The growth of twin apply inside public hospitals has been a strategic response to the growing attrition of senior specialist physicians to the personal sector. This phenomenon, termed Full Paying Affected person (FPP) providers, was initiated by the Malaysian Ministry of Well being in 2007. The first purpose is to retain senior specialists by permitting them to generate supplementary revenue whereas additionally assuaging the federal government’s monetary burden of subsidizing healthcare for many who can afford to pay.
A analysis staff, supervised by Professor Sharifa Puteh from College Kebangsaan Malaysia, has developed a examine protocol to evaluate the impression of FPP inpatient providers on the monetary efficiency of chosen Malaysian hospitals. The examine is primarily carried out by PhD researcher Dr. Malindawati Fadzil, alongside contributions from Dr. Azimatun Aizuddin from College Kebangsaan Malaysia, Dr. Zafar Ahmed from Northumbria College, and Dr. Nor Muhamad and Dr. Abdul Harith from the Ministry of Well being of Malaysia. Their work, which goals to find out whether or not the revenues from FPP providers can cowl the prices and probably generate revenue, is revealed within the journal PLOS ONE.
The examine focuses on 4 hospitals: Serdang Hospital, Pulau Pinang Hospital, Sultanah Aminah Hospital, and Sarawak Coronary heart Centre. It analyzes information from current years, together with service quantity, income, and price to carry out a price quantity revenue (CVP) evaluation. This evaluation calculates the break-even level, which signifies the quantity of providers wanted to cowl prices with out producing a loss or revenue.
Professor Puteh defined the importance of the examine: “The effectiveness of FPP providers in recouping service supply prices and yielding a revenue continues to be unsure after a few years of implementation. This examine is designed to judge the impression of Full Paying Affected person inpatient providers quantity, income, and price on revenue versus loss at chosen hospitals.”
The researchers used a complete method to collect and analyze the mandatory information. They employed the Malaysian Prognosis-Associated Teams (MalaysianDRG) Casemix system, which helps classify ailments and calculate prices primarily based on precise medical information. This technique gives an in depth breakdown of the prices related to completely different medical circumstances and coverings, enabling a radical evaluation of the monetary facets of FPP providers.
To know the monetary viability of FPP providers, the researchers examined each mounted and variable prices. Mounted prices are people who stay fixed whatever the variety of sufferers handled, equivalent to salaries and utilities. Variable prices, then again, fluctuate with the quantity of providers offered, like medical provides and drugs. By distinguishing between these two varieties of prices, the staff may extra precisely assess the profitability of the providers.
One vital side of the examine is its deal with understanding how variations in service quantity, value, and pricing impression healthcare suppliers’ profitability. This data is essential for making knowledgeable choices to make sure the sustainability of FPP providers. The researchers additionally explored the developments in service volumes, revenues, and prices to establish patterns and potential areas for enchancment.
“The outcomes of this examine could not precisely mirror the profitability of FPP providers, and it could be essential to conduct additional analysis on this space,” famous Professor Puteh. The examine additionally examined the potential for cross-subsidization, the place revenues from personal affected person providers is perhaps used to help public healthcare providers.
In abstract, this complete analysis of FPP providers in Malaysian hospitals by Professor Puteh and her colleagues goals to find out whether or not these providers can obtain monetary sustainability. The findings will information policymakers and healthcare managers in making strategic choices to reinforce the effectiveness and effectivity of healthcare supply in Malaysia.
Journal Reference
Malindawati Mohd Fadzil, Sharifa Ezat Wan Puteh, Azimatun Noor Aizuddin, Zafar Ahmed, Nor Asiah Muhamad, Abdul Aziz Harith. “Price quantity revenue evaluation for full paying affected person providers in Malaysia: A examine protocol.” PLOS ONE (2023). DOI: https://doi.org/10.1371/journal.pone.0294623
Concerning the Authors
Prof. Dr. Sharifa Ezat Wan Puteh fundamental pursuits are within the areas of well being coverage, well being inequality and well being economics. She has been appointed as a casemix guide, coding specialist (with UNU-IIGH and ITCC UKM) to conduct analysis & capability constructing in Well being System in creating nation. She has sat on earlier posts, because the Deputy Dean, because the Honorary Fellow to Tun Fatimah Hashim Ladies’s Management Heart UKM and Chairman to Technical Advisory Committee for Well being Applied sciences, Financial Analysis (TACHTEE), MoH. She was appointed as a guide to the Ministry of Human Useful resource on Burden of Occupational Associated Illnesses; Grant reviewers with the Ministry of Schooling (MoE), session with MoE on the problem of vape use amongst college’s candidates, a panel auditor for native universities with SETARA Ministry of Schooling, the Ministry of Well being on Cluster Hospital effectivity examine and Prime Minister’s Division on Prevalence of Autism amongst youngsters in Malaysia. She is a reviewer of different journals, regionally and overseas and revealed papers regionally and overseas, commonly writes in newspapers, chapters, books and has appeared on the media for points relating the care of group, well being financing and Various nicotine merchandise. She is ardent advocate on hurt discount in Malaysia and is a part of the regional hurt discount consultants in Asia Pacific.
Dr. Malindawati Mohd Fadzil is a medical skilled with a background in each medical apply and healthcare administration. She obtained her medical diploma from Trinity Faculty of Dublin, Eire, and later pursued her Grasp of Science in Worldwide Well being Companies and Hospital Administration from London South Financial institution College, United Kingdom, in 2016. Her skilled pursuits embody a broad vary of matters, together with hospital and well being administration, well being planning and coverage, and well being financing. Transitioning from medical apply to healthcare administration, Dr. Malindawati assumed key management roles throughout the Ministry of Well being Malaysia (MOH). As a Senior Principal Assistant Director and subsequently as Principal Assistant Director on the Hospital Administration & Companies Unit, Medical Growth Division, from 2013 to 2019, she spearheaded quite a few initiatives aimed toward enhancing the standard and accessibility of specialist providers in public hospitals. Her strategic oversight was pivotal within the growth and implementation of the Specialty and Subspecialty Companies Growth plans and MOH hospitals’ infrastructure plans, which had been designed to enhance entry to specialist care and elevate the usual of healthcare providers obtainable to the inhabitants. DR. Malindawati was chargeable for overseeing the Full Paying Affected person (FPP) Companies in MOH hospitals, the place her management was instrumental in conducting cost-volume-profit analyses and formulating insurance policies and tips which have formed the FPP Companies framework. Moreover, she has a eager curiosity in Lean Healthcare and performed a vital function in introducing and implementing Lean methodologies in MOH’s pioneer enchancment initiatives. She can also be an alumna of the MOH Expertise Grooming Programme, a structured expertise growth programme for technical healthcare professionals within the MOH. Presently, Dr. Malindawati serves because the Deputy Director Medical II on the Nationwide Most cancers Institute of Malaysia underneath the Ministry of Well being Malaysia. On this function, she continues to use her intensive expertise and strategic perception to advance public well being initiatives and optimize healthcare supply throughout the nation. She just lately accomplished her PhD in Public Well being at Universiti Kebangsaan Malaysia, additional solidifying her dedication to advancing the sphere of public well being.
Affiliate Professor Dr. Azimatun Noor Aizuddin is a educated Medical Physician, earned Masters and PhD in Group Drugs. She is a Public Well being Advisor and at the moment the Head of Worldwide Centre for Casemix and Medical Coding, Hospital Canselor Tuanku Muhriz moreover as a Senior Lecturer at Division of Public Well being Drugs in College of Drugs, UKM. She can also be a former assistant editor of Worldwide Journal of Public Well being Analysis and reviewer of some journals regionally and internationally. She has revealed and introduced greater than 80 papers regionally and overseas in addition to a books’ chapter. As well as, she is a member of Technical Advisory Committee for Well being Applied sciences Financial Analysis; Technical Advisory Committee for Casemix; Technical Committee Members for ICD11 Implementation, Exterior Reviewer for Scientific Evaluate Board (SRB), Institute for Well being System Analysis, MOH; Honorary Secretary of the Well being Economics Affiliation Malaysia; EXCO and Life Member of the Malaysian Pharmacoeconomics and Consequence Analysis (MySPOR), Life Member of the Malaysian Public Well being Physicians Affiliation, and Honorary Treasurer of Malaysian One Well being Community College (MyOHUN), Professional-team Committee.
Dr. Zafar Ahmed is a medical physician, determined early in his skilled life to pursue a profession in public well being. After MBBS and coaching, Dr. Zafar accomplished his Grasp in Enterprise Administration, adopted by Grasp in Economics, and he completed his PhD in Public Well being concentrating on Well being Administration and Well being Economics from Nationwide College of Malaysia / United Nations College Worldwide Institute for World Well being (UNU IIGH), Kuala Lumpur Malaysia. He’s at the moment working as an Assistant Professor, on the Division of Social Work, Schooling and Group Wellbeing (SWECW), College of Well being and Life Sciences, Northumbria College, United Kingdom. Dr. Zafar has labored extensively for Well being Sector Reforms in Malaysia and different nations. In Well being Sector Reforms, he makes a speciality of Financial evaluation of well being methods, Healthcare Financing. He has labored with worldwide organizations equivalent to Asian Growth Financial institution (ADB), World Financial institution (WB), GTZ, AUSAID, and World Well being Group (WHO). Nations he has labored with embody Malaysia, Indonesia, Philippines, Mongolia, Vietnam, Lao PDR, Cambodia, Uruguay, Pakistan and United Kingdom. His analysis curiosity consists of Illness burden and financial burden of illness, financial analysis/evaluation of well being interventions, and illness and financial modeling. He has particular curiosity in Well being Informatics and Knowledge administration and evaluation. Dr. Zafar have intensive educating expertise and has been concerned in graduate stage educating inside and outdoors United Kingdom; this embody Northumbria College, UK, Universiti Kebangsaan Malaysia (UKM), College Malaysia Sarawak (UNIMAS), College Malaysia Sabah (UMS) and Universiti Teknologi Malaysia (UTM) in addition to in Aga Khan College, Karachi, Dow College of Well being Sciences, Karachi Pakistan and College Science and Know-how, Sanaa, Yemen. He’s additionally concerned commonly with varied ministries and worldwide organizations, for coaching & capability constructing and consultations. Majority of his publications and analysis papers are Financial Analysis in healthcare, Casemix implementation and Effectivity of Well being Care Methods.
