Theses (MBA In Healthcare Management)

Aims: With the rapid proliferation of data in healthcare it has provided an opportune platform creation of Artificial Intelligence (AI). AI has brought a paradigm shift for healthcare professionals, promising improvement in delivery and quality. This study aims to determine the perception of healthcare personnel on perceived ease of use, perceived usefulness, and subjective norm toward attitude for artificial intelligence acceptance. Methods: This is a cross-sectional single institutional study of employees’ perception of adopting AI in the hospital. The study population is all healthcare personnel of a private hospital. The inclusion criteria include all healthcare personnel involved with clinical management such as doctors, nurses, and others. The survey was conducted using a questionnaire adapted from Technology Acceptance Model and a four-point Likert scale was used for the measurement variables in this study. Data were analysed using IBM Statistical Package for the Social Sciences (SPSS) Version 26. Results: There were 96 respondents. This study started off with three hypotheses but has found that only two hypotheses have been accepted and one hypothesis has been rejected. H2 to H3 perceived usefulness and subjective norm respectively, showed positive relationship between their perception on artificial intelligence acceptance and were accepted However, H1 which was ease of use, was rejected as it did not generate a positive relationship between ease of use on attitude and artificial intelligence acceptance. Conclusion: This study has shown the significant relationship and the importance of ease of use, perceived usefulness, and subjective norm to the acceptance of AI. In the study results, there are determining factor and mostly those with most interaction with the patients and clinical management have a strong acceptance of AI in their practices. Key words: Artificial Intelligence, Acceptance, Healthcare, Healthcare Professionals

The COVID-19 pandemic has had an immense impact on healthcare systems worldwide particularly in terms of infection control measures. Hospital Sungai Buloh has implemented a novel walk-away queuing system for outpatient clinics, namely the iQMS. This system enables infection control via facilitating social distancing whilst waiting for their appointments and affords waiting location flexibility. However, the factors affecting outpatients’ intention to use the iQMS is yet unknown, and this is the subject of this study. The Technology Acceptance Model (TAM), Perceived System Usability and sociodemographic factors were used to study this relationship. This study used a cross-sectional quantitative design utilizing a self-administered questionnaire to obtain data. The questionnaire comprised of sociodemographic factors, Perceived Usefulness, Perceived Ease of Use, Intention to use the iQMS and Perceived System Usability. Two hundred and fifty-four respondents completed the questionnaire, corresponding to a response rate of 87.8%. The questionnaire showed satisfactory construct validity, discriminant validity and reliability. Perceived Usefulness and Perceived Ease of Use had a significant impact on the Intention to use the iQMS, while Perceived System Usability showed a moderate positive relationship with the Perceived Ease of Use. Sociodemographic factors did not influence the Intention to use the iQMS. In conclusion, the Intention to use the iQMS is associated with the Perceived Ease of Use and Perceived Usefulness of the system. Keywords: COVID-19, Queue Management System, Technology Acceptance Model, System Usability Scale

Aims: With the increasing complexity of healthcare system, there has been an increase in the need for more healthcare managers to manage the delivery of health services. Studies have shown that organizations with management practices, strong leadership, and clinically qualified managers have had greater performances. The application of Evidence-Based Medicine has long existed, which have led to the idea of applying the same within the field of management – Evidence-Based Management (EBMgt). This study therefore aims to understand the intention of these healthcare leaders to apply the practice of EBMgt in their decision-making process. Methods: This is a cross-sectional study conducted among 234 healthcare managers in major private healthcare facilities in Malaysia. An online survey was distributed to healthcare managers from 58 private hospitals in Malaysia with MSQH accreditation. The survey was adapted from the Theory of Planned Behaviour (TPB) and a fivepoint Likert scale was used for the measurement variables in this study. The data collected was exported to IBM Statistical Package for the Social Sciences (SPSS) Version 26. Results: Attitude towards use of EBMgt has a direct positive effect on intention to use (β = 0.489, p ˂0.05) and so as with subjective norm which also indicated a direct positive effect on intention to use (β = 0.317, p ˂ 0.05). However, perceived behavioural control was found not to be statistically significant (β = -0.038, p ˂ 0.47) in relation to intention to use EBMgt. Conclusion: Attitude and subjective norms were significant to predict healthcare managers’ intention to use EBMgt which will likely lead to actual use of EBMgt in their decision making. Key words: Evidence-based management, EBMgt, Attitude, Subjective norm, Perceived behavioural control, Intention, Healthcare management.

Objectives To assess the rate of Influenza Like Illness (ILI) among influenza vaccinated and non-vaccinated employees on rate of absenteeism and presenteeism due to ILI, and to estimate the cost benefit of influenza vaccination in workplace from the employer’s perspective. Methods A cross-sectional questionnaire survey was conducted amongst employees of a private hospital voluntarily vaccinated, were compared with non-vaccinated employees matched for age, sex, and job category. The outcome of cost-benefit analysis was evaluated by self-reporting on absenteeism and presenteeism from work related to ILI. Costs and benefits of the influenza vaccination from the employer point of view were calculated. Analyses were performed with SPSS 23.0. Results A total of four hundred and twenty-one respondents participated in this study. The influenza vaccination rate in this group was 63.0 % (n=265). The non-vaccinated were 37.0 % (n=156). The rate of ILI was lower among vaccinated (17.0 %) compared to non-vaccinated (47.0 %). The ILI related absenteeism reported was 40.0 % by vaccinated employees compared to 57.5 % by non-vaccinated employee, with absenteeism rate of 0.16 day per employee and 1.05 day per employee respectively. This led to a 6.5 times higher absenteeism rate amongst the non-vaccinated. The influenza vaccination strategy reduced absenteeism due to ILI by 84.8 %. Influenza vaccination was financially beneficial, with savings for employer of up to RM 79.41 per vaccinated employee when only labour cost was included (54.0 % cost saving). The cost saving drastically rise to RM 708.15 (71.0 % cost saving) when the operating income per employee was also incorporated. Conclusions Implementing an influenza vaccination program would reduce the burden o ILI and save substantial amount of financial reserves for the company. This study showed that influenza vaccination for working adults on average is cost saving and cost beneficial when translated into financial investments for the employer. It has significant impact averting cost of absenteeism and presenteeism. The approach on economic evaluation and cost benefit analysis used in this study can be applied to other workplace vaccination strategies in their settings. Keywords: Influenza vaccination, workplace, Influenza Like Illness, absenteeism, presenteeism, cost and benefit.

Background: The global outbreak of COVID-19, also known as the coronavirus disease 2019 raged across the world and was an international public health threat. It caused significant impacts to health, both physically and psychologically. The quarantine measures imposed caused economic, education and social disruptions. The escalated usage of face masks and personal protective equipment’s (PPE’s) created massive wastage that impacted the environment negatively whilst many lost their livelihoods and sources of income. Globally as of 19 July 2023, there have been 768,237,778 confirmed cases of COVID-19 including 6,951,677 deaths reported to WHO (WHO, 2023). This study aimed to determine factors associated with consumers intention to continue using face mask due to COVID-19 pandemic using “The Health Belief Model (HBM)”, a cross-sectional study in Malaysian respondents from May to August of 2022. During this time, COVID -19 was still declared as a pandemic by World Health Organization (WHO). The end of the pandemic was only declared year later in May 2023. Methods: A total of 282 respondents, aged 18 and above who declared to have worn face masks in the last one year all across Malaysia were surveyed. The survey instrument included socio- demographic data and measures on the four main constructs for HBM, namely perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. Cues to action and self-efficacy were left out as not all previous studies using the HBM included them. Descriptive and inferential analysis was done using SPSS version 25 software to determine rates and predictors of face mask wearing. Results: Perceived susceptibility was the only HBM construct that was found to be a significant predictor for consumers intention to continue using face mask. Socio-demographic factors had no effect on face mask wearing probably due to a very high rate of mask wearing compliance in the community at that point in time. Additional survey questions found that 84% of respondents would wear a mask due to family reasons such as wanting to protect their family or feeling encouraged by their family to do so. Respondents also reported preferring cheaper, single use face masks as opposed to reusable ones, surgical masks as opposed to non-surgical face masks and face masks with no aesthetic appeal. Conclusion: The Health Belief Model is a useful model in identifying factors that determine face mask wearing. These findings can be used for effective planning of health education and programmes by health organizations. It can also assist the government in creating policies in relation to face mask to increase its compliance as well as guide face mask production for the global market of face masks. KEY WORDS: Health Belief Model, COVID-19 preventive behaviour, Face Masks

Background: Telemedicine is a new technology innovation in Malaysia, but it plays an increasingly important role in the country’s healthcare system. In response to the limited discussion regarding its acceptance by people, this study aims to increase knowledge about telemedicine adoption factors in Malaysia. Methods: A cross-sectional study was performed among residents residing in Malaysia. Data was collected through an online survey. A total of 403 respondents participated in the survey. The results were analysed using the PLS-SEM method. Results: It was found that the service quality, user satisfaction and perceived usefulness play a significant and important role in affecting users’ intention to adopt telemedicine services. Perceived ease of use is however not significantly influencing the adoption of telemedicine. The results also confirmed the moderating role of user satisfaction on the relationship between service quality, perceived usefulness and perceived ease of use on telemedicine acceptance. Conclusions: Although most Malaysians were willing to use telemedicine services to manage their health condition, they insisted on quality service and a useful system. Since telemedicine is still in its infancy in Malaysia, further research is needed to determine its impact on patients' quality of healthcare service. Keywords: telemedicine, service quality, user satisfaction, perceived ease of use, perceived usefulness, behavioural intention, technology adoption

Introduction: Malaysian population is predicted to increase to 41 million people by year 2040 and ageing population is expected to increase to 14.5%. WHO emphasised on healthy ageing frame work and the need to study multiple factors such as financial support, medical care, life-long learning and evolvement of technology in relation to the selection of healthy retirement environment in Malaysia. Objective: To determine the factors influencing customer’s decision and relationship on selection of healthy retirement environment Methodology: This was a cross sectional study conducted in Greater Kuala Lumpur and Sabah. Samples were stratified using probability purposive sampling. Two thousand seven hundred and fifty cover letters and questionnaires were mailed or using WhatsApp electronically to selected respondents. Mail survey respondents returned 369 usable questionnaires yielding a 14.5% response rate. Results were analysed using structural model and the hypothesis testing. Result: It was found that the factors influencing consumer’s decision showed that the perception towards financial planning, receptiveness towards health insurance and lifelong learning programme are positively related to selection of healthy retirement environment. Technology advancement is however not significantly related to healthy retirement environment. Conclusion: To achieve provision of care for successful healthy ageing, this study showed that multiple services components namely perception towards financial planning, receptiveness towards health insurance and lifelong learning program provided by care provider are favourable components of retirement environment for elderly health. Although the results showed that technology advancement was not significantly related to healthy retirement environment, it is shown in other studies that it is an important part of the infrastructure of an institutional care provider to facilitate the services as a basic element for environment support. However, the concern on data privacy and the data protection should made priority to the residents for security and safety purposes. Keywords: healthy retirement, healthy retirement environment, healthy ageing, financial planning, health insurance, lifelong learning program, technology advancement

Background: Internships, also known as industrial training, is an opportunity to integrate work experience into tertiary education curricula, acting as a bridge between academia and industry for students. Regardless of its wide practice and significance, limited empirical work has been conducted to inquire about the predictors of internship satisfaction among the healthcare student population. Aims: This study aims to determine the relationship between the factors of organisational environment, job characteristics, job prospects, university support and individual factors towards student internship satisfaction. Methods: A quantitative cross sectional study design was carried out by utilising an online self-administered survey with question items adapted from existing literature. Across two months period, a total of 158 usable responses were collected among the healthcare undergraduate student population from a private medical and health sciences university in Malaysia. Results: Hypothesis testing on the relationship between the five independent variables and internship satisfaction were conducted through multiple linear regression analysis. Findings suggested that organisational environment, job characteristics, job prospects and individual factors have a positive and statistically significant relationship with internship satisfaction among healthcare undergraduate students. Conclusion: Relevant stakeholders should pay close attention to enriching these identified factors within an internship program as it has shown to play a role in student internship satisfaction.

Objectives To determine the relationship between quality of medical services; physician’s consultation, information to patient, physical environment, perceived service costs, service provisioning and to calculate opportunity revenue for recommendation to relatives/ friends/ others. on patient satisfaction towards their loyalty. Methods This was a single-centre cross-sectional survey conducted in a private hospital. It was conducted between the month of April 2020 and August 2020. The target population was outpatients who received treatment or consultation at Nilai Medical Centre during the study period. Selection of respondents was conducted using simple random sampling had been generated by auto-generated hospital database from 2,324 patients that visited outpatient from April until August 2020. Questionnaires were sent out to selected patients via e-mail due to recent pandemic which does not allow interaction with patients physically. There were 209 questionnaires returned as the sample sizes for this study. Results A total of 209 respondents were involved in this study. Data that have been collected through questionnaires were used to test the model using the Statistical Package for the Social Sciences (SPSS) version 25. The findings showed that physician’s consultation, information to patient, physical environment and perceived service costs positively influence patients’ satisfaction and loyalty. Service provisioning processes, however, was not significantly influence patients’ satisfaction and loyalty. This study reconciles these discrepancies by providing a more comprehensive explanation to the patients’ loyalty. For this, a research model was developed to identify and evaluate the factors of the patients’ loyalty. Conclusion This study found that patients’ satisfaction mediates the relationship between physician consultation, information to patient, physical environment, perceived service costs and patient loyalty. Meanwhile, patients’ satisfaction plays a role on the relationship towards patient loyalty. This study contributes towards a better understanding of the patients’ satisfaction in private healthcare industry particularly in Malaysia. Notably, the findings emphasize the importance of patients’ loyalty as a strategy to help private hospital increase their revenue. Therefore, the findings from the study are useful for the private healthcare policy makers by providing high quality services, improving patients’ satisfaction, and ultimately promoting revisiting and recommending medical services to others. Key words Physician’s Consultation, Information to Patient, Physical Environment, Perceived Service Costs, Service Provisioning Processes, Satisfaction, Loyalty

The transition to Electronic Health Records (EHRs) from paper-based patient records has presented various challenges, such as coordinating care, usability of software interfaces, privacy and cybersecurity issues, new types of medication errors, and psychological distress leading to burnout and a negative user experience. Similar difficulties have been observed in a specialized health center in Saudi Arabia that recently implemented new EHRs software with nurses expressing dissatisfaction towards the changes. This study aimed to identify and analyze the factors influencing the adoption of EHRs among nurses in Saudi Arabia. It employed a non-experimental cross-sectional research design with 141 clinical nurses participating. Drawing inspiration from several theories including Theory of Reasoned Action, Theory of Planned Behavior, Technology Adoption Model, Diffusion of Innovation Model and Technology-Organization-Environment Framework; the proposed conceptual framework sought to establish relationships between EHRs usability digital competency attitude toward technology usage organizational training with perceived usefulness ease-of-use. Lastly it explores the role these variables play in fostering adoption of EHRs system. The results showed positive associations between usability, digital competency, attitude toward technologies, and organizational training with how easily adoptable the system was. The study did not explore the demographic implications on the adoption or whether a representative sample size could limit its applicability. Self-report questionnaires may introduce bias; however, despite this limitation, the innovative framework and insights provided could serve as a valuable foundation for further research in the field of health information systems.

Nurses' knowledge, facilitators, and barriers related to Evidence-based Practice (EBP) are among the main issues that may determine the readiness of nurses to utilize EBP in their clinical settings. This study aims to identify factors that facilitates or hinders the adoption of EBP and to determine nurses' readiness to implement EBPs in their workplace. This is a quantitative study, cross-sectional design, involving 300 nurses working in the organization studied and used Rogers' diffusion of innovation theory. The study data were collected using a questionnaire and analyzed using regression and one-way ANOVA analysis. Nurses' knowledge of EBP strongly impacts their readiness for EBP, while facilitators and barriers have little effect. Years of experience and level of qualification moderately influence readiness. Improving nurses' knowledge and skills related to EBP is crucial. This can be achieved through education, training, and support. Healthcare organizations can strengthen EBP readiness by developing protocols and guidelines and overseeing intervention effectiveness. In summary, the study highlights that nurses' knowledge towards EBP is a critical factor in determining their readiness to implement it in healthcare settings. Therefore, healthcare organizations should emphasize improving their ability to evaluate evidence and enhance EBP skills among nurses. Keywords: survey, EBP, use, registered nurses, barriers, facilitator, and Saudi Arabia

Background: Obesity presents a significant health challenge in Malaysia. Despite bariatric surgery's proven efficacy in treating morbid obesity, its low uptake hints at possible issues with public perception and acceptance. Aim: This study aims to evaluate the non-patients’ knowledge and attitudes towards bariatric surgery at a private hospital in Klang Valley, Malaysia. By gaining insights into the factors influencing public perception and acceptance of bariatric surgery, the study provides a foundation for informed interventions and strategies aimed at combating obesity and improving healthcare outcomes. Methods: The study employs a cross-sectional design using a survey targeted at non-patients from multiple demographic backgrounds in a private healthcare setting. Using non-probability convenience sampling, the responses of 169 respondents were collected and analyzed through SPSS. Results: Analysis showed that gender, religion, and BMI had significant association with knowledge towards bariatric while sociodemographic factors such as age, and education levels held no bearing. Female, Muslims, and those with normal BMI were more well-informed with regards to knowledge on bariatric. On the other hand, age, and BMI (P = 0.027) had significant association with attitude towards bariatric surgery. Young adults and those who are overweight tend to view bariatric surgery in a more favourable light (P = 0.435). Conclusion: The findings showed that public perception towards obesity and bariatric surgery in Klang Valley is still limited. Coordinated effort by healthcare practitioners, media, and government health agencies is required to improve public awareness. Keywords: Bariatric surgery, morbid obesity, public perception, knowledge, attitude

BACKGROUND: Assessing the quality of healthcare delivery care services in medical facilities is crucial, and maternal satisfaction serves as a key metric in this evaluation. A positive experience with mother’s care is closely linked to improved health outcomes for both babies and mothers. OBJECTIVES: The objectives of the study was to evaluate mother's level of satisfaction regarding the service quality of delivery care service in the private hospitals utilizing SERVQUAL model. METHODOLOGY: A cross-sectional study was implemented utilizing the SERVQUAL model. 272 postnatal women attending the facility were selected to take part in the study. Data was gathered using a validated SERVQUAL questionnaire and was analysed using SPSS. Descriptive statistics was done, and paired sample t-test were performed to compare mean gap scores. Pearson correlation was employed to identify correlation between Servqual dimension and maternal satisfaction. We considered a p-value below 0.05 to be statistically significant.. RESULTS: The findings of this study indicate that mothers were all expressed satisfaction with the delivery care provided by private hospitals. However, there were still negative gap score for all five service dimensions, signifying a reduction in satisfaction level on each Servqual domain. The overall mean gap score for satisfaction level in the 5 service dimensions was -0.264 (±SD 0.55), and for each dimension : tangiblity (-0.24), reliability (-0.25), empathy (-0.26), assurance (-0.26), and responsiveness (-0.3). CONCLUSION: Overall, mother were satisfied with the care service provided during childbirth in private hospitals. However, there were minor gaps persisted between their perceptions and expectation scores, especially responsiveness dimension. A subtle improvement may be required to further enhance mother’s satisfaction by addressing factors that affecting level of satisfaction. Keywords : Maternal satisfaction, Delivery care service, Private hospital, SERVQUAL model

The transformation of healthcare delivery has inspired more people all around the globe to seek health information online. This study investigates the factors influencing online health information seeking activity among Malaysian millennials, particularly in the aftermath of COVID-19. This study employs a quantitative, cross-sectional research design based on a combination of the Comprehensive Model of Information Seeking (CMIS) and the Information Adoption Model (IAM), aimed to investigate the relationship between personal characteristics, health-related factors, information and source quality. The data revealed that the majority of Malaysian millennials use search engines to get health information only when it is absolutely required. Furthermore, the primary motive for seeking health-related information focused around therapy and medicines. The salience of health problems, high quality argument, reputable source of information, and perceived usefulness of information were all significant predictors of online health information seeking behaviour (OHISB). However, there were no significant correlation between demographics, direct experience, and personal beliefs with OHISB. Furthermore, this study found that information usefulness plays an important mediating role in strengthening the link between salience, argument quality, and source trustworthiness towards OHISB. This study, which focuses primarily on millennials may restrict generalizability to other generations and cultural contexts. Social bias from selfreported surveys might potentially have an impact on the findings as well. Despite these limitations, the novel and fresh viewpoint of this conceptual framework and the insight provided, may be utilised as a stepping stone for future studies to be undertaken in the digital health context. Finally, this study aids various stakeholders to further understand the nature of Malaysian millennials' online health information seeking behaviours in this present digital age.

Healthcare quality assessment is the key to drive organizations towards a patient-centred approach, and the evaluation of service quality by exploring patient and family satisfaction is one of the ways forward in identifying the principal drivers for optimal patient experience. This study investigates the factors affecting customer satisfaction in a private rehabilitation hospital in Putrajaya by adapting SERVQUAL model which are tangibles, reliability, responsiveness, empathy, and assurance. The study further investigates the relationship between customer satisfaction and the willingness to recommend the hospital and the mediation effect of customers satisfaction on SERVQUAL dimension and willingness to recommend the hospital. This study employs quantitative, cross-sectional research design and adapted systematic random sampling. The target population were patients and family members attending rehabilitation sessions at DAEHAN Rehabilitation Hospital Putrajaya. The study was conducted from March to April 2024 involving 161 respondents. The findings revealed that tangibles, reliability, empathy, and assurance of the SERVQUAL dimension has a significant relationship with customer satisfaction, with assurance being the most important factor. Further analysis shows that customer satisfaction has a significant relationship with the willingness to recommend the hospital. This study also found that customer satisfaction plays an important mediating role in strengthening the relationship between tangibles, reliability, empathy and assurance towards the willingness to recommend the hospital. One of the limitations of the study is that it focuses primarily on a private rehabilitation hospital in Putrajaya, thus restricting generalizability to other private and public hospitals. Despite the limitations, the novel findings of this study and the insights provided may contribute to future studies, besides providing better understanding of service quality assessment in the healthcare context. Finally, the finding of the study is aimed as a steppingstone and to shed light for hospital leaders to decide on comprehensive and attentive quality improvement strategies.