Tag: health

Opportunity costs

Posted on by Prav

In Disease Detectives, I talked about the utilisation of limited resources.

So the question is what factors come into play when making decisions about what are the best possible interventions/actions we should take.

Opportunity costs is one of those factors.

In healthcare our main issues are

  1. How do we get the best outcomes
  2. How do we reach the most amount of people
  3. How do we keep costs low or within the scope of the resources available

And this of course means we always have to make choices, and opportunity costs is one of the guiding factors in this decision making process. So what is opportunity costs?

It is basically the potential good outcome that is lost by the utilisation of resources or efforts in another area/intervention.

What on earth does this even mean?

The easiest way I understand this is in terms of hospital beds (in wards) and primary health care centres (outpatient/GPs).

So let us say we figure out that if one person is admitted in hospital, the same amount of funds could have been allocated to treating 15 people in a GP setting. So this is an opportunity cost because by having that one bed/admission, we lose the funds to treat 15 people in an outpatient setting.

And if I relate it to paediatrics, for every child admitted to ward requiring their parents to take time off work – that time spent in the hospital with one child also means a missed activity with other family/children or even wages lost .

Why is this important?

Because it shows us that requiring admission for treatment really should be a last resort and that it would be more cost effective if we could reduce the number of admissions.

So the next question is how do we figure out which is the best way to do that?

Mythology, culture, beliefs and health

Posted on by Prav

To Understand Health Services as they are today, we need to understand what has influenced them over the years. In our module we are given examples of 9 historical factors given that has shaped health services in the United Kingdom today.

These factors are :

1. Evolving understanding of illness
2. Technology
3. Socio-demographic changes
4. Social attitudes
5. Religion
6. Finance
7. Physical environment
8. War
9. Healthcare professionals

Being Malaysian and having worked in healthcare at home, I cannot help but think of what has affected and shaped our health service. Built on the backbone of our colonial history, Malaysia’s healthcare system is similar to that of the NHS. However, one of the most pertinent historical factors which I believe still plays a role today, would be culture, mythology and religion.

From visiting the local medicine man or “bomoh”, to the consumption of Chinese Herbs to balance out the hot and cold elements, to resorting to religious leaders in search of a cure through prayer and offerings. Malaysians have come very far in their understanding of illness and do seek medical attention at hospitals, yet these cultural practices have stood the test of time and while they mostly coexist quite harmoniously, I have unfortunately had to convince some of my patients that it might be best to hedge your bets and get the best of both worlds.

However it is these reasons as well that Mental Health is still a work in progress, as a lot of it is associated with being possessed by evil demons and spirits, to having being put under a spell.

An example would be ‘Amok’ or more contemporarily known as to run amok. Amok is actually listed as a syndrome in the Diagnostic and Statistical Manual of Mental Disorders. Described by Merriam-Webster as a sudden episode of mass assault by a single individual following a period of brooding. The belief behind it was that there was a hantu belian – tiger spirit that took over the person and caused them to act out in that manner. These beliefs still persist till this day and are only some of the barriers left to overcome in addressing Mental Health issues in Malaysia. What about your country?

Can you identify with any of the 9 historical factors listed with regards to what has your country’s current healthcare services? Please do drop me a line in the comments, would love to hear about them.