65
67
2.89
39
1.64
9
0.38
30
Kedah
Public
306
-
55
-
251
-
368
-
104
-
264
-
Kedah
Private
271
-
108
-
163
-
346
-
85
-
261
2.66
Kedah
Total
577
2.96
163
0.84
414
2.13
714
3.62
189
0.96
525
Kedah & Perlis
Public
388
-
70
-
318
-
407
-
113
-
294
-
Kedah & Perlis
Private
271
-
108
-
163
-
346
-
85
-
261
2.51
Kedah & Perlis
Total
659
3.02
178
0.82
481
2.21
753
3.41
198
0.90
555
Pulau Pinang
Public
186
-
65
-
121
-
284
-
193
-
91
-
Pulau Pinang
Private
1,063
-
108
-
955
-
1,270
-
147
-
1,123
7.62
Pulau Pinang
Total
1,249
8.00
173
1.11
1,076
6.89
1,554
9.75
340
2.13
1,214
Perak
Public
273
-
51
-
222
-
301
-
55
-
246
-
Perak
Private
693
-
257
-
436
-
588
-
131
-
456
-
Perak
Total
966
4.11
308
1.31
658
2.80
889
3.71
186
0.78
702
2.93
Selangor & WP
Putrajaya
Public
447
-
126
-
321
-
510
-
148
-
362
-
Selangor & WP
Putrajaya
Private
1,534
-
187
-
1,347
-
1,599
-
171
-
1,428
-
Selangor & WP
Putrajaya
Total
1,981
3.58
313
0.57
1,668
3.01
2,109
3.73
319
0.56
1,790
3.17
WP Kuala Lumpur
Public
227
-
74
-
153
-
320
-
70
-
250
-
WP Kuala Lumpur
Private
791
-
192
-
599
-
996
-
172
-
823
-
WP Kuala Lumpur
Total
1,018
6.08
266
1.59
752
4.49
1,316
7.77
242
1.43
1,073
6.33
Selangor & WP
Putrajaya & WPKL
Public
674
-
200
-
474
-
830
-
218
-
612
-
Selangor & WP
Putrajaya & WPKL
Private
2,325
-
379
-
1,946
-
2,595
-
343
-
2,251
-
Selangor & WP
Putrajaya & WPKL
Total
2,999
4.16
579
0.80
2,420
3.36
3,425
4.66
561
0.76
2,863
3.90
Negeri Sembilan
Public
97
-
37
-
60
-
83
-
7
-
76
-
Negeri Sembilan
Private
192
-
28
-
164
-
328
-
25
-
302
3.62
Negeri Sembilan
Total
289
2.83
65
0.64
224
2.19
411
3.94
32
0.31
378
Melaka
Public
103
-
41
-
62
-
121
-
63
-
58
-
Melaka
Private
423
-
112
-
311
-
420
-
52
-
368
-
Melaka
Total
526
6.41
153
1.86
373
4.54
541
6.49
115
1.38
426
5.11
Johor
Public
374
-
224
-
150
-
455
-
226
-
229
-
Johor
Private
1,393
-
237
-
1,156
-
773
-
178
-
596
-
Johor
Total
1,767
5.28
461
1.38
1,306
3.90
1,228
3.61
404
1.19
825
2.43
Pahang
Public
130
-
31
-
99
-
132
-
34
-
98
-
Pahang
Private
73
-
29
-
44
-
115
-
8
-
107
1.34
Pahang
Total
203
1.35
60
0.40
143
0.95
247
1.62
42
0.28
205
Terengganu
Public
48
-
26
-
22
-
70
-
35
-
35
-
Terengganu
Private
2
-
0
-
2
-
2
-
0
-
2
0.34
Terengganu
Total
50
0.48
26
0.25
24
0.23
72
0.67
35
0.33
37
Kelantan
Public
147
-
24
-
123
-
177
-
17
-
160
-
Kelantan
Private
44
-
21
-
23
-
57
-
11
-
46
-
Kelantan
Total
191
1.24
45
0.29
146
0.95
234
1.45
28
0.17
206
1.28
184
-
55
-
129
-
215
-
86
-
129
-
Sabah & WP Labuan Public
Sabah & WP Labuan Private
151
-
32
-
119
-
156
-
30
-
126
-
Sabah & WP Labuan Total
335
1.02
87
0.26
248
0.75
371
1.09
116
0.34
255
0.75
Sarawak
Public
320
-
106
-
214
-
311
-
121
-
190
-
Sarawak
Private
355
-
67
-
288
-
366
-
65
-
301
-
Sarawak
Total
675
2.73
173
0.70
502
2.03
677
2.69
186
0.74
491
1.95
4
State
2011
55
HOSPITAL
Table 4.10 Number of OGDS Scopes and OGDS Procedures Performed by Surgical and Medical Specialists in Malaysian Public
Hospitals by State, 2011
State
Malaysia
Total OGDS Functioning
Scopes OGDS Scopes
Total OGDS
PROCEDURES
OGDS PROCEDURES OGDS PROCEDURES
by Surgical
by Medical
251
175
63,864
45,574
18,323
Perlis
4
3
885
869
16
Kedah
27
20
4,113
2,647
1,466
Kedah & Perlis
31
23
4,998
3,516
1,482
Pulau Pinang
15
13
4,846
3,867
979
Perak
19
11
6,136
5,285
851
41
24
10,258
7,315
2,976
WP Kuala Lumpur
39
29
10,556
4,346
6,210
80
53
20,814
11,661
9,186
Negeri Sembilan
8
5
2,284
2,059
225
Melaka
2
1
1,903
1,903
0
Johor
18
12
6,926
6,626
300
Pahang
8
6
2,798
1,998
800
Terengganu
6
4
1,062
938
124
Kelantan
17
16
2,700
1,453
1,247
Sabah & WP Labuan
23
18
4,543
1,813
2,730
Sarawak
24
13
4,854
4,455
399
Table 4.11 Number of OGDS Scopes and OGDS Procedures Performed in Malaysian Private Hospitals by State, 2011
State
Total OGDS Scopes
Total OGDS PROCEDURES
209
79,791
Perlis
na
na
Kedah
7
2,783
Kedah & Perlis
7
2,783
Pulau Pinang
34
13,256
Perak
19
9,826
46
17,391
WP Kuala Lumpur
37
10,775
83
28,166
Negeri Sembilan
10
5,550
Melaka
12
5,500
Johor
20
9,005
Pahang
6
1,268
Terengganu
1
52
Kelantan
2
242
Sabah & WP Labuan
4
1,397
11
2,746
Malaysia
Sarawak
56
HOSPITAL
Table 4.12 Number of Colonoscopes and Colonoscopy Procedures Performed by Surgical and Medical Specialists in Malaysian
Public Hospitals by State, 2011
Total
Colonoscopes
Functioning
Colonoscopes
Total
Colonoscopy
PROCEDURES
Colonoscopy
PROCEDURES
by Surgical
Colonoscopy
PROCEDURES
by Medical
178
133
30,939
24,416
6,274
Perlis
3
1
286
286
0
Kedah
20
14
1,733
1,236
497
Kedah & Perlis
23
15
2,019
1,522
497
Pulau Pinang
10
9
2,394
2,182
212
Perak
14
11
3,284
3,025
259
29
18
5,503
4,808
695
WP Kuala Lumpur
27
26
5,026
1,734
3,292
56
44
10,529
6,542
3,987
Negeri Sembilan
7
5
1,395
1,110
36
Melaka
2
1
1,053
1,053
0
Johor
12
9
3,098
3,088
10
Pahang
7
4
1,408
1,186
222
Terengganu
4
2
543
504
39
Kelantan
10
9
1,039
854
185
Sabah & WP Labuan
18
14
2,199
1,439
760
Sarawak
15
10
1,978
1,911
67
State
Malaysia
State
Total Colonoscopes
Total Colonoscopy PROCEDURES
171
51,144
Perlis
na
na
Kedah
6
1,435
Kedah & Perlis
6
1,435
Pulau Pinang
25
9,638
Perak
19
4,718
34
11,255
WP Kuala Lumpur
29
6,971
63
18,226
Negeri Sembilan
10
4,223
Melaka
9
3,103
Johor
15
6,016
Pahang
7
785
Terengganu
1
12
Kelantan
2
109
Sabah & WP Labuan
4
1,048
10
1,831
Malaysia
Sarawak
4
Table 4.13 Number of Colonoscopes and Colonoscopy Procedures Performed in Malaysian Private Hospitals by State, 2011
57
HOSPITAL
Table 4.14 Number of ERCP Scopes and ERCP Procedures Performed by Surgical and Medical Specialists in Malaysian Public
Hospitals by State, 2011
Total ERCP
Scopes
Functioning
ERCP Scopes
Total ERCP
PROCEDURES
ERCP PROCEDURES
by Surgical
ERCP PROCEDURES
by Medical
134
70
5,007
3,458
1,549
Perlis
3
1
0
0
0
Kedah
18
7
542
530
12
Kedah & Perlis
21
8
542
530
12
Pulau Pinang
9
5
327
310
17
Perak
5
3
236
236
0
22
13
825
301
524
WP Kuala Lumpur
27
17
826
71
755
49
30
1,651
372
1,279
Negeri Sembilan
5
1
109
109
0
Melaka
2
2
245
245
0
Johor
9
4
447
447
0
Pahang
7
5
243
220
23
Terengganu
3
1
75
75
0
Kelantan
8
4
246
200
46
11
6
427
255
172
5
1
459
459
0
State
Malaysia
Sabah & WP Labuan
Sarawak
Table 4.15 Number of ERCP Scopes and ERCP Procedures Performed in Malaysian Private Hospitals by State, 2011
State
Total ERCP Scopes
Total ERCP PROCEDURES
129
2,549
Perlis
na
na
Kedah
5
52
Kedah & Perlis
5
52
Pulau Pinang
22
725
Perak
14
282
27
527
WP Kuala Lumpur
23
283
50
810
Negeri Sembilan
7
52
Melaka
9
132
Johor
11
303
Pahang
5
46
Terengganu
0
0
Kelantan
1
3
Sabah & WP Labuan
2
46
Sarawak
3
98
Malaysia
58
HOSPITAL
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Total OGDS Scopes
No.
PMP
251
209
460
15.88
4
na
na
4
16.84
27
7
34
17.23
31
7
38
17.19
15
34
49
30.75
19
19
38
15.85
41
46
87
15.39
39
37
76
44.85
80
83
163
22.18
8
10
18
17.26
2
12
14
16.81
18
20
38
11.17
8
6
14
9.18
6
1
7
6.52
17
2
19
11.76
23
4
27
7.93
24
11
35
13.91
Total ERCP Scopes
No.
PMP
134
129
263
9.08
3
na
na
3
12.63
18
5
23
11.66
21
5
26
11.76
9
22
31
19.45
5
14
19
7.92
22
27
49
8.67
27
23
50
29.51
49
50
99
13.47
5
7
12
11.51
2
9
11
13.21
9
11
20
5.88
7
5
12
7.87
3
0
3
2.79
8
1
9
5.57
11
2
13
3.82
5
3
8
3.18
4
Total Colonoscopes
No.
PMP
178
171
349
12.05
3
na
na
3
12.63
20
6
26
13.18
23
6
29
13.12
10
25
35
21.96
14
19
33
13.76
29
34
63
11.14
27
29
56
33.05
56
63
119
16.19
7
10
17
16.30
2
9
11
13.21
12
15
27
7.94
7
7
14
9.18
4
1
5
4.66
10
2
12
7.43
18
4
22
6.46
15
10
25
9.94
Table 4.16 Total Number and Density of OGDS Scopes, Colonoscopes and ERCP Scopes in Malaysian Hospitals by State and Sector,
2011
59
HOSPITAL
Table 4.17 Number and Density of Theatre Scrub Nurses, 2011
State
Sector
Total Theatre Scrub
Nurses
No.
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
1,978
1,730
3,708
27
na
27
143
75
218
170
75
245
128
338
466
181
133
314
343
378
721
170
268
438
513
646
1,159
56
90
146
47
108
155
226
179
405
77
41
118
81
8
89
108
25
133
206
20
226
185
67
252
Per 10,000
population
1.28
na
1.14
1.10
1.11
2.92
1.31
1.28
2.58
1.58
1.40
1.86
1.19
0.77
0.83
0.82
0.66
1.00
60
with Peri-operative
Post Basic
Per 10,000
No.
population
874
383
1,257
0.43
14
na
na
14
0.59
66
15
81
0.41
80
15
95
0.43
66
62
128
0.80
79
39
118
0.49
159
88
247
0.44
48
66
114
0.67
207
154
361
0.49
33
31
64
0.61
30
13
43
0.52
64
31
95
0.28
35
11
46
0.30
47
0
47
0.44
58
6
64
0.40
87
2
0.26
89
88
19
107
0.43
without Peri-operative
Post Basic
Per 10,000
No.
population
1,107
1,340
2,447
0.84
13
na
na
13
0.55
77
60
137
0.69
90
60
150
0.68
62
268
330
2.07
102
95
197
0.82
184
291
475
0.84
122
202
324
1.91
306
493
799
1.09
23
59
82
0.79
17
95
112
1.34
162
148
310
0.91
42
29
71
0.47
34
8
42
0.39
50
19
69
0.43
119
18
137
0.40
100
48
148
0.59
HOSPITAL
Table 4.18 Number of General Surgeons and Anaesthesiologists in Malaysia by State and Sector, 2011
General Surgeons
Anaesthesiologists
State
Sector
Per 10,000
Per General
No.
No.
population
Surgeon
Malaysia
Public
298
381
1.28
Malaysia
Private
259
304
1.17
Malaysia
Total
557
0.19
685
1.23
Perlis
Public
3
4
1.33
Perlis
Private
na
na
na
na
Perlis
Total
3
0.13
4
1.33
Kedah
Public
22
17
0.77
Kedah
Private
11
10
0.91
Kedah
Total
33
0.17
27
0.82
Kedah & Perlis
Public
25
21
0.84
Kedah & Perlis
Private
11
10
0.91
Kedah & Perlis
Total
36
0.16
31
0.86
Pulau Pinang
Public
15
20
1.33
Pulau Pinang
Private
29
35
1.21
Pulau Pinang
Total
44
0.28
55
1.25
Perak
Public
16
29
1.81
Perak
Private
19
23
1.21
Perak
Total
35
0.15
52
1.49
Public
55
72
1.31
Private
68
86
1.26
Total
123
0.22
158
1.28
WP Kuala Lumpur
Public
61
87
1.43
WP Kuala Lumpur
Private
49
71
1.45
WP Kuala Lumpur
Total
110
0.65
158
1.44
116
159
1.37
117
157
1.34
233
0.32
316
1.36
Negeri Sembilan
Public
11
11
1.00
Negeri Sembilan
Private
11
9
0.82
Negeri Sembilan
Total
22
0.21
20
0.91
Melaka
Public
7
10
1.43
Melaka
Private
13
17
1.31
Melaka
Total
20
0.24
27
1.35
Johor
Public
25
35
1.40
Johor
Private
27
25
0.93
Johor
Total
52
0.15
60
1.15
Pahang
Public
13
17
1.31
Pahang
Private
6
6
1.00
Pahang
Total
19
0.12
23
1.21
Terengganu
Public
8
12
1.50
Terengganu
Private
0
1
0.00
Terengganu
Total
8
0.07
13
1.63
Kelantan
Public
25
27
1.08
Kelantan
Private
3
2
0.67
Kelantan
Total
28
0.17
29
1.04
Sabah & WP Labuan
Public
20
22
1.10
Sabah & WP Labuan
Private
7
5
0.71
Sabah & WP Labuan
Total
27
0.08
27
1.00
Sarawak
Public
17
18
1.06
Sarawak
Private
16
14
0.88
Sarawak
Total
33
0.13
32
0.97
4
61
HOSPITAL
Table 4.19 Number and Density of Breast Surgeons, Breast and Endocrine Surgeons in Malaysia by State and Sector, 2010-2011
2010
2011
Breast and
Breast and
Breast Surgeons
Endocrine
Breast Surgeons
Endocrine
State
Sector
Surgeons
Surgeons
Per 10,000
Per 10,000
Per 10,000
Per 10,000
No.
No.
No.
No.
population
population
population
population
Malaysia
Public
3
12
3
19
Malaysia
Private
3
5
4
4
Malaysia
Total
6
0.00
17
0.01
7
0.00
23
0.01
Perlis
Public
0
0
0
0
Perlis
Private
na
na
na
na
na
na
na
na
Perlis
Total
0
0.00
0
0.00
0
0.00
0
0.00
Kedah
Public
0
0
0
0
Kedah
Private
0
0
0
0
Kedah
Total
0
0.00
0
0.00
0
0.00
0
0.00
Kedah & Perlis
Public
0
0
0
0
Kedah & Perlis
Private
0
0
0
0
Kedah & Perlis
Total
0
0.00
0
0.00
0
0.00
0
0.00
Pulau Pinang
Public
0
0
0
0
Pulau Pinang
Private
1
0
1
0
Pulau Pinang
Total
1
0.01
0
0.00
1
0.01
0
0.00
Perak
Public
0
0
0
0
Perak
Private
0
0
0
0
Perak
Total
0
0.00
0
0.00
0
0.00
0
0.00
Public
1
5
1
8
Private
0
2
0
2
Total
1
0.00
7
0.01
1
0.00
10
0.02
WP Kuala Lumpur
Public
2
4
2
8
WP Kuala Lumpur
Private
2
3
2
2
WP Kuala Lumpur
Total
4
0.02
7
0.04
4
0.02
10
0.06
3
9
3
16
2
5
2
4
5
0.01
14
0.02
5
0.01
20
0.03
Negeri Sembilan
Public
0
0
0
0
Negeri Sembilan
Private
0
0
0
0
Negeri Sembilan
Total
0
0.00
0
0.00
0
0.00
0
0.00
Melaka
Public
0
0
0
0
Melaka
Private
0
0
1
0
Melaka
Total
0
0.00
0
0.00
1
0.01
0
0.00
Johor
Public
0
1
0
1
Johor
Private
0
0
0
0
Johor
Total
0
0.00
1
0.00
0
0.00
1
0.00
Pahang
Public
0
0
0
0
0
0
Pahang
Private
0
0
Pahang
Total
0
0.00
0
0.00
0
0.00
0
0.00
Terengganu
Public
0
1
0
1
Terengganu
Private
0
0
0
0
Terengganu
Total
0
0.00
1
0.01
0
0.00
1
0.01
Kelantan
Public
0
1
0
1
Kelantan
Private
0
0
0
0
Kelantan
Total
0
0.00
1
0.01
0
0.00
1
0.01
Sabah & WP Labuan
Public
0
0
0
0
Sabah & WP Labuan
Private
0
0
0
0
Sabah & WP Labuan
Total
0
0.00
0
0.00
0
0.00
0
0.00
Sarawak
Public
0
0
0
0
Sarawak
Private
0
0
0
0
Sarawak
Total
0
0.00
0
0.00
0
0.00
0
0.00
62
HOSPITAL
Table 4.20 Number and Density of Vascular Surgeons, Hepatobiliary Surgeons, and Colorectal Surgeons in Malaysia by State and
Sector, 2010-2011
Sector
Colorectal
Surgeons
No.
Per 10,000
population
No.
Per 10,000
population
2011
Hepatobiliary
Surgeons
Vascular
Surgeons
No.
Per 10,000
population
No.
Per 10,000
population
No.
Colorectal
Surgeons
Per 10,000
Per 10,000
No.
population
population
Malaysia
Public
10
-
18
-
9
-
10
-
18
-
7
Malaysia
Private
9
-
11
-
17
-
9
-
12
-
23
-
Malaysia
Total
19
0.01
29
0.01
26
0.01
19
0.01
30
0.01
30
0.01
Perlis
Public
0
-
0
-
0
-
0
-
0
-
0
-
Perlis
Private
na
na
na
na
na
na
na
na
na
na
na
na
Perlis
Total
0
0.00
0
0.00
0
0.00
0
0.00
0
0.00
0
0.00
Kedah
Public
0
-
2
-
1
-
0
-
2
-
1
-
Kedah
Private
0
-
0
-
0
-
0
-
0
-
0
-
Kedah
Total
0
0.00
2
0.01
1
0.01
0
0.00
2
0.01
1
0.01
Kedah & Perlis
Public
0
-
2
-
1
-
0
-
2
-
1
-
Kedah & Perlis
Private
0
-
0
-
0
-
0
-
0
-
0
-
Kedah & Perlis
Total
0
0.00
2
0.01
1
0.00
0
0.00
2
0.01
1
0.00
Pulau Pinang
Public
0
-
1
-
1
-
0
-
1
-
0
-
Pulau Pinang
Private
2
-
1
-
1
-
2
-
1
-
2
-
Pulau Pinang
Total
2
0.01
2
0.01
2
0.01
2
0.01
2
0.01
2
0.01
Perak
Public
0
-
0
-
0
-
0
-
0
-
0
-
Perak
Private
0
-
0
-
2
-
0
-
0
-
2
-
Perak
Total
0
0.00
0
0.00
2
0.01
0
0.00
0
0.00
2
0.01
Selangor & WP
Putrajaya
Public
2
-
6
-
1
-
2
-
7
-
1
-
Selangor & WP
Putrajaya
Private
4
-
7
-
7
-
4
-
7
-
7
-
Selangor & WP
Putrajaya
Total
6
0.01
13
0.02
8
0.01
6
0.01
14
0.02
8
0.01
WP Kuala Lumpur
Public
7
-
6
-
2
-
7
-
6
-
2
-
WP Kuala Lumpur
Private
1
-
3
-
4
-
2
-
3
-
5
-
WP Kuala Lumpur
Total
8
0.05
9
0.05
6
0.04
9
0.05
9
0.05
7
0.04
Selangor & WP
Putrajaya & WPKL
Public
9
-
12
-
3
-
9
-
13
-
3
-
Private
5
-
10
-
11
-
6
-
10
-
12
-
Total
14
0.02
22
0.03
14
0.02
15
0.02
23
0.03
15
0.02
Negeri Sembilan
Public
0
-
0
-
1
-
0
-
0
-
1
-
Negeri Sembilan
Private
0
-
0
-
1
-
0
-
1
-
1
-
Negeri Sembilan
Total
0
0.00
0
0.00
2
0.02
0
0.00
1
0.01
2
0.02
Melaka
Public
0
-
1
-
0
-
0
-
1
-
0
-
Melaka
Private
1
-
0
-
0
-
0
-
0
-
0
-
Melaka
Total
1
0.01
1
0.01
0
0.00
0
0.00
1
0.01
0
0.00
Johor
Public
0
-
0
-
1
-
0
-
0
-
1
-
Johor
Private
1
-
0
-
2
-
1
-
0
-
3
-
Johor
Total
1
0.00
0
0.00
3
0.01
1
0.00
0
0.00
4
0.01
Pahang
Public
1
-
0
-
1
-
1
-
0
-
0
-
Pahang
Private
0
-
0
-
0
-
0
-
0
-
2
-
Pahang
Total
1
0.01
0
0.00
1
0.01
1
0.01
0
0.00
2
0.01
Terengganu
Public
0
-
0
-
0
-
0
-
0
-
0
-
Terengganu
Private
0
-
0
-
0
-
0
-
0
-
0
-
Terengganu
Total
0
0.00
0
0.00
0
0.00
0
0.00
0
0.00
0
0.00
Kelantan
Public
0
-
0
-
1
-
0
-
0
-
1
-
Kelantan
Private
0
-
0
-
0
-
0
-
0
-
0
-
Kelantan
Total
0
0.00
0
0.00
1
0.01
0
0.00
0
0.00
1
0.01
0
-
0
-
0
-
0
-
0
-
0
-
0
-
0
-
0
-
0
-
0
-
0
-
0
0.00
0
0.00
0
0.00
0
0.00
0
0.00
0
0.00
Sarawak
Public
0
-
2
-
0
-
0
-
1
-
0
-
Sarawak
Private
0
-
0
-
0
-
0
-
0
-
1
-
Sarawak
Total
0
0.00
2
0.01
0
0.00
0
0.00
1
0.00
1
0.00
Selangor & WP
Putrajaya & WPKL
Selangor & WP
Putrajaya & WPKL
4
-
State
2010
Hepatobiliary
Surgeons
Vascular
Surgeons
63
Chapter 5
HOSPITAL
| ONCOLOGY SERVICES IN MALAYSIAN HOSPITALS
Gerard LCC1, Foo CY2*, Kamilah D2*, Fuad I3, Hafizah ZA4, Lim YS5, Aslan NMA3, Cheah NLC4, Lau KL1, Sarah Lee A1
1. Hospital Kuala Lumpur 2. National Clinical Research Centre, Ministry of Health 3. Universiti Kebangsaan Malaysia Medical Centre 4. Hospital Pulau Pinang 5. Hospital Ampang
* Corresponding author
Summary: There were 58 hospitals offering oncology services 2011. Of these, only 22 of the hospitals had radiotherapy facilities.
There were 67 oncologists in 2011. In all, there was no significant change in manpower and facilities since the last report in
2010. There was a disproportionately higher allocation of oncology resources in the urban areas. The East Coast of Peninsular
Malaysia were particularly lacking in the services. More trained staff, newer centres with more sophisticated equipment and
upgrading of the existing services are needed to improve access of our services to the population and provide quality treatment.
Facilities
We had a 100% response rate in 2011. There were 58 hospitals providing oncology services in 2011. Thirty-one were in the public sector,
including three University hospitals. The remaining 27 were in the private sector (Table 5.1). Of the 58 hospitals, only 46 had resident or visiting
oncologist. The remaining 12 hospitals did not have either a clinical, medical or radiation oncologists (Table 5.2). However, these centres were
supervised by physicians, surgeons or gynaecologists with a special interest in oncology. The distribution for oncology services was skewed
towards the urban areas, especially the Klang Valley and the West coast of Peninsular Malaysia. The three regions with the highest number of
oncology centres were Selangor and Putrajaya (10 centres), Pulau Pinang (9 centres), and Wilayah Persekutuan Kuala Lumpur (WPKL) (8 centres).
There was an additional three hospitals providing oncology services in 2011.
There were 46 hospitals providing clean rooms (Table 5.3) and 35 with isolators for cytotoxic drug reconstitution (Table 5.4). Five hospitals (2 public
and 3 private) outsourced their cytotoxic drug reconstitution services (Table 5.3). Fifty hospitals (26 public and 24 private) with 290 chemotherapy
beds and 253 chemotherapy chairs provided chemotherapy day care services (Table 5.5).
Activities
The number of patients and the type of oncology activities were studied in 4 public oncology centres and these were representative of both
Peninsular and East Malaysia. These centres provided chemotherapy with intent to cure to 2,305, 1,078, 567 and 474 patients respectively. In
all these four centres, at least 90% of the patients were given treatment within 2 weeks from the time of consent to the time of chemotherapy
administration. We did not collect data on palliative chemotherapy in this survey. The same centres also provided radiotherapy with intent to cure
to 1,072, 1,217, 696 and 1665 patients respectively. Radiotherapy was given within four weeks from the time of simulation in 47%, 93%, 65%
and 33% of patients respectively. One of these centres reported 2,874 new cancer cases in 2011 and of these, 40% were given appointment for
their first consultation within 2 weeks.
Workforce
There were 230 oncology trained nurses working in hospitals in 2011. Of these, 75% were in public sector. There were 101 Cytotoxic Drug
Reconstitution (CDR) pharmacists in the country and of these, 63% were in the public sector. There were 283 radiation therapists of which 73%
were in the public sector (Table 5.7). There were 82 physicists, of whom 50% were in the public sector.
Medical Equipment
In 2011, there were 29 simulators, 36 megavoltage machines and 14 brachytherapy machines; 40% of these were in the public sector. Perlis,
Kedah, Terengganu and Pahang did not have any radiotherapy equipment (Table 5.8). Most centres had either one or two megavoltage machine(s).
The exceptions were Hospital Kuala Lumpur (4 megavoltage machines), Mount Miriam Hospital and Sarawak General Hospital (3 megavoltage
machines each).
5
There were 22 hospitals with treatment planning devices and quality assurance tools (Table 5.9). There were 20 machines capable of carrying out
Intensity Modulated Radiotherapy (IMRT); 14 machines capable of Image Guided Radiotherapy (IGRT) and 12 machines capable of Stereotactic
Radiotherapy (SRS) (Table 5.10).
ONCOLOGY SERVICES IN MALAYSIAN HOSPITALS
There were 67 oncologists in the country with 43% practicing in the public sector. The number of oncologists were higher in urban areas, i.e. WPKL
(23), Pulau Pinang (13), Selangor and Putrajaya (10), and these represented 68% of the oncologists in Malaysia (Table 5.6).
65
HOSPITAL
Discussion
There were no significant changes in the oncology services provided for in 2011 when compared to 2010; the number of hospitals with oncology
services, megavoltage machines and oncologists being the same. This may be expected as only a year has elapsed between the 2 surveys. The
ratio of megavoltage machine to population was 1.27 per million populations. This is below the recommended ratio of 5 per million population.
1, 2
As a comparison, the United Kingdom in 2012 had 265 linear accelerators providing of 4.2 per million population.3 However, we do accept that
changes in services will take time due to the complexity of commissioning and decommissioning therapy machines.
There were 67 oncologists in Malaysia, giving a density of 2 per million populations. In comparison, the density of clinical oncologists in the UK was
8.6 per million populations in 2011. Furthermore, the number of clinical oncologists there had increased to 544 in 2012. 3
There was a disproportionate distribution in the oncology workforce between private and public sectors. On the one hand, the number of oncologists
in the private sector was more than the public sector (56% vs. 44%). On the other hand, the number of support staff, namely oncology trained
nurses, radiation therapists and CDR pharmacists, was higher in the public sector. Furthermore, more megavoltage machines were located in the
private sector.
Eighty one percent of the hospitals providing oncology services had a clean room for reconstitution of cytotoxic drugs. There was an apparent
decrease in the number of oncology trained nurses in 2011 when compared to 2010. This may have been due to a revised definition used in the
2011 survey.
In conclusion, there were no significant changes in the number of oncologists, paramedical staff and facilities, both in the public and private
sector over the past year. We are lagging behind most developed nations and there is therefore, room for improvement.3, 5 We also recognise that
improving the oncology services nationally needs time, proper planning, a strong commitment, optimal interagency cooperation and engaging the
public-private partnership.
Radiotherapy remains an important priority for the services. The authorities should ensure that access to this service should be increased. As
an indicator of the quality of service, the time interval between treatment decision and initiation of therapy will be a useful guide. This report has
shown that more needs to be done to optimise our services.
Limitations
Changes made to the survey in 2011 have resulted in differences in the kind of responses when compared to 2010.
1. Oncology services were defined in 2011 as services provided by permanent/resident and visiting oncologists including those hospitals
that delivered basic chemotherapy and included services provided by medical oncologists, clinical oncologists, surgeons, ear, nose, throat
(ENT), gynaecologist and respiratory physicians with special interest in oncology. The definition was different in 2010, where the inclusion of
hospitals providing oncology services was based on the decision of the expert panel.
2. The survey in 2011 excluded services provided by haematologists and paediatric oncologists. Although not explicitly stated in the survey for
2010, the expert panel had excluded them only in the final report.
3. The role of oncology trainee doctors was withdrawn in survey in 2011.
4. The survey in 2011 included additional questions like “Does your establishment have an oncologist” and “if yes, total number (permanent/
resident/visiting)”. This restructuring of the questions had allowed for a more accurate capture of the number of practising oncologist(s) in
these centres. Internal and historical consistency checks were performed to improve reliability and accuracy of the data.
5. The definition of oncology trained nurse was specifically defined in 2011 as “nurse who has undergone training in post basic oncology and
served in an oncology setting during 2011”. This definition was not stated in the 2010 report. Based on this definition, the number of oncology
trained nurse in 2011 was reduced when defined as such.
6. An additional section on oncology activities (chemotherapy and radiotherapy) was included in 2011 for the public sector. However, most of the
centres were unable to provide these data. We thus decided to report only those centres that could provide accurate data in order to provide
the actual situation for oncology services in the public sector for 2011.
7. Another new variable captured in survey in 2011 included hospitals outsourcing their CDR service and their chemotherapy beds and chairs.
This was not present in 2010.
References
Guidance on the Development and Management of Devolved Radiotherapy Services. The Royal College of Radiologists. 2004
2. The Royal College of Radiologists (2000) the Provision and Replacement of Radiotherapy Equipment BCFO (00)2. London: Royal College of
Radiologists
3. Radiotherapy Services in England. National Radiotherapy Implementation Group (NRIG). Department of Health Cancer Policy Team. 2012
(https://www.gov.uk/government/publications/radiotherapy-services-in-england-2012)
4. Planning for the Best. Tripartite National Strategic Plan for Radiation Oncology 2012-2022. The Royal Australian and New Zealand College of
1.
66
HOSPITAL
5
Radiologists, Australian Institute of Radiography, Australasian Institute of Physical Scientists and Engineers in Medicine 2012
Table 5.1 Number and Density of Hospitals Providing Oncology Services in Malaysia by State and Sector in 2010 and 2011
Hospitals Providing Oncology
Services 2010
Services 2011
State
Sector
Per 10,000
Per 10,000
Number
Number
population
population
Malaysia
Public
28
31
Malaysia
Private
27
27
Malaysia
Total
55
0.02
58
0.02
Perlis
Public
0
0
Perlis
Private
na
na
na
na
Perlis
Total
0
0.00
0
0.00
Kedah
Public
2
2
Kedah
Private
0
0
Kedah
Total
2
0.01
2
0.01
Kedah & Perlis
Public
2
2
Kedah & Perlis
Private
0
0
Kedah & Perlis
Total
2
0.01
2
0.01
Pulau Pinang
Public
2
2
Pulau Pinang
Private
7
7
Pulau Pinang
Total
9
0.06
9
0.06
Perak
Public
4
4
Perak
Private
3
3
Perak
Total
7
0.03
7
0.03
Public
3
4
Private
6
6
Total
9
0.02
10
0.02
WP Kuala Lumpur
Public
3
3
WP Kuala Lumpur
Private
5
5
WP Kuala Lumpur
Total
8
0.05
8
0.05
6
7
11
11
17
0.02
18
0.02
Negeri Sembilan
Public
1
1
Negeri Sembilan
Private
1
1
Negeri Sembilan
Total
2
0.02
2
0.02
Melaka
Public
1
1
Melaka
Private
2
2
Melaka
Total
3
0.04
3
0.04
Johor
Public
4
4
Johor
Private
1
1
Johor
Total
5
0.01
5
0.01
Pahang
Public
1
1
Pahang
Private
0
0
Pahang
Total
1
0.01
1
0.01
Terengganu
Public
1
1
Terengganu
Private
0
0
Terengganu
Total
1
0.01
1
0.01
Kelantan
Public
2
2
Kelantan
Private
0
0
Kelantan
Total
2
0.01
2
0.01
Sabah & WP Labuan
Public
1
3
Sabah & WP Labuan
Private
1
1
Sabah & WP Labuan
Total
2
0.01
4
0.01
Sarawak
Public
3
3
Sarawak
Private
1
1
-
67
State
Sector
Sarawak
Total
HOSPITAL
Services 2010
Per 10,000
Number
population
4
0.02
Services 2011
Per 10,000
Number
population
4
0.02
Table 5.2 Number and Density of Hospitals Providing Oncology Services with and without Oncologist in Malaysia by State and
Sector in 2010 and 2011
2010
State
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 & WP
Putrajaya
Selangor & WP
Putrajaya
Selangor & WP
Putrajaya
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Selangor & WP
Putrajaya & WPKL
Selangor & WP
Putrajaya & WPKL
Selangor & WP
Putrajaya & WPKL
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP
Labuan
Sector
2011
Hospitals
Providing
Oncology
Services with
oncologist
Hospitals
Providing
Oncology
Services
Hospitals Providing
Basic Oncology
Services without
oncologist
Hospitals
Providing
Basic Oncology
Services
without
oncologist
Per 10,000
Per 10,000
No.
No.
population
population
Hospitals
Providing
Oncology
Services with
oncologist
Hospitals
Providing
Oncology
Services
No.
Per 10,000
population
No.
Per 10,000
population
No.
Per 10,000
population
No.
Per 10,000
population
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
28
27
55
0
0
0
2
0
2
2
0
2
2
7
9
4
3
7
0.02
na
0.00
0.01
0.01
0.06
0.03
24
26
50
0
na
0
1
0
1
1
0
1
2
7
9
2
2
4
0.02
na
0.00
0.01
0.00
0.06
0.02
4
1
5
0
na
0
1
0
1
1
0
1
0
0
0
2
1
3
0.00
na
0.00
0.01
0.00
0.00
0.01
31
27
58
0
na
0
2
0
2
2
0
2
2
7
9
4
3
7
0.02
na
0.00
0.01
0.01
0.06
0.03
20
26
46
0
na
0
1
0
1
1
0
1
2
7
9
2
2
4
0.02
na
0.00
0.01
0.00
0.06
0.02
11
1
12
0
na
0
1
0
1
1
0
1
0
0
0
2
1
3
0.00
na
0.00
0.01
0.00
0.00
0.01
Public
3
-
3
-
0
-
4
-
1
-
3
-
Private
6
-
6
-
0
-
6
-
6
-
0
-
Total
9
0.02
9
0.02
0
0.00
10
0.02
7
0.01
3
0.01
Public
Private
Total
3
5
8
0.05
3
5
8
0.05
0
0
0
0.00
3
5
8
0.05
3
5
8
0.05
0
0
0
0.00
Public
6
-
6
-
0
-
7
-
4
-
3
-
Private
11
-
11
-
0
-
11
-
11
-
0
-
Total
17
0.02
17
0.02
0
0.00
18
0.02
15
0.02
3
0.00
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
1
1
2
1
2
3
4
1
5
1
0
1
1
0
1
2
0
2
0.02
0.04
0.01
0.01
0.01
0.01
1
1
2
1
2
3
4
1
5
1
0
1
1
0
1
2
0
2
0.02
0.04
0.01
0.01
0.01
0.01
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.00
0.00
0.00
0.00
0.00
0.00
1
1
2
1
2
3
4
1
5
1
0
1
1
0
1
2
0
2
0.02
0.04
0.01
0.01
0.01
0.01
1
1
2
1
2
3
2
1
3
1
0
1
1
0
1
1
0
1
0.02
0.04
0.01
0.01
0.01
0.01
0
0
0
0
0
0
2
0
2
0
0
0
0
0
0
1
0
1
0.00
0.00
0.01
0.00
0.00
0.01
Public
1
-
1
-
0
-
3
-
3
-
0
-
68
HOSPITAL
2010
State
Sabah & WP
Labuan
Sabah & WP
Labuan
Sarawak
Sarawak
Sarawak
Sector
2011
Hospitals
Providing
Oncology
Services with
oncologist
Hospitals
Providing
Oncology
Services
Hospitals Providing
Basic Oncology
Services without
oncologist
Hospitals
Providing
Basic Oncology
Services
without
oncologist
Per 10,000
Per 10,000
No.
No.
population
population
Hospitals
Providing
Oncology
Services with
oncologist
Hospitals
Providing
Oncology
Services
No.
Per 10,000
population
No.
Per 10,000
population
No.
Per 10,000
population
No.
Per 10,000
population
Private
1
-
1
-
0
-
1
-
1
-
0
-
Total
2
0.01
2
0.01
0
0.00
4
0.01
4
0.01
0
0.00
Public
Private
Total
3
1
4
0.02
2
1
3
0.01
1
0
1
0.00
3
1
4
0.02
1
1
2
0.01
2
0
2
0.01
5
69
HOSPITAL
Table 5.3 Number and Density of Hospitals with Clean Room for Reconstitution of Cytotoxic Drugs and Number of Total Clean Room for
Reconstitution of Cytotoxic Drugs in Malaysia by State and Sector in 2010 and 2011
State
Sector
2010
2011
Hospital
Hospitals
Hospitals
Hospital
providing
Total
Hospitals
sproviding
providing
Total
sOutsourcing
Clean Room
Clean Room
providing
Clean Room
Clean Room for Reconstitution
Clean Room
for Cytotoxic for Cytotoxic Clean Room for
for Cytotoxic
for Cytotoxic
Cytotoxic drugs of Cytotoxic
drugs with
drugs
Cytotoxic drugs
drugs with
drugs
drugs
Oncologists
Oncologists
Per 10,000
Per 10,000
Per 10,000
Per 10,000
Per 10,000
Per 10,000
Per 10,000
No.
No.
No.
No.
No.
No.
No.
Population
Population
Population
Population
Population
Population
Population
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
& WPKL
& WPKL
& WPKL
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
24
22
46
0
0
0
2
0
2
2
0
2
0
6
6
3
3
6
3
5
8
3
3
6
- 20
- 21
0.02 41
- 0
na 0
0.00 0
- 1
- 0
0.01 1
- 1
- 0
0.01 1
- 0
- 6
0.04 6
- 1
- 2
0.03 3
- 3
- 5
0.01 8
- 3
- 3
0.04 6
Public
6
-
Private
8
-
14
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
1
1
2
1
2
3
4
1
5
1
0
1
1
0
1
1
0
1
1
0
1
3
1
4
0.01
na
0.00
0.01
0.00
0.04
0.01
0.01
0.04
27
22
49
0
na
0
2
0
2
2
0
2
0
6
6
3
3
6
4
5
9
4
3
7
0.02
na
0.00
0.01
0.01
0.04
0.03
0.02
0.04
26
20
46
0
na
0
2
0
2
2
0
2
2
5
7
3
2
5
4
5
9
3
3
6
- 17
- 20
0.02 37
- 0
na na
0.00 0
- 1
- 0
0.01 1
- 1
- 0
0.01 1
- 2
- 5
0.04 7
- 1
- 2
0.02 3
- 1
- 5
0.02 6
- 3
- 3
0.04 6
6
-
8
-
7
-
8
-
8
-
8
-
0.02 14
0.02 16
0.02
15
0.02
0.04
0.01
0.01
0.01
0.01
0.00
0.02
0.02
0.04
0.01
0.01
0.01
0.01
0.00
0.01
0.02
0.04
0.01
0.01
0.01
0.01
0.00
0.02
1
1
2
1
1
2
2
1
3
1
0
1
1
0
1
2
0
2
2
1
3
2
1
3
1
1
2
1
2
3
4
1
5
1
0
1
1
0
1
1
0
1
1
0
1
2
1
3
1
1
2
1
2
3
4
1
5
1
0
1
1
0
1
1
0
1
1
0
1
4
1
5
70
0.01
na
0.00
0.01
0.00
0.04
0.01
0.01
0.04
28
21
49
0
na
0
2
0
2
2
0
2
2
5
7
3
2
5
4
5
9
4
3
7
- 2
- 3
0.02 5
- 0
na na
0.00 0
- 0
- 0
0.01 0
- 0
- 0
0.01 0
- 0
- 0
0.04 0
- 0
- 0
0.02 0
- 0
- 1
0.02 1
- 0
- 2
0.04 2
4
-
8
-
0
-
8
-
8
-
3
-
0.02 12
0.02
16
0.02
3
0.00
0.02
0.02
0.01
0.01
0.01
0.01
0.01
0.01
0.02
0.02
0.01
0.01
0.01
0.01
0.01
0.01
1
2
3
1
1
2
2
1
3
1
0
1
1
0
1
3
0
3
2
1
3
2
1
3
0.03
0.02
0.01
0.01
0.01
0.02
0.01
0.01
0
0
0
0
0
0
2
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.00
0.00
0.01
0.00
0.00
0.00
0.00
0.00
1
1
2
1
1
2
1
1
2
1
0
1
1
0
1
1
0
1
2
1
3
1
1
2
0.00
na
0.00
0.00
0.00
0.00
0.00
0.00
0.01
Table 5.4 Number and Density of Hospitals Providing Cytotoxic Drug Reconstitution (CDR) in Malaysia by State and Sector in 2010 & 2011
2010
2011
Hospitals with Cytotoxic Drug
Hospitals with Cytotoxic Drug
State
Sector
Reconstitution (CDR) Isolator
Reconstitution (CDR) Isolator
Per 10,000
Per 10,000
No.
No.
population
population
Malaysia
Public
8
14
Malaysia
Private
20
21
Malaysia
Total
28
0.01
35
0.01
Perlis
Public
0
0
Perlis
Private
na
na
na
na
Perlis
Total
0
0.00
0
0
Kedah
Public
0
2
Kedah
Private
0
0
Kedah
Total
0
0.00
2
0.01
Kedah & Perlis
Public
0
2
Kedah & Perlis
Private
0
0
Kedah & Perlis
Total
0
0.00
2
0.01
Pulau Pinang
Public
2
2
Pulau Pinang
Private
6
7
Pulau Pinang
Total
8
0.05
9
0.06
Perak
Public
2
2
Perak
Private
2
2
Perak
Total
4
0.02
4
0.02
Public
0
1
Private
4
4
Total
4
0.01
5
0.01
WP Kuala Lumpur
Public
1
1
WP Kuala Lumpur
Private
3
3
WP Kuala Lumpur
Total
4
0.02
4
0.02
Public
1
2
Private
7
7
Total
8
0.01
9
0.01
Negeri Sembilan
Public
0
0
Negeri Sembilan
Private
1
1
Negeri Sembilan
Total
1
0.01
1
0.01
Melaka
Public
0
1
Melaka
Private
2
2
Melaka
Total
2
0.02
3
0.04
Johor
Public
0
2
Johor
Private
1
1
Johor
Total
1
0.00
3
0.01
Pahang
Public
0
0
Pahang
Private
0
0
Pahang
Total
0
0.00
0
0
Terengganu
Public
0
0
Terengganu
Private
0
0
Terengganu
Total
0
0.00
0
0
Kelantan
Public
1
1
Kelantan
Private
0
0
Kelantan
Total
1
0.01
1
0.01
Sabah & WP Labuan
Public
1
1
Sabah & WP Labuan
Private
1
0
Sabah & WP Labuan
Total
2
0.01
1
0
Sarawak
Public
1
1
Sarawak
Private
0
1
Sarawak
Total
1
0.00
2
0.01
HOSPITAL
5
71
HOSPITAL
Table 5.5 Number and Density of Hospitals Providing Chemotherapy Daycare Services, Chemotherapy Beds and Chairs in Malaysia
by State and Sector in 2011
Hospitals Providing
Chemotherapy Daycare Chemotherapy Beds
Chemotherapy Chairs
Services
State
Sector
Per 10,000
Per 10,000
Per 10,000
No.
No.
No.
population
population
population
Malaysia
Public
26
- 180
112
Malaysia
Private
24
- 110
141
Malaysia
Total
50
0.02 290
0.10
253
0.09
Perlis
Public
0
0
0
Perlis
Private
na
na
na
na
na
na
Perlis
Total
0
0.00
0
0.00
0
0.00
Kedah
Public
1
2
0
Kedah
Private
0
0
0
Kedah
Total
1
0.01
2
0.01
0
0.00
Kedah & Perlis
Public
1
2
0
Kedah & Perlis
Private
0
0
0
Kedah & Perlis
Total
1
0.00
2
0.01
0
0.00
Pulau Pinang
Public
2
14
12
Pulau Pinang
Private
7
29
51
Pulau Pinang
Total
9
0.06
43
0.27
63
0.40
Perak
Public
3
26
5
Perak
Private
2
4
11
Perak
Total
5
0.02
30
0.13
16
0.07
Public
3
23
12
Private
5
40
15
Total
8
0.01
63
0.11
27
0.05
WP Kuala Lumpur
Public
3
22
25
WP Kuala Lumpur
Private
4
17
33
WP Kuala Lumpur
Total
7
0.04
39
0.23
58
0.34
6
45
37
9
57
48
15
0.02 102
0.14
85
0.12
Negeri Sembilan
Public
1
20
6
Negeri Sembilan
Private
1
6
0
Negeri Sembilan
Total
2
0.02
26
0.25
6
0.06
Melaka
Public
1
6
0
Melaka
Private
2
1
23
Melaka
Total
3
0.04
7
0.08
23
0.28
Johor
Public
4
20
13
Johor
Private
1
2
8
Johor
Total
5
0.01
22
0.06
21
0.06
Pahang
Public
1
6
0
Pahang
Private
0
0
0
Pahang
Total
1
0.01
6
0.04
0
0.00
Terengganu
Public
1
4
0
Terengganu
Private
0
0
0
Terengganu
Total
1
0.01
4
0.04
0
0.00
Kelantan
Public
1
4
0
Kelantan
Private
0
0
0
Kelantan
Total
1
0.01
4
0.02
0
0.00
Sabah & WP Labuan
Public
2
25
12
Sabah & WP Labuan
Private
1
3
0
Sabah & WP Labuan
Total
3
0.01
28
0.08
12
0.04
Sarawak
Public
3
8
27
Sarawak
Private
1
8
0
Sarawak
Total
4
0.02
16
0.06
27
0.11
72
HOSPITAL
5
Table 5.6 Number and Density of Oncologists in Malaysian Hospitals by State and Sector in 2009, 2010 and 2011
2009
2010
2011
Oncologists
Oncologists
Oncologists
State
Sector
Per 10,000
Per 10,000
Per 10,000
No.
No.
No.
population
population
population
Malaysia
Public
29
33
29
Malaysia
Private
28
34
38
Malaysia
Total
57
0.02
67
0.02
67
0.02
Perlis
Public
0
0
0
Perlis
Private
na
na
na
na
na
na
Perlis
Total
0
0
0
0.00
0
0.00
Kedah
Public
0
0
0
Kedah
Private
0
0
0
Kedah
Total
0
0
0
0.00
0
0.00
Kedah & Perlis
Public
0
0
0
Kedah & Perlis
Private
0
0
0
Kedah & Perlis
Total
0
0
0
0.00
0
0.00
Pulau Pinang
Public
2
2
2
Pulau Pinang
Private
7
10
11
Pulau Pinang
Total
9
0.06
12
0.08
13
0.08
Perak
Public
0
0
0
Perak
Private
2
2
2
Perak
Total
2
0.01
2
0.01
2
0.01
Public
0
0
0
Private
6
9
10
Total
6
0.01
9
0.02
10
0.02
WP Kuala Lumpur
Public
17
21
18
WP Kuala Lumpur
Private
6
5
5
WP Kuala Lumpur
Total
23
0.14
26
0.16
23
0.14
17
21
18
12
14
15
29
0.04
35
0.05
33
0.05
Negeri Sembilan
Public
1
1
0
Negeri Sembilan
Private
2
2
3
Negeri Sembilan
Total
3
0.03
3
0.03
3
0.03
Melaka
Public
0
0
0
Melaka
Private
3
3
5
Melaka
Total
3
0.04
3
0.04
5
0.06
Johor
Public
2
2
2
Johor
Private
1
2
1
Johor
Total
3
0.01
4
0.01
3
0.01
Pahang
Public
1
1
1
Pahang
Private
0
0
0
Pahang
Total
1
0.01
1
0.01
1
0.01
Terengganu
Public
0
0
0
Terengganu
Private
0
0
0
Terengganu
Total
0
0
0
0.00
0
0.00
Kelantan
Public
2
2
2
Kelantan
Private
0
0
0
Kelantan
Total
2
0.01
2
0.01
2
0.01
Sabah & WP Labuan
Public
1
1
1
Sabah & WP Labuan
Private
1
1
1
Sabah & WP Labuan
Total
2
0.01
2
0.01
2
0.01
3
3
Sarawak
Public
3
Sarawak
Private
0
0
0
Sarawak
Total
3
0.01
3
0.01
3
0.01
73
HOSPITAL
Table 5.7 Number and Density of Oncology Trained Nurses, Radiation Therapists and Physicists in Malaysia by State and Sector in 2010 & 2011
2010
State
Oncology
Sector Trained Nurses
No.
CDR
Pharmacists
2011
Radiation
Therapists
Oncology
Trained Nurses
Physicists
Per 10,000
Per 10,000
Per 10,000
No.
No.
population
population
population
No.
Per 10,000
population
No.
CDR
Pharmacists
Radiation
Therapists
Physicists
Per 10,000
Per 10,000
Per 10,000
Per 10,000
No.
No.
No.
population
population
population
population
Malaysia
Public
244
- 47
- 188
-
42
- 173
-
64
- 206
- 41
Malaysia
Private
68
- 31
-
69
-
41
-
-
37
- 77
- 41
-
Malaysia
Total
312
0.11 78
0.03 257
0.09
83
0.08 101
0.03 283
0.10 82
0.03
Perlis
Public
0
Perlis
Private
na
Perlis
Total
0
0.00
Kedah
Public
19
-
Kedah
Private
0
Kedah
Total
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Total
Pulau Pinang
Pulau Pinang
-
57
0.03 230
-
0
0
-
0
-
0
-
0
-
0
na na
na
na
na
na
na
na
na
na
0
0.00
0
0.00
0
0.00
0
0.00
0
0.00
0
0.00
0
0.00
3
-
0
-
0
-
0
-
2
-
0
-
0
-
-
0
-
0
-
0
-
0
-
0
-
0
-
0
-
19
0.10
3
0.02
0
0.00
0
0.00
0
0.00
2
0.01
0
0.00
0
0.00
Public
19
-
3
-
0
-
0
-
0
-
2
-
0
-
0
-
Private
0
-
0
-
0
-
0
-
0
-
0
-
0
-
0
-
19
0.09
3
0.01
0
0.00
0
0.00
0
0.00
2
0.01
0
0.00
0
0.00
Public
8
-
4
-
15
-
2
-
8
-
8
- 15
-
1
-
Private
18
- 10
-
19
-
11
-
13
-
15
- 21
- 10
-
Pulau Pinang
Total
26
0.17 14
0.09
34
0.22
13
0.08
21
0.13
23
0.14 36
0.23 11
0.07
Perak
Public
8
-
6
-
0
-
0
-
16
-
6
-
0
-
0
Perak
Private
9
-
4
-
4
-
3
-
3
-
2
-
3
-
2
-
Perak
Selangor & WP
Putrajaya
Selangor & WP
Putrajaya
Selangor & WP
Putrajaya
WP Kuala Lumpur
Total
17
0.07 10
0.04
4
0.02
3
0.01
19
0.08
8
0.03
3
0.01
2
0.01
Public
24
-
6
-
0
-
2
-
7
-
7
-
0
-
0
-
Private
18
-
6
-
20
-
10
-
18
-
7
- 21
- 11
-
Total
42
0.08 12
0.02
20
0.04
12
0.02
25
0.04
14
0.02 21
0.04 11
0.02
Public
94
- 11
-
82
-
20
-
66
-
13
- 89
- 21
-
WP Kuala Lumpur Private
10
-
4
-
11
-
6
-
11
-
6
- 15
-
na na
-
-
0
-
na na
na
-
6
-
WP Kuala Lumpur
Selangor & WP
Putrajaya & WPKL
Selangor & WP
Putrajaya & WPKL
Selangor & WP
Putrajaya & WPKL
Negeri Sembilan
Total
104
0.62 15
0.09
93
0.56
26
0.16
77
0.45
19
0.11 104
0.61 27
0.16
Public
118
- 17
-
82
-
22
-
73
-
20
- 89
- 21
-
Private
28
- 10
-
31
-
16
-
29
-
13
- 36
- 17
-
146
0.20 27
0.04 113
0.16
38
0.05 102
0.14
33
0.04 125
0.17 38
0.05
Public
4
-
2
-
0
-
0
-
6
-
1
-
0
-
0
Negeri Sembilan
Private
4
-
1
-
5
-
2
-
3
-
1
-
5
-
2
-
Negeri Sembilan
Total
8
0.08
3
0.03
5
0.05
2
0.02
9
0.09
2
0.02
5
0.05
2
0.02
Melaka
Public
1
-
1
-
0
-
0
-
2
-
2
-
0
-
0
-
Melaka
Private
4
-
3
-
6
-
5
-
4
-
3
-
7
-
6
-
Melaka
Total
5
0.06
4
0.05
6
0.07
5
0.06
6
0.07
5
0.06
7
0.08
6
0.07
Johor
Public
50
-
3
-
26
-
5
-
16
-
12
- 27
-
6
-
Johor
Private
3
-
1
-
3
-
3
-
3
-
2
-
3
-
3
-
Johor
Total
53
0.16
4
0.01
29
0.09
8
0.02
19
0.06
14
0.04 30
0.09
9
0.03
Pahang
Public
6
-
1
-
0
-
2
-
3
-
1
-
0
-
0
-
Pahang
Private
0
-
0
-
0
-
0
-
0
-
0
-
0
-
0
-
Pahang
Total
6
0.04
1
0.01
0
0.00
2
0.01
3
0.02
1
0.01
0
0.00
0
0.00
Terengganu
Public
0
-
1
-
0
-
0
-
6
-
2
-
0
-
0
-
Terengganu
Private
0
-
0
-
0
-
0
-
0
-
0
-
0
-
0
-
Terengganu
Total
0
0.00
1
0.01
0
0.00
0
0.00
6
0.06
2
0.02
0
0.00
0
0.00
Kelantan
Public
14
-
2
-
8
-
4
-
23
-
3
- 15
-
3
-
Kelantan
Private
0
-
0
-
0
-
0
-
0
-
0
-
0
-
0
-
Kelantan
Sabah & WP
Labuan
Sabah & WP
Labuan
Sabah & WP
Labuan
Sarawak
Total
14
0.09
2
0.01
8
0.05
4
0.03
23
0.14
3
0.02 15
0.09
3
0.02
Public
3
-
1
-
14
-
1
-
10
-
2
- 15
-
4
-
Private
0
-
2
-
1
-
1
-
0
-
0
-
2
-
1
-
Total
3
0.01
3
0.01
15
0.05
2
0.01
10
0.03
2
0.01 17
0.05
5
0.01
Public
13
-
6
-
43
-
6
-
10
-
5
- 45
-
6
Sarawak
Private
2
-
0
-
0
-
0
-
2
-
1
-
0
-
0
-
Sarawak
Total
15
0.06
6
0.02
43
0.17
6
0.02
12
0.05
6
0.02 45
0.18
6
0.02
Total
Abbreviation: na – not applicable; - – not available; CDR – Cytotoxic Drug Reconstitution
74
-
HOSPITAL
Table 5.8 Number and Density of Megavoltage Machines, Brachytherapy Machines and Simulators in Malaysia by State and Sector
in 2010 and 2011
Sector
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 & WP
Putrajaya
Selangor & WP
Putrajaya
Selangor & WP
Putrajaya
WP Kuala
Lumpur
WP Kuala
Lumpur
WP Kuala
Lumpur
Selangor & WP
Putrajaya & WPKL
Selangor & WP
Putrajaya & WPKL
Selangor & WP
Putrajaya & WPKL
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP
Labuan
Sabah & WP
Labuan
Sabah & WP
Labuan
Sarawak
Sarawak
Sarawak
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Simulators
No.
11
18
29
0
na
0
0
0
0
0
0
0
0
5
5
0
1
1
PMP
1.02
na
0.00
0.00
0.00
3.20
0.43
2011
Megavoltage Brachytherapy
Machines
Machines
No.
PMP
No.
PMP
14
6
22
8
36
1.27
14
0.49
0
0
na
na
na
na
0
0.00
0
0.00
0
0
0
0
0
0.00
0
0.00
0
0
0
0
0
0.00
0
0.00
0
0
6
1
6
3.84
1
0.64
0
0
1
0
1
0.43
0
0.00
Simulators
No.
11
18
29
0
na
0
0
0
0
0
0
0
0
4
4
0
1
1
PMP
1.02
na
0.00
0.00
0.00
2.56
0.43
Public
0
-
0
-
0
-
0
-
0
-
0
-
Private
6
-
4
-
4
-
6
-
3
-
5
-
Total
6
1.08
4
0.72
4
0.72
6
1.08
3
0.54
5
0.90
Public
8
-
3
-
6
7
-
3
-
6
-
Private
4
-
1
-
3
4
-
1
-
3
-
Total
12
7.17
4
2.39
9
5.37
11
6.57
4
2.39
9
5.37
Public
8
-
3
-
6
-
7
-
3
-
6
-
Private
10
-
5
-
7
-
10
-
4
-
8
-
Total
18
2.50
8
1.11
13
1.80
17
2.36
7
0.97
14
1.94
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
0
2
2
0
3
3
2
1
3
0
0
0
0
0
0
2
0
2
1.96
3.65
0.90
0.00
0.00
1.30
0
1
1
0
2
2
1
0
1
0
0
0
0
0
0
1
0
1
0.98
2.44
0.30
0.00
0.00
0.65
0
1
1
0
2
2
2
1
3
0
0
0
0
0
0
1
0
1
0.98
2.44
0.90
0.00
0.00
0.65
0
2
2
0
2
2
2
1
3
0
0
0
0
0
0
1
0
1
1.96
2.44
0.90
0.00
0.00
0.65
0
1
1
0
2
2
1
0
1
0
0
0
0
0
0
1
0
1
0.98
2.44
0.30
0.00
0.00
0.65
0
1
1
0
3
3
2
1
3
0
0
0
0
0
0
1
0
1
0.98
3.65
0.90
0.00
0.00
0.65
Public
0
-
0
-
0
-
1
-
0
-
0
-
Private
1
-
1
-
1
-
0
-
0
-
0
-
Total
1
0.30
1
0.30
1
0.30
1
0.30
0
0.00
0
0.00
Public
Private
Total
3
0
3
1.21
1
0
1
0.40
2
0
2
0.81
3
0
3
1.21
1
0
1
0.40
2
0
2
0.81
5
State
2010
Megavoltage Brachytherapy
Machines
Machines
No.
PMP
No.
PMP
15
6
24
10
39
1.38
16
0.56
0
0
na
na
na
na
0
0.00
0
0.00
0
0
0
0
0
0.00
0
0.00
0
0
0
0
0
0.00
0
0.00
0
0
6
1
6
3.84
1
0.64
0
0
1
0
1
0.43
0
0.00
75
HOSPITAL
Table 5.9 Number and Density of Hospital with Physics Equipment and Treatment Planning System Devices in Malaysia by State
and Sector in 2010 and 2011
2010
State
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 & WP
Putrajaya
Selangor & WP
Putrajaya
Selangor & WP
Putrajaya
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Selangor & WP
Putrajaya & WPKL
Selangor & WP
Putrajaya & WPKL
Selangor & WP
Putrajaya & WPKL
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
Hospitals with Physics
Sector
Equipment
2011
Hospitals with
Treatment Planning
System Devices
Hospitals with Physics
Equipment
Hospitals with
Treatment Planning
System Devices
Number
PMP
Number
PMP
Number
PMP
Number
PMP
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
6
16
22
0
na
0
0
0
0
0
0
0
0
3
3
0
1
1
0.78
na
0.00
0.00
0.00
1.92
0.43
6
16
22
0
na
0
0
0
0
0
0
0
0
3
3
0
1
1
0.78
na
0.00
0.00
0.00
1.92
0.43
7
15
22
0
na
0
0
0
0
0
0
0
0
3
3
0
1
1
0.78
na
0.00
0.00
0.00
1.92
0.43
7
15
22
0
na
0
0
0
0
0
0
0
0
3
3
0
1
1
0.78
na
0.00
0.00
0.00
1.92
0.43
Public
0
-
0
-
0
-
0
-
Private
4
-
4
-
4
-
4
-
Total
4
0.72
4
0.72
4
0.72
4
0.72
Public
Private
Total
3
3
6
3.58
3
3
6
3.58
3
3
6
3.58
3
3
6
3.58
Public
3
-
3
-
3
-
3
-
Private
7
-
7
-
7
-
7
-
10
1.39
10
1.39
10
1.39
10
1.39
0
1
1
0
2
2
1
1
2
0
0
0
0
0
0
1
0
1
0
1
1
1
0
1
0.98
2.44
0.60
0.00
0.00
0.65
0.30
0.40
0
1
1
0
2
2
1
1
2
0
0
0
0
0
0
1
0
1
0
1
1
1
0
1
0.98
2.44
0.60
0.00
0.00
0.65
0.30
0.40
0
1
1
0
2
2
1
1
2
0
0
0
0
0
0
1
0
1
1
0
1
1
0
1
0.98
2.44
0.60
0.00
0.00
0.65
0.30
0.40
0
1
1
0
2
2
1
1
2
0
0
0
0
0
0
1
0
1
1
0
1
1
0
1
0.98
2.44
0.60
0.00
0.00
0.65
0.30
0.40
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
76
CHAPTER 6
HOSPITAL
| PSYCHIATRIC SERVICES IN MALAYSIAN HOSPITALS
Toh CL1, Sivasampu S2*, Fatihah M2*, Lim CH3, Azizul A4, Rahima D5, Chee KY6, Khairuddin AW7, Aizah SNA6, Ong LY8
1. Hospital Selayang 2. National Clinical Research Centre, Ministry of Health, 3. Hospital Ampang 4. Hospital Putrajaya 5.Hospital Kajang 6. Hospital Kuala Lumpur, 7. Hospital Melaka.
8. Hospital Bahagia Ulu Kinta, Perak.
*Corresponding author.
Summary: This chapter presents information relating to psychiatric services in Malaysian hospitals in 2011.
Services provided outside the hospital setting were not represented. Psychiatric services were offered by 49
public and 45 private hospitals and with a total of 94 hospitals for the whole country. In 2011, the number of
psychiatrists practising was 234 with the majority (186) in the public sector and the remaining 48 in the private
sector. Within the psychiatric services, the availability of allied health professionals such as paramedics with post
basic training, clinical psychologists, counsellors and medical social workers was generally low and confined to
a few centres. Despite the acknowledged limitations of the survey, the impression was that there was a need for
further resources to improve the services in Malaysia.
The psychiatric services in Malaysia were provided mainly by hospitals within the Ministry of Health, the Ministry of Higher Education (University
Hospitals), the Ministry of Defence (Armed Forces Hospitals), the private sector, and several non-governmental organisations (NGOs). Despite an
expansion in the services, the gap between demand and the service provided remains wide. This is contrary to the WHO’s vision of narrowing the
gap between psychiatric services and demands of the users.1 This gap becomes very significant when viewed against the prevalence of substantial
psychiatric morbidity in the country, as shown by the recent National Health and Morbidity Survey (NHMS) 2011: Generalized Anxiety Disorder
(prevalence 1.7%), lifetime depression (2.4%), suicidal ideation (1.7%), suicidal plan (0.9%) and suicidal attempt (0.5%). 2
Psychiatric services available in Malaysian hospitals are:
● Outpatient care at the specialist clinics
● Inpatient care in the wards
● Community and rehabilitation psychiatric services (e.g. supported employment)
● Subspeciality services in various disciplines (e.g. child and adolescent psychiatry, forensic psychiatry, psychogeriatric services, neuropsychiatric
service, etc)
● Specific psychological interventions (e.g. cognitive behavioural therapy)
● Physical interventions (e.g. electroconvulsive therapy)
● Specific programmes for substance related disorders
● Psychiatric collaborative networking with other clinical disciplines or mental health providers.
The present survey is based on data collected from all public hospitals and private hospitals providing psychiatric services in the country. Ninety
of the 93 eligible hospitals (96.8%) responded to the survey.
Services
In 2011, there were 21,529 psychiatric admissions of which 18% were to mental institutions (Table 6.3). This does not mean that there were
all unique admissions. Some patients were admitted first to acute curative hospitals and subsequently transferred to the mental institutions and
usually because they required a prolonged hospital stay. The mean bed occupancy rate (BOR) was 63% and average length of stay (ALOS) was 35
days for the hospitals with psychiatry services. The highest BOR was 104% and in Wilayah Persekutuan Kuala Lumpur (WPKL). The lowest was
51% and in Perak. Sarawak was found to have the longest ALOS of 72 days while Perlis had the shortest at 9 days (Table 6.3).
77
6
In 2011, there were 49 public and 45 private hospitals providing psychiatric services, a density of 1 hospital to 333,333 population (Table 6.1). A
total of 5,367 dedicated in-patient psychiatric beds were available of which, more than 99% were in the public hospitals (Table 6.2). This gave a
bed density of 1.85 beds per 10,000 population. The majority (4,240) of the psychiatric beds were located in four mental institutions in the country.
The remaining 1,127 beds (21.0%) were located in specialist hospitals that provided acute and short stay psychiatric care. Of these, 1,127 acute
beds, 45 (4.1%) were located in private hospitals. Selangor and Putrajaya had the lowest ratio of beds to population (0.11 beds per 10,000).
PSYCHIATRIC SERVICES IN MALAYSIAN HOSPITALS
Facilities
HOSPITAL
A total of 460,824 outpatient follow-up visits were reported in 2011, giving a rate of 159.1 visits per 10,000 population (Table 6.4). The highest
rate of outpatient visits was for WPKL with 402.0 visits per 10,000 and lowest in Sabah with 73.5 visits per 10,000. The total number of new
outpatient cases was 39,730 in 2011 with a rate of 13.7 cases per 10,000 population. The highest rate of new outpatients was for WPKL at 32.7
cases per 10,000 population and the lowest was for Sabah and WP Labuan with a rate of 5.1 cases per 10,000 population (Table 6.4).
There were a total of 24,394 referrals to psychiatry from wards and emergency departments within the 66 hospitals surveyed; a rate of 8.42
referrals per 10,000 population (Table 6.4). Hospitals in Kelantan reported the highest rate of referrals with a rate of 20.8 referrals per 10,000
population. The lowest rate was for Sabah and WP Labuan with the rate of 2.45 per 10,000 population.
In line with the National Mental Health Policy and the implementation of the Mental Health Act 2001 and Mental Health Regulations 2010 in June
15th 2010, the country is currently in the process of developing a more comprehensive community and rehabilitative services. 4, 5, 6 There were 46
hospitals providing community services, an increase four hospitals from 2010 (Table 6.5). Perak had the highest rate of home/workplace visits with
84.5 visits per 10,000 population. Sabah and WP Labuan recorded the lowest rate with 5.4 visits per 10,000 population.
A total of 37 hospitals provided psychiatric rehabilitation services and there were 178,535 visits recorded, giving a rate of 61.6 visits per 10,000
population. WPKL recorded the highest rate of psychiatric rehabilitation visits at 237.9 per 10,000 population and Kelantan had the lowest rate at
4.0 visits per 10,000 population (Table 6.5).
The psychiatric services provided care to a wide range of patients, from children to the elderly. Data from 84 hospitals in 2011 showed that the
number of patient visits for those of ages below 18 years was 36.9 per 10,000 population. For those above 60 years it was 229.1 per 10,000
populations (Table 6.6). However, the density for those below 18 years of age is an underestimate because the denominator used for the
calculation was the population aged below 19 years (Table A3.4).
For 2011, 25 hospitals provided Methadone replacement therapy service to 7,220 patients, giving a density of 2.49 methadone patients per
10,000 population. Data from Sabah and Sarawak were not available (Table 6.7).
There were 51 hospitals that provided electroconvulsive therapy (ECT) in 2011, both for in-patients (2.23 procedures per 10,000 population) as
well as out-patients (0.15 procedures per 10,000 population) (Table 6.8).
Human Workforce
In 2011, there were 234 psychiatrists in the country, of whom 186 practised in the public sector and 48 in the private sector, giving an overall
density of 0.08 psychiatrists per 10,000 population (Table 6.9). The distribution of psychiatrists varied considerably across states. The majority
were concentrated in WPKL with a density of 0.35 psychiatrists per 10,000 population. Sabah and WP Labuan had the lowest density at 0.02
psychiatrists per 10,000 population. These densities were far below the World Health Organisation (WHO) recommendation of 1 psychiatrist per
10,000 population. 7
The numbers of clinical psychologists, counsellors and medical social workers available were very low in 2011, a density of 0.01 professionals
per 10,000 population for all 3 categories. Furthermore, in 2010 their services were only available in certain states. There was a decline in the
number of permanent/resident clinical psychologists from 25 in 2010 to 16 in 2011 (Table 6.10, Table 6.11, and Table 6.12).
The number of nurses working in psychiatric services and in hospitals was 1,185 in 2011 giving a density of 0.41 nurses per 10,000 population.
There was an absolute increase of 1,159 nurses when compared to 2010. Although they made up the largest proportion of the workforce in any
psychiatric facility in the country, their numbers are still low when compared to the WHO recommendation8 of 0.97 nurses per 10,000 population
for countries in the upper middle income group. The number of nurses with post basic training was 270 in 2011 (0.10 nurses per 10,000
population) (Table 6.13). There was a reduction in the number of assistant medical officers (AMO) from 739 in 2010 to 700 in 2011 (Table 6.14).
The ratio of AMOs to population was 0.24 AMOs per 10,000 population in 2011.
Limitations
1. No data was obtained for the psychiatric services provided by Armed Forces Hospitals.
2. This report focused only on hospital-based psychiatric services. Mental health services are also provided at the Primary Health Care level and
by individual clinic-based private practitioners, but these were not captured in this survey
3. Services delivered outside the hospital setting (e.g. home psychiatric rehabilitation for the child and adolescent service) were not represented
in this survey.
4. A number of private hospitals did not report having psychiatric services although they did report having a resident or visiting psychiatrist.
Therefore the provision of psychiatric services by private hospitals may have been underestimated.
5. Several items in the questionnaire were misinterpreted by some respondents. The respondents were contacted and the affected data verified
and corrected.
78
HOSPITAL
References
1. World Health Organization. Mental Health Action Programme 2008. mhGAP Intervention Guide for mental, neurological and substance use
disorders in non-specialized health settings. Geneva; 2010
2. Institute for Public Health (IPH). The National Health Morbidity Survey 2011. Prevalence of Psychiatric Morbidity. Ministry of Health, Malaysia;
2011.
3. Clinical research Centre. National Healthcare Establishment and Workforce Survey (Hospital) 2010. Kuala Lumpur 2012
4. Malaysia Mental Health Act, 2001.
5. Malaysia Mental Health Regulations, 2010.
6. Malaysia National Mental Health Policy, 1998, Ministry of Health, Malaysia.
7. Mental Health Workforce Advisory Committee Mental Health Workforce: supply of psychiatrist. Australia; February, 2008. 1-5p.
6
8. World Health Organization. Mental Health Atlas 2011: mental health care delivery Geneva; 2011.48-59p.
79
HOSPITAL
Table 6.1 Number and Density of Hospitals Providing Psychiatry Services in Malaysia by State and Sector, 2010-2011
2010
State
Sector
2011
Per 10,000
population
NO.
NO.
Per 10,000
population
Malaysia
Public
46
-
49
-
Malaysia
Private
38
-
45
-
Malaysia
Total
84
0.03
94
0.03
Perlis
Public
1
-
1
-
Perlis
Private
na
na
na
na
Perlis
Total
1
0.04
1
0.04
Kedah
Public
2
-
3
-
Kedah
Private
2
-
2
0.03
Kedah
Total
4
0.02
5
Kedah & Perlis
Public
3
-
4
-
Kedah & Perlis
Private
2
-
2
-
Kedah & Perlis
Total
5
0.02
6
0.03
Pulau Pinang
Public
2
-
2
-
Pulau Pinang
Private
4
-
5
-
Pulau Pinang
Total
6
0.04
7
0.04
Perak
Public
6
-
6
-
Perak
Private
3
-
5
-
Perak
Total
9
0.04
11
0.05
Public
7
-
7
-
Private
9
-
9
-
Total
16
0.03
16
0.03
WP Kuala Lumpur
Public
3
-
3
-
WP Kuala Lumpur
Private
11
-
9
-
WP Kuala Lumpur
Total
14
0.08
12
0.07
Public
10
-
10
-
Private
20
-
18
-
Total
30
0.04
28
0.04
Negeri Sembilan
Public
2
-
2
-
Negeri Sembilan
Private
2
-
2
-
Negeri Sembilan
Total
4
0.04
4
0.04
Melaka
Public
1
-
1
-
Melaka
Private
2
-
3
-
Melaka
Total
3
0.04
4
0.05
Johor
Public
7
-
7
-
Johor
Private
0
-
2
-
Johor
Total
7
0.02
9
0.03
Pahang
Public
3
-
3
-
Pahang
Private
0
-
0
-
Pahang
Total
3
0.02
3
0.02
Terengganu
Public
2
-
3
-
Terengganu
Private
0
-
0
-
Terengganu
Total
2
0.02
3
0.03
Kelantan
Public
3
-
4
-
Kelantan
Private
1
-
1
-
Kelantan
Total
4
0.03
5
0.03
Sabah & WP Labuan
Public
3
-
3
-
Sabah & WP Labuan
Private
1
-
1
-
Sabah & WP Labuan
Total
4
0.01
4
0.01
Sarawak
Public
4
-
4
-
Sarawak
Private
3
-
6
-
Sarawak
Total
7
0.03
10
0.04
80
Table 6.2 Number and Density of Inpatient Dedicated Beds and Functioning Inpatient Dedicated Beds in Malaysia by State and
Sector, 2010-2011
2010
2011
Inpatient
Inpatient
Functioning Inpatient
Dedicated Beds
Dedicated Beds
Dedicated Beds
State
Sector
Per 10,000
Per 10,000
No.
No.
No. Per 10,000 population
population
population
Malaysia
Public
5,230
- 5,322
- 5,096
Malaysia
Private
46
45
45
Malaysia
Total
5,276
1.86 5,367
1.85 5,141
1.77
Perlis
Public
16
16
16
Perlis
Private
na
na
na
na
na
na
Perlis
Total
16
0.69
16
0.67
16
0.67
Kedah
Public
46
46
46
Kedah
Private
0
0
0
Kedah
Total
46
0.24
46
0.23
46
0.23
Kedah & Perlis
Public
62
62
62
Kedah & Perlis
Private
0
0
0
Kedah & Perlis
Total
62
0.28
62
0.28
62
0.28
Pulau Pinang
Public
72
104
74
Pulau Pinang
Private
34
28
28
Pulau Pinang
Total
106
0.68
132
0.83
102
0.64
Perak
Public
2,306
- 2,328
- 2,303
Perak
Private
12
15
15
Perak
Total
2,318
9.85 2,343
9.77 2,318
9.67
Public
34
60
46
Private
0
0
0
Total
34
0.06
60
0.11
46
0.08
WP Kuala Lumpur
Public
170
174
174
WP Kuala Lumpur
Private
0
2
2
WP Kuala Lumpur
Total
170
1.02
176
1.04
176
1.04
204
234
220
0
2
2
204
0.28
236
0.32
222
0.30
Negeri Sembilan
Public
48
52
52
Negeri Sembilan
Private
0
0
0
Negeri Sembilan
Total
48
0.47
52
0.50
52
0.50
Melaka
Public
60
40
40
Melaka
Private
0
0
0
Melaka
Total
60
0.73
40
0.48
40
0.48
Johor
Public
1,464
- 1,472
- 1,472
Johor
Private
0
0
0
Johor
Total
1,464
4.37 1,472
4.33 1,472
4.33
Pahang
Public
94
110
110
Pahang
Private
na
0
0
Pahang
Total
94
0.63
110
0.72
110
0.72
Terengganu
Public
30
30
30
Terengganu
Private
na
0
0
Terengganu
Total
30
0.29
30
0.28
30
0.28
Kelantan
Public
169
169
169
Kelantan
Private
0
0
0
Kelantan
Total
169
1.10
169
1.05
169
1.05
Sabah & WP Labuan
Public
330
330
270
Sabah & WP Labuan
Private
0
0
0
Sabah & WP Labuan
Total
330
1.00
330
0.97
270
0.79
Sarawak
Public
391
391
294
Sarawak
Private
0
0
0
Sarawak
Total
391
1.58
391
1.55
294
1.17
HOSPITAL
6
81
HOSPITAL
Table 6.3 Number and Density of Inpatient Psychiatry Admission, Mean Bed Occupancy Rate (BOR) and Mean Average Length of
Stay (ALOS) in Malaysia by State and Sector, 2011
Inpatient Psychiatry Admission
State
Sector
Mean BOR
Mean ALOS
Per 10,000
No.
population
Malaysia
Public
20,913
63
35
Malaysia
Private
616
na
na
Malaysia
Total
21,529
7.43
63
35
Perlis
Public
348
55
9
Perlis
Private
0
na
na
Perlis
Total
348
14.65
55
9
Kedah
Public
571
92
35
Kedah
Private
0
na
na
Kedah
Total
571
2.89
92
35
Kedah & Perlis
Public
919
80
26
Kedah & Perlis
Private
0
na
na
Kedah & Perlis
Total
919
4.16
80
26
Pulau Pinang
Public
1,116
73
16
Pulau Pinang
Private
370
na
na
Pulau Pinang
Total
1,486
9.32
73
16
Perak
Public
3,573
51
57
Perak
Private
55
na
na
Perak
Total
3,628
15.13
51
57
Public
1,209
59
11
Private
79
na
na
Total
1,288
2.28
59
11
WP Kuala Lumpur
Public
3,643
104
18
WP Kuala Lumpur
Private
38
na
na
WP Kuala Lumpur
Total
3,681
21.72
104
18
4,852
81
14
117
na
na
4,969
6.76
81
14
Negeri Sembilan
Public
884
57
14
Negeri Sembilan
Private
5
na
na
Negeri Sembilan
Total
889
8.52
57
14
Melaka
Public
694
57
12
Melaka
Private
12
na
na
Melaka
Total
706
8.48
57
12
Johor
Public
2,807
53
45
Johor
Private
4
na
na
Johor
Total
2,811
8.26
53
45
Pahang
Public
1,389
62
19
Pahang
Private
0
na
na
Pahang
Total
1,389
9.11
62
19
Terengganu
Public
724
75
12
Terengganu
Private
0
na
na
Terengganu
Total
724
6.74
75
12
Kelantan
Public
1,765
64
23
Kelantan
Private
0
na
na
Kelantan
Total
1,765
10.93
64
23
Sabah & WP Labuan
Public
1,108
56
48
Sabah & WP Labuan
Private
6
na
na
Sabah & WP Labuan
Total
1,114
3.27
56
48
Sarawak
Public
1,082
56
72
Sarawak
Private
47
na
na
Sarawak
Total
1,129
4.49
56
72
82
HOSPITAL
Table 6.4 Number and Density of Follow up Outpatient Visits, New Cases, Referrals to Psychiatry from Wards or Emergency
Department in Malaysia by State and Sector, 2010-2011
State
Sector Outpatient Follow
Up Patient Visits
Per 10,000
No.
Population
Malaysia
Public
Malaysia
Private
Malaysia
Total
392,244
- 2011
Outpatient
Psychiatry New
Cases
No.
28,240
Outpatient
Psychiatry New
Cases
Outpatient Follow
Up Patient Visits
Per 10,000
Population
No.
Per 10,000
Population
No.
- 411,329
- 32,884
Referrals to Psychiatry
from Wards or Emergency
Department
Per 10,000
No. of
No. of Per 10,000
Population Hospital Referrals Population
- 45
23,510
- 46,390
- 5,912
- 49,495
- 6,846
- 21
884
- 438,634
154.81
34,152
12.05
460,824
159.1
39,730
13.72
66
24,394
8.42
Perlis
Public
8,993
- 291
- 7,898
- 345
- 1
98
- Perlis
Private
na
na
na
na
na
na
na
na
na
na
na
Perlis
Total
8,993
388.47
291
12.57
7,898
332.55
345
14.53
1
98
4.13
Kedah
Public
26,147
- 1,421
- 27,466
- 1,840
- 3
1,190
- Kedah
Private
6,098
- 581
- 5,099
- 407
- 1
124
- Kedah
Total
32,245
165.55
2,002
10.28
32,565
165.04
2,247
11.39
4
1,314
6.66
Kedah & Perlis
Public
35,140
- 1,712
- 35,364
- 2,185
- 4
1,288
- Kedah & Perlis
Private
6,098
- 581
- 5,099
- 407
- 1
124
- Kedah & Perlis
Total
41,238
189.23
2,293
10.52
40,463
183.04
2,592
11.73
5
1,412
6.39
Pulau Pinang
Public
22,235
- 1,640
- 19,952
- 1,527
- 2
629
- Pulau Pinang
Private
12,086
- 1,309
- 15,260
- 1,515
- 4
145
- Pulau Pinang
Total
34,321
219.81
2,949
18.89
35,212
220.96
3,042
19.09
6
774
4.86
- Perak
Public
51,462
- 4,289
- 58,234
- 3,739
- 5
1,714
Perak
Private
2,006
- 247
- 4,406
- 429
- 4
159
- Perak
Total
53,468
227.26
4,536
19.28
62,640
261.26
4,168
17.38
9
1,873
7.81
- Selangor & WP Putrajaya Public
33,282
- 3,397
- 39,903
- 5,801
- 7
6,373
Selangor & WP Putrajaya Private
7,848
- 821
- 7,730
- 1,582
- 2
27
- 41,130
74.32
4,218
7.62
47,633
84.25
7,383
13.06
9
6,400
11.32
- Selangor & WP Putrajaya Total
WP Kuala Lumpur
Public
47,271
- 3,436
- 60,814
- 4,161
- 3
2,138
WP Kuala Lumpur
Private
11,167
- 2,090
- 7,308
- 1,383
- 4
241
- WP Kuala Lumpur
Total
58,438
348.97
5,526
33
68,122
402.02
5,544
32.72
7
2,379
14.04
Public
& WPKL
80,553
- 6,833
- 100,717
- 9,962
- 10
8,511
- Selangor & WP Putrajaya
Private
& WPKL
19,015
- 2,911
-
15,038
- 2,965
- 6
268
- Selangor & WP Putrajaya
Total
& WPKL
99,568
138.11
9,744
13.52
115,755
157.53
12,927
17.59
16
8,779
11.95
Negeri Sembilan
15,160
- 1,571
- 18,831
- 1,909
- 2
518
- Public
Negeri Sembilan
Private
140
- 80
-
214
- 79
- 1
17
- Negeri Sembilan
Total
15,300
149.84
1,651
16.17
19,045
182.62
1,988
19.06
3
535
5.13
- Melaka
Public
19,381
- 1,479
- 17,749
- 1,263
- 1
1,089
Melaka
Private
4,542
- 414
- 6,094
- 820
- 1
64
- Melaka
Total
23,923
291.35
1,893
23.05
23,843
286.23
2,083
25.01
2
1,153
13.84
Johor
Public
60,139
- 4,016
- 54,369
- 5,373
- 7
3,367
- Johor
Private
0
- 0
- 412
- 192
- 0
0
- Johor
Total
60,139
179.61
4,016
11.99
54,781
161.04
5,565
16.36
7
3,367
9.9
Pahang
Public
16,437
- 1,134
- 17,993
- 1,250
- 3
797
- Pahang
Private
na
- na
- 0
- 0
- 0
0
- Pahang
Total
16,437
109.52
1,134
7.56
17,993
118
1,250
8.2
3
797
5.23
Terengganu
Public
9,835
- 841
- 9,908
- 817
- 2
379
- Terengganu
Private
na
- na
- 0
- 0
- 0
0
- Terengganu
Total
9,835
94.93
841
8.12
9,908
92.25
817
7.61
2
379
3.53
Kelantan
Public
28,392
- 1,521
- 20,824
- 1,717
- 4
3,360
- Kelantan
Private
30
- 0
- 31
- 2
- 0
0
- Kelantan
Total
28,422
184.61
1,521
9.88
20,855
129.12
1,719
10.64
4
3,360
20.8
Public
22,200
- 1,352
- 24,272
- 1,571
- 2
790
- Private
475
- 123
- 753
- 157
- 1
45
- Sabah & WP Labuan
Total
22,675
68.85
1,475
4.48
25,025
73.47
1,728
5.07
3
835
2.45
Sarawak
Public
31,310
- 1,852
- 33,116
- 1,571
- 3
1,068
- Sarawak
Private
1,998
- 247
- 2,188
- 280
- 3
62
-
Sarawak
Total
33,308
134.79
2,099
8.49
35,304
140.31
1,851
7.36
6
1,130
4.49
6
Sabah & WP Labuan
Sabah & WP Labuan
2010
83
HOSPITAL
Table 6.5 Number and Density of Public Hospitals with Community Psychiatry and Psychiatric Rehabilitation Services in Malaysia
by State, 2011
Community Psychiatry
Psychiatric Rehabilitation
State
No. of
No of Home / Per 10,000
No. of No. of patient
Per 10,000
Hospitals Workplace Visits population Hospitals
Visits population
Malaysia
46
91,264
31.51
37
178,535
61.64
Perlis
1
1,393
58.65
1
3,708
156.13
Kedah
3
1,965
9.96
2
4,700
23.82
Kedah & Perlis
4
3,358
15.19
3
8,408
38.03
Pulau Pinang
2
6,120
38.40
1
5,689
35.70
Perak
6
20,258
84.49
5
9,537
39.78
5
5,394
9.54
4
4,631
8.19
WP Kuala Lumpur
3
5,450
32.16
3
40,305
237.86
8
10,844
14.76
7
44,936
61.15
Negeri Sembilan
2
787
7.55
2
3,746
35.92
Melaka
1
4,447
53.39
1
3,501
42.03
Johor
7
22,586
66.39
5
58,618
172.31
Pahang
3
2,570
16.85
3
7,252
47.56
Terengganu
3
3,255
30.31
3
1,801
16.77
Kelantan
4
5,469
33.86
2
645
3.99
Sabah & WP Labuan
2
1,828
5.37
2
9,471
27.81
Sarawak
4
9,742
38.72
3
24,931
99.08
84
HOSPITAL
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
49
35
84
1
na
1
3
2
5
4
2
6
2
5
7
6
4
10
7
6
13
3
7
10
10
13
23
2
2
4
1
1
2
7
2
9
3
0
3
3
0
3
4
1
5
3
1
4
4
4
8
38,009
1,074
39,083
329
na
329
1,180
131
1,311
1,509
131
1,640
4,188
451
4,639
2,903
29
2,932
3,503
102
3,605
8,523
242
8,765
12,026
344
12,370
1,146
11
1,157
282
12
294
7,368
21
7,389
1,806
0
1,806
889
0
889
1,944
3
1,947
2,227
5
2,232
1,721
67
1,788
(a) Population Below 20 Years old (0-19 years old)
(b) Population Above 60 Years old (>60 years old)
47
37
84
1
na
1
3
1
4
4
1
5
2
5
7
6
5
11
6
7
13
2
7
9
8
14
22
2
2
4
1
1
2
7
2
9
3
0
3
3
0
3
4
1
5
3
1
4
4
5
9
50,871
2,694
53,565
847
na
847
2,871
394
3,265
3,718
394
4,112
4,464
1,167
5,631
9,454
86
9,540
3,728
158
3,886
4,416
232
4,648
8,144
390
8,534
2,691
28
2,719
124
12
136
9,513
63
9,576
1,702
0
1,702
189
0
189
1,822
3
1,825
2,625
113
2,738
6,425
438
6,863
229.08
na
327.03
172.11
131.29
339.42
329.99
111.38
352.12
177.46
281.76
16.61
333.31
133.39
23.36
129.62
177.68
315.40
6
36.87
na
35.57
17.05
19.04
93.70
33.45
19.59
173.32
52.74
30.30
9.60
61.16
29.59
18.80
26.43
16.60
18.62
Table 6.6 Number of Hospitals and Hospital Visits with Patients below 18 Years Old and above 60 Years Old in Malaysia by State
and Sector, 2011
Patients Below
Patients Above
18 Years Old
60 Years Old
No. of
No. of
State
Sector
No. of
No. of
Hospitals
Per 10,000
Per 10,000 Hospitals
Patients
Patients
population(b)
population(a)
Visits
Visits
85
HOSPITAL
Table 6.7 Number of Public Hospitals Providing Methadone Replacement Therapy (MRT) Services and Total MRT Patients in
Malaysia by State, 2010-2011
2010
2011
Hospitals
Hospitals
Providing
Total MRT Patients
Providing
Total MRT Patients
State
MRT Services
MRT Services
Per 10,000
Per 10,000
No.
No.
No.
No.
population
population
Malaysia
Perlis
22
6,361
2.24
25
7,220
2.49
1
123
5.31
1
113
4.76
Kedah
1
276
1.42
1
290
1.47
Kedah & Perlis
2
399
1.83
2
403
1.82
Pulau Pinang
2
993
6.36
2
1,089
6.83
Perak
4
1,253
5.33
5
1,533
6.39
2
243
0.44
2
319
0.56
WP Kuala Lumpur
2
1,628
9.72
2
1,481
8.74
4
1,871
2.60
4
1,800
2.45
Negeri Sembilan
2
297
2.91
2
291
2.79
Melaka
1
228
2.78
1
246
2.95
Johor
1
239
0.71
1
498
1.46
Pahang
2
561
3.74
2
583
3.82
Terengganu
2
445
4.30
3
675
6.28
Kelantan
2
75
0.49
3
102
0.63
Sabah & WP Labuan
0
0
0.00
0
0
0.00
Sarawak
0
0
0.00
0
0
0.00
86
HOSPITAL
Table 6.8 Number and Density of Electroconvulsive Therapy (ECT) Machines and Procedures in Malaysian Hospitals by State and
Sector, 2010-2011
State
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
Sector
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
ECT Machines
2011
Outpatient ECT
Procedures
Inpatient ECT
Procedures
ECT Machines
Outpatient ECT
Procedures
Inpatient ECT
Procedures
No.
PMP
No.
Per 10,000
population
No.
Per 10,000
population
No.
PMP
No.
Per 10,000
population
No.
Per 10,000
population
46
6
52
0
na
0
2
0
2
2
0
2
2
3
5
7
1
8
4
0
4
8
0
8
12
0
12
2
0
2
1
1
2
5
0
5
3
na
3
1
na
1
3
0
3
3
1
4
5
0
5
1.84
na
0.00
1.03
0.92
3.20
3.40
0.72
4.78
1.66
1.96
2.44
1.49
2.00
0.97
1.95
1.21
2.02
442
61
503
0
na
0
0
0
0
0
0
0
41
24
65
0
6
6
0
0
0
80
0
80
80
0
80
6
0
6
18
31
49
36
0
36
0
na
0
54
na
54
0
0
0
36
0
36
171
0
171
0.18
na
0.00
0.00
0.00
0.42
0.03
0.00
0.48
0.11
0.06
0.60
0.11
0.00
0.52
0.00
0.11
0.69
6,098
426
6,524
0
na
0
211
0
211
211
0
211
38
418
456
1,011
0
1,011
192
0
192
1,150
0
1,150
1,342
0
1,342
51
0
51
477
8
485
477
0
477
62
na
62
0
na
0
1,058
0
1,058
411
0
411
960
0
960
2.30
na
0.00
1.08
0.97
2.92
4.30
0.35
6.87
1.86
0.50
5.91
1.42
0.41
0.00
6.87
1.25
3.88
44
7
51
0
na
0
2
0
2
2
0
2
2
4
6
6
1
7
3
0
3
7
0
7
10
0
10
2
0
2
1
2
3
7
0
7
3
na
3
1
na
1
3
0
3
2
0
2
5
0
5
1.76
na
0.00
1.01
0.90
3.77
2.92
0.53
4.13
1.36
1.92
3.60
2.06
1.97
0.93
1.86
0.59
1.99
287
146
433
0
na
0
0
0
0
0
0
0
117
35
152
0
0
0
0
0
0
21
0
21
21
0
21
10
0
10
0
111
111
91
0
91
0
na
0
20
na
20
0
0
0
5
0
5
23
0
23
0.15
na
0.00
0.00
0.00
0.95
0.00
0.00
0.12
0.03
0.10
1.33
0.27
0.00
0.19
0.00
0.01
0.09
5,870
587
6,457
0
na
0
186
0
186
186
0
186
142
539
681
1,269
40
1,309
355
0
355
1,065
0
1,065
1,420
0
1,420
212
0
212
120
8
128
938
0
938
180
na
180
33
na
33
259
0
259
458
0
458
653
0
653
2.23
na
0.00
0.94
0.84
4.27
5.46
0.63
6.29
1.93
2.03
1.54
2.76
1.18
0.31
1.60
1.34
2.60
6
Abbreviation: na – not applicable; PMP – per million population
2010
87
HOSPITAL
Table 6.9 Number and Density of Psychiatrists, in Malaysian Hospitals by State and Sector, 2010-2011
State
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
Sector
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
2010
Psychiatrists
2011
Psychiatrists
No.
Per 10,000
population
No.
Per 10,000
population
179
49
229
2
na
2
7
2
9
9
2
11
10
6
16
17
3
20
27
12
39
42
18
61
69
31
100
6
2
8
4
3
7
19
0
19
11
na
11
4
na
4
16
0
16
6
1
7
8
2
10
0.08
na
0.09
0.05
0.05
0.10
0.09
0.07
0.36
0.14
0.08
0.09
0.06
0.07
0.04
0.10
0.02
0.04
186
48
234
2
na
2
6
2
8
8
2
10
8
6
14
18
3
21
26
15
41
47
12
59
73
27
100
6
2
8
3
3
6
19
2
21
11
0
11
6
0
6
17
0
17
7
1
8
10
2
12
0.08
na
0.08
0.04
0.05
0.09
0.09
0.07
0.35
0.14
0.08
0.07
0.06
0.07
0.06
0.11
0.02
0.05
88
HOSPITAL
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
10
15
25
0
na
0
0
1
1
0
1
1
0
2
2
0
0
0
2
7
9
7
4
11
9
11
20
0
0
0
0
0
0
0
0
0
0
na
0
0
na
0
1
0
1
0
1
1
0
0
0
0.01
na
0.00
0.01
0.00
0.01
0.00
0.02
0.07
0.03
0.00
0.00
0.00
0.00
0.00
0.01
0.00
0.00
0
16
16
0
na
0
0
0
0
0
0
0
0
2
2
0
1
1
0
11
11
0
2
2
0
13
13
0
0
0
0
0
0
0
0
0
0
na
0
0
na
0
0
0
0
0
0
0
0
0
0
6
10
16
0
na
0
0
1
1
0
1
1
0
2
2
0
1
1
0
5
5
5
1
6
5
6
11
0
0
0
0
0
0
0
0
0
0
na
0
0
na
0
1
0
1
0
0
0
0
0
0
0.01
na
0.00
0.01
0.00
0.01
0.00
0.01
0.04
0.01
0.00
0.00
0.00
0.00
0.00
0.01
0.00
0.00
9
17
26
0
na
0
0
0
0
0
0
0
2
4
6
0
3
3
6
0
6
0
9
9
6
9
15
1
1
2
0
0
0
0
0
0
0
na
0
0
na
0
0
0
0
0
0
0
0
0
0
0.01
na
0.00
0.00
0.00
0.04
0.01
0.01
0.05
0.02
0.02
0.00
0.00
0.00
0.00
0.00
0.00
0.00
6
0.01
na
0.00
0.00
0.00
0.01
0.00
0.02
0.01
0.02
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Table 6.10 Number and Density of Clinical Psychologists in Malaysian Hospitals by State and Sector, 2010-2011
2010
2011
Clinical
Clinical
Clinical
Clinical
Psychologists
Psychologists
Psychologists
Psychologists
State
Sector
Permanent /
Permanent /
Visiting
Visiting
Resident
Resident
Per 10,000
Per 10,000
Per 10,000
Per 10,000
No.
No.
No.
No.
population
population
population
population
89
HOSPITAL
Table 6.11 Number and Density of Counsellors in Malaysian Hospitals by State and Sector, 2011
State
Sector
Counsellors Full Time
No.
Counsellors Common User
No.
Malaysia
Public
33
-
35
-
Malaysia
Private
1
-
0
-
Malaysia
Total
34
0.01
35
0.01
Perlis
Public
0
-
1
-
Perlis
Private
na
na
na
na
Perlis
Total
0
0.00
1
0.04
Kedah
Public
3
-
2
-
Kedah
Private
0
-
0
-
Kedah
Total
3
0.02
2
0.01
Kedah & Perlis
Public
3
-
3
-
Kedah & Perlis
Private
0
-
0
-
Kedah & Perlis
Total
3
0.01
3
0.01
Pulau Pinang
Public
1
-
2
-
Pulau Pinang
Private
0
-
0
-
Pulau Pinang
Total
1
0.01
2
0.01
Perak
Public
4
-
3
-
Perak
Private
0
-
0
0.01
Perak
Total
4
0.02
3
Public
3
-
6
-
Private
1
-
0
-
Total
4
0.01
6
0.01
WP Kuala Lumpur
Public
9
-
9
-
WP Kuala Lumpur
Private
0
-
0
-
WP Kuala Lumpur
Total
9
0.05
9
0.05
Public
12
-
15
-
Private
1
-
0
-
Total
13
0.02
15
0.02
Negeri Sembilan
Public
0
-
3
-
Negeri Sembilan
Private
0
-
0
0.03
Negeri Sembilan
Total
0
0.00
3
Melaka
Public
1
-
0
-
Melaka
Private
0
-
0
-
Melaka
Total
1
0.01
0
0.00
Johor
Public
5
-
3
-
Johor
Private
0
-
0
-
Johor
Total
5
0.01
3
0.01
Pahang
Public
1
-
1
-
Pahang
Private
na
-
na
-
Pahang
Total
1
0.01
1
0.01
Terengganu
Public
2
-
0
-
Terengganu
Private
na
-
na
-
Terengganu
Total
2
0.02
0
0.00
Kelantan
Public
1
-
2
-
Kelantan
Private
0
-
0
-
Kelantan
Total
1
0.01
2
0.01
Sabah & WP Labuan
Public
0
-
2
-
Sabah & WP Labuan
Private
0
-
0
-
Sabah & WP Labuan
Total
0
0.00
2
0.01
Sarawak
Public
3
-
1
-
Sarawak
Private
0
-
0
-
Sarawak
Total
3
0.01
1
0.00
90
HOSPITAL
Table 6.12 Number and Density of Public Hospitals Medical Social Workers in Malaysia by State, 2011
Medical Social WorkerS Full Time
Medical Social WorkerS Common user
State
No.
No.
Malaysia
17
0.01
94
0.03
0
0.00
2
0.08
Kedah
0
0.00
2
0.01
Kedah & Perlis
0
0.00
4
0.02
Pulau Pinang
0
0.00
3
0.02
Perak
5
0.02
6
0.03
0
0.00
16
0.03
WP Kuala Lumpur
0
0.00
3
0.02
0
0.00
19
0.03
Negeri Sembilan
0
0.00
5
0.05
Melaka
0
0.00
2
0.02
Johor
6
0.02
15
0.04
Pahang
0
0.00
3
0.02
Terengganu
0
0.00
6
0.06
Kelantan
2
0.01
12
0.07
Sabah & WP Labuan
1
0.00
9
0.03
Sarawak
3
0.01
10
0.04
6
Perlis
91
HOSPITAL
Table 6.13 Number and Density of Nurses in Psychiatry Services Malaysian Hospitals by State and Sector, 2010-2011
2010
State
Malaysia
Public
Malaysia
Private
Malaysia
Total
Perlis
Perlis
Perlis
Kedah
Nurses With Post
Basic training
Nurses
Sector
2011
Nurses With Post
Basic training
Nurses
Community Nurse
No.
Per 10,000
population
No.
Per 10,000
population
No.
Per 10,000
population
No.
Per 10,000
population
No.
Per 10,000
population
1,144
-
269
-
1,150
-
270
-
127
-
15
-
7
-
35
-
na
na
na
na
1,159
0.41
276
0.10
1,185
0.41
270
0.09
127
0.04
Public
9
-
4
-
10
-
4
-
2
-
Private
na
-
na
-
0
-
na
na
na
na
Total
9
0.39
4
0.17
10
0.42
4
0.17
2
0.08
Public
35
-
7
-
41
-
9
-
8
-
Kedah
Private
0
-
0
-
0
-
na
na
na
na
Kedah
Total
35
0.18
7
0.04
41
0.21
9
0.05
8
0.04
Kedah & Perlis
Public
44
-
11
-
51
-
13
-
10
-
Kedah & Perlis
Private
0
-
0
-
0
-
na
na
na
na
Kedah & Perlis
Total
44
0.20
11
0.05
51
0.23
13
0.06
10
0.05
Pulau Pinang
Public
28
-
5
-
25
-
3
-
0
-
Pulau Pinang
Private
12
-
5
-
15
-
na
na
na
na
Pulau Pinang
Total
40
0.26
10
0.06
40
0.25
3
0.02
0
0.00
Perak
Public
283
-
99
-
271
-
79
-
14
-
Perak
Private
3
-
0
-
18
-
na
na
na
na
Perak
Total
286
1.22
99
0.42
289
1.21
79
0.33
14
0.06
Selangor & WP
Putrajaya
Public
37
-
4
-
53
-
4
-
5
-
Selangor & WP
Putrajaya
Private
0
-
0
-
0
-
na
na
na
na
Selangor & WP
Putrajaya
Total
37
0.07
4
0.01
53
0.09
4
0.01
5
0.01
WP Kuala Lumpur
Public
119
-
16
-
162
-
27
-
39
-
WP Kuala Lumpur
Private
0
-
2
-
1
-
na
na
na
na
WP Kuala Lumpur
Total
119
0.71
18
0.11
163
0.96
27
0.16
39
0.23
Selangor & WP
Putrajaya & WPKL
Public
156
-
20
-
215
-
31
-
44
-
Selangor & WP
Putrajaya & WPKL
Private
0
-
2
-
1
-
na
na
na
na
Selangor & WP
Putrajaya & WPKL
Total
156
0.22
22
0.03
216
0.29
31
0.04
44
0.06
Negeri Sembilan
Public
26
-
3
-
23
-
6
-
0
-
Negeri Sembilan
Private
0
-
0
-
0
-
na
na
na
na
Negeri Sembilan
Total
26
0.25
3
0.03
23
0.22
6
0.06
0
0.00
Melaka
Public
25
-
4
-
17
-
2
-
2
-
Melaka
Private
0
-
0
-
0
-
na
na
na
na
Melaka
Total
25
0.30
4
0.05
17
0.20
2
0.02
2
0.02
Johor
Public
205
-
61
-
205
-
60
-
5
-
Johor
Private
0
-
0
-
0
-
na
na
na
na
Johor
Total
205
0.61
61
0.18
205
0.60
60
0.18
5
0.01
Pahang
Public
49
-
5
-
44
-
8
-
4
-
Pahang
Private
na
-
na
-
0
-
na
na
na
na
Pahang
Total
49
0.33
5
0.03
44
0.29
8
0.05
4
0.03
Terengganu
Public
20
-
3
-
19
-
6
-
3
-
Terengganu
Private
na
-
na
-
0
-
na
na
na
na
Terengganu
Total
20
0.19
3
0.03
19
0.18
6
0.06
3
0.03
Kelantan
Public
47
-
16
-
55
-
15
-
3
-
Kelantan
Private
0
-
0
-
0
-
na
na
na
na
Kelantan
Total
47
0.31
16
0.10
55
0.34
15
0.09
3
0.02
128
-
18
-
97
-
19
-
10
-
0
-
0
-
1
-
na
na
na
na
128
0.39
18
0.05
98
0.29
19
0.06
10
0.03
Sarawak
Public
133
-
24
-
128
-
28
-
32
-
Sarawak
Private
0
-
0
-
0
-
na
na
na
na
Sarawak
Total
133
0.54
24
0.10
128
0.51
28
0.11
32
0.13
92
HOSPITAL
6
Table 6.14 Number and Density of Public Hospitals Assistant Medical Officers in Psychiatry Services Malaysia by State, 20102011
2010
2011
Assistant
Assistant
Assistant
Assistant
Medical
Assistant
Medical
Medical Officers
Medical
Officers With
Medical
Officers
State
With Post Basic
Officers
Post Basic
Officers
Without Post
training
training
Basic training
Per 10,000
Per 10,000
Per 10,000
Per 10,000
Per 10,000
No.
No.
No.
No.
No.
population
population
population
population
population
Malaysia
739
0.26 176
0.06 700
0.24 176
0.06 524
0.18
Perlis
7
0.30
2
0.09
5
0.21
2
0.08
3
0.13
Kedah
22
0.11
5
0.03 24
0.12
4
0.02
20
0.10
Kedah & Perlis
29
0.13
7
0.03 29
0.13
6
0.03
23
0.10
Pulau Pinang
23
0.15
1
0.01 21
0.13
1
0.01
20
0.13
Perak
189
0.80
87
0.37 200
0.83
87
0.36 113
0.47
21
0.04
2
0.00 30
0.05
1
0.00
29
0.05
WP Kuala Lumpur
31
0.19
5
0.03 42
0.25
4
0.02
38
0.22
52
0.07
7
0.01 72
0.10
5
0.01
67
0.09
& WPKL
Negeri Sembilan
17
0.17
0
0.00 16
0.15
0
0.00
16
0.15
Melaka
14
0.17
2
0.02 10
0.12
2
0.02
8
0.10
Johor
114
0.34
40
0.12 135
0.40
37
0.11
98
0.29
Pahang
37
0.25
3
0.02 35
0.23
4
0.03
31
0.20
Terengganu
117
1.13
2
0.02 20
0.19
3
0.03
17
0.16
Kelantan
36
0.23
9
0.06 35
0.22
12
0.07
23
0.14
Sabah & WP Labuan
43
0.13
7
0.02 61
0.18
6
0.02
55
0.16
Sarawak
68
0.28
11
0.04 66
0.26
13
0.05
53
0.21
93
CHAPTER 7
HOSPITAL
| OPHTHALMOLOGY SERVICES IN MALAYSIAN HOSPITALS
Elias S1, Arunah C2*, Kamilah D2, Mariam Ismail1, Anusiah K. Selvathurai3, Norlaila Talib4, Chandramalar TS5, Thayanithi KS6
1. Hospital Selayang, 2. National Clinical Research Centre, Kuala Lumpur, 3.Hospital Melaka, 4. Hospital Serdang, 5. Hospital Sungai Buloh, 6. Hospital Kuala lumpur
*Corresponding author.
Summary: There were a total of 348 hospitals in the country of which, 98 had ophthalmology services available.
This chapter analyses their facilities such as the availability of dedicated operating rooms, the distribution of
workforce, the number of surgeries done e.g. cataract, glaucoma, vitreoretinal surgeries and the use of some
devices. The response rate to this survey was 91.8%; 100% from the 39 public hospitals and 86.4% from the 51
private hospitals.
Facilities
There were 36 Ministry of Health (MOH) hospitals, 3 University Hospitals and 59 hospitals in the private sector providing Ophthalmology services
in Malaysia in 2011.
The Klang Valley (Wilayah Persekutuan Kuala Lumpur/WPKL, WP Putrajaya, Selangor) and Melaka had the highest density of hospitals providing
ophthalmology services, a density of 0.05 hospitals per 10,000 population. The states with the lowest density of hospitals providing services were
Terengganu, Sabah and WP Labuan with a density of 0.01 per 10,000 population (Table 7.1).
All 39 public hospitals providing ophthalmology services had dedicated ophthalmology operating rooms. There were 54 functioning dedicated
operating rooms (Table 7.2). On average, an ophthalmologist in the public sector had 26 elective operating hours per month (Table 7.3). However
ophthalmologists from some states e.g. the Klang Valley (18 hours), Perlis (19 hours), Melaka (18 hours) and Terengganu (18 hours) did not
achieve this national average.
Services
All 98 hospitals offered cataract surgery (Table 7.4). However, only 61 hospitals provided surgery for glaucoma (Table 7.5) and 49 hospitals for
vitreoretinal (VR) surgery (Table 7.6). A total of 51,887 cataract surgeries were performed in Malaysia in 2011, of which 36,068 (69.5%) were
done in the public and 15,819 (30.5%) were done in the private sector (Table 7.4). Fifty two percent of these cataract surgeries were performed
as day care surgery and the remaining 48% as inpatient. In the MOH hospitals, 49% of cataract surgeries were performed as day care*.
A total 61 hospitals offered glaucoma surgery. However in 49 of these hospitals only 10 or less surgeries were done. In all, 1,250 surgeries were
performed in Malaysia in 2011, of which, 974 (78%) were done in the public and 276 (22%) were done in the private sector (Table 7.5). Of these,
321 (26%) were done with glaucoma drainage implants, 21% being from the public sector and 43% from the private sector.
A total of 49 hospitals offered VR surgeries. However in 24 of these, only 10 or less surgeries were being done. In all, 4,327 VR surgeries were
performed in 2011, of which 3,754 (87%) were performed in the public hospitals (Table 7.6). A total of 1,632 (38%) VR surgeries were done for
complications of diabetic retinopathy. Of these, 92% were performed in the public sector.
There were a total of 382 ophthalmologists in the country i.e. one ophthalmologist to a population of 76,923; a density of 0.13 per 10,000
population (Table 7.7). Of these, 218 (57%) were in public service and 164 (43%) in the private sector. The Global Advisory Committee of Vision
2020 recommends a norm of one ophthalmologist per 50,000 population by the year 2020. Only two states, Melaka and WPKL, have met these
criteria. Most of the ophthalmologists were working in Selangor, WPKL and WP Putrajaya and these states had a ratio of one ophthalmologist to
a population of 41,666 (0.24 per 10,000 population). Sabah had the lowest ratio with one ophthalmologist to a population of 200,000 (0.05 per
10,000 population).
There were a total of 213 resident optometrists, of whom 189 (89%) were in the public sector (Table 7.8).
A total of 144 assistant medical officers served in the public sector, of which 66 (46%) had post basic ophthalmology training (Table 7.9). A total of
347 nurses served in the public sector, of which 152 (44%) had post basic ophthalmology training. In all, there were 218 (1:133,333) ophthalmic
assistants with post basic training in the country (Table 7.10).
95
7
Workforce
OPHTHALMOLOGY SERVICES IN MALAYSIAN HOSPITALS
Forty-three percent of all glaucoma surgeries and 49% of VR surgeries in the country were done in the Klang Valley itself. Of these, 70% of the
glaucoma and 78% of the VR surgeries were done in the public sector.
HOSPITAL
Devices
There were 166 operating microscopes in the country in 2011. Of these, 77 (46%) were in the public sector and 89 (54%) in private sector.
A total of 108 stand alone phacoemulsification machines were available; 52 in the public sector and 56 in the private sector. There were
61 combined phacoemulsification and vitrectomy machines; 23 in the public sector and 38 in the private sector. There were only 17 stand
alone vitrectomy machines, with 5 in the private sector. There were 82 automated perimetry devices, 55 in the public sector and 27 in the
private sector (Table 7.11).
Table: Ratio of Phacoemulsification Machines (Stand Alone and Combined) to Cataract Surgeries
Sector
Cataract Surgeries
Phacoemulsification Machines
Ratio
33,404
63
530:1
2,664
12
222:1
15,819
94
168:1
Ministry of Health
University
Private
From the * National Eye Database, 52.3% of the surgeries were performed as day care; day care surgery being defined as surgery done with the patient admitted and discharged on the same day.
Limitations
1. This survey did not include:
a. Hospitals in the Ministry of Defence
b. Private Centres not licensed as ‘Hospitals’ as stated in the only Private Healthcare Facilities and Services Act 1998
c. Hospital Sarikei that started providing ophthalmological services in 2011
2. The surgical volume reported may be an under estimation since a large volume of cataract surgery is being done in the ambulatory care
setting in private centres. These do not fall under the definition of a “hospital”.
3. The volume of day care surgery may have also been underestimated because of differences in the definition of day care centres in the various
institutions.
96
HOSPITAL
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
7
2011
Number
39
59
98
0.03
1
na
na
1
0.04
2
4
6
0.03
3
4
7
0.03
2
5
7
0.04
4
5
9
0.04
6
14
20
0.04
3
13
16
0.09
9
27
36
0.05
2
2
4
0.04
1
3
4
0.05
4
4
8
0.02
2
1
3
0.02
1
0
1
0.01
3
0
3
0.02
4
1
5
0.01
4
7
11
0.04
Table 7.1 Number and Density of Hospitals Providing Ophthalmology Services in Malaysia by State and Sector, 2011
97
HOSPITAL
Table 7.2 Number and Density of Dedicated Ophthalmology Operating Rooms (ORs) in Public Hospitals in Malaysia by State and Sector, 2011
State
Hospitals with
Dedicated
Ophthalmology (ORs)
Total Dedicated
Ophthalmology (ORs)
Total Functioning Dedicated
Ophthalmology ORs
No.
No.
39
56
0.02
54
0.02
Perlis
1
1
0.04
1
0.04
Kedah
2
2
0.01
2
0.01
Kedah & Perlis
3
3
0.01
3
0.01
Pulau Pinang
2
3
0.02
3
0.02
Perak
4
7
0.03
7
0.03
6
11
0.02
9
0.02
WP Kuala Lumpur
3
7
0.04
7
0.04
9
18
0.02
16
0.02
Negeri Sembilan
2
2
0.02
2
0.02
Melaka
1
1
0.01
1
0.01
Johor
4
5
0.01
5
0.01
Pahang
2
3
0.02
3
0.02
Terengganu
1
2
0.02
2
0.02
Kelantan
3
4
0.02
4
0.02
Sabah & WP Labuan
4
4
0.01
4
0.01
Sarawak
4
4
0.02
4
0.02
Malaysia
Table 7.3 Number and Density of Ophthalmology Elective Operating Hours in Public Hospitals in Malaysia by State and Sector, 2011
State
Ophthalmologists
Elective Operating Hours (EOH) per 4 week-month
No.
No. of Hours
EOH : Ophthalmologists Ratio
218
5,565
25.53
Perlis
3
56
18.67
Kedah
11
388
35.27
Kedah & Perlis
14
444
31.71
Pulau Pinang
9
227
25.22
Perak
8
690
86.25
55
922
16.76
WP Kuala Lumpur
44
837
19.02
99
1,759
17.77
Negeri Sembilan
9
227
25.22
Melaka
7
128
18.29
Johor
13
357
27.46
Pahang
12
397
33.08
7
128
18.29
Kelantan
18
474
26.33
Sabah & WP Labuan
11
314
28.55
Sarawak
11
420
38.18
Malaysia
Terengganu
98
HOSPITAL
Table 7.4 Number and Density of Cataract Surgery Done as Day Care and Inpatient in Malaysia by State and Sector, 2011
Sector
Cataract Surgery
Done as Day care
Cataract Surgery Done
as Inpatient
Total Cataract
Surgery
No.
No.
Per 10,000
population
No.
Per 10,000
population
No.
Per 10,000
population
17,660
9,475
27,135
15
na
15
592
9.37
na
0.63
-
18,408
6,344
24,752
394
na
394
2,197
8.55
na
16.59
-
36,068
15,819
51,887
409
na
409
2,789
17.91
na
17.22
-
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Public
Private
Total
Public
Private
Total
Public
39
59
98
1
na
1
2
Kedah
Private
4
715
-
69
-
784
-
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
6
3
4
7
2
5
7
4
5
9
6
14
20
3
13
16
9
27
36
2
2
4
1
3
4
4
4
8
2
1
3
1
0
1
3
0
3
4
1
5
4
7
11
1,307
607
715
1,322
3,178
2,245
5,423
766
523
1,289
3,379
2,933
6,312
2,547
1,045
3,592
5,926
3,978
9,904
1,594
555
2,149
1,533
347
1,880
377
219
596
442
11
453
371
0
371
197
0
197
723
57
780
1,946
825
2,771
6.62
5.98
34.03
5.38
11.16
21.20
13.48
20.61
22.57
1.75
2.97
3.45
1.22
2.29
11.01
2,266
2,591
69
2,660
361
527
888
3,319
718
4,037
1,732
1,934
3,666
1,755
1,391
3,146
3,487
3,325
6,812
978
60
1,038
97
1,113
1,210
2,330
447
2,777
789
18
807
407
0
407
1,293
0
1,293
1,870
30
1,900
886
37
923
11.48
12.03
5.57
16.84
6.48
18.57
9.27
9.95
14.53
8.16
5.29
3.79
8.01
5.58
3.67
3,573
3,198
784
3,982
3,539
2,772
6,311
4,085
1,241
5,326
5,111
4,867
9,978
4,302
2,436
6,738
9,413
7,303
16,716
2,572
615
3,187
1,630
1,460
3,090
2,707
666
3,373
1,231
29
1,260
778
0
778
1,490
0
1,490
2,593
87
2,680
2,832
862
3,694
18.11
18.01
39.60
22.21
17.65
39.76
22.75
30.56
37.09
9.92
8.26
7.24
9.22
7.87
14.68
7
State
Hospitals
providing
Cataract
Surgery
99
HOSPITAL
Table 7.5 Number and Density of Glaucoma Surgery with and without Implant in Malaysia by State and Sector, 2011
Hospitals
Glaucoma
providing
Glaucoma Surgery
Total Glaucoma
Surgery without
Glaucoma
with Implant
Surgery
Implant
State
Sector
Surgery
Per 10,000
Per 10,000
Per 10,000
No.
No.
No.
No.
population
population
population
Malaysia
Public
29
202
- 772
974
Malaysia
Private
32
119
- 157
276
Malaysia
Total
61
321
0.11 929
0.32
1,250
0.43
Perlis
Public
1
8
- 16
24
Perlis
Private
na
na
na
na
na
na
na
Perlis
Total
1
8
0.34 16
0.67
24
1.01
Kedah
Public
2
12
- 73
85
Kedah
Private
1
0
3
3
Kedah
Total
3
12
0.06 76
0.39
88
0.45
Kedah & Perlis
Public
3
20
- 89
109
Kedah & Perlis
Private
1
0
3
3
Kedah & Perlis
Total
4
20
0.09 92
0.42
112
0.51
Pulau Pinang
Public
1
0
6
6
Pulau Pinang
Private
3
7
8
15
Pulau Pinang
Total
4
7
0.04 14
0.09
21
0.13
Perak
Public
4
6
- 61
67
Perak
Private
2
36
3
39
Perak
Total
6
42
0.18 64
0.27
106
0.44
Public
4
13
- 114
127
Private
10
28
- 105
133
Total
14
41
0.07 219
0.39
260
0.46
WP Kuala Lumpur
Public
3
151
- 94
245
WP Kuala Lumpur
Private
6
17
- 11
28
WP Kuala Lumpur
Total
9
168
0.99 105
0.62
273
1.61
7
164
- 208
372
16
45
- 116
161
23
209
0.28 324
0.44
533
0.73
Negeri Sembilan
Public
0
0
0
0
Negeri Sembilan
Private
1
1
1
2
Negeri Sembilan
Total
1
1
0.01
1
0.01
2
0.02
Melaka
Public
1
2
- 40
42
Melaka
Private
1
0
- 11
11
Melaka
Total
2
2
0.02 51
0.61
53
0.64
Johor
Public
2
1
- 46
47
Johor
Private
3
4
8
12
Johor
Total
5
5
0.01 54
0.16
59
0.17
Pahang
Public
1
1
- 18
19
Pahang
Private
0
0
0
0
Pahang
Total
1
1
0.01 18
0.12
19
0.12
Terengganu
Public
1
0
- 27
27
Terengganu
Private
0
0
0
0
Terengganu
Total
1
0
0.00 27
0.25
27
0.25
Kelantan
Public
3
8
- 116
124
Kelantan
Private
0
0
0
0
Kelantan
Total
3
8
0.05 116
0.72
124
0.77
Sabah & WP Labuan
Public
3
0
- 87
87
Sabah & WP Labuan
Private
1
1
6
7
Sabah & WP Labuan
Total
4
1
0.00 93
0.27
94
0.28
Sarawak
Public
3
0
- 74
74
Sarawak
Private
4
25
1
26
Sarawak
Total
7
25
0.10 75
0.30
100
0.40
100
HOSPITAL
Table 7.6 Number and Density of Vitreoretinal Surgery and Vitreoretinal Surgery for Diabetic Retinopathy in Malaysia by State and Sector, 2011
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Sector
Total Vitreoretinal
Surgeries
Total Vitreoretinal
Surgery for Diabetic
Retinopathy
Per 10,000
No.
population
No.
No.
Per 10,000
population
16
33
49
0
na
0
1
0
1
1
3,754
573
4,327
0
na
0
452
0
452
452
1.49
na
0.00
2.29
-
1,496
136
1,632
0
na
0
110
0
110
110
2.04
2.50
0.05
2.91
2.81
2.88
1.81
-
110
172
0
172
0
0
0
610
121
731
70
2
72
680
123
803
90
0
90
20
0.80
-
33
190
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Kedah & Perlis
Private
0
0
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
1
1
3
4
0
2
2
2
11
13
3
7
10
5
18
23
1
1
2
1
452
347
52
399
0
11
11
1,375
268
1,643
272
204
476
1,647
472
2,119
166
23
189
67
Melaka
Private
1
0
Melaka
Johor
Total
Public
2
1
67
349
Johor
Private
3
9
Johor
Pahang
Total
Public
4
1
358
59
Pahang
Private
0
0
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Total
Public
Private
Total
Public
Private
Total
1
1
na
1
1
na
1
59
70
na
70
195
na
195
Sabah & WP Labuan
Public
1
74
Sabah & WP Labuan
Private
1
4
Sabah & WP Labuan
Total
2
78
Sarawak
Public
2
328
71
Sarawak
Private
4
2
0
Sarawak
Total
6
330
0
0.50
1.08
0.00
1.29
0.42
1.09
0.86
-
13
0.40
-
0
1.05
-
190
36
0.56
-
0
0.39
na
0.65
na
1.21
36
17
na
17
110
na
110
0.24
na
0.16
na
0.68
0
0
0.23
1.31
0
71
0.00
0.28
7
0.56
na
0.00
0.56
-
State
Hospitals providing
Vitreoretinal
Surgery
101
HOSPITAL
Table 7.7 Number and Density of Ophthalmologists in Malaysian Hospitals by State and Sector, 2011
Total
Permanent / Resident
Ophthalmologists
Ophthalmologists
State
Sector
Per 10,000
Per 10,000
No.
No.
population
population
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Sarawak
Total
Visiting
Ophthalmologists
Per 10,000
No.
population
218
164
382
3
na
3
11
7
18
14
7
21
9
20
29
8
14
22
55
51
106
44
30
74
99
81
180
9
6
15
7
11
18
13
9
22
12
2
14
7
0
7
18
1
19
11
6
17
11
7
0.13
na
0.13
0.09
0.09
0.18
0.09
0.19
0.44
0.24
0.14
0.22
0.06
0.09
0.07
0.12
0.05
-
211
86
297
3
na
3
12
3
15
15
3
18
9
11
20
9
7
16
49
32
81
45
15
60
94
47
141
8
2
10
7
6
13
13
4
17
11
0
11
6
0
6
19
0
19
10
2
12
10
4
0.10
na
0.13
0.08
0.08
0.13
0.07
0.14
0.35
0.19
0.10
0.16
0.05
0.07
0.06
0.12
0.04
-
17
88
105
0
na
0
0
2
2
0
2
2
0
2
2
3
2
5
3
27
30
5
32
37
8
59
67
0
3
3
0
6
6
0
2
2
2
2
4
0
0
0
1
0
1
2
4
6
1
6
0.04
na
0.00
0.01
0.01
0.01
0.02
0.05
0.22
0.09
0.03
0.07
0.01
0.03
0.00
0.01
0.02
-
18
0.07
14
0.06
7
0.03
102
HOSPITAL
Table 7.8 Number and Density of Optometrists in Malaysian Hospitals by State and Sector, 2011
State
Sector
Permanent / Resident
Optometrists
Malaysia
Public
189
-
1
-
Malaysia
Private
24
-
20
-
Visiting Optometrists
Malaysia
Total
213
0.07
21
0.01
Perlis
Public
2
-
0
-
Perlis
Private
na
na
na
na
Perlis
Total
2
0.08
0
0.00
Kedah
Public
8
-
0
-
Kedah
Private
0
-
0
-
Kedah
Total
8
0.04
0
0.00
Kedah & Perlis
Public
10
-
0
-
Kedah & Perlis
Private
0
-
0
-
Kedah & Perlis
Total
10
0.05
0
0.00
Pulau Pinang
Public
11
-
0
-
Pulau Pinang
Private
2
-
0
-
Pulau Pinang
Total
13
0.08
0
0.00
Perak
Public
15
-
0
-
Perak
Private
1
-
3
-
Perak
Total
16
0.07
3
0.01
Public
37
-
0
-
Private
18
-
7
-
Total
55
0.10
7
0.01
WP Kuala Lumpur
Public
24
-
0
-
WP Kuala Lumpur
Private
2
-
2
-
WP Kuala Lumpur
Total
26
0.15
2
0.01
Public
61
-
0
-
Private
20
-
9
-
Total
81
0.11
9
0.01
Negeri Sembilan
Public
8
-
0
-
Negeri Sembilan
Private
0
-
8
-
Negeri Sembilan
Total
8
0.08
8
0.08
Melaka
Public
7
-
0
-
Melaka
Private
0
-
0
0.00
Melaka
Total
7
0.08
0
Johor
Public
20
-
0
-
Johor
Private
0
-
0
-
Johor
Total
20
0.06
0
0.00
Pahang
Public
12
-
0
-
Pahang
Private
Pahang
Total
0
-
0
-
12
0.08
0
0.00
Terengganu
Public
8
-
0
-
Terengganu
Private
0
-
0
-
Terengganu
Total
8
0.07
0
0.00
Kelantan
Public
14
-
0
-
Kelantan
Private
0
-
0
-
Kelantan
Total
14
0.09
0
0.00
Sabah & WP Labuan
Public
12
-
1
-
Sabah & WP Labuan
Private
0
-
0
-
Sabah & WP Labuan
Total
12
0.04
1
0.00
Public
11
-
0
-
Private
1
-
0
-
Sarawak
Total
12
0.05
0
0.00
7
Sarawak
Sarawak
No.
103
HOSPITAL
Table 7.9 Number and Density of Assistant Medical Officers (AMOs) with and without Post-Basic in Ophthalmology Public Hospital in Malaysia
by State and Sector, 2011
AMOs with Post-Basic
AMOs without Post-Basic
in Ophthalmology
in Ophthalmology
State
No.
No.
Malaysia
66
0.02
78
0.03
Perlis
2
0.08
1
0.04
Kedah
3
0.02
7
0.04
Kedah & Perlis
5
0.02
8
0.04
Pulau Pinang
2
0.01
4
0.03
10
0.04
6
0.03
9
0.02
17
0.03
WP Kuala Lumpur
8
0.05
3
0.02
17
0.02
20
0.03
Negeri Sembilan
4
0.04
4
0.04
Melaka
2
0.02
5
0.06
Johor
8
0.02
5
0.01
Pahang
2
0.01
9
0.06
Terengganu
3
0.03
2
0.02
Kelantan
2
0.01
4
0.02
Sabah & WP Labuan
6
0.02
7
0.02
Sarawak
5
0.02
4
0.02
Perak
Table 7.10 Number and Density of Nurses with and without Post-Basic in Ophthalmology in Public Hospital in Malaysia by State and Sector, 2011
Nurses with Post-Basic
Nurses without Post-Basic
in Ophthalmology
in Ophthalmology
State
No.
No.
Malaysia
152
0.05
195
0.07
Perlis
1
0.04
3
0.13
Kedah
5
0.03
14
0.07
Kedah & Perlis
6
0.03
17
0.08
Pulau Pinang
12
0.08
17
0.11
Perak
12
0.05
1
0.00
22
0.04
14
0.02
WP Kuala Lumpur
22
0.13
56
0.33
44
0.06
70
0.10
Negeri Sembilan
3
0.03
4
0.04
Melaka
7
0.08
20
0.24
Johor
7
0.02
14
0.04
Pahang
5
0.03
5
0.03
Terengganu
3
0.03
3
0.03
Kelantan
20
0.12
16
0.10
Sabah & WP Labuan
17
0.05
12
0.04
Sarawak
16
0.06
16
0.06
104
HOSPITAL
Table 7.11 Number and Density of Ophthalmology Devices in Malaysia by State and Sector, 2011
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
No.
77
89
166 5.73
1
na
na
1 4.21
3
4
7 3.55
4
4
8 3.62
3
13
16 10.04
7
4
11 4.59
16
26
42 7.43
9
18
27 15.93
25
44
69 9.39
3
2
5 4.79
2
4
6 7.20
9
6
15 4.41
4
1
5 3.28
2
0
2 1.86
6
0
6 3.71
8
2
10 2.94
4
9
13 5.17
52
56
108
1
na
1
4
4
8
5
4
9
2
10
12
5
2
7
14
16
30
5
8
13
19
24
43
2
1
3
1
4
5
5
3
8
4
1
5
0
0
0
4
0
4
2
0
2
3
7
10
3.73
na
4.21
4.05
4.07
7.53
2.92
5.31
7.67
5.85
2.88
6.00
2.35
3.28
0.00
2.48
0.59
3.97
2.11
na
4.21
0.00
0.45
5.65
2.09
1.77
7.08
2.99
2.88
3.60
1.76
1.31
0.93
0.62
0.59
2.38
12
5
17
1
na
1
2
0
2
3
0
3
1
0
1
0
0
0
2
4
6
1
0
1
3
4
7
1
0
1
0
0
0
1
0
1
1
0
1
0
0
0
1
0
1
1
1
2
0
0
0
0.59
na
4.21
1.01
1.36
0.63
0.00
1.06
0.59
0.95
0.96
0.00
0.29
0.66
0.00
0.62
0.59
0.00
No.
PMP
55
27
82
1
na
1
4
3
7
5
3
8
3
3
6
5
0
5
8
10
18
8
3
11
16
13
29
3
1
4
1
0
1
5
3
8
4
0
4
2
0
2
3
0
3
5
2
7
3
2
5
2.83
na
4.21
3.55
3.62
3.77
2.09
3.18
6.49
3.95
3.84
1.20
2.35
2.62
1.86
1.86
2.06
1.99
7
23
38
61
1
na
1
0
0
0
1
0
1
0
9
9
1
4
5
2
8
10
8
4
12
10
12
22
1
2
3
1
2
3
3
3
6
2
0
2
1
0
1
1
0
1
1
1
2
1
5
6
Automated
Perimetry
Device
State
Combined
Stand-Alone
Stand-Alone
Phacoemulsification
Phacoemulsification
Vitrectomy
and Vitrectomy
Machine
Machine
Machine
PMP
No.
PMP
No.
PMP No.
PMP
Functioning
Operating
Microscope
105
APPENDICES
APPENDIX 1 |
HOSPITAL
LIST OF DEFINITIONS
ACUTE CURATIVE HOSPITAL CHAPTER
Entrepreneurship
Sole Proprietor
A business entity owned by one person. The owner may operate on his or her own or may employ others. The owner of the business has total and
unlimited personal liability of the debts incurred by the business.
Corporate Body
A body incorporated under the Companies Act 1965 [Act 125].
Partnership
A business entity in which two or more people operate for the common goal of making profit. Each partner has total and unlimited personal liability
of the debts incurred by the partnership.
Society
An association, club or body that function based on membership consisting of seven (7) members or more in addition to having certain purposes,
whether temporary or permanent, which is registered under the Societies Act 1966 [Act 335] (considered under the Private Healthcare Facilities
and Services Act 1998 [Act 586])
Hospital
An institution with primary function to provide inpatient diagnostic and therapeutic services for a variety of medical conditions both surgical and
non surgical.
A hospital that provides services including medicine and surgery to meet the general medicine and surgery needs of the community without
permanent or resident specialists.
Specialist Hospital
A hospital that provides services including medicine, surgery and other services to meet the general medicine and surgery needs of the community
with permanent or resident specialists.
Hospital with Tertiary Services
A hospital that provides up to 45 resident specialty or subspecialty services.
Hospital with Secondary Services
A hospital that provides up to 20 resident specialty or subspecialty services.
Special Institution
A hospital with specific resident specialty services.
A hospital that is used or intended to be used for the provision of obstetrics and/ or gynaecological care that extends beyond care in a normal
pregnancy/ labour/ post-partum period/ normal newborns and may involve the conduct of deliveries besides spontaneous vertex deliveries.
Inpatient Bed
A bed used for patients admitted for diagnostic and/or therapeutic purposes in a hospital; both occupied and vacant on any given day.
● The reported beds are the functioning beds only
109
Appx 1 LIST OF DEFINITIONS
Maternity Centre
HOSPITAL
Included beds:
● Cots/ bassinet set aside for babies requiring special care at SCN (Special Care Nursery), NICU (Neonatal Intensive Care Unit).
Excluded beds are those situated in:
● Treatment rooms
● Examination rooms
● Emergency services
● Physical therapy
● Labour rooms
● Observation or recovery room beds at in/ out-patient department
● Cots for normal newborns in the obstetrics wards
Functioning Inpatient Bed
A bed that is readily available to take in a patient and provide care according to the nurses and equipment available for that bed.
Operating Theatre
A facility within a hospital that is designed and equipped with facilities to perform sterile surgical operations and has facilities to monitor patients
in the immediate post-operative period.
Operating Room
A room within an operating theatre that is designed and equipped with facilities to perform sterile surgical operations. One operating theatre (OT)
usually has more than one operating room (OR).
Inpatient
A person who undergoes a formal process whereby he/ she is accepted by a hospital for the purpose of hospital treatment.
Admission
Admission (or inpatient admission) is the formal acceptance by a hospital of a patient who will occupy a hospital bed, crib or bassinet for
observation, care, diagnosis or treatment and will have a medical record maintained for him / her.
Neonates born in the hospital that need medical care and for whom separate medical records are maintained; are considered as admissions,
(foetal deaths or still births are not counted as admissions)
Average Length of Stay (ALOS) (in days)
The average number of days that inpatients (excluding newborns) remained in the hospital.
Length of Stay = (Sum of Length of Stay of discharged patients for a given period/Total number of discharged patients in the same period)
Bed Occupancy Rate (BOR) (%)
The percentage of inpatient beds occupied for a given period of time. Also known as the percentage of occupancy,
BOR = (Inpatient Days of Care/ Bed Days Available) x 100
Where:
Inpatient Days of Care: Sum of each daily inpatient census for the given period.
Beds denote inpatient beds that are set up, staffed and available for care.
Bed Days Available: The maximum number of inpatient days of care that would have been provided if all beds were filled during the given
period and takes into account changes in the number of beds available for use during the same period.
110
HOSPITAL
For example:
Hospital X had 300 beds from July 1 to Feb 28. The number of beds in services was increased to 350 beds from March 1 to June 30. The bed
days available are calculated as:
300 beds x 243 days = 72,900 (July 1- February 28)
350 beds x 122 days = 42,700 (March 1-June 30)
Total bed days available= 72,900 + 42,700 = 115,600
Turnover Interval (TOI) (In Days)
Average period in days that an available bed remains empty between the discharge of one inpatient and the admission of the next.
TOI = Total number of inpatients bed X 365.25 - ALOS
Total number of inpatient admissions
Nurse with Post Basic Training
A registered nurse with a degree/ diploma and has post basic training.
Nurse without Post Basic Training
A registered nurse with a degree/ diploma but without post basic training.
Community Nurse
A registered nurse with a certificate in nursing.
Assistant Medical Officer
A registered assistant medical officer with the Medical Assistant Board
Specialist
A registered medical practitioner with post-graduate qualification recognised by both the Ministry of Health and the Public Service Department
Malaysia; and has the necessary core clinical competence and core procedural skills as expected of doctors with the responding recognised postgraduate qualification.
Resident
An in-house medical practitioner/specialist who is available to diagnose and treat patients at a hospital; and is a permanent staff in the establishment.
Visiting
A medical practitioner/specialist who is available to diagnose and treat patients in a hospital; but he/she is not a permanent staff. That medical
practitioner may make regular visits (e.g. monthly/biweekly/weekly etc) to see patients in the hospital or is accessible on an ad-hoc or emergency
basis only.
Computed Tomography Scanner (CT Scan)
Imaging equipment that uses a combination of x-rays and computer technology to produce detailed cross-sectional images (slices), both horizontally
and vertically, of any part of the body.
Imaging equipment that uses a combination of large magnets, radio frequencies and computer technology to produce detailed images of organs
and structures within the body.
Positron Emission Tomography (PET)
Imaging equipment that comprises of multiple rings of detectors which record the emission of energy from radiotracers given to patients, and is
in turn, used to develop biologic images that reflect metabolic activities of cells.
111
Magnetic Resonance Imaging (MRI) unit
HOSPITAL
OBSTETRICS CHAPTER
Delivery Bed
Any bed on which a delivery is conducted. It is not used for inpatient care. It would be possible to put a patient in lithotomy position on such a bed
Dedicated Maternity OT
A facility within a hospital that is designed and equipped with facilities to perform sterile surgical operations exclusively for obstetrics patients.
Obstetrics HDU
A facility that provides monitoring facilities for obstetric patients that would not normally be found in the wards. Ventilation of such patients would
not be carried out in this facility.
Spontaneous Vertex Delivery (SVD)
An event whereby a pregnant woman goes into labour without the use of any drugs or techniques to induce labour and delivers the baby vaginally
without any intervention.
Assisted Vaginal Breech Delivery
Delivery of the baby vaginally when the presenting part is either the buttock or foot.
Vacuum Assisted Vaginal Delivery
The use of a vacuum extractor to assist the mother to deliver the baby vaginally.
Forceps Assisted Vaginal Delivery
The use of forceps to assist the mother to deliver the baby vaginally
Lower Segment Caesarean Section (LSCS)
A surgical procedure in which a transverse incision is made in the lower uterine segment to deliver one or more babies.
Hysterotomy
A surgical procedure in which a vertical incision is made on the upper segment of the uterus to deliver one or more premature babies/ stillbirths
when the lower uterine segment is not formed.
Caesarean Hysterectomies
A surgical procedure in which the uterus is removed following a caesarean section.
Multiple pregnancy
When a woman is pregnant with two or more foetuses.
Eclampsia
A complication during pregnancy or postpartum when a woman previously diagnosed with preeclampsia (elevated blood pressure with proteinuria)
develops seizures or coma. Post partum refers to a period from time of delivery up to 42 days.
Primary PPH
The loss of 500 ml or more of blood from the genital tract within 24 hours of the birth of a baby.
112
HOSPITAL
Massive Post Partum Haemorrhage (PPH)
Blood loss of 1500mls and more within 24 hours of the birth of a baby.
Medical Officer
A registered medical practitioner who possesses an annual practicing certificate issued by the MMC and is working in the obstetrics and labour
wards.
Staff Nurse/ Community Nurse with Midwifery Training in Obstetrics Wards
A nurse who is registered as a midwife with the Midwives Board Malaysia working in obstetrics wards.
Staff Nurse/ Community Nurse with Midwifery Training in Labour Wards
A nurse who is registered as a midwife with the midwives Board Malaysia working in labour wards.
Obstetrics Ward
A ward that provides care to antenatal and postnatal patients. There will be possibilities where other patients share the ward with postnatal patients.
Labour Ward
A ward that allows the monitoring of a pregnant mother in labour and provides facilities for the conduct of normal and instrumental deliveries as
well as care of the newborn infant(s).
Maternity Home
Any premises, used or intended to be used for the reception of, and the provision of nursing care and midwifery in labour, or of women immediately
after childbirth.
GENERAL SURGERY CHAPTER
Dedicated Emergency/ Trauma Theatre
A 24 hours operating theatre dedicated for emergency cases only. Excluded are OTs dedicated for emergency LSCS and orthopaedics emergency.
Elective Operating Hours / Month
Allocated elective GA/ regional block time for general surgery
● To include day care OT time
● To include Saturday OT time
● To exclude locum OT time
● To exclude time given to specialties outside general surgery
Elective Case
A planned, non-emergency surgical procedure performed either in main OT or day care OT.
A case where anaesthesia is administrated by an anaesthetic team. This includes regional and plexus block.
LA Case
A case where anaesthesia is administrated as sedation, local anaesthetic or nerve block. Exclude blocks that are given by an anaesthetic team.
113
GA Case
HOSPITAL
Emergency Case
A surgery that cannot be delayed, for which there is no other alternative and a delay could result in death or permanent impairment.
Mastectomy
Surgery performed to remove the breast(s) with or without axillary clearance:
● To include surgery for gynaecomastia
● To include both benign and malignant cases
● To exclude breast lumpectomy, wide excision, breast hook wire surgery and other breast conservative surgery
Endoscopic Procedure
OGDS and colonoscopy cases including diagnostic and therapeutic scopes regardless of the type of anaesthesia and where it is performed.
● By the surgical team: Performed by general surgeons or;
● By the medical team: Performed by gastroenterologists / physicians
General Surgeon
● Includes: The general, breast, breast & endocrine, upper, gastrointestinal, colorectal, vascular, hepatobilliary, trauma and thoracic surgery.
● Excludes: Paediatric surgeon, plastic surgeon, urology, neuro surgeon, cardiothoracic surgeon, ENT surgeon, ophthalmologist, gynaecologist,
orthopaedic surgeon and dental /maxillofacial surgeon.
Permanent/ Resident General Surgeon
An in-house general surgeon who is available to diagnose and perform surgery in the hospital and is a permanent staff. It only includes surgeons
who are officially gazetted as of 31/12/2011, and does not include surgeons who are still under gazzetment.
Visiting General Surgeon
A surgeon who is available to diagnose and perform operation at a hospital; but he/she is not a permanent staff at the hospital. The surgeon may
make regular visits (e.g. monthly/ weekly/ biweekly) to see patients in the hospital or is accessible only on an ad-hoc or emergency basic. Exclude
the visiting surgeon from other subspecialty.
Theatre Scrub Nurse
Includes all scrub nurses (including matron & sister) working in the OT’s in the hospital.
Exclude GA/anaesthetic nurses
● For HKL, only scrub nurses from main OT. To exclude scrub nurse from Urology, Emergency Department, Paediatric, Neurology and Maternity OTs.
Functioning OGDS/ Colonoscopy/ ERCP
Functioning devices that were used in daily procedures at the participating hospitals. It excludes:
i. Equipment deemed as in Beyond Economic Repair (BER) or
ii. Equipment which, although were still in working condition, were non-operational (not used) at the hospital.
ONCOLOGY CHAPTER
Clean Room for Reconstitution of Cytotoxic Drug
A room with highly regulated air quality, temperature and humidity to reduce contamination (microorganism and particulates) and designated for
preparation of sterile cytotoxic drugs.
Outsource
Outsourcing of cytotoxic drugs reconstitution outside the hospital where chemotherapy is given.
114
HOSPITAL
Chemotherapy Day Care
Practice of planned admission to provide diagnostic and therapeutic services within the day of admission. This can include chemotherapy and
other drugs given on the same day.
Cytotoxic Drug Reconstitution (CDR)
The process of preparing the cytotoxic drugs into a form ready for use.
Cytotoxic Drug Reconstitution (CDR) Isolator
A closed room in which preparation of chemotherapy is done under controlled conditions.
Simulation Time
Simulation is a treatment planning step and not an actual radiation therapy treatment. The simulation procedure is generally done by Therapists
(specially trained technologists) under the supervision of the Radiation Oncologist
Palliative Radiotherapy
Radiotherapy given in one field or more with simple or conformal technique. Treatment intent is palliation.
Radical/ Adjuvant Radiotherapy
Radiotherapy given by simple or conformal technique. Treatment intent is curative.
Oncology Trained Nurse
A nurse who have undergone training in post basic oncology.
Radiation Therapist
A person who performs medical radiation procedures and applies ionizing radiation, to any part of the human body, for radiotherapy imaging and
therapeutic purposes. The radiation therapist shall hold a recognised qualification in radiotherapy or other related fields that is approved by the
appropriate authority and the qualifications shall be in the same field for which the duties are performed.
Physicist
A person who has qualifications of, and has undergone accredited training in the application of the principles of physics to imaging and/or
therapeutic radiation as approved by the appropriate authority. The medical physicist performing medical physics duties for a facility shall have
adequate experience in the same fields for which the duties are performed.
Megavoltage Machine
A high energy machine with energy greater than 1000 kilovolts. A machine that uses electricity to form a stream of fast-moving subatomic
particles that creates high-energy radiation that may be used to treat cancer. Commonly used megavoltage machines includes tomography, linear
accelerator, cyber knife and cobalt 60.
Brachytherapy (internal radiation therapy) is delivered by placing radiation source(s) inside or next to the area requiring treatment. To include low
dose radiation (LDR) and High Dose Radiation (HDR).
Simulator
Includes either conventional simulator/ CT simulator
115
Brachytherapy Machine
HOSPITAL
Physics Equipment
All types of measuring tools used in testing the performance of radiation equipment and data commissioning.
Examples:
● Water-phantom/solid water
● Ionization chambers, electrometer
● QA devices (for linac, HDR and imaging systems)
● Survey meter
● In vivo dosimetry equipment
Treatment Planning System
A treatment planning system that consists of a hardware package and a software package. It enables the input of patient data, the anatomy
definition, beam set-up, the dose distribution calculation, the plan evaluation in terms of dose, volume, biological effect and the output for
documentation and transfer to other units (simulator, record and verify system, treatment machine).
Examples:
● Full-capacity external beam/ brachytherapy/ RT planning system
● DICOM connections to receive images from the in-house CT, linac’s CBCT, and from outside imaging centres, to directly transfer planning
parameters to the record/ verification electronic charting system
● Remote planning capability, allowing physicians, physicists and dosimetrists to review and participate in the planning process remotely.
PSYCHIATRY CHAPTER
Dedicated Bed
A bed that is readily available to take in only psychiatric patients
Bed Occupancy Rate
The percentage of inpatient beds occupied for a given period of time. Also known as the percentage of occupancy,
BOR = (Inpatient Days of Care / Bed Days Available) x 100
Where:
● Inpatient Days of Care: Sum of each daily inpatient census for the given period.
● Beds denote inpatient beds that are set up, staffed and available for care.
● Bed Days Available: The maximum number of inpatient days of care that would have been provided if all beds were filled during the given
period and takes into account changes in the number of beds available for use during the same period.
For example,
Hospital X had 300 beds from July 1 to Feb 28. The number of beds in services was increased to 350 beds from March 1 to June 30. The bed
days available are calculated as:
● 300 beds x 243 days = 72,900 (July 1-February 28)
● 350 beds x 122 days = 42,700 (March 1-June 30)
● Total bed days available = 72,900 + 42,700 = 115,600
Total Number of Admissions
Includes patients admitted to non psychiatric ward with co-existing psychiatric indications.
116
HOSPITAL
Community Psychiatric Services
Psychiatric services provided in the community or homes of patients.
Psychiatric Rehabilitation
Activities carried out with psychiatric patients to achieve optimum functions.
Methadone Clinic
An outpatient programme that give opioid dependent individuals controlled access to methadone for the purpose of treating their dependence
and/or for harm reduction
Clinical Psychologist
One with Masters or doctorate in Clinical Psychology.
Common User
Services used by other department besides psychiatry.
Medical Social Worker
One with degree or diploma in social work.
Community Nurse
A registered nurse with a certificate in nursing.
ECT Procedures
One application of ECT refers to one procedure.
Outpatient Psychiatry
ECT administered to patients who are registered as outpatients.
Inpatient Psychiatry
ECT administered to patients admitted to the ward.
Outpatient Follow Up
To exclude methadone patients coming for methadone supply and only depot injection.
New Cases
All patient seen and first clerked (all ages) at psychiatric clinic excluding those for drug certification, referrals from ward and emergency department
and methadone patients.
OPHTHALMOLOGY CHAPTER
Functional Operating Room
Number of Elective Operating Hours (4 week month)
Allocated elective local/ general anaesthesia for ophthalmic surgery which includes visiting surgeons/ Saturday OT.
Cataract Surgery
Cataract surgery is the removal of the natural lens of the eye (also called “crystalline lens”) that has developed an opacification. To include both
adult and paediatric patients.
117
An operating room which is readily available to take in patients and provide the level of care according to the equipment and nurses available for
that operating room.
HOSPITAL
Day Care
Services provided for patients who undergo treatment for less than 24 hours and do not require admission to a hospital and allowed to go home
in the same day.
Glaucoma Surgery
A filtering surgery that reduces intraocular pressure (IOP) with implant (drainage device) or without implant (trabeculectomy).
Vitreoretinal Surgery
Any surgical procedure that involves the retina, macula, and vitreous. It includes: posterior vitrectomy for any indication, retinal detachment
repair that includes sclera buckle and pneumatic retinopexy.
Diabetic Retinopathy
A common complication of diabetes affecting the blood vessels in the retina.
Optometrist
A registered eye care professional who is registered under the Optical Act 1991 and provides vision care.
Allied Health Personnel
Medical personnel, a nurse and an assistant medical officer who is dedicated and trained to assist in the provision of ophthalmology.
Allied Health Personnel With Post-Basic In Ophthalmology
Allied health personnel who have obtained certification in a post basic ophthalmology.
Operating Microscopes
An optical microscope specifically designed to be used in a surgical setting, typically to perform microsurgery.
Phacoemulsification Machine
A machine which uses ultrasound wave length to remove the cataract.
Posterior Vitrectomy Machine
A machine used for vitreoretinal surgery which may be in combination with a phacoemulsification machine. If it is in a combination machine it is
considered as a posterior vitrectomy machine.
Automated Perimetry Device
Systematic measurement of differential light sensitivity in the visual field by the detection of the presence of test targets on a defined
background by an automated device.
118
APPENDIX 2
HOSPITAL
| PARTICIPANTS FOR NHEWS (HOSPITAL) 2011
HOSPITAL SECTOR: PUBLIC/ MINISTRY OF HEALTH
Perlis
1.
Hospital Tuanku Fauziah, Kangar
Wilayah Persekutuan Putrajaya
1
Hospital Putrajaya
Wilayah Persekutuan Labuan
1
Hospital Labuan
1
Institute of Respiratory Medicine
2
3
Hospital Melaka
Melaka
1
Hospital Jasin
2
Hospital Alor Gajah
Pulau Pinang
1
Hospital Balik Pulau
4
2
Hospital Bukit Mertajam
5
Hospital Seberang Jaya
3
Hospital Kepala Batas
6
Hospital Sungai Bakap
Negeri Sembilan
1
Hospital Jelebu
4
Hospital Tampin
2
Hospital Jempol
5
Hospital Tuanku Jaafar, Seremban
3
Hospital Port Dickson
6
Hospital Tuanku Ampuan Najihah, Kuala Pilah
Terengganu
1
Hospital Besut
4
Hospital Kemaman
2
Hospital Dungun
5
Hospital Setiu
3
Hospital Hulu Terengganu
6
Hospital Sultanah Nur Zahirah, Kuala Terengganu
1
Hospital Gua Musang
6
Hospital Raja Perempuan Zainab II, Kota Bharu
2
Hospital Jeli
7
Hospital Tanah Merah
3
Hospital Kuala Krai
8
Hospital Tengku Anis, Pasir Puteh
4
Hospital Machang
9
Hospital Tumpat
5
Hospital Pasir Mas
6
7
8
9
Hospital Sik
Hospital Sultan Abdul Halim, Sungai Petani
Hospital Yan
Kedah
1
Hospital Baling
2
Hospital Jitra
3
Hospital Kuala Nerang
4
Hospital Kulim
5
Hospital Langkawi
119
Appx 2 PARTICIPANTS FOR NHEWS (HOSPITAL) 2011
Kelantan
HOSPITAL
Selangor
1
2
3
4
5
Hospital Ampang
Hospital Banting
Hospital Kuala Kubu Bharu
Hospital Selayang
Hospital Tengku Ampuan Jemaah, Sabak Bernam
6
7
8
9
10
Hospital Tengku Ampuan Rahimah, Klang
Hospital Serdang
Hospital Tanjong Karang
Hospital Kajang
Pahang
1
Hospital Bentong
6
Hospital Pekan
2
Hospital Jengka
7
Hospital Raub
3
Hospital Jerantut
8
Hospital Sultan Haji Ahmad Shah, Temerloh
4
Hospital Kuala Lipis
9
Hospital Tengku Ampuan Afzan, Kuantan
5
Hospital Sultanah Hajjah Kalsom,
Tanah Rata Cameron Highlands
10
Hospital Muadzam Shah, Rompin
1
Hospital Batu Pahat
7
2
Hospital Kluang
8
Hospital Sultanah Fatimah Specialist, Muar
3
Hospital Sultan Ismail, Johor Bahru
9
Hospital Kota Tinggi
4
Hospital Mersing
10
Hospital Tangkak
5
Hospital Pontian
11
Hospital Segamat
6
Hospital Temenggung Seri Maharaja Tun Ibrahim, Kulai
Johor
Perak
1
Hospital Batu Gajah
8
Hospital Seri Manjung
2
Hospital Changkat Melintang
9
Hospital Slim River
3
Hospital Gerik
10
Hospital Sungai Siput
4
Hospital Raja Permaisuri Bainun, Ipoh
11
Hospital Taiping
5
Hospital Kampar
12
Hospital Tapah
6
Hospital Kuala Kangsar
13
Hospital Teluk Intan
7
Hospital Parit Buntar
14
Hospital Selama
Sarawak
1
2
3
4
5
6
7
8
9
10
11
Bau District Hospital
Betong Hospital
Sri Aman Hospital
Bintulu Hospital
Daro Hospital
Kanowit Hospital
Kapit Hospital
Lawas District Hospital
Limbang Hospital
Lundu District Hospital
Marudi Hospital
12
13
14
15
16
17
18
19
20
21
120
Miri Hospital
Mukah Hospital
Saratok Hospital
Serian Hospital
Sibu Hospital
Simunjan Hospital
Rajah Charles Brooke Memorial Hospital
Sarawak General Hospital
Sarikei Hospital
Dalat Hospital
HOSPITAL
Sabah
1
Beaufort Hospital
13
Queen Elizabeth Hospital, Kota Kinabalu
2
Beluran Hospital
14
Ranau Hospital
3
Duchess of Kent Hospital, Sandakan
15
Semporna Hospital
4
Keningau Hospital
16
Sipitang Hospital
5
Kinabatangan Hospital
17
Tambunan Hospital
6
Kota Belud Hospital
18
Tawau Hospital
7
Kota Marudu Hospital
19
Tenom Hospital
8
Kudat Hospital
20
Tuaran Hospital
9
Kunak Hospital
21
Pitas Hospital
10
Lahad Datu Hospital
22
Kuala Penyu Hospital
11
Likas Hospital
23
Queen Elizabeth II Hospital
12
Papar Hospital
HOSPITAL SECTOR: PUBLIC/ MINISTRY OF HEALTH/ PSYCHIATRIC INSTITUTION
1
Hospital Bahagia, Ulu Kinta, Perak
3
Hospital Permai, Johor
2
Sentosa Hospital, Sarawak
4
Mesra Hospital, Bukit Padang, Sabah
3
Universiti Sains Malaysia Hospital, Kubang Kerian, Kelantan
HOSPITAL SECTOR: PUBLIC/ UNIVERSITY
1
Universiti Kebangsaan Malaysia Medical Center (UKMMC), WPKL
2
University Malaya Medical Center (UMMC), WPKL
HOSPITAL SECTOR: PUBLIC/ JABATAN KEMAJUAN ORANG ASLI
1
Hospital Kemajuan Orang Asli, Selangor
HOSPITAL SECTOR: PRIVATE
Terengganu
Kuala Terengganu Specialist Hospital
Kelantan
1
Perdana Specialist Hospital
2
Kota Bharu Medical Center
3
Pusat Perubatan An-Nisa’
Melaka
1
Putra Specialist Hospital (Melaka)
3
Mahkota Medical Center
2
Pantai Hospital, Ayer Keroh
4
Damai Medical and Heart Clinic
121
1
HOSPITAL
Pahang
1
Kuantan Medical Center
2
Kuantan Specialist Hospital
5
6
Pusat Rawatan Keluarga MUIP Sdn. Bhd.
Darul Makmur Medical Centre Sdn. Bhd.
3
4
7
8
Sethu Medical Centre
Klinik Pakar Wanita Chan
Dr S.T. Chong, Maternity and Surgery
W. Y. Ko Specialist Maternity and Gynaecology Center
Sabah
1
2
Tawau Maternity and Specialist Hospital
3
Sabah Medical Center (A Member of KPJ Healthcare Berhad)
SMC Healthcare
Kota Kinabalu Specialist Center
Negeri Sembilan
1
2
3
Columbia Asia Extended Care, Seremban
National Cancer Institute (NCI) Hospital
Senawang Specialist Hospital
4
5
Columbia Asia Medical Center, Seremban
Seremban Specialist Hospital
1
Columbia Asia Taiping Hospital
7
Yeak Maternity & Gynae Center
2
Fatimah Hospital
8
Klinik Yasmin/Klinik Bersalin Yasmin
3
Taiping Medical Center
9
Kinta medical Centre Sdn. Bhd.
4
KPJ Ipoh Specialist Hospital
10
Pusat Perubatan UNIKL-RCMP
5
Tan Specialist Maternity Centre
11
Sejati Maternity & Specialist Centre
6
Pusat Perubatan Ar-Ridzuan
12
Perak Community Specialist Centre
Perak
Kedah
1
Kedah Medical Center
5
Wisma Pakar Perbidanan & Sakit Puan
2
INS Specialist Center
6
Metro Specialist Hospital
3
Pusat Pakar Amanjaya
7
Chang & Koh Maternity & Fertility Center
4
Putra Medical Center
8
Pantai Hospital, Sg. Petani
Sarawak
1
Kuching Specialist Hospital
6
Columbia Asia Hospital-Miri
2
Rejang Medical Center
7
Normah Medical Specialist Center
3
Miri City Medical Center
8
Helen Ngu Women Hospital
4
Timberland Medical Center
9
Columbia Asia Hospital-Bintulu
5
Sibu Specialist Medical Center
10
Teo’s Maternity Center
HOSPITAL SECTOR: PRIVATE
Pulau Pinang
1
Island Hospital
6
Public Specialist Center
2
Pantai Hospital Pulau Pinang
7
K.S. Wan & Liow Specialist Maternity Center
3
Lam Wah Ee Hospital
8
Loh Guan Lye Specialists Center
4
Mount Miriam Cancer Hospital
9
5
Tan & Tan Specialist Maternity & Gynaecology Center
Pulau Pinang Adventist Hospital
(Adventist Hospital & Clinic Services (M)
122
HOSPITAL
Johor
1
Columbia Asia Hospital, Nusajaya
9
Tan Klinik Pakar Perbidanan
2
Pantai Hospital, Batu Pahat
10
Ng Specialist Maternity
3
Penawar Hospital
11
Pusat Pakar Perbidanan & Sakit Puan Raja
4
Puteri Specialist Hospital
12
Hoo Specialists Maternity & Surgery
5
KPJ Johor Specialist Hospital
13
Johor Jaya Maternity Center
6
Waqaf An-Nur Hospital, Pasir Gudang
14
Kluang Utama Specialist Hospital
7
Loke Specialist Maternity Center
15
Century Specialist Maternity
8
Pelangi Medical Centre Sdn. Bhd.
16
Kempas Medical Centre
1
Prince Court Medical Center
11
Gleneagles Hospital, Kuala Lumpur
2
Hospital Pakar KPJ Tawakal (KPJ Tawakal Specialist Hospital)
12
Institut Jantung Negara Sdn Bhd
3
Tung Shin Hospital
13
University Malaya Specialist Center (UMSC)
4
Lourdes Medical Center
14
Kuala Lumpur Sports Medicine Center (KLSMC)
5
Al-Islam Specialist Hospital
15
Pudu Specialist Centre Sdn. Bhd.
6
Pantai Hospital, Cheras
16
Cheras Specialist Maternity Center
7
Pantai Hospital, Kuala Lumpur
17
Dato Harnam E.N.T. Specialist Clinic
8
Damai Service Hospital (HQ)
18
Sentul Medical Centre
9
Sentosa Medical Center Sdn. Bhd.
19
IHEAL Medical Centre Kuala Lumpur
10
Coop Medical Center (Sambhi Clinic)
20
Universiti Kebangsaan Malaysia Specialist Center (UKMSC)
KPMC Puchong
17
KPJ Damansara Specialist Hospital
1
2
Columbia Asia Hospital Puchong
18
Sime Darby Medical Center Subang Jaya
3
Hospital Pusrawi SMC
19
Hospital Pakar An-Nur Hasanah Sdn Bhd
4
Az-Zahrah Islamic Medical Center
20
KPJ Ampang Puteri Specialist Hospital
5
Sunway Medical Center
21
Klinik Pakar Wanita & Bersalin Subang Permai
6
Arunamari Specialist Medical Center
22
Pusat Pakar Wanita Dan Bersalin Selayang
7
KPJ Selangor Specialist Hospital
23
KPJ Kajang Specialist Hospital
8
Tun Hussein Onn National Eye Hospital
24
Wijaya International Medical Center
9
Pantai Hospital, Ampang
25
Klinik Pakar Bersalin & Bedah Serendah
10
Sri Kota Specialist Medical Center
26
Darul Aiman Sdn. Bhd. (Putra Medical Centre)
11
Columbia Asia Hospital – Cheras
27
Klinik Pakar wanita Sheela Sdn. Bhd.
12
Columbia Asia Bukit Rimau
28
DEMC Specialist Hospital, Shah Alam
13
Metro Maternity Sdn. Bhd
29
Pusat Perubatan Kohilal Sdn. Bhd.
14
Pusat Perubatan Damansara Damai
30
Hospital Bersalin Razif
15
Columbia Asia Extended Care Hospital
31
Pantai Hospital Klang
16
Assunta Hospital
32
Klinik Pakar Wanita & Keluarga Kapar Indah
6
7
8
9
10
Pusat Perubatan Intan Sdn. Bhd., Terengganu
Pusat Rawatan Mahsuri, Kedah
Hospital Wanita Metro, Selangor
Klinik Wanita Mentakab, Pahang
Klinik Dan Rumah Bersalin Nor, Selangor
HOSPITAL SECTOR: PRIVATE/ MATERNITY HOMES
1
2
3
4
5
Klinik Rawatan Keluarga, Terengganu
St. Joseph Maternity Home, Sabah
Wisma Bersalin Ikhwan, Selangor
Poliklinik Dan Surgeri Wanita, WPKL
Poliklinik Kotaraya & Klinik Pakar Wanita, Selangor
123
Selangor
APPENDIX 3 |
HOSPITAL
MALAYSIAN POPULATION, 2011
Table A3.1 Total Population by State, Malaysia 2011
Source
Population
Malaysia
28,964,300
Selangor
5,577,400
Johor
3,401,800
Sabah
3,316,400
Sarawak
2,516,200
Perak
2,397,600
Kedah
1,973,100
WPKL
1,694,500
Kelantan
1,615,200
Pulau Pinang
1,593,600
Pahang
1,524,800
Terengganu
1,074,000
Negeri Sembilan
1,042,900
Melaka
833,000
Perlis
237,500
WP Labuan
89,800
WP Putrajaya
76,400
Source: Department of Statistics, Malaysia, 2011
Source
Population
Malaysia
14,052,300
Selangor
2,686,600
Johor
1,608,700
Sabah
1,589,900
Sarawak
1,213,900
Perak
1,184,700
Kedah
976,100
WPKL
829,600
Kelantan
804,300
Pulau Pinang
794,400
Pahang
715,400
Terengganu
526,100
Negeri Sembilan
504,300
Melaka
413,600
Perlis
120,700
WP Labuan
43,500
WP Putrajaya
40,600
125
Appx 3 MALAYSIAN POPULATION, 2011
Table A3.2 Total Population of Female by State, Malaysia 2011
HOSPITAL
Table A3.3 Number of Live Birth by State, Malaysia 2011
Source
Population
Malaysia
494,601
Selangor
98,519
Johor
56,473
Sabah
52,321
Sarawak
41,986
Kelantan
36,609
Perak
36,447
Kedah
34,816
WP Kuala Lumpur
26,227
Pahang
26,167
Terengganu
24,016
Pulau Pinang
21,747
Negeri Sembilan
17,118
Melaka
13,553
Perlis
4,035
WP Putrajaya
2,881
WP Labuan
1,686
Table A3.4 Total Population Under 19 Years Old by State, Malaysia 2011
Source
Population
Malaysia
10,599,000
Selangor
1,810,800
Sabah
1,309,300
Johor
1,208,100
Sarawak
960,200
Perak
876,500
Kedah
768,900
Kelantan
736,700
Pahang
610,300
WP Kuala Lumpur
505,700
Pulau Pinang
495,100
Terengganu
472,900
Negeri Sembilan
381,900
Melaka
306,200
Perlis
92,500
WP Labuan
34,900
WP Putrajaya
29,100
126
HOSPITAL
Table A3.5 Total Population above 60 Years Old by State, Malaysia 2011
Source
Population
Malaysia
2,338,300
Selangor
347,900
Perak
289,100
Johor
287,300
Sarawak
217,600
Kedah
189,700
Pulau Pinang
165,900
Sabah
150,400
Kelantan
140,800
WP Kuala Lumpur
132,000
Pahang
127,600
Negeri Sembilan
96,500
Melaka
81,900
Terengganu
80,900
Perlis
25,900
WP Labuan
3,700
WP Putrajaya
1,000
Appx 3 MALAYSIAN POPULATION, 2011
127
APPENDIX 4
HOSPITAL
| DATA QUALITY STATEMENT
NHEWS 2011 Quality Statement – General (Multiple Sources of Data)
Data Source:
National Healthcare Establishment and Workforce Statistics
Institutional Environment
Data Collector(s): The data was collected by the Health Statistics Unit (HSU) of the National Clinical Research
Centre (CRC) Malaysia.
Collection authority: Public hospitals and clinics under the jurisdiction of the Medical Development and Family
Health Development Divisions were directed by the Ministry of Health (MOH) to provide access to available data
and participate in this survey.
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.
Data Compiler(s): The data was compiled by the same organization 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
organization website where the report and data is posted. All effort will be made to ensure any data error is
corrected within 5 working days and be re-released. All key data users will be specifically notified through email
or telephone.
Data topic: The data represents all acute curative hospitals and specified health services of both the private and
public sectors within Malaysia for 2011. Health services included General Surgery, Ophthalmology, Psychiatry,
Oncology and Maternity.
Level of geography: Data is available by state/region.
Key Data Items: The key data items produced from this collection include the facility, device, activity and
workforce of the identified healthcare services for 2011.
Numerator/Denominator Source: Numerators and denominators of all the rates, percentages and densities was
derived from the same data source and auxiliary sources e.g. vital statistics and population census obtained
from the Malaysia Department of Statistic (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 and status of the above
specified health services in term of facility, activity, device and workforce. Related healthcare facilities not
included in this survey were:
1. Private stand-alone eye surgery centres (Ophthalmology Chapter)
2. Health establishments of Non-governmental Organizations (NGO) (Hospital Chapter)
Key variables have been defined in this survey to assist in data standardization. However, no standard
international coding or classification has been used due to technical and capacity limitations.
129
Appx 4 DATA QUALITY STATEMENT
Relevance
HOSPITAL
Data Source:
Timeliness
Data collected: The data is collected annually after the end of each calendar year.
Data available: The data collection is done from July-September. This is followed by data cleaning, validation
and verification between September-December. The report will be signed and released by the Ministry of
Health by July of the next calendar year.
Referenced Period: The data reference period is from 1st-Jan-2011 to 31st-Dec-2011
Additional information: Updates or revisions of the data may have to be done 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. Percentages (%) of item and unit non-response
for each survey are presented below:
% ITEM
NON-RESPONSE
% UNIT NONRESPONSE
Acute curative hospital establishment survey
22.1
0.6
2
Maternity services survey
18.6
0.9
3
General surgical services survey
14.5
2.9
4
Ophthalmology services survey
8.2
0.9
5
Psychiatry services survey
4.3
2.7
6
Oncology services survey
0
0
NO.
SURVEY CHAPTER
1
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 6.
Collection size: This census survey includes all 337 registered acute curative hospitals, 26 private maternity
homes and 4 public psychiatry institutions within the country.
Under and over counts: Undercounts for particular variables will not be known until a post enumeration survey is
conducted to measure how effective the original survey was. The information from the post enumeration survey
will help the collector to weight the data better in order to compensate for the missing sample/non-respondent.
The information will also allow for an improved method for the next enumeration period to better capture the
population that were undercounted.
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
is undertaken to minimize processing errors. All hospitals in the country fulfilling the inclusion criteria were
accounted for in this survey.
130
HOSPITAL
Data Source:
Coherence
Consistency over time: Similar survey methods have been used for this survey in 2009 and 2010. However,
the 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.
Consistency of jurisdictions: The data consistency between establishments, state and region has not been
formally assessed in this survey. For example, number of spontaneous vertex delivery has shown some
discrepancy in interpretation; some establishments consider twin delivery to be 2 spontaneous vertex deliveries
whereas some consider it to be one.
Numerator/ denominator: The impact of the 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.
Additional information: There were no significant changes of the mode of data collection compared to the
previous year. Further, there were no real world events regionally or locally that may have had an impact on the
data since the last report.
Data from the Health Informatics Centre (HIC) of the Ministry of Health are broadly comparable with the data
collected in this survey. HIC’s data are routine data submitted monthly and directly to the HIC centre by the
healthcare establishments. However, certain data may not be directly comparable because of the differences
in definition and in different 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.
Besides the routine monthly data collected by HIC, no other similar information or data source are available at
the national level.
Interpretability
Context: Due to the alterations of certain important definitions in this report, any increase or decrease reported
may not reflect the actual situation. Specific issues related to this area have been discussed in the limitation
sections of each chapter.
Other supporting information: Please refer to the data dictionary, revised methodology section and the discussion
of limitation of each chapter for a better understanding of this data source.
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: [email protected]
Website: http://www.crc.gov.my/nhsi
Additional information:
Anonymous data is available in spreadsheet format on request for custom analysis.
A printed report will be mailed to all related hospital administrators upon publishing.
Soft copy reports can be downloaded at http://www.crc.gov.my/nhsi
Training courses on analysing and interpreting NHSI data can be provided if required.
Name:
Telephone Number:
Email Address:
Appx 4 DATA QUALITY STATEMENT
For further information please contact:
Health Statistics Unit
+603-40439300
[email protected]
131
APPENDIX 5 |
HOSPITAL
SURVEY PROFILES AND RESPONSE RATES
Chapter 2: Hospital Services in Malaysia
PERCENTAGE (%) with
missing values
Imputation
Type of Establishment
0
-
Entrepreneurship
0
-
Total Number of Gazetted Inpatient Beds
0
-
Total Number of Functioning Gazetted Inpatient Beds
1
Yes
Total Number of Non Gazetted Inpatient Beds
2
Yes
Total Number of Inpatient Admissons
1
Yes
Total Number of Operation Theatre, OT
1
Yes
Total Number of Operation Room, OR
1
Yes
Total Number of Functioning Operation Room, OR
1
Yes
Total Number of Medical Doctors
0
-
ALOS
1
Yes
Bed Occupancy Rate
1
Yes
Turnover Interval
1
Yes
Total Number of CT Scanner
0
-
17
Yes
0
-
13
Yes
Total Number of PET Scanner
0
-
Total Number of PET Scan Procedures Performed
1
Yes
Total Number of Nurses with Post Basic Training
2
Yes
Total Number of Nurses without Post Basic Training
3
Yes
Total Number of Community Nurses
0
Yes
Total Number of Assistant Nurses
1
Yes
Total Number of Assistant Medical Officer with Post Basic Training
0
Yes
Total Number of Assistant Medical Officer without Post Basic Training
0
Yes
Total Number of Pharmacists
0
Yes
Total Number of Physiotherapists
0
Yes
Total Number of Occupational Therapists
0
Yes
Total Number of Dieticians
0
Yes
Total Number of Medical Record Officers
0
Yes
Total Number of Medical Social Officers
0
Yes
Outcome variable
Total Number of CT Scan Procedures Performed
Total Number of MRI Scanner
Total Number of MRI Scan Procedures Performed
133
Appx 5 SURVEY PROFILES AND RESPONSE RATES
Table A5.1 Outcome Variables with Missing Data and Imputation Methods for Hospital Services, 2011
HOSPITAL
Table A5.2 Number and Rate of Respondents by State and Sector for Hospital Services, 2011
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Respondent
Number
134
130
264
1
na
1
9
8
17
10
8
18
6
%
100.00
63.41
77.88
100.00
na
100.00
100.00
88.89
94.44
100.00
88.89
94.74
100.00
Pulau Pinang
Private
9
40.91
13
59.09
22
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
15
14
12
26
11
31
42
4
19
23
15
50
65
6
5
11
3
4
7
11
16
27
10
8
18
6
1
7
10
3
13
23
4
27
20
10
30
53.57
100.00
75.00
86.67
100.00
63.27
70.00
100.00
52.78
57.50
100.00
58.82
65.00
100.00
55.56
73.33
100.00
100.00
100.00
100.00
53.33
65.85
100.00
88.89
94.74
100.00
100.00
100.00
100.00
100.00
100.00
100.00
80.00
96.43
100.00
83.33
93.75
13
0
4
4
0
18
18
0
17
17
0
35
35
0
4
4
0
0
0
0
14
14
0
1
1
0
0
0
0
0
0
0
1
1
0
2
2
46.43
0.00
25.00
13.33
0.00
36.73
30.00
0.00
47.22
42.50
0.00
41.18
35.00
0.00
44.44
26.67
0.00
0.00
0.00
0.00
46.67
34.15
0.00
11.11
5.26
0.00
0.00
0.00
0.00
0.00
0.00
0.00
20.00
3.57
0.00
16.67
6.25
28
14
16
30
11
49
60
4
36
40
15
85
100
6
9
15
3
4
7
11
30
41
10
9
19
6
1
7
10
3
13
23
5
28
20
12
32
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
134
Non Respondent
Number
%
0
0.00
75
36.59
75
22.12
0
0.00
na
na
0
0.00
0
0.00
1
11.11
1
5.56
0
0.00
1
11.11
1
5.26
0
0.00
Total
134
205
339
1
na
1
9
9
18
10
9
19
6
HOSPITAL
Chapter 3: Maternity Services in Malaysian Hospitals and Maternity Homes
Table A5.3 Outcome Variables with Missing Data and Imputation Methods for Maternity Services, 2011
Total Number of Delivery Beds
Imputation
Yes
Number of Hospital with OT Facilities
0
-
Total Number of Functioning OR
0
-
Number of Hospital HDU/ICU within the O&G unit
0
-
Total Number of Functioning Obstetrics HDU/ICU Beds outside the O&G unit
0
-
Total Number of All Types of Deliveries
0
-
Total Number of Spontaneous Vertex Delivery (SVD)
2
Yes
Total Number of Vaginal Breech Deliveries
8
Yes
Total Number of Vacuum assisted Vaginal Deliveries
2
Yes
Total Number of Forceps assisted Vaginal Deliveries
2
Yes
Total Number of Caesarian Surgeries
3
Yes
Total Number of Elective Surgeries
0
-
Total Number of Emergency Surgeries
0
-
Total Number of Lower Segment Caesarian Section (LSCS)
0
Yes
Total Number of Hysterotomy Procedures Performed
1
Yes
Total Number of Caesarean Hysterectomy Procedures Performed
2
Yes
Total Number of Multiple Pregnancies Delivered
4
Yes
Total Number of Eclampsia
3
Yes
Number of Hospital with Post Partum Haemorrhage (PPH)
6
Yes
Total Number of Post Partum Haemorrhage (PPH)
7
Yes
Total Number of Primary Post Partum Haemorrhage (PPH)
11
Yes
Total Number of Massive Post Partum Haemorrhage (PPH)
15
Yes
Total Number of Newborns Delivered
1
Yes
Total Number of Newborns Admitted to Paediatric/NICU/SCN
1
Yes
Hospital with O&G Specialist
0
-
Total Number of Permanent O&G Specialist
0
-
Total Number of Visiting O&G Specialist
0
-
Total Number of Medical Officer in O&G
0
-
Total Number of Staff Nurses in O&G
5
Yes
Total Number of Nurses With Midwifery Training in Obstetric Ward
0
-
Total Number of Nurses With Midwifery Training in Labour Ward
0
-
Total Number of Nurses With Midwife Training in Obstetric HDU
0
-
13
Yes
Total Number of Community Nurses With Midwifery Training in Obstetric Ward
0
-
Total Number of Community Nurses With Midwifery Training in Labour Ward
0
-
Total Number of Community Nurses With Midwife Training in Obstetric HDU
0
-
Total Number of Community Nurses in O&G
135
PERCENTAGE (%) with
missing values
0 (respondent), 45
(Non -respondent)
Outcome variable
HOSPITAL
Table A5.4 Number and Rate of Respondents by State and Sector for Maternity Services, 2011
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Respondent
Number
133
125
258
1
na
1
9
8
17
10
8
18
6
14
20
14
12
26
12
29
41
3
17
20
15
46
61
6
3
9
3
3
6
11
15
26
10
7
17
6
1
7
10
3
13
22
4
26
20
9
29
136
%
100.00
67.93
81.39
100.00
na
100.00
100.00
88.89
94.44
100.00
88.89
94.74
100.00
82.35
86.96
100.00
80.00
89.66
100.00
63.04
70.69
100.00
54.84
58.82
100.00
59.74
66.30
100.00
50.00
75.00
100.00
100.00
100.00
100.00
53.57
66.67
100.00
77.78
89.47
100.00
100.00
100.00
100.00
100.00
100.00
100.00
80.00
96.30
100.00
81.82
93.55
Non Respondent
Number
%
0
0.00
59
32.07
59
18.61
0
0.00
na
na
0
0.00
0
0.00
1
11.11
1
5.56
0
0.00
1
11.11
1
5.26
0
0.00
3
17.65
3
13.04
0
0.00
3
20.00
3
10.34
0
0.00
17
36.96
17
29.31
0
0.00
14
45.16
14
41.18
0
0.00
31
40.26
31
33.70
0
0.00
3
50.00
3
25.00
0
0.00
0
0.00
0
0.00
0
0.00
13
46.43
13
33.33
0
0.00
2
22.22
2
10.53
0
0.00
0
0.00
0
0.00
0
0.00
0
0.00
0
0.00
0
0.00
1
20.00
1
3.70
0
0.00
2
18.18
2
6.45
Total
133
184
317
1
na
1
9
9
18
10
9
19
6
17
23
14
15
29
12
46
58
3
31
34
15
77
92
6
6
12
3
3
6
11
28
39
10
9
19
6
1
7
10
3
13
22
5
27
20
11
31
HOSPITAL
Chapter 4: Surgical Services in Malaysian Hospitals
Table A5.5 Outcome Variables with Missing Data and Imputation Methods for Surgical Services, 2011
Total Number of Dedicated Emergency/Trauma Theatres
Imputation
-
Total Number of Elective Operating Hours
0
-
Total Number of Elective Cases
0
-
Total Number of Elective Cases under GA
1
Yes
Total Number of Elective Cases under LA
1
Yes
Total number of Emergency Cases
0
-
Total Number of Emergency Cases under GA
2
Yes
Total Number of Emergency Cases under LA
2
Yes
Total Number of Mastectomies Procedures
0
-
Total Number of Hospital with Inguinal Hernia Surgery
0
-
Total Number of Inguinal Hernia Surgery: Open Procedures
1
Yes
Total Number of Inguinal Hernia Surgery: Laparascopic Procedures
7
Yes
Total Number of Hospital with Cholecystectomies
0
-
Total Number of Cholecystectomies: Open Procedures
2
Yes
Total Number of Cholecystectomies: Laparascopic Procedures
1
Yes
Total Number of Hospital with OGDS Endoscopy Procedures
0
-
Total Number of OGDS Endoscopy Procedures
0
-
Total Number of OGDS Endoscopy Procedures by Surgical Team
24
Yes
Total Number of OGDS Endoscopy Procedures by Medical Team
26
Yes
Total Number of Hospital with Colonoscopy Endoscopy Procedures
0
-
Total Number of Colonoscopy Endoscopy Procedures
0
-
Total Number of Colonoscopy Endoscopy Procedures by Surgical Team
26
Yes
Total Number of Colonoscopy Endoscopy Procedures by Medical Team
27
Yes
Total Number of Hospital with ERCP Endoscopy Procedures
0
-
Total Number of ERCP Endoscopy Procedures
0
Yes
Total Number of ERCP Endoscopy Procedures by Surgical Team
24
Yes
Total Number of ERCP Endoscopy Procedures by Medical Team
24
Yes
Total Number of Hospital with Surgeons
0
-
Total Number of Permanent/Resident Surgeons
0
-
Total Number of Visiting Surgeons
0
-
Total Number of Theatre Scrub Nurses
0
-
Total Number of Theatre Scrub Nurses with Periopreative Post Basic
0
-
Total Number of Theatre Scrub Nurses without Periopreative Post Basic
0
-
Total Number of OGDS Scope
2
Yes
Total Number of Functioning OGDS Scope
0
-
Total Number of Non Functioning OGDS Scope
0
-
Total Number of Colonoscope
2
Yes
Total Number of Functioning Colonoscope
0
-
Total Number of Non Functioning Colonoscope
0
-
Total Number of ERCP Scope
2
Yes
Total Number of Functioning ERCP Scope
0
-
Total Number of Non Functioning ERCP Scope
0
-
Abbreviation:; - – not available
137
PERCENTAGE (%) with
missing values
0
Outcome variable
HOSPITAL
Table A5.6 Number and Rate of Respondents by State and Sector for Surgical Services, 2011
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Respondent
Number
59
83
142
1
na
1
4
5
9
5
5
10
4
7
11
5
8
13
7
17
24
2
14
16
9
31
40
2
4
6
1
3
4
7
6
13
2
4
6
3
1
4
6
3
9
8
3
11
7
8
15
138
%
98.33
78.30
85.54
100.00
na
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
70.00
78.57
100.00
72.73
81.25
100.00
73.91
80.00
66.67
77.78
76.19
90.00
75.61
78.43
100.00
66.67
75.00
100.00
100.00
100.00
100.00
54.55
72.22
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
Non Respondent
Number
1
23
24
0
na
0
0
0
0
0
0
0
0
3
3
0
3
3
0
6
6
1
4
5
1
10
11
0
2
2
0
0
0
0
5
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
%
1.67
21.70
14.46
0.00
na
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
30.00
21.43
0.00
27.27
18.75
0.00
26.09
20.00
33.33
22.22
23.81
10.00
24.39
21.57
0.00
33.33
25.00
0.00
0.00
0.00
0.00
45.45
27.78
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Total
60
106
166
1
na
1
4
5
9
5
5
10
4
10
14
5
11
16
7
23
30
3
18
21
10
41
51
2
6
8
1
3
4
7
11
18
2
4
6
3
1
4
6
3
9
8
3
11
7
8
15
HOSPITAL
Chapter 5: Oncology Services in Malaysian Hospitals
Table A5.7 Outcome Variables with Missing Data and Imputation Methods for Oncology Services, 2011
PERCENTAGE (%)
with missing
values
Outcome variable
Imputation
0
-
Hospital with Cleanrooms for Reconstruction of Cytotoxic Drugs
0
-
Total Number of Cleanrooms for Reconstruction of Cytotoxic Drugs
0
-
Hospital without Cleanrooms for Reconstruction of Cytotoxic Drugs (Outsource the Service)
0
-
Hospital with Chemotherapy Daycare
0
-
Number of Chemotherapy Beds
0
-
Number of Chemotherapy Chairs
0
-
Number of Hospital with for Cytotoxic Drugs Reconstruction CDR Isolators
0
-
Total Number of Oncology Trained Nurse
0
-
Total Number of Radiation Therapist
0
-
Total Number of Physicists
0
-
Total Number of CDR Pharmacist
0
-
Total Number of Megavoltage Machine
0
-
Total Number of Brachytherapy Machine
0
-
Total Number of Simulators
0
-
Total Number of Physics Equipment
0
-
Total Number of Treatment Planning System
0
-
Total Number of Equipment Capable of Carrying Out Intensity Modulated Radiotherapy
0
-
Total Number of Equipment Capable of Carrying Out Image Guided Radiotherapy
0
-
Total Number of Equipment Capable of Carrying Out Stereotactic RadioSurgery
0
-
Hospital with Oncology Services
139
HOSPITAL
Table A5.8 Number and Rate of Respondents by State and Sector for Oncology Services, 2011
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Respondent
Number
31
27
58
na
na
na
2
na
2
2
na
2
2
7
9
4
3
7
4
6
10
3
5
8
7
11
18
1
1
2
1
2
3
4
1
5
1
na
1
1
na
1
2
na
2
3
1
4
3
1
4
Abbreviation: na - not applicable
140
%
100.00
100.00
100.00
na
na
na
100.00
na
100.00
100.00
na
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
na
100.00
100.00
na
100.00
100.00
na
100.00
100.00
100.00
100.00
100.00
100.00
100.00
Non Respondent
Number
0
0
0
na
na
na
0
na
0
0
na
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
na
0
0
na
0
0
na
0
0
0
0
0
0
0
%
0.00
0.00
0.00
na
na
na
0.00
na
0.00
0.00
na
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
na
0.00
0.00
na
0.00
0.00
na
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Total
31
27
58
na
na
na
2
na
2
2
na
2
2
7
9
4
3
7
4
6
10
3
5
8
7
11
18
1
1
2
1
2
3
4
1
5
1
na
1
1
na
1
2
na
2
3
1
4
3
1
4
HOSPITAL
Chapter 6: Psychiatric Services in Malaysian Hospitals
Table A5.9 Outcome Variables with Missing Data and Imputation Methods for Psychiatric Services, 2011
Hospital with Psychiatry Services
Imputation
-
Hospital with Gazetted Psychiatry Beds
0
-
Total Number of Inpatient Psychiatry Dedicated Beds
0
-
Total Number of Functioning Inpatient Psychiatry Dedicated Beds
0
-
Inpatient Psychiatry Bed Occupancy Rate
0
-
Average Length of Stay
0
-
Total Number of Inpatient Psychiatry Admissions
7
Yes
Total Number of Outpatient Psychiatry Follow up Patients Visits
16
Yes
Total Number of Outpatient Psychiatry New Cases
18
Yes
Hospital with Community & Rehabilitation Services
0
-
Total Number of Community & Rehabilitation Services
0
-
Hospital with Rehabilitation Services
0
-
Total Number of Rehabilitation Services
1
Yes
Hospital with Patients below 18 years old
4
Yes
15
Yes
3
Yes
16
Yes
Hospital with Methadone Clinic Services
0
-
Total Number of Methadone Clinic Patients
0
-
Hospital with Referrals from Psychiatry Wards or Emergency Dept
0
-
13
Yes
Hospital with Psychiatrists
0
-
Total Number of Permanent Psychiatrists
0
-
Total Number of Visiting Psychiatrists
0
-
Total Number of Permanent Clinical Psychologists
1
Yes
Total Number of Visiting Clinical Psychologists
1
Yes
Total Number of Counselors – Full Time
0
-
Total Number of Counselors – Common User
0
-
Total Number of Medical Social Worker – Full Time
0
-
Total Number of Medical Social Worker – Common User
0
-
Total Number of Nurses in Mental Health Facilities
0
-
Total Number of Nurses with Post Basic Psychiatry Training
0
-
Total Number of Community Nurses
0
-
Total Number of Assistant Medical Officer in Mental Health Facilities
0
-
Total Number of Assistant Medical Officer with Post Basic Psychiatry Training
0
-
Total Number of Assistant Medical Officer without Post Basic Psychiatry Training
0
-
Total Number of ECT Machines
0
-
Total Number of ECT Procedures - Outpatient
0
-
Total Number of ECT Procedures - Inpatient
0
-
Total Number of Patients below 18 years old
Hospital with Patients above 60 years old
Total Number of Patients above 60 years old
Total Number of Referrals from Psychiatry Wards or Emergency Dept
141
PERCENTAGE (%) with
missing values
0
Outcome variable
HOSPITAL
Table A5.10 Number and Rate of Respondents in Hospitals by State and Sector for Psychiatry Services, 2011
STATE
SECTOR
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
RESPONDENT
NUMBER
49
41
90
1
na
1
3
2
5
4
2
6
2
5
7
6
4
10
7
8
15
3
9
12
10
17
27
2
2
4
1
2
3
7
2
9
3
na
3
3
na
3
4
1
5
3
1
4
4
5
9
142
%
100.00
91.11
95.74
100.00
na
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
80.00
90.91
100.00
88.89
93.75
100.00
100.00
100.00
100.00
94.44
96.43
100.00
100.00
100.00
100.00
66.67
75.00
100.00
100.00
100.00
100.00
na
100.00
100.00
na
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
83.33
90.00
NON RESPONDENT
NUMBER
0
4
4
0
na
0
0
0
0
0
0
0
0
0
0
0
1
1
0
1
1
0
0
0
0
1
1
0
0
0
0
1
1
0
0
0
0
na
0
0
na
0
0
0
0
0
0
0
0
1
1
%
0.00
8.89
4.26
0.00
na
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
20.00
9.09
0.00
11.11
6.25
0.00
0.00
0.00
0.00
5.56
3.57
0.00
0.00
0.00
0.00
33.33
25.00
0.00
0.00
0.00
0.00
na
0.00
0.00
na
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
16.67
10.00
TOTAL
49
45
94
1
na
1
3
2
5
4
2
6
2
5
7
6
5
11
7
9
16
3
9
12
10
18
28
2
2
4
1
3
4
7
2
9
3
na
3
3
na
3
4
1
5
3
1
4
4
6
10
HOSPITAL
Chapter 7: Ophthalmology Services in Malaysian Hospitals
Table A5.11 Outcome Variables with Missing Data and Imputation Methods for Opthalmology Services, 2011
PERCENTAGE (%)
with missing
values
Outcome variable
Imputation
0
-
Total Number of Dedicated Ophthalmology Operating Rooms, ORs
0
-
Total Number of Functioning Dedicated Ophthalmology Operating Rooms, ORs
0
-
Total Number of Elective Operating Hours (4 week month)
0
-
Hospital with Cataract Surgery
0
-
Total Number of Cataract Surgeries Done as Daycare
2
Yes
Total Number of Cataract Surgeries Done as Inpatient
2
Yes
Hospital with Glaucoma Surgery
2
Yes
Total Number of Glaucoma Surgeries with Implant
3
Yes
Total Number of Glaucoma Surgeries without Implant
3
Yes
Hospital with Vitreoretinal Surgery
2
Yes
Total Number of Vitreoretinal Surgeries
2
Yes
Total Number of Vitreoretinal Surgeries for Diabetic Retinopathy
5
Yes
Hospital with Ophthalmologists
0
-
Total Number of Permanent Ophthalmologists
0
-
Total Number of Visiting Ophthalmologists
0
-
Total Number of Permanent Optometrists
0
-
Total Number of Visiting Optometrists
0
-
Total Number of Assistant Medical Officers with Post-Basic in Ophthalmology
0
-
Total Number of Assistant Medical Officers without Post-Basic in Ophthalmology
0
-
Total Number of Nurses with Post-Basic in Ophthalmology
0
-
Total Number of Nurses without Post-Basic in Ophthalmology
0
-
Total Number of Functioning Operating Microscope
0
-
Total Number of Functioning Phacoemulsification Machine (Stand-Alone)
0
-
Total Number of Functioning Posterior Vitrectomy Machine Combination
0
-
Total Number of Functioning Posterior Vitrectomy Machine (Stand-Alone)
0
-
Total Number of Automated Perimetry Devices
0
Hospital with Dedicated Ophthalmology Operating Rooms, ORs
143
HOSPITAL
Table A5.12 Number and Rate of Respondents in Hospitals by State and Sector for Opthalmology Services, 2011
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Respondent
Number
39
51
90
1
na
1
2
3
5
3
3
6
2
4
6
4
4
8
6
13
19
3
11
14
9
24
33
2
2
4
1
3
4
4
3
7
2
1
3
1
na
1
3
na
3
4
1
5
4
6
10
144
%
100.00
86.44
91.84
100.00
na
100.00
100.00
75.00
83.33
100.00
75.00
85.71
100.00
80.00
85.71
100.00
80.00
88.89
100.00
92.86
95.00
100.00
84.62
87.50
100.00
88.89
91.67
100.00
100.00
100.00
100.00
100.00
100.00
100.00
75.00
87.50
100.00
100.00
100.00
100.00
na
100.00
100.00
na
100.00
100.00
100.00
100.00
100.00
85.71
90.91
Non Respondent
Number
%
0
0.00
8
13.56
8
8.16
0
0.00
na
na
0
0.00
0
0.00
1
25.00
1
16.67
0
0.00
1
25.00
1
14.29
0
0.00
1
20.00
1
14.29
0
0.00
1
20.00
1
11.11
0
0.00
1
7.14
1
5.00
0
0.00
2
15.38
2
12.50
0
0.00
3
11.11
3
8.33
0
0.00
0
0.00
0
0.00
0
0.00
0
0.00
0
0.00
0
0.00
1
25.00
1
12.50
0
0.00
0
0.00
0
0.00
0
0.00
na
na
0
0.00
0
0.00
na
na
0
0.00
0
0.00
0
0.00
0
0.00
0
0.00
1
14.29
1
9.09
Total
39
59
98
1
na
1
2
4
6
3
4
7
2
5
7
4
5
9
6
14
20
3
13
16
9
27
36
2
2
4
1
3
4
4
4
8
2
1
3
1
na
1
3
na
3
4
1
5
4
7
11
APPENDIX 6 |
HOSPITAL
MEDICAL SUBSPECIALTIES
Table A6.1 Number and Density of Anaesthesiologists, Emergency Medicine Specialists and Paediatricians in
Malaysia by State and Sector, 2011
State
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
Sector
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Emergency Medicine
Specialists
Paediatricians
No.
Per 10,000
Population
No.
Per 10,000
Population
No.
Per 10,000
Population
381
302
683
4
na
4
17
10
27
21
10
31
20
35
55
29
23
52
72
85
157
87
70
157
159
155
314
11
9
20
10
17
27
35
25
60
17
6
23
12
1
13
27
2
29
22
5
27
18
14
32
0.24
na
0.17
0.14
0.14
0.35
0.22
0.28
0.93
0.43
0.19
0.32
0.18
0.15
0.12
0.18
0.08
0.13
101
1
102
2
na
2
5
0
5
7
0
7
4
1
5
5
0
5
19
0
19
25
0
25
44
0
44
3
0
3
3
0
3
5
0
5
3
0
3
4
0
4
15
0
15
5
0
5
3
0
3
0.04
na
0.08
0.03
0.03
0.03
0.02
0.03
0.15
0.06
0.03
0.04
0.01
0.02
0.04
0.09
0.01
0.01
377
292
669
3
na
3
17
10
27
20
10
30
29
41
70
27
20
47
61
88
149
102
56
158
163
144
307
13
15
28
8
13
21
28
17
45
13
6
19
7
1
8
26
5
31
20
5
25
23
15
38
0.23
na
0.13
0.14
0.14
0.44
0.20
0.26
0.93
0.42
0.27
0.25
0.13
0.12
0.07
0.19
0.07
0.15
145
Appx 6 MEDICAL SUBSPECIALTIES
Anaesthesiologists
HOSPITAL
Table A6.2 Number and Density of Internal Medicine and Infectious Diseases Specialists in Malaysia by State
and Sector, 2011
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Internal Medicine Specialists
Infectious Diseases Specialists
Per 10,000
Per 10,000
No.
No.
Population
Population
327
15
163
3
490
0.17
18
0.01
3
0
na
na
na
na
3
0.13
0
0.00
26
0
5
0
31
0.16
0
0.00
29
0
5
0
34
0.15
0
0.00
28
2
19
0
47
0.29
2
0.01
18
1
15
0
33
0.14
1
0.00
56
5
26
2
82
0.15
7
0.01
63
3
29
0
92
0.54
3
0.02
119
8
55
2
174
0.24
10
0.01
10
0
17
0
27
0.26
0
0.00
7
0
10
0
17
0.20
0
0.00
20
1
14
0
34
0.10
1
0.00
22
0
7
0
29
0.19
0
0.00
15
1
1
0
16
0.15
1
0.01
14
1
3
1
17
0.11
2
0.01
22
1
6
0
28
0.08
1
0.00
23
0
11
0
34
0.14
0
0.00
146
HOSPITAL
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
No.
62
50
112
0
na
0
2
2
4
2
2
4
6
8
14
1
5
6
12
17
29
20
6
26
32
23
55
2
2
4
1
4
5
3
2
5
2
0
2
2
0
2
4
1
5
4
1
5
3
2
5
147
Nephrologists
Per 10,000
Population
0.04
na
0.00
0.02
0.02
0.09
0.03
0.05
0.15
0.07
0.04
0.06
0.01
0.01
0.02
0.03
0.01
0.02
Endocrinologists
Per 10,000
No.
Population
34
17
51
0.02
0
na
na
0
0.00
0
0
0
0.00
0
0
0
0.00
2
3
5
0.03
1
1
2
0.01
10
8
18
0.03
13
5
18
0.11
23
13
36
0.05
1
0
1
0.01
1
0
1
0.01
0
0
0
0.00
0
0
0
0.00
0
0
0
0.00
4
0
4
0.02
1
0
1
0.00
1
0
1
0.00
Table A6.3 Number and Density of Nephrologists and Endocrinologists in Malaysia by State and Sector, 2011
HOSPITAL
Table A6.4 Number and Density of Cardiologists and Respiratory Medicine Specialists in Malaysia by State and
Sector, 2011
Cardiologists
State
Sector
No.
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
39
160
199
0
0
0
1
6
7
1
6
7
2
19
21
1
10
11
7
33
40
8
52
60
15
85
100
0
4
4
0
11
11
5
8
13
2
2
4
0
1
1
3
2
5
4
3
7
6
9
15
148
Per 10,000
Population
0.07
0.00
0.04
0.03
0.13
0.05
0.07
0.35
0.14
0.04
0.13
0.04
0.03
0.01
0.03
0.02
0.06
Respiratory Medicine
Specialists
Per 10,000
No.
Population
32
35
67
0.02
0
0
0
0.00
2
1
3
0.02
2
1
3
0.01
2
5
7
0.04
2
3
5
0.02
2
14
16
0.03
15
9
24
0.14
17
23
40
0.05
0
1
1
0.01
0
1
1
0.01
2
0
2
0.01
1
1
2
0.01
0
0
0
0.00
2
0
2
0.01
4
0
4
0.01
0
0
0
0.00
HOSPITAL
Hepatologists
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
No.
9
0
9
0
na
0
0
0
0
0
0
0
0
0
0
0
0
0
7
0
7
2
0
2
9
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
149
Per 10,000
Population
0.00
na
0.00
0.00
0.00
0.00
0.00
0.01
0.01
0.01
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Gastroenterologists
Per 10,000
No.
Population
29
76
105
0.04
0
na
na
0
0.00
3
3
6
0.03
3
3
6
0.03
1
9
10
0.06
0
4
4
0.02
4
26
30
0.05
12
20
32
0.19
16
46
62
0.08
0
1
1
0.01
0
6
6
0.07
0
4
4
0.01
1
0
1
0.01
0
0
0
0.00
5
0
5
0.03
3
1
4
0.01
0
2
2
0.01
Table A6.5 Number and Density of Hepatologists and Gastroenterologists in Malaysia by State and Sector, 2011
HOSPITAL
Table A6.6 Number and Density of Clinical Haematologists in Malaysia by State and Sector, 2011
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Clinical Haematologists
No.
Per 10,000 Population
35
12
47
0.02
0
na
na
0
0.00
0
0
0
0.00
0
0
0
0.00
2
2
4
0.03
1
1
2
0.01
19
3
22
0.04
7
3
10
0.06
26
6
32
0.04
0
0
0
0.00
0
1
1
0.01
0
0
0
0.00
0
0
0
0.00
0
0
0
0.00
3
0
3
0.02
2
0
2
0.01
1
2
3
0.01
150
HOSPITAL
Neurologists
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
No.
30
36
66
0
na
0
0
1
1
0
1
1
3
5
8
1
2
3
0
11
11
20
10
30
20
21
41
0
1
1
1
3
4
0
1
1
1
0
1
1
0
1
2
0
2
0
1
1
1
1
2
151
Per 10,000
Population
0.02
na
0.00
0.01
0.00
0.05
0.01
0.02
0.18
0.06
0.01
0.05
0.00
0.01
0.01
0.01
0.00
0.01
Rheumatologists
Per 10,000
No.
Population
26
14
40
0.01
0
na
na
0
0.00
0
0
0
0.00
0
0
0
0.00
0
1
1
0.01
1
1
2
0.01
11
6
17
0.03
3
4
7
0.04
14
10
24
0.03
3
1
4
0.04
1
0
1
0.01
1
1
2
0.01
1
0
1
0.01
1
0
1
0.01
1
0
1
0.01
2
0
2
0.01
1
0
1
0.00
Table A6.7 Number and Density of Neurologists and Rheumatologists in Malaysia by State and Sector, 2011
HOSPITAL
Table A6.8 Number and Density of Geriatric Medicine Specialists in Malaysia by State and Sector, 2011
State
Geriatric Medicine Specialists
No.
7
6
13
0.00
0
na
na
0
0.00
0
0
0
0.00
0
0
0
0.00
0
1
1
0.01
0
2
2
0.01
0
0
0
0.00
5
2
7
0.04
5
2
7
0.01
0
0
0
0.00
0
0
0
0.00
0
0
0
0.00
0
0
0
0.00
0
0
0
0.00
0
0
0
0.00
1
0
1
0.00
1
1
2
0.01
Sector
Malaysia
Public
Malaysia
Private
Malaysia
Total
Perlis
Public
Perlis
Private
Perlis
Total
Kedah
Public
Kedah
Private
Kedah
Total
Kedah & Perlis
Public
Kedah & Perlis
Private
Kedah & Perlis
Total
Pulau Pinang
Public
Pulau Pinang
Private
Pulau Pinang
Total
Perak
Public
Perak
Private
Perak
Total
Public
Private
Total
WP Kuala Lumpur
Public
WP Kuala Lumpur
Private
WP Kuala Lumpur
Total
Negeri Sembilan
Public
Negeri Sembilan
Private
Negeri Sembilan
Total
Melaka
Public
Melaka
Private
Melaka
Total
Johor
Public
Johor
Private
Johor
Total
Pahang
Public
Pahang
Private
Pahang
Total
Terengganu
Public
Terengganu
Private
Terengganu
Total
Kelantan
Public
Kelantan
Private
Kelantan
Total
Sabah & WP Labuan
Public
Sabah & WP Labuan
Private
Sabah & WP Labuan
Total
Sarawak
Public
Sarawak
Private
Sarawak
Total
152
HOSPITAL
APPENDIX 7 | OTHER SPECIALTIES IN MEDICINE
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Cardiothoracic Surgeons
Per 10,000
No.
Population
24
45
69
0.02
0
na
na
0
0.00
0
0
0
0.00
0
0
0
0.00
2
9
11
0.07
0
1
1
0.00
7
8
15
0.03
5
22
27
0.16
12
30
42
0.06
0
0
0
0.00
0
3
3
0.04
4
1
5
0.01
0
0
0
0.00
0
0
0
0.00
2
0
2
0.01
2
0
2
0.01
2
1
3
0.01
153
Paediatric Surgeons
Per 10,000
No.
Population
19
20
39
0.01
0
na
na
0
0.00
2
0
2
0.01
2
0
2
0.01
0
4
4
0.03
0
1
1
0.00
1
6
7
0.01
9
6
15
0.09
10
12
22
0.03
0
0
0
0.00
0
0
0
0.00
2
1
3
0.01
1
0
1
0.01
0
0
0
0.00
2
2
4
0.02
1
0
1
0.00
1
0
1
0.00
Appx 7 OTHER SPECIALTIES IN MEDICINE
Table A7.1 Number and Density of Cardiothoracic and Paediatric Surgeons in Malaysia by State and Sector, 2011
HOSPITAL
Table A7.2 Number and Density of Plastic and Reconstructive Surgeons in Malaysia by State and Sector, 2011
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Plastic and Reconstructive Surgeons
No.
34
33
67
0.02
0
na
na
0
0.00
1
0
1
0.01
1
0
1
0.00
3
3
6
0.04
2
3
5
0.02
5
10
15
0.03
8
12
20
0.12
13
22
35
0.05
0
0
0
0.00
0
1
1
0.01
3
2
5
0.01
0
0
0
0.00
1
0
1
0.01
7
0
7
0.04
4
1
5
0.01
0
1
1
0.00
154
HOSPITAL
Table A7.3 Number and Density of Neurosurgeons and Urologists in Malaysia by State and Sector, 2011
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Neurosurgeons
Per 10,000
No.
Population
44
33
77
0.03
0
na
na
0
0.00
1
0
1
0.01
1
0
1
0.00
3
7
10
0.06
1
2
3
0.01
4
9
13
0.02
16
5
21
0.12
20
14
34
0.05
0
0
0
0.00
0
6
6
0.07
5
2
7
0.02
0
1
1
0.01
2
0
2
0.02
7
0
7
0.04
2
0
2
0.01
3
1
4
0.02
155
Urologists
No.
34
63
97
0
na
0
1
4
5
1
4
5
2
8
10
0
3
3
5
17
22
16
11
27
21
28
49
0
2
2
0
7
7
2
6
8
2
2
4
0
0
0
2
1
3
2
1
3
2
1
3
Per 10,000
Population
0.03
na
0.00
0.03
0.02
0.06
0.01
0.04
0.16
0.07
0.02
0.08
0.02
0.03
0.00
0.02
0.01
0.01
State
HOSPITAL
Table A7.4 Number and Density of Orthopaedic Surgeons and Sport Medicine Specialists in Malaysia by State and
Sector, 2011
Orthopaedic Surgeons
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
No. Per 10,000 Population
279
283
562
4
na
4
15
14
29
19
14
33
10
33
43
20
24
44
49
67
116
63
57
120
112
124
236
8
14
22
6
16
22
23
25
48
14
9
23
9
1
10
30
4
34
13
7
20
15
12
27
156
0.19
na
0.17
0.15
0.15
0.27
0.18
0.21
0.71
0.32
0.21
0.26
0.14
0.15
0.09
0.21
0.06
0.11
Sport Medicine Specialists
Per 10,000
No.
Population
10
0
10
0.00
0
na
na
0
0.00
0
0
0
0.00
0
0
0
0.00
0
0
0
0.00
1
0
1
0.00
3
0
3
0.01
4
0
4
0.02
7
0
7
0.01
1
0
1
0.01
0
0
0
0.00
0
0
0
0.00
0
0
0
0.00
0
0
0
0.00
0
0
0
0.00
1
0
1
0.00
0
0
0
0.00
HOSPITAL
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Radiologists
Per 10,000
No.
Population
247
166
413
0.14
2
na
na
2
0.08
11
7
18
0.09
13
7
20
0.09
13
23
36
0.23
13
14
27
0.11
47
41
88
0.16
65
32
97
0.57
112
73
185
0.25
7
8
15
0.14
5
9
14
0.17
19
15
34
0.10
13
3
16
0.10
8
0
8
0.07
18
1
19
0.12
12
2
14
0.04
14
11
25
0.10
157
Nuclear Medicine Specialists
Per 10,000
No.
Population
8
7
15
0.01
0
na
na
0
0.00
0
0
0
0.00
0
0
0
0.00
2
1
3
0.02
0
0
0
0.00
0
4
4
0.01
3
1
4
0.02
3
5
8
0.01
0
0
0
0.00
0
0
0
0.00
1
1
2
0.01
0
0
0
0.00
0
0
0
0.00
1
0
1
0.01
0
0
0
0.00
1
0
1
0.00
Table A7.5 Number and Density of Radiologists and Nuclear Medicine Specialists in Malaysia by State and Sector, 2011
HOSPITAL
Table A7.6 Number and Density of Pathologists and Forensic Pathologists in Malaysia by State and Sector, 2011
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Pathologists
Per 10,000
No.
Population
302
42
344
0.12
3
na
na
3
0.13
10
0
10
0.05
13
0
13
0.06
11
2
13
0.08
14
2
16
0.07
44
17
61
0.11
100
16
116
0.68
144
33
177
0.24
11
0
11
0.11
8
3
11
0.13
15
0
15
0.04
13
0
13
0.09
9
0
9
0.08
48
0
48
0.30
11
0
11
0.03
5
2
7
0.03
158
Forensic Pathologists
Per 10,000
No.
Population
25
0
25
0.01
0
na
na
0
0.00
1
0
1
0.01
1
0
1
0.00
2
0
2
0.01
1
0
1
0.00
5
0
5
0.01
8
0
8
0.05
13
0
13
0.02
1
0
1
0.01
1
0
1
0.01
2
0
2
0.01
2
0
2
0.01
0
0
0
0.00
1
0
1
0.01
1
0
1
0.00
0
0
0
0.00
HOSPITAL
Rehabilitation Medicine Specialists
State
Sector
Malaysia
Malaysia
Malaysia
Perlis
Perlis
Perlis
Kedah
Kedah
Kedah
Kedah & Perlis
Kedah & Perlis
Kedah & Perlis
Pulau Pinang
Pulau Pinang
Pulau Pinang
Perak
Perak
Perak
WP Kuala Lumpur
WP Kuala Lumpur
WP Kuala Lumpur
Negeri Sembilan
Negeri Sembilan
Negeri Sembilan
Melaka
Melaka
Melaka
Johor
Johor
Johor
Pahang
Pahang
Pahang
Terengganu
Terengganu
Terengganu
Kelantan
Kelantan
Kelantan
Sabah & WP Labuan
Sabah & WP Labuan
Sabah & WP Labuan
Sarawak
Sarawak
Sarawak
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
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
Public
Private
Total
No.
34
3
37
0
na
0
0
0
0
0
0
0
1
0
1
2
0
2
9
1
10
12
2
14
21
3
24
5
0
5
0
0
0
3
0
3
0
0
0
0
0
0
1
0
1
1
0
1
0
0
0
0.01
na
0.00
0.00
0.00
0.01
0.01
0.02
0.08
0.03
0.05
0.00
0.01
0.00
0.00
0.01
0.00
0.00
159
Otorhinolaryngologists
Per 10,000
No.
Population
153
141
294
0.10
4
na
na
4
0.17
9
6
15
0.08
13
6
19
0.09
4
18
22
0.14
12
10
22
0.09
28
40
68
0.12
33
29
62
0.37
61
69
130
0.18
4
5
9
0.09
4
9
13
0.16
12
11
23
0.07
10
4
14
0.09
5
0
5
0.05
15
2
17
0.11
7
2
9
0.03
6
5
11
0.04
Table A7.7 Number and Density of Rehabilitation Medicine Specialists and Otorhinolaryngologists in Malaysia by State
and Sector, 2011
Better use of statistics for better policies & health outcomes
www.crc.gov.my
NATIONAL CLINICAL RESEARCH CENTRE
MINISTRY OF HEALTH MALAYSIA
3RD FLOOR, 124, JALAN PAHANG, MMA HOUSE, 53000 KUALA LUMPUR.
TEL:03-40439300 , FAX:03-40439500

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