Identified Barriers in Keeping Appointments During The COVID-19 Pandemic in Malaysia

Nurhayati Shaharuddin, Nur Wahida Zulkifli, Izzatur Rahmi Mohd Ujang, Samsiah Awang, Divya Nair Narayanan, Normaizira Hamidi, Khalidah Maruan, Roslina Supadi, Mariyah Mohamad: Identified Barriers in Keeping Appointments During The COVID-19 Pandemic in Malaysia. published online at https://apcph.cphm.my, 2022, (Type: POSTER PRESENTATION; Organisation: Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia; Faculty of Pharmacy, University of Technology MARA, Selangor).

Abstract

Introduction: The COVID-19 pandemic has posed challenges to the global health system by increasing the demand for COVID-19 care and epidemic control measures which disrupted care delivery for other health conditions. This increasing burden on healthcare systems created barriers to care for health conditions unrelated to COVID-19. This study focused on describing the barriers to accessing healthcare services among patients with appointments during the COVID-19 pandemic in Malaysia.
Method: This cross-sectional study, conducted between 13th October to 23rd November 2020 used convenience sampling among the public who utilised healthcare facilities (public and private) during the study period, aged 18 years and above, who understood Malay or English languages. A validated online questionnaire adapted from the National Health Morbidity Survey (NHMS) 2019 was disseminated through various online channels including the official Ministry of Health (MOH) Facebook, official government and non-government emails, and via WhatsApp to a quality improvement liaison officer in every state. A descriptive analysis was performed using the Statistical Package for Social Sciences (SPSS) 25.0 to describe the sociodemographic characteristics and percentage of reported barriers to accessing health services among respondents, which was classified based on the accessibility domains adapted from the modified Penchansky and Thomas's Theory of Access.
Results: In total, 838 out of 6117 respondents reported having appointments during the COVID-19 pandemic, out of which 16% were unable to access healthcare services. The majority of the respondents were females and adults (30-59 years old), which were 65 and 77 percent respectively. The percentages of barriers classified according to accessibility domains were: (i) Accommodation (51.4%), (ii) Awareness (27.6%), (iii) Accessibility (9.8%), (iv) Availability (6.0%), (v) Acceptability (5.2%), and (vi) Affordability (none identified). The three highest cited barriers to attending health care appointments were postponed appointments (44.8%), being scared or afraid to go out (21.6%), and journey obstacles due to roadblocks (8.2%). These barriers belonged to the accommodation, awareness, and accessibility domains accordingly. Discussion: This study described potential accessibility barriers experienced by patients with appointments at healthcare facilities during the COVID-19 pandemic. The reasons for difficulties in keeping appointments during the pandemic were primarily due to accommodation issues likely because of the rescheduling of appointments. As the rescheduling is necessary to minimise the risk of COVID-19 exposure at facilities, the virtual clinic approach and expansion may benefit stable patients who face accommodation barriers such as waiting time being too long (>30 minutes) and work commitments, thus ensuring continuity of care during this pandemic.

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@proceedings{APCPH2022-P-59,
title = {Identified Barriers in Keeping Appointments During The COVID-19 Pandemic in Malaysia},
author = {Nurhayati Shaharuddin and Nur Wahida Zulkifli and Izzatur Rahmi Mohd Ujang and Samsiah Awang and Divya Nair Narayanan and Normaizira Hamidi and Khalidah Maruan and Roslina Supadi and Mariyah Mohamad},
url = {https://apcph.cphm.my/wp-content/uploads/2022/07/APCPH2022-P-59.pdf 
 
https://apcph.cphm.my/wp-content/uploads/wpforms/1176-1e04940bb5d885bf8711ed19095a89ed/APCPH-Poster_Identified-Barriers-in-Keeping-Appointment-During-t-e65f9ccdf5bafceb566ac8929539702a.pdf},
year  = {2022},
date = {2022-08-02},
urldate = {2022-08-02},
issue = {7},
abstract = {Introduction: The COVID-19 pandemic has posed challenges to the global health system by increasing the demand for COVID-19 care and epidemic control measures which disrupted care delivery for other health conditions. This increasing burden on healthcare systems created barriers to care for health conditions unrelated to COVID-19. This study focused on describing the barriers to accessing healthcare services among patients with appointments during the COVID-19 pandemic in Malaysia. 
Method: This cross-sectional study, conducted between 13th October to 23^{rd} November 2020 used convenience sampling among the public who utilised healthcare facilities (public and private) during the study period, aged 18 years and above, who understood Malay or English languages. A validated online questionnaire adapted from the National Health Morbidity Survey (NHMS) 2019 was disseminated through various online channels including the official Ministry of Health (MOH) Facebook, official government and non-government emails, and via WhatsApp to a quality improvement liaison officer in every state. A descriptive analysis was performed using the Statistical Package for Social Sciences (SPSS) 25.0 to describe the sociodemographic characteristics and percentage of reported barriers to accessing health services among respondents, which was classified based on the accessibility domains adapted from the modified Penchansky and Thomas's Theory of Access. 
Results: In total, 838 out of 6117 respondents reported having appointments during the COVID-19 pandemic, out of which 16% were unable to access healthcare services. The majority of the respondents were females and adults (30-59 years old), which were 65 and 77 percent respectively. The percentages of barriers classified according to accessibility domains were: (i) Accommodation (51.4%), (ii) Awareness (27.6%), (iii) Accessibility (9.8%), (iv) Availability (6.0%), (v) Acceptability (5.2%), and (vi) Affordability (none identified). The three highest cited barriers to attending health care appointments were postponed appointments (44.8%), being scared or afraid to go out (21.6%), and journey obstacles due to roadblocks (8.2%). These barriers belonged to the accommodation, awareness, and accessibility domains accordingly. Discussion: This study described potential accessibility barriers experienced by patients with appointments at healthcare facilities during the COVID-19 pandemic. The reasons for difficulties in keeping appointments during the pandemic were primarily due to accommodation issues likely because of the rescheduling of appointments. As the rescheduling is necessary to minimise the risk of COVID-19 exposure at facilities, the virtual clinic approach and expansion may benefit stable patients who face accommodation barriers such as waiting time being too long (\>30 minutes) and work commitments, thus ensuring continuity of care during this pandemic.},
howpublished = {published online at https://apcph.cphm.my},
note = {Type: POSTER PRESENTATION; Organisation: Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia; Faculty of Pharmacy, University of Technology MARA, Selangor},
keywords = {appointment, barriers, Covid-19, healthcare services, survey},
pubstate = {published},
tppubtype = {proceedings}
}