4 research outputs found
Healthcare Service Quality Gaps During Covid-19 Pandemic: Secondary Analysis From Patient Satisfaction Surveys
No full textService quality is one of the leading performance dimensions for organisational efficieny.
In the healthcare industry, service quality is a major determinant for patient satisfaction.
Maintaining patient satisfaction is critical to achieving excellent clinical outcomes in any
patients. The COVID-19 pandemic, has disrupted the healthcare system and impacted the
healthcare service quality delivery. This study investigated the healthcare service quality
during the pandemic, by performing secondary analysis on readily available SERVQUAL
datasets obtained during the pandemic through routine patient satisfaction surveys, in a
tertiary healthcare centre that manages severe COVID-19 cases. This study discovered
that significant service quality gaps existed in all quality dimensions at the inpatient
setting during the pandemic, with Tangible service quality being the most negatively
impacted. During the pandemic, hospitalised patients also significantly expected for
Assurance and Outcome service quality dimensions. When IPA approach was applied to
the datasets, service quality items from the Tangible, Reliability, and Responsiveness
dimensions were identified as the priority areas for quality improvement during a
pandemic. This research could help healthcare managers effectively direct their resources
when launching quality improvement intervention. Finally, with these findings,
sustainable healthcare system that can withstand difficult and challenging crises can be
properly planned to maintain satisfactory service quality in the Malaysian hospitals
Survival of patients with advanced and recurrent ovarian cancer treated using integrative medicine in Malaysia: A case series
No full textBackground This case series describes the survival outcomes of patients who underwent integrative medicine (IM) protocol for ovarian cancer, a treatment protocol, that integrated a carefully selected set of complementary and alternative medicine (CAM) into the conventional treatment for ovarian cancers.
Materials and methods Retrospective review of patients' medical records was conducted at a private medical centre that delivered the IM protocol for patients with advanced and recurrent ovarian cancers. We explored and analysed the overall survival and disease progressions of those who received the IM treatment for at least 2 months.
Results Forty patients with advanced ovarian cancers fulfilled the inclusion criteria for this case series. An overall of 75% of the cases achieved remission with initial IM treatment, 17.5% had a partial response and 7.5% showed progressive disease. The overall 5-year survival for all 40 cases is 53.1%. When explored further, the 5-year survival for cases who received CAM only is 75%, and cases who received combined limited chemotherapy with CAM had a 5-year survival of 55%. At study endpoint, 11 cases died due to ovarian cancer.
Conclusion These findings suggest that CAM may be a valuable addition to conventional therapy to treat and improve the survival of patients with ovarian cancers. A formal randomized control trial is required to evaluate the efficacy and long-term outcomes of using IM to treat advanced and recurrent ovarian cancers.
[Disclaimer: Abstract text might vary slightly from what is displayed in the e-poster]This poster was submitted to the 14th National Conference for Clinical Research (NCCR) in August 18-20, 2021. https://nccrconference.com.my
Feasibility of case-control and test-negative designs to evaluate dengue vaccine effectiveness in Malaysia
No full textBackground: The world's first dengue vaccine [Dengvaxia; Sanofi Pasteur] was licensed in 2015 and others are in development. Real-world evaluations of dengue vaccines will therefore soon be needed. We assessed feasibility of case control (CC) and test-negative (TN) design studies for dengue vaccine effectiveness by measuring associations between socio-demographic risk factors, and hospitalized dengue outcomes, in Malaysia. Methods: Following ethical approval, we conducted hospital-based dengue surveillance for one year in three referral hospitals. Suspected cases aged 9–25 years underwent dengue virological confirmation by RT-PCR and/or NS1 Ag ELISA at a central laboratory. Two age- and geography-matched hospitalized non-dengue case-controls were recruited for a traditional CC study. Suspected cases testing negative were test-negative controls. Socio-demographic, risk factor and routine laboratory data were collected. Logistic regression models were used to estimate associations between confirmed dengue and risk factors. Results: We recruited 327 subjects; 155 were suspected of dengue. The planned sample size was not met. 124 (80%) of suspected cases were dengue-confirmed; seven were assessed as severe. Three had missing RT-PCR results; the study recruited 28 test-negative controls. Only 172 matched controls could be recruited; 90 cases were matched with ≥1 controls. Characteristics of cases and controls were mostly similar. By CC design, two variables were significant risk factors for hospitalized dengue: recent household dengue contact (OR: 54, 95% CI: 7.3–397) and recent neighbourhood insecticidal fogging (OR: 2.1; 95% CI: 1.3–3.6). In the TN design, no risk factors were identified. In comparison with gold-standard diagnostics, routine tests performed poorly. Conclusions: The CC design may be more appropriate than the TN design for hospitalized dengue vaccine effectiveness studies. Selection bias in case control selection could be minimized by protocol changes more easily than increasing TN design control numbers, because early-stage dengue diagnosis in endemic countries is highly specific. MREC study approval: (39)KKM/NIHSEC/P16-1334.published_or_final_versio
