Saperi Sulong

Impact of routine PCV7 (Prevenar) vaccination of infants on the clinical and economic burden of pneumococcal disease in Malaysia

BackgroundPneumococcal disease is the leading cause of vaccine-preventable death in children younger than 5 years of age worldwide. The World Health Organization recommends pneumococcal conjugate vaccine as a priority for inclusion into national childhood immunization programmes. Pneumococcal vaccine has yet to be included as part of the national vaccination programme in Malaysia although it has been available in the country since 2005. This study sought to estimate the disease burden of pneumococcal disease in Malaysia and to assess the cost effectiveness of routine infant vaccination with PCV7.MethodsA decision model was adapted taking into consideration prevalence, disease burden, treatment costs and outcomes for pneumococcal disease severe enough to result in a hospital admission. Disease burden were estimated from the medical records of 6 hospitals. Where local data was unavailable, model inputs were obtained from international and regional studies and from focus group discussions. The model incorporated the effects of herd protection on the unvaccinated adult population.ResultsAt current vaccine prices, PCV7 vaccination of 90% of a hypothetical 550,000 birth cohort would incur costs of RM 439.6 million (US

Function and quality of life following stroke rehabilitation: have our stroke patients gained optimum recovery?

128 million). Over a 10 year time horizon, vaccination would reduce episodes of pneumococcal hospitalisation by 9,585 cases to 73,845 hospitalisations with cost savings of RM 37.5 million (US

Evaluation of introduction to UNU-Casemix grouper & IT in Casemix system workshop for health staff in Indonesia

10.9 million) to the health system with 11,422.5 life years saved at a cost effectiveness ratio of RM 35,196 (US

Exploring views on long term rehabilitation for people with stroke in a developing country: findings from focus group discussions

10,261) per life year gained.ConclusionsPCV7 vaccination of infants is expected to be cost-effective for Malaysia with an incremental cost per life year gained of RM 35,196 (US

Factors influencing willingness to pay for healthcare

10,261). This is well below the WHOs threshold for cost effectiveness of public health interventions in Malaysia of RM 71,761 (US

Cost analysis of colorectal cancer (CRC) management in UKM Medical Centre using clinical pathway

20,922).

The UNU-CBGs: development and deployment of a real international open source Casemix grouper for resource challenged countries

Materials and methods This was a cross-sectional study of 91 stroke patients; mean age 58.9±10.6 years, 79% male, median stroke duration 13 months who have completed intensive individual rehabilitation at the Universiti Kebangsaan Malaysia Medical Centre in the years 2010 and 2011. Rehabilitation outcome was measured with the use of standardised tools; Rivermead Mobility Scale (RMI), Berg’s Balance Scale (BBS), Sit to Stand Test (STS) for lower limb strength and Timed 10 metre walk test for walking speed. Post-rehabilitation disability level and quality of life were also assessed on a Modified Rankin Scale (mRS) and Euro-Qol 5 Dimensions-Visual analogue Scale (EQ5D-VAS), respectively. All data were analysed descriptively using SPSS version 18.

Asthma treatment adherence among asthmatic patients in Yazd

Implementation of Casemix system needs a well-organized and computerized system with well-trained and oriented staff, otherwise the system will fail. Improving knowledge and understanding of the funding system among staff and managers in hospitals and health systems can provide the groundwork for service improvements. The aim of this study was to evaluate the effectiveness of Introduction to UNU-Casemix Grouper & IT in Casemix System workshop which was conducted in Indonesia.

National Drug Formulary review of statin therapeutic group using the multiattribute scoring tool

BackgroundThe importance of long term rehabilitation for people with stroke is increasingly evident, yet it is not known whether such services can be materialised in countries with limited community resources. In this study, we explored the perception of rehabilitation professionals and people with stroke towards long term stroke rehabilitation services and potential approaches to enable provision of these services. Views from providers and users are important in ensuring whatever strategies developed for long term stroke rehabilitations are feasible and acceptable.MethodsFocus group discussions were conducted involving 15 rehabilitation professionals and eight long term stroke survivors. All recorded conversations were transcribed verbatim and analysed using the principles of qualitative research.ResultsBoth groups agreed that people with stroke may benefit from more rehabilitation compared to the amount of rehabilitation services presently provided. Views regarding the unavailability of long term rehabilitation services due to multi-factorial barriers were recognised. The groups also highlighted the urgent need for the establishment of community-based stroke rehabilitation centres. Family-assisted home therapy was viewed as a potential approach to continued rehabilitation for long term stroke survivors, given careful planning to overcome several family-related issues.ConclusionsBarriers to the provision of long term stroke rehabilitation services are multi-factorial. Establishment of community-based stroke rehabilitation centres and training family members to conduct home-based therapy are two potential strategies to enable the continuation of rehabilitation for long term stroke survivors.

Economic Impact of Pneumococcal Protein-D Conjugate Vaccine (PHiD-CV) on the Malaysian National Immunization Programme

Background Health financing is a sensitive issue that is currently being discussed around the world. Main concerns related to this are quality of health services and increasing healthcare cost. The most important features of health services that must be preserved are its equitability, affordability and quality. In many developing countries people are expected to contribute to the cost of healthcare from their own resources. The objective of this review is to identify the factors that influence willingness to pay for healthcare.