Variations in the delivery of primary diabetes care in Malaysia Lessons to be learnt and potential for improvement
Abstract Background The paper describes variations in the organisation of clinical services for diabetes patients in ten public primary health clinics in Malaysia with the view to learn from current innovations and improve diabetes service provision. Methods This study combined the use of secondary data and a qualitative multi-case study approach applying observations in ten randomly selected MOH health clinics in Kuala Lumpur and Selangor, and semi-structured interviews of the Family Medicine Specialists from the same clinics. Results Although there are specific Ministry of Health guidelines for diabetes care, some clinics had introduced innovations for diabetes care such as the novel ‘personalised care’, ‘one-stop-centre’ and utilisation of patients’ waiting time for health education. Analysis showed that there was room for improvement in terms of task shifting to free precious time of staff with specialised functions, streamlining appointments for various examinations, increasing continuity of consultations with same doctors and monitoring of performance. Conclusion We contend that there is a potential for increased effectiveness and efficiency of primary diabetes care in Malaysia without increasing the resources – a potential that may be tapped into by systematic learning from on-going innovation.