CHAPTER 3.2 120 Information System ( Sistem Maklumat Rawatan Pesakit ) at the Health Informatics Centre, Ministry of Health (MOH) Malaysia. This initiative began with compilation of aggregated records from MOH hospitals since 1981. Then, individual patient data became available for MOH hospitals in 1999 while private hospitals started contributing data in 2008, followed by the public university and Ministry of Defence hospitals in 2017. It is worth noting that some data between 2012 and 2013 from several health centres were loss during a data migration process conducted by the data owner. The Hospital Discharge Registers contain summary information about the patient admission episodes including admission and discharge date, and primary discharge diagnosis that was coded in International Classification of Disease-10 codes (ICD-10) in addition to demographic information such as age, sex and ethnicity. However, the information on patients’ comorbidities and drug therapies were not available in the register. Malaysia is an upper-middle income country of population size of 31.7 million in 2016, with a multi-ethnic population distribution as follows: 68.6% Bumiputera (comprising mainly of Malay ethnicity), 23.4% Chinese, 7.0% Indians and 1.0% other ethnicities. Of the total hospital admissions in the country in 2014, about two-thirds were managed by MOH hospitals (66%) followed by 30% in the private hospitals and lastly 4% managed in the remaining eight Ministry of Defence and university hospitals.[8] On HF hospitalizations specifically, unpublished data from the Health Informatics Centre showed that MOH hospitals covered between 77% to 93% of HF hospitalizations in Malaysia when considering only MOH and private hospital data from 2008 to 2016. Because complete patient-level data was required for the trend analysis, we included only hospitalizations from MOH hospitals. Study population Patients aged 20 years and above who had incident hospitalizations for HF between January 2007 and December 2016 were eligible for study inclusion. An incident HF hospitalization was defined as a hospitalization with a primary discharge diagnosis of HF without prior admission for HF within the past two years.[9] We used the unique personal identification number (MyKad), previous national identification or passport number for foreign nationalities in combination with date of birth and sex to determine recurrent hospital admissions by a unique patient. Any duplicated records
RkJQdWJsaXNoZXIy MjY0ODMw