State and future of interventional radiology in Malaysia

The fundamental principle of the Malaysian healthcare system is that accessibility to health care should not be related to one's ability to pay, especially when involving sickness [1]. This is based on the Government's recognition that health represents human capital, which forms the central thrust to sustainable economic growth and development of the country. The Malaysian healthcare system has been able to achieve a higher standard of health status despite the relatively limited resources available to the health sector (2.0% to 4.0% of GDP). From 1990 to 2005, the life expectancy at birth increased significantly (males from 69.0 years to 71.8 years, females from 73.5 years to 76.2 years) while the infant mortality rate fell (from 13.5 to 5.1 per 1,000 live births) and correspondingly the maternal mortality rate has remained unchanged (at 30 per 100,000 live births) [2]. In the World Health Report 2000 (which assessed the overall health system performance against three objectives of good health, responsiveness and fair financial contribution), Malaysia ranked 49 from 191 WHO member countries [3]. With regards to the Delivery of Health Care, a dual health care system, with both the public and private health services, co-exists in Malaysia. Public health care is provided through government hospitals and health clinics throughout the country. The services range from outpatient curative care to preventive and promotion of health. The main public health provider is Ministry of Health (MOH) that provides primary care, secondary care and tertiary care through various types of health facilities (such as general hospitals, district hospitals and health clinics). In 2008 there were 130 MOH hospitals (with a total of 33,004 beds), 6 special medical institutions (with 5,000 beds), National Institutes of Health (6), 802 health clinics, 1,927 rural clinics, 95 maternal and child health clinics, and 193 mobile clinics [4]. An open-door policy in regard to general outpatient services and hospital admissions has been practiced by the public health sector. Access to specialist services is, nonetheless, controlled through a national system of referral. Specialist services are available at designated hospitals (such as national referral hospital in the capital, the state hospital and selected district hospitals). Referral of patients for specialist services is to the nearest facility if patients cannot be managed at general outpatient facilities. The National Quality Assurance Programme was implemented to maintain, improve and evaluate the quality, efficiency and effectiveness in the delivery of public health services [5]. The …