Ab Rahman Norazida, Sivasampu Sheamini, Mohamad Noh Kamaliah, Khoo Ee Ming
Healthcare Statistics Unit, Clinical Research Centre, Ministry of Health, Kuala Lumpur, Malaysia.
Family Health Development Division, Ministry of Health, Putrajaya, Malaysia.
BMC Health Serv Res. 2016 Jun 14;16:197. doi: 10.1186/s12913-016-1444-0.
The world population has become more globalised with increasing number of people residing in another country for work or other reasons. Little is known about the health profiles of foreign population in Malaysia. The aim of this study was to provide a detailed description of the health problems presented by foreigners attending primary care clinics in Malaysia.
Data were derived from the 2012 National Medical Care Survey (NMCS), a cross sectional survey of primary care encounters from public and private primary care clinics sampled from five regions in Malaysia. Patients with foreign nationality were identified and analysed for demographic profiles, reasons for encounter (RFEs), diagnosis, and provision of care.
Foreigners accounted for 7.7 % (10,830) of all patient encounters from NMCS. Most encounters were from private clinics (90.2 %). Median age was 28 years (IQR: 24.0, 34.8) and 69.9 % were male. Most visits to the primary care clinics were for symptom-based complaints (69.5 %), followed by procedures (23.0 %) and follow-up visit (7.4 %). The commonest diagnosis in public clinics was antenatal care (21.8 %), followed by high risk pregnancies (7.5 %) and upper respiratory tract infection (URTI) (6.8 %). Private clinics had more cases for general medical examination (13.5 %), URTI (13.1 %) and fever (3.9 %). Medications were prescribed to 76.5 % of these encounters.
More foreigners were seeking primary medical care from private clinics and the encounters were for general medical examinations and acute minor ailments. Those who sought care from public clinics were for obstetric problems and chronic diseases. Medications were prescribed to two-thirds of the encounters while other interventions: laboratory investigations, medical procedures and follow-up appointment had lower rates in private clinics. Foreigners are generally of young working group and are expected to have mandatory medical checks. The preponderance of obstetrics seen in public clinics suggests a need for improved access to maternal care and pregnancy related care. This has implication on policy and health care provision and access for foreigners and future studies are needed to look into strategies to solve these problems.
随着越来越多的人因工作或其他原因居住在另一个国家,全球人口变得更加全球化。对于马来西亚外国人口的健康状况知之甚少。本研究的目的是详细描述在马来西亚基层医疗诊所就诊的外国人所呈现的健康问题。
数据来自2012年全国医疗保健调查(NMCS),这是一项对从马来西亚五个地区抽取的公立和私立基层医疗诊所的基层医疗就诊情况进行的横断面调查。确定具有外国国籍的患者,并分析其人口统计学特征、就诊原因(RFEs)、诊断和医疗服务提供情况。
在NMCS的所有患者就诊中,外国人占7.7%(10,830例)。大多数就诊来自私立诊所(90.2%)。中位年龄为28岁(四分位间距:24.0,34.8),69.9%为男性。大多数到基层医疗诊所就诊是基于症状的主诉(69.5%),其次是医疗程序(23.0%)和随访就诊(7.4%)。公立诊所最常见的诊断是产前检查(21.8%),其次是高危妊娠(7.5%)和上呼吸道感染(URTI)(6.8%)。私立诊所一般医疗检查(13.5%)、URTI(13.1%)和发热(3.9%)的病例更多。这些就诊中有76.5%开了药。
越来越多的外国人在私立诊所寻求基层医疗服务,就诊原因是一般医疗检查和急性小病。在公立诊所就诊的人是因为产科问题和慢性病。三分之二的就诊开了药,而其他干预措施:实验室检查、医疗程序和随访预约在私立诊所的比例较低。外国人一般属于年轻工作群体,预计需要进行强制性体检。公立诊所产科就诊占优势表明需要改善孕产妇保健和与妊娠相关保健的可及性。这对政策和外国人的医疗保健提供及可及性有影响,需要未来的研究来探讨解决这些问题的策略。