Analysis of costs and utilization of ambulance services in the ministry of health facilities, Malaysia.

<h4>Background</h4>Despite emergency ambulance services playing a pivotal role in accessibility to life-saving treatments in Malaysia, there are still numerous gaps in knowledge in terms of their utilization and cost. This leads to current policies on procurement, maintenance, and alloca...

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Main Authors: Mohd Shahri Bahari, Farhana Aminuddin, Sivaraj Raman, Ainul Nadziha Mohd Hanafiah, Mohd Shaiful Jefri Mohd Nor Sham Kunusagaran, Nur Amalina Zaimi, Nor Zam Azihan Mohd Hassan, Ahmad Tajuddin Mohamad Nor
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0276632
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author Mohd Shahri Bahari
Farhana Aminuddin
Sivaraj Raman
Ainul Nadziha Mohd Hanafiah
Mohd Shaiful Jefri Mohd Nor Sham Kunusagaran
Nur Amalina Zaimi
Nor Zam Azihan Mohd Hassan
Ahmad Tajuddin Mohamad Nor
author_facet Mohd Shahri Bahari
Farhana Aminuddin
Sivaraj Raman
Ainul Nadziha Mohd Hanafiah
Mohd Shaiful Jefri Mohd Nor Sham Kunusagaran
Nur Amalina Zaimi
Nor Zam Azihan Mohd Hassan
Ahmad Tajuddin Mohamad Nor
author_sort Mohd Shahri Bahari
collection DOAJ
description <h4>Background</h4>Despite emergency ambulance services playing a pivotal role in accessibility to life-saving treatments in Malaysia, there are still numerous gaps in knowledge in terms of their utilization and cost. This leads to current policies on procurement, maintenance, and allocation being predicated on historical evidence and expert opinions. This study thus aims to analyse the cost and utilization of ambulance services in selected public health facilities in Malaysia.<h4>Methods</h4>A cross-sectional study was employed involving 239 ambulances from selected hospitals and clinics. Ambulance service utilization was based on the number of trips, distance and duration of travel obtained from travel logbooks. A mixed top-down and activity-based costing approach was used to estimate the monthly cost of ambulance services. This constituted personnel, maintenance, fuel, overhead, consumables, ambulance, and medical equipment costs. The utilization and costs of ambulance services were further compared between settings and geographical locations.<h4>Results</h4>The average total cost of ambulance services was MYR 11,410.44 (US$ 2,756.14) for hospitals and MYR 9,574.39 (US$ 2,312.65) for clinics, albeit not significantly different. Personnel cost was found to be the main contributor to the total cost, at around 44% and 42% in hospitals and clinics, respectively. There was however a significant difference in the total cost in terms of the type and age of ambulances, in addition to their location. In terms of service utilization, the median number of trips and duration of ambulance usage was significantly higher in clinics (31.88 trips and 58.58 hours) compared to hospitals (16.25 trips and 39.25 hours).<h4>Conclusions</h4>The total cost of ambulance services was higher in hospitals compared to clinics, while its utilization showed a converse trend. The current findings evidence that despite the ambulance services being all under the MOH, their operating process and utilization reflected an inherent difference by setting.
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spelling doaj.art-4fc4ca54c97f4dd7b93a60b479a6b06a2022-12-22T04:16:02ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-011711e027663210.1371/journal.pone.0276632Analysis of costs and utilization of ambulance services in the ministry of health facilities, Malaysia.Mohd Shahri BahariFarhana AminuddinSivaraj RamanAinul Nadziha Mohd HanafiahMohd Shaiful Jefri Mohd Nor Sham KunusagaranNur Amalina ZaimiNor Zam Azihan Mohd HassanAhmad Tajuddin Mohamad Nor<h4>Background</h4>Despite emergency ambulance services playing a pivotal role in accessibility to life-saving treatments in Malaysia, there are still numerous gaps in knowledge in terms of their utilization and cost. This leads to current policies on procurement, maintenance, and allocation being predicated on historical evidence and expert opinions. This study thus aims to analyse the cost and utilization of ambulance services in selected public health facilities in Malaysia.<h4>Methods</h4>A cross-sectional study was employed involving 239 ambulances from selected hospitals and clinics. Ambulance service utilization was based on the number of trips, distance and duration of travel obtained from travel logbooks. A mixed top-down and activity-based costing approach was used to estimate the monthly cost of ambulance services. This constituted personnel, maintenance, fuel, overhead, consumables, ambulance, and medical equipment costs. The utilization and costs of ambulance services were further compared between settings and geographical locations.<h4>Results</h4>The average total cost of ambulance services was MYR 11,410.44 (US$ 2,756.14) for hospitals and MYR 9,574.39 (US$ 2,312.65) for clinics, albeit not significantly different. Personnel cost was found to be the main contributor to the total cost, at around 44% and 42% in hospitals and clinics, respectively. There was however a significant difference in the total cost in terms of the type and age of ambulances, in addition to their location. In terms of service utilization, the median number of trips and duration of ambulance usage was significantly higher in clinics (31.88 trips and 58.58 hours) compared to hospitals (16.25 trips and 39.25 hours).<h4>Conclusions</h4>The total cost of ambulance services was higher in hospitals compared to clinics, while its utilization showed a converse trend. The current findings evidence that despite the ambulance services being all under the MOH, their operating process and utilization reflected an inherent difference by setting.https://doi.org/10.1371/journal.pone.0276632
spellingShingle Mohd Shahri Bahari
Farhana Aminuddin
Sivaraj Raman
Ainul Nadziha Mohd Hanafiah
Mohd Shaiful Jefri Mohd Nor Sham Kunusagaran
Nur Amalina Zaimi
Nor Zam Azihan Mohd Hassan
Ahmad Tajuddin Mohamad Nor
Analysis of costs and utilization of ambulance services in the ministry of health facilities, Malaysia.
PLoS ONE
title Analysis of costs and utilization of ambulance services in the ministry of health facilities, Malaysia.
title_full Analysis of costs and utilization of ambulance services in the ministry of health facilities, Malaysia.
title_fullStr Analysis of costs and utilization of ambulance services in the ministry of health facilities, Malaysia.
title_full_unstemmed Analysis of costs and utilization of ambulance services in the ministry of health facilities, Malaysia.
title_short Analysis of costs and utilization of ambulance services in the ministry of health facilities, Malaysia.
title_sort analysis of costs and utilization of ambulance services in the ministry of health facilities malaysia
url https://doi.org/10.1371/journal.pone.0276632
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