马来西亚老年医学分析——顺应政治变革的浪潮
15 November 2018
Maw Pin Tan, Shaharul B Kamaruzzaman, Philip Jun Hua Poi
摘要
Malaysia became the centre of international attention when it democratically removed a semi-authoritarian government of 62 years during its 14th general election this year. This electoral success has provided geriatric medicine in Malaysia with a high-impact ageing icon by installing the oldest prime minister in the world. A wave of optimism for the expansion of geriatric services in Malaysia, which met with numerous challenges in the last two decades, has emerged as a result of this political change. The number of geriatrics specialists and services had begun to see slow expansions under the previous government. However, existing geriatricians will need to reassess the landscape of delivery and access to care in our rapidly growing ageing population and develop new strategies to truly expand their services. In addition to unrelenting efforts in the recruitment and training of future geriatricians, the steady expansion of the geriatric workforce should take into account the inclusion of geriatric medicine in the undergraduate training curricula of all healthcare professionals. Expansion of geriatric services will also be a cost-effective strategy to reduce the growing national healthcare budget incurred by the growing needs of an ageing population.
参考资料
- Department of Statistics Malaysia. (2018). Current population estimates. Department of Statistics Malaysia.
- Department of Statistics Malaysia. (2016). Population projections (revised). Department of Statistics Malaysia.
- Poi, P. J., Forsyth, D. R., & Chan, D. K. (2004). Services for older people in Malaysia: Issues and challenges. Age and Ageing, 33, 444–446.
- Koh, G. C. H. (2007). A review of geriatric education in Singapore. Annals of the Academy of Medicine, Singapore, 36, 687–690.
- Chua, M. P. W., Tan, C. H., Merchant, R., & Soiza, R. L. (2008). Attitudes of first-year medical students in Singapore towards older people and willingness to consider a career in geriatric medicine. Annals of the Academy of Medicine, Singapore, 37, 947.
- Robbins, T. D., Crocker-Buque, T., Forrester-Paton, C., Cantlay, A., Gladman, J. R. F., & Gordon, A. L. (2011). Geriatrics is rewarding but lacks earning potential and prestige: Responses from the national medical student survey of attitudes to and perceptions of geriatric medicine. Age and Ageing, 40, 405–408.
- Lim, V. K. E. (2008). Medical education in Malaysia. Medical Teacher, 30, 119–123.
- Malaysian Medical Council Secretariat. (2016). The Malaysian Medical Council annual report 2015. Malaysian Medical Council.
- Malaysian Medical Council Secretariat. (2018). Second schedule, Medical Act 1971 (pp. 32–35). Malaysian Medical Council.
- NoorAni, A., Rajini, S., Balkish, M. N., Noraida, M. K., Smaria, A., Fadhli, M. Y., Jabrullah, A. H., & Tahir, A. (2018). Morbidity patterns and healthcare utilisation among older people in Malaysia: 1996–2015. Public Health, 163, 105–112.
- Chua, H. T., & Cheah, J. C. H. (2012). Financing universal coverage in Malaysia: A case study. BMC Public Health, 12, S7.
- Thomas, S., Beh, L., & Nordin, R. B. (2011). Health care delivery in Malaysia: Changes, challenges and champions. Journal of Public Health in Africa, 2, e23.
- Attorney General’s Chambers. (2013). Private Healthcare Facilities and Services (Private Hospitals and Other Private Healthcare Facilities) (Amendment) Order 2013 (Vol. 433, pp. 5–7). Attorney General’s Chambers.
- Yunus, N. M., Manaf, N. H. A., & Omar, A. (2017). Determinants of healthcare utilisation among the elderly in Malaysia. Institutions and Economies, 9, 115–140.
- Dawood, O. T., Hassali, M. A., Saleem, F., Ibrahim, I. R., Abdulameer, A. H., & Jasim, H. H. (2017). Assessment of health seeking behaviour and self-medication among general public in the state of Penang, Malaysia. Pharmacy Practice, 15, 991.
- Saidi, S., Milnes, L. J., & Griffiths, J. (2018). Fatalism, faith and fear: A case study of self-care practice among adults with type 2 diabetes in urban Malaysia. Journal of Clinical Nursing.
- Mohd Mokhtar, M. A., Pin, T. M., Zakaria, M. I., Hairi, N. N., Kamaruzzaman, S. B., Vyrn, C. A., & Hua, P. P. J. (2015). Utilization of the emergency department by older residents in Kuala Lumpur, Malaysia. Geriatrics & Gerontology International, 15, 944–950.
- Banerjee, J., Conroy, S., & Cooke, M. W. (2013). Quality care for older people with urgent and emergency care needs in UK emergency departments. Emergency Medicine Journal, 30, 699–700.
- Safurah, J., Kamaliah, M. N., Khairiyah, A. M., Nour Hanah, O., Healy, J., Kalsom, M., & Zakiah, M. S. (2012). Malaysia health system review. World Health Organization.
- Samad, S. A., & Mansor, N. (2017). Population ageing and social protection in Malaysia. Malaysian Journal of Economic Studies, 50, 139–156.
- Department of Statistics Malaysia. (2018). Abridged life tables, Malaysia, 2015–2017. https://www.dosm.gov.my/v1/index.php?r=column/cthemeByCat&cat=116&bul_id=dkdvKzZ0K1NiemEwNlJteDBSUGorQT09&menu_id=L0pheU43NWJwRWVSZklWdzQ4TlhUUT09
- Sooryanarayana, R., Choo, W. Y., Hairi, N. N., Chinna, K., & Bulgiba, A. (2015). Insight into elder abuse among urban poor of Kuala Lumpur, Malaysia: A middle-income developing country. Journal of the American Geriatrics Society, 63, 180–182.
- Samsudin, E. Z., Isahak, M., & Rampal, S. (2018). The prevalence, risk factors and outcomes of workplace bullying among junior doctors: A systematic review. European Journal of Work and Organizational Psychology, 1–19.
- Boev, C., & Xia, Y. (2015). Nurse-physician collaboration and hospital-acquired infections in critical care. Critical Care Nurse, 35, 66–72.
- Crowe, S., Clarke, N., & Brugha, R. (2017). “You do not cross them”: Hierarchy and emotion in doctors’ narratives of power relations in specialist training. Social Science & Medicine, 186, 70–77.
- Hameed, L. M., & Nor, F. M. (2014). Public and private shares in the distribution of doctors in Malaysia. In Proceedings of the Conference on Management and Muamalah, Bandar Seri Putra, Malaysia, 26–27 May 2014. http://www.kuis.edu.my/comm2014/eproceedings/C006%20PUBLIC%20AND%20PRIVATE%20SHARES%20IN%20THE%20DISTRIBUTION%20OF%20DOCTORS%20IN%20MALAYSIA.pdf
- Ismail, N. W., Rahman, H., & Hamid, T. (2015). Does population aging affect economic growth in Malaysia. Prosiding Perkem, 10, 205–210.
- Wong, R. S. Y., & Abdul Kadir, S. Y. (2017). Medical education in Malaysia: Quality versus quantity. Perspectives on Medical Education, 6, 10–11.
- Hogan, D. B., Borrie, M., Basran, J. F. S., Chung, A. M., Jarrett, P. G., Morais, J. A., Peters, E., Rockwood, K. J., St. John, P. D., Sclater, A. L., et al. (2012). Specialist physicians in geriatrics—Report of the Canadian Geriatrics Society Physician Resource Work Group. Canadian Geriatrics Journal, 15, 68–79.
- Fisher, J. M., Garside, M., Hunt, K., & Lo, N. (2014). Geriatric medicine workforce planning: A giant geriatric problem or has the tide turned? Clinical Medicine, 14, 102–106.
- Bardach, S. H., & Rowles, G. D. (2012). Geriatric education in the health professions: Are we making progress? The Gerontologist, 52, 607–618.
- Masud, T., Blundell, A., Gordon, A. L., Mulpeter, K., Roller, R., Singler, K., Goeldlin, A., & Stuck, A. (2014). European undergraduate curriculum in geriatric medicine developed using an international modified Delphi technique. Age and Ageing, 43, 695–702.
- Bhardwaj, A., Kavitha, N., & Ibrahim, S. (2017). Malaysian Medical License Examination (MMLE): Is this a way forward? Education in Medicine Journal, 9, 63–67.
- Burch, V. C., Adnan, N. A. M., Afolabi, B. B., Ismail, Z., Jafri, W., Olapede-Olaopa, E. O., Otieno-Nyunya, B., Supe, A., Togoo, A., & Vargas, A. (2006). Accreditation of undergraduate medical training programs: Practices in nine developing countries as compared with the United States. Education for Health, 19, 207–222.
- Sourdet, S., Lafont, C., Rolland, Y., Nourhashemi, F., Andrieu, S., & Vellas, B. (2015). Preventable iatrogenic disability in elderly patients during hospitalization. Journal of the American Medical Directors Association, 16, 674–681.
- Verma, P., Ford, J. A., Stuart, A., Howe, A., Everington, S., & Steel, N. (2016). A systematic review of strategies to recruit and retain primary care doctors. BMC Health Services Research, 16, 126.
- Tran, V. (2015). Dealing with bullying and harassment: A practical guide for Australasian emergency medicine trainees. Emergency Medicine Australasia, 27, 473–477.
- Weller, J., Boyd, M., & Cumin, D. (2014). Teams, tribes and patient safety: Overcoming barriers to effective teamwork in healthcare. Postgraduate Medical Journal, 90, 149–154.
- Ellis, G., Whitehead, M. A., O’Neill, D., Langhorne, P., & Robinson, D. (2014). Comprehensive geriatric assessment for older adults admitted to hospital. Cochrane Database of Systematic Reviews.
- Stott, D. J., & Quinn, T. J. (2017). Principles of rehabilitation of older people. Medicine, 45, 1–5.
- Wei, K. C., Lee, C., Mahendran, R., & Lim, C. G. (2012). Improving mental health care for people with an intellectual disability in Singapore: Bridging the health-social care divide. Singapore Medical Journal, 53, 428–432.
- Zhu, H., & Walker, A. (2018). The gap in social care provision for older people in China. Asian Social Work and Policy Review, 12, 17–28.
- Alderwick, H., & Ham, C. (2017). Sustainability and transformation plans for the NHS in England: What do they say and what happens next? BMJ, 356.
- Goodwin, N., Dixon, A., Anderson, G., & Wodchis, W. (2014). Providing integrated care for older people with complex needs: Lessons from seven international case studies. King’s Fund.
- Alley, D. E., Asomugha, C. N., Conway, P. H., & Sanghavi, D. M. (2016). Accountable health communities—Addressing social needs through Medicare and Medicaid. The New England Journal of Medicine, 374, 8–11.
- Thornicroft, G., Alem, A., Santos, R. A., Barley, E., Drake, R. E., Gregorio, G., Hanlon, C., Ito, H., Latimer, E., Law, A., et al. (2010). WPA guidance on steps, obstacles and mistakes to avoid in the implementation of community mental health care. World Psychiatry, 9, 67–77.


