Transcript Sistem Kesihatan di Malaysia

PERSIDANGAN PROMOSI KESIHATAN KEBANGSAAN 2011
10 – 11 OKTOBER 2011
Hasmuny Bt Osmat
Pegawai Pendidikan Kesihatan
Unit Perancangan Dasar Dan Pelan Kesihatan
Bahagian Perancangan Dan Pembangunan
Kementerian Kesihatan Malaysia
Kenapa perlu
transformasi?
1Care for
1Malaysia ?
Apakah bentuk
transformasi
BEBAN
PENYAKIT
KEMAJUAN
TEKNOLOGI
MAKLUMAT
DAN
PERALATAN
ISU &
INTEGRASI
SISTEM
KESIHATAN
CABARAN
TENAGA
KERJA
KUALITI
KESIHATAN
PEMBIAYAAN
KESIHATAN
5
Sistem Kesihatan di Malaysia
6
Public & Private Sector Resources &
Workload (2008)
11%
Health clinics (with doctors)
802
6371
38%
Outpatient visits (m)
38.4
62.65
143
209
41%
No. of Hospitals
78%
Hospital Beds
11689
41249
74%
2199310
Admissions
754378
55%
12081
Doctors (excl. Houseman)
10006
45%
13.54
Health Expenditure (RM billion) (2007)
Public
Private
0%
20%
16.68
40%
60%
80%
100%
10
Source: Health Informatics Center (HIC),MOH
7
Changing Demographic Trends
- Increasing Elderly Population (>60 yrs)
2500
8.0%
2000
6.0%
5.0%
1500
4.0%
1000
3.0%
2.0%
500
Elderly (% of Population)
Elderly Population ('000)
7.0%
1.0%
0
0.0%
91
92
93
94
95
96
97
98
99
00
01
02
03
04
05
06
07
08
Year
Source : Department of Statistics
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Disease Burden
Malaysia experiencing changing pattern of
diseases
Disease Burden Study (2004)
Leading burden of disease
•Ischaemic heart disease
•Mental illness,
•Cerebrovascular disease
•Road traffic injuries
•Cancers
•Asthma & COPD
•Diabetes mellitus
Diseases that still pose threat to
country
•TB
• Dengue & DHF
• Malaria
• HIV/AIDS
• Viral hepatitis
• Emerging Diseases
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Matlamat Gagasan Transformasi
1Care
1Care adalah menyusun semula
sistem kesihatan kebangsaan yang
responsif & menyediakan pilihan
penjagaan kesihatan yang
berkualiti, memastikan
perlindungan sejagat untuk
keperluan penjagaan kesihatan
penduduk yang berdasarkan
perpaduan & ekuiti
Reduce
Brain Drain
Enhance
Client
Satisfaction
Safety Net
Universal
Coverage
(Depth &
Spread)
Integrated
Affordable
1Care
targets
Better
Health
Outcomes
Sustainable
Equitable
High
Quality
Efficient
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• Sistem Penyampaian Kesihatan
• Tadbir urus Perkhidmatan Kesihatan
• Sistem Pembiayaan Kesihatan
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PENYAMPAIAN PERKHIDMATAN KESIHATAN
& PERGERAKAN PESAKIT
KKM
ORGANISASI PEMBIAYAAN KESIHATAN
KEBANGSAAN (NHFA)
PESAKIT
MHDS
PHCP
Perkhidmatan tambahan
(Wang saku atau insuran kesihatan swasta)
Rujukan
Hospital
SWASTA
KERAJAAN
Kerajaan Swasta
Terima
rawatan
Kerajaan
Kemasukan ke
hospital
Swasta
Rumah
Tadbirurus dan halatuju
dasar
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Transformasi tadbir urus
Badan berkanun
- Majlis Keselamatan Pesakit
-- Lembaga Promosi Kesihatan
-- Majlis Kesihatan pelancongan
Malaysia
-- Lain-lain
KESIHATAN
AWAM
-Kawalan
penyakit
PEMANTAUAN &
PENILAIAN
-HIC
- MNHA
- Pengawasan
- Kualiti air
- TCM
Badan profesional
-MMC
-MDC
-Lembaga Farmasi
-Lain-lain
KKM
PENGGUBALAN
DASAR
-Keselamatan
pesakit
- Perkhidmatanperkhidmatan
- Penyelidikan
- TCM
- Pembnagunan
Sumber manusia
- Biaya
- Infrastuktur dan
kelengkapan
-HTA
- Kualiti
- ICT
NHFA
PERATURAN &
PENGUATKUASAAN
Penguatkuasaan
Perundangan
PENYAMPAIAN
KESIHATAN AWAM
AUTONOMI
•Penjagaan kesihatan
primer
LATIHAN
PENYELIDIKAN
• Penjagaan
kesihatan hospital
•Perkhidmatan lain
PENYAMPAIAN
KESIHATAN
SWASTA
•Penjagaan
kesihatan primer
• Penjagaan
kesihatan hospital
•Perkhidmatan
lain
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Financing Arrangements
• Combination of financing mechanisms
– Social health insurance (SHI)
– General government revenue (GGR)
– minimal co-payments for a defined Benefits
Package
• Pooled as single fund to promote social
solidarity and unity as per 1Malaysia concept
• To be managed by NHFA – not for profit
government autonomous agency under
supervision of MOH
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STATUS
Proses penyediaan blueprint
2010-2012
2012 akan dibentang kepada Majlis
Tindakan Ekonomi yang
dipengerusikan oleh PM
TARIKH PELAKSANAAN?
Phases of Health Sector Transformation
Steady State – 1Care for 1Malaysia
1Care: Full reform funded through GGR & SHI
Phase 4
1Care: PHC reform funded through GGR
1Care: Public Facility autonomy funded through GGR
1Care: Strengthening of the current health system
Phase 3
Phase 2
Phase 1
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A journey of a thousand miles begins
with a single step. Lao-tzu
Chinese Philosopher
(604 BC - 531 BC)
Full
1Care
Status
Quo
Health System
Strengthening
Public
Sector
Autonomy
PHC
Reform
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