Today the Ministry of Health Malaysia launched the Standard Operating Procedure Daycare Surgery and the Polisi Perkhidmatan Rawatan Harian di Hospital-hospital Kementerian Kesihatan Malaysia, in conjunction with the 4th National Daycare Conference 2016 at Selayang Hospital. The concept of Daycare Services implies that the patients come into the hospital to undergo diagnostic or therapeutic procedure and go home on the same day.
As people live longer, chronic diseases increases, and the frequency of patients visit to hospital increases. Therefore the ability for the physician to manage clinical conditions play an increasing role in the development of Daycare service. Over the last two Malaysia Plans, the Ministry of Health has built dedicated “Ambulatory Care Centres” (ACC) for this purpose at some of our state and major specialist hospitals. At present the Ministry of Health have 9 such purpose built ACCs consisting of multi- disciplinary units and over 130 public hospitals providing Daycare services.
The objectives of Daycare services are:
- To allow the patient to return home on the day of surgery with minimal disruption to daily life
- For elderly person, avoiding the disorientation and decreased functionality associated with hospital admission
- Decrease costs associated with inpatient hospital stay
- Reduce surgical waiting time for patients
- Avoiding risk of nosocomial infections
- To encourage increase utilisation of daycare services for paediatric group of patients, because it provides minimal separation from parentsand minimal exposure to hospital environment
- To reduce inpatient admission
The benefits from Day Care Surgery was evident in reducing surgical waiting time to 2–10 weeks for selected elective procedures and the reduction of inpatient admission to the surgical based departments by 28.2%. The Daycare service centres in the United States has managed to reduce the cost of Medicare by USD7.5 billion from the year 2008 to 2011. Unsurprising, the Daycare surgery rates in advanced countries are as high as 70-80%. However, at the moment in Malaysia it is only around 5-15%. As we move towards achieving developed country status, the Ministry of Health is serious about promoting Daycare as it has been proven to be cost effective, patient-centred approach and safe.
Daycare services has now come to be an accepted modality of treatment for most surgical patients and it has multiple advantages to patients. However, there are strict criteria for patient selection to ensure patient safety and quality of care is maintained. Among common patient selection criteria for Daycare services are:
- Patient must be willing to undergo treatment or procedure at Daycare
- Patient must be able to understand and cooperate with instruction at the Daycare service
- Patient must reside within one hour away from the Day Care facility, has suitable transportation means and accompanied by a responsible family member or carer.
Standard Operating Procedure (SOP) of Day Care Surgery is the first of its kind in Malaysia. This SOP will be benificial to the surgeons and other medical staffs as a guideline in selecting suitable procedure for Day Care surgery. This will ensure patient safety and the patient can be discharged on the same day safely.
Traditionally the patient that would be suitable to undergo procedure as day case would need to be admitted one day prior to it. In the advancement of technology, availibility of expert health professionals and state-of-the- art facilities available in MOH ACC buildings, the patient would have the benefit of coming to the hospital on the same day and discharge home later that day. Therefore the Ministry of Health encourages the implementation of “True Day Care Surgery” as this service reflects the use of the Daycare facilities in full.
Public are encouraged to enquire about the Daycare service to their attending physician or surgeon when they need to undergo such procedures at MOH hospitals. Afterall it is the MOH vision to empower the public with information and knowledge on health to advance the health status of the country.
Datuk Dr Noor Hisham Abdullah
Director-General of Health Malaysia
5th August 2016