CHARACTERISTICS OF THE DOCTORS

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CHAPTER 5: THE PATIENTS

This chapter reports the socio-demographic characteristics of the patient encounters. Mode of payment IRUSULPDU\FDUHVHUYLFHVLVVXDQFHRIPHGLFDOFHUWLÀFDWHDQGGXUDWLRQRIVLFNOHDYHJLYHQDWSULPDU\FDUH visits are also discussed in this chapter.

5.1 AGE-GENDER DISTRIBUTION OF PATIENTS

The overall distribution of patients at the point of encounter by age and gender was presented in Figure 5.1. ‡ 2YHUDOOIHPDOHVDFFRXQWHGIRURIHQFRXQWHUV ‡ 7KHSHUFHQWDJHRISDWLHQWYLVLWVLQFUHDVHGZLWKDJHIURPEHORZ\HDUROGVSHDNHGDWDJHVRI years and declined as the age increased. ‡ 7KHODUJHVWGLIIHUHQFHLQWKHSURSRUWLRQRISDWLHQWVE\JHQGHULVREVHUYHGDPRQJWKRVHDJHG \HDUV IHPDOH YHUVXV PDOH 7KLV REVHUYHG GLIIHUHQFH OLNHO\ UHÁHFWV WKH KLJKHU numbers of antenatal visits within this female reproductive age group and the greater likelihood of delay in seeking help during illness among the males. 1 Figure 5.1: Age-gender distribution of patients in primary care clinics in 2012

5.2 PATIENT SOCIO-DEMOGRAPHIC CHARACTERISTICS

Table 5.1 shows the socio-demographic characteristics of the patients. ‡ 7KHSULYDWHFOLQLFVVHHDODUJHUVKDUHRISDWLHQWHQFRXQWHUV ‡ 0RVWSDWLHQWVZHUHHLWKHU0DOD\VLDQVRUSHUPDQHQWUHVLGHQWVRI0DOD\VLD7KHSURSRUWLRQRI encounters by non-Malaysians 7.8 corresponds to the reported 8.2 of non-citizens from the total general population. 2 ‡ 0DMRULW\RISDWLHQWVSUHVHQWLQJWRSULPDU\FDUHFOLQLFVZHUH0DOD\V7KHGLVWULEXWLRQRI ethnicity reported for NMCS 2012 were similar to general population data as reported by the Department of Statistics Malaysia. 2 ‡ 1HDUO\RIWKHSDWLHQWVZKRYLVLWHGSULPDU\FDUHZHUH\HDUVDQGROGHU7KHHOGHUO\• years currently make up 5.3 of the Malaysian population and this number is projected to reach 7.3 by 2021. 3 Thus, the proportion of attendances by patients of this age group and complexity of morbidities in primary care is anticipated to increase as the population ages. Male Percent Age Group years Female 1 1-4 5-19 20-39 40-59 60 1.9 30 25 20 15 10 5 3.0 5.0 16.9 12.7 5.1 1.7 3.0 4.5 26.1 13.3 6.6 Note: Missing data removed ✁ ✂ ✄ ☎ ✁ ✆ ✝ ✞ ✟ ✄ ✠ ✁ ✆ ✠ ✁ ✡ ✞ ☛ ✂ ✁ ✂ ✄ ☛ ✂ ✄ ✠ ☛ ☞ ✌ ✍ ☞ ✢ ✪ Table 5.1: Characteristics of patient encounters in primary care clinics in 2012 Patient Characteristics Number Percentage 95 CI LCL UCL Gender a 137,604 Male 61,702 44.8 44.6 45.1 Female 75,902 55.2 54.8 55.6 Missing n = 3,989 Age group year a 140,145 1 5,115 3.7 3.6 3.8 1-4 8,587 6.1 6.0 6.3 5-19 13,530 9.7 9.5 9.8 20-39 60,671 43.3 43.0 43.6 40-59 36,130 25.8 25.6 26.0 • 16,111 11.5 11.3 11.7 Missing n = 1,448 Nationality a 138,686 Malaysian + permanent resident 127,855 92.2 92.0 92.3 Foreigner 10,830 7.8 7.7 8.0 Missing n = 2,907 Type of primary care clinic 141,593 Public 42,340 29.9 29.7 30.1 Private 99,253 70.1 69.9 70.3 Ethnicity a 129,607 Malay 82,353 63.5 63.3 63.8 Chinese 25,188 19.4 19.2 19.7 Indian 14,805 11.4 11.3 11.6 Others b 7,260 5.6 5.5 5.7 Missing n = 11,986 Seen at clinic in the last 2 years a 124,562 Yes 90,891 73.0 72.7 73.2 No 33,671 27.0 26.8 27.3 Missing n = 17,031 a Missing data were excluded from analysis b Include all ethnic groups that do not fall in to the 3 groups listed ✁ ✂ ✄ ☎ ✁ ✆ ✝ ✞ ✟ ✄ ✠ ✁ ✆ ✠ ✁ ✡ ✞ ☛ ✂ ✁ ✂ ✄ ☛ ✂ ✄ ✠ ☛ ☞ ✌ ✍ ☞ ✣ ✧

5.3 MODE OF PAYMENT

Figure 5.2 describes the mode of payment for encounters in primary care clinics. ‡ 7KLUW\WZRSHUFHQWRISDWLHQWHQFRXQWHUVZHUHVXEVLGLVHGE\WKHJRYHUQPHQWUHÁHFWLQJWKHSURSRUWLRQ of visits to public clinics. ‡ PRQJYLVLWVWRSULYDWHFOLQLFVRIHQFRXQWHUVZHUHRXWRISRFNHWSD\PHQWZKLOHRIWKHP were either fully or partially paid by third party payers. Third party payer payments include those by private insurance, employer and managed care organisations. ‡ 7KHUHZHUHIHZFDVHVZKHUHE\SD\PHQWZDVPDGHWKURXJKFRPELQDWLRQRIRXWRISRFNHWDQGWKLUG party payers. ‡ VPDOOSURSRUWLRQRIYLVLWVWRSULPDU\FDUHFOLQLFVZHUHQRWFKDUJHGDQ\IHH Figure 5.2: Mode of payment in primary care clinics in 2012

5.4 MEDICAL CERTIFICATE AND DURATION OF SICK LEAVE

WRWDO SDWLHQWV ZHUH LVVXHG PHGLFDO FHUWLÀFDWHV ZKHQ YLVLWLQJ SULPDU\ FDUH FOLQLFV LJXUHRPSDULVRQE\VHFWRUVUHYHDOHGWKDWPHGLFDOFHUWLÀFDWHVZHUHJLYHQWRRISDWLHQWV visiting public clinics and 34.9 of patients at private clinics. The number of days of sick leave that were documented ranged from half day to 21 days Table 5.2. Ra te pe r 1 e nc o unt e rs 36.4

31.8 31.5

0.2 0.2 40 35 30 25 20 15 10 5 Out - of -pocket Out - of -pocket + Third party prayer Government subsidy Third party prayer No payment ✁ ✂ ✄ ☎ ✁ ✆ ✝ ✞ ✟ ✄ ✠ ✁ ✆ ✠ ✁ ✡ ✞ ☛ ✂ ✁ ✂ ✄ ☛ ✂ ✄ ✠ ☛ ☞ ✌ ✍ ☞ ✣ ✜ LJXUH3HUFHQWDJHRISULPDU\FDUHHQFRXQWHUVLVVXHGPHGLFDOFHUWLÀFDWHLQ Table 5.2: Duration of sick leave issued in primary care clinics in 2012 Duration of sick leave day Number Rate per 100 encounters 95 CI LCL UCL 0.5 - 1 27,844 83.0 82.6 83.4 1.5 - 2 5,045 15.0 14.7 15.4 3 - 7 637 1.9 1.8 2.1 7 21 0.1 0.0 0.1 Subtotal a 33,547 100.0 100.0 100.0 D7RWDOHQFRXQWHUVZLWKGHWDLOVRQWKHGXUDWLRQRIVLFNOHDYHIRUZKLFKDPHGLFDOFHUWLÀFDWHZDVLVVXHG REFERENCES 1. Galdas PM, Cheater F, Marshall P. Men and health help-seeking behaviour: literature review. J Adv Nurs. 2005;496:616-23. 2. Department of Statistics, Malaysia. Population distribution and basic demographic characteristics 2010. [Viewed January 2014]. Available from: http:www.statistics.gov.myportaldownload_ 3RSXODWLRQÀOHVFHQVXV7DEXUDQB3HQGXGXNBGDQBLULFLULBVDVBHPRJUDÀSGI 3. Department of Statistics, Malaysia. Population projections 2010-2040. Nov 2012. [Viewed January YDLODEOH IURP KWWSZZZVWDWLVWLFVJRYP\SRUWDOGRZQORDGB3RSXODWLRQÀOHVSRSXODWLRQB projectionsPopulation_Projection_2010-2040.pdf Yes No 28.7 71.3 Chapter 6 Reasons For Encounter