Assessment of the Knowledge, Attitude and Perception on Casemix System Among the Hospital Staff and Assessment of Hospital Information System in Malaysia and Indonesia: Evaluation of the Readiness Towards Casemix Implementation

Abstract

A study was carried out in Malaysia and Indonesia to assess the current state of Knowledge, Attitude & Perception (KAP) among the hospital staff regarding Casemix and to assess the Health Information System (HIS) used in the hospitals. Samples of hospitals and respondents were selected via random and purposive sampling, respectively. A total of five hundred and fifty (550) self-administered questionnaires were distributed among the hospital staff and three hundred and fifty (350) questionnaires were returned and completed giving the response rate of 63.6%. Most of the respondents were from Indonesia (58.6%) and the rest were from Malaysia. Most of the respondents (58.0%) had a moderate level of knowledge score, medium level of perception score (84.9%) and negative attitude (90.0%) on Casemix. The study found that years of working experience, type of occupation, hospital type, country and those with training in Casemix were significantly related to knowledge score. No independent variable except for country was related to perception score. Multivariate analysis showed that respondents from Indonesia (B=2.854; p<0.0001) and hospital type B (B=0.394; p=0.032) were significantly related to high knowledge score. Also, respondents having more experience (B=1.722; p=0.005) were significantly related to attitude score. Those respondents in Indonesia (B=2.167; p<0.001) working in hospital type B (B=-0.987; p=0.008) and type C (B=-1.632; p<0.01) were significantly related to perception score. It was also found that majority (66.7%) of the participating hospitals (N=36) completely captured the demographic data in their HIS, 47.2% completely implementing the coding module as per Casemix requirement and 27.8% of the hospitals recorded the Activity Daily Living (ADL) score in their system. In conclusion, Indonesian respondents had higher knowledge and perception compared to respondents from Malaysia. It also indicated that, if the hospital staffs were supplied with adequate knowledge, they may eventually have positive perception on Casemix. HIS in most hospitals are ready to adopt the Casemix system with minor enhancement.