Article Text

Original research
Comparison between primary care service delivery in Malaysia and other participating countries of the QUALICOPC project: a cross-sectional study
  1. Ming Tsuey Lim1,
  2. Su Miin Ong1,
  3. Seng Fah Tong2,
  4. Peter Groenewegen3,4,
  5. Sheamini Sivasampu1
  1. 1Centre for Clinical Outcome Research, Institute for Clinical Research, Shah Alam, Selangor, Malaysia
  2. 2Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Kuala Lumpur, Malaysia
  3. 3Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
  4. 4Departments of Human Geography and Department of Sociology, Utrecht University, Utrecht, The Netherlands
  1. Correspondence to Mr Su Miin Ong; ongsm{at}crc.gov.my

Abstract

Objectives Most countries including Malaysia have set goals to incorporate a strong primary care into the healthcare system. The aim of this study was to evaluate the strength of service delivery process dimensions in Malaysia and compare it with England, the Netherlands, Spain, North Macedonia, Romania and Turkey which participated in the Quality and Costs of Primary Care (QUALICOPC) study.

Methods This cross-sectional study utilised the QUALICOPC study data on primary care performance, which was conducted in 2011–2013 (QUALICOPC in Europe Australia, New Zealand and Canada) and 2015–2016 (Malaysia). A standardised questionnaire was completed by primary care practitioners from participating countries. Multilevel regression analysis and composite scores were constructed to compare the performance of primary care on four process dimensions: accessibility, comprehensiveness, continuity of care and coordination.

Results The high-income countries with strong primary care performed better in comprehensiveness, continuity and coordination but poorer in accessibility to services compared with upper-middle-income countries. Among the upper-middle-income countries, Malaysia scored the best in comprehensiveness and coordination. None of the studied countries were having consistent performance over all indicators either in their respective best or worst primary care services delivery dimensions.

Conclusions There is a wide variation in primary care services delivery across and within the studied countries. The findings indicate room for quality improvement activities to strengthen primary healthcare services. This includes addressing current healthcare challenges in response to the population health needs which are essential for more integrated and efficient primary care services delivery.

  • primary care
  • quality in health care
  • health services administration & management

Data availability statement

Data are available on reasonable request. The deidentified data are available on reasonable request to protect the confidentiality and privacy of the participants. Request can be made to the corresponding author (ORCID ID: 0000-0002-5430-5040) and coauthor Peter Groenewegen (ORCID ID: 0000-0003-2127-8442) for Malaysian and European data, respectively. Approval of request is subject to the data sharing policy of the organisations.

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Data availability statement

Data are available on reasonable request. The deidentified data are available on reasonable request to protect the confidentiality and privacy of the participants. Request can be made to the corresponding author (ORCID ID: 0000-0002-5430-5040) and coauthor Peter Groenewegen (ORCID ID: 0000-0003-2127-8442) for Malaysian and European data, respectively. Approval of request is subject to the data sharing policy of the organisations.

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Footnotes

  • MTL and SMO contributed equally.

  • Contributors MTL: conceptualisation, methodology, formal analysis, writing-original draft, writing-review and editing. SMO: conceptualisation, methodology, formal analysis, visualisation, writing-review and editing. SFT: conceptualisation, methodology, formal analysis, writing-review and editing. PG: conceptualisation, methodology, formal analysis, writing- review and editing, lead partner of European QUALICOPC. SS: conceptualisation, methodology, writing-review and editing, principal investigator, project manager, funding acquisition.

  • Funding QUALICOPC Malaysia was supported by a grant from Ministry of Health Malaysia under the Malaysian Health System Research Initiative (MHSR). The QUALICOPC (Quality and Costs of Primary Care in Europe) project was cofunded by the European Commission under the Seventh Framework Programme (FP7/2007-2013) under grant agreement 242 141. Opinions, results and conclusions reported in this manuscript are those of the authors and are independent from the funding source.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.