Patient Perceptions the Literature Review

Patient Perceptions

The literature review is important in this study because it provides much more than what is normally provided by a literature review. In this study it will provide information that will assist in showing how health care clinics are generally viewed by its patients as well as how the health care employees view their work, and how the interactions between the two entities provides an health care environment that will allow for the improvement of health care.

The literature review will also show how the country of Malaysia, and specifically the city and area of Kuala Lumpur, is quickly becoming a modern, developed country complete with the financial, industrial and, of course, the medical facilities that denote that development. The review will include information on how health care facilities can encounter problems as well as how health care clinics are able to generate revenue and profits for themselves or the hospitals they are affiliated with.

"Malaysia is developing rapidly from an agricultural to a developed state. The nation's health status has improved significantly with its infant mortality rate decreasing from 19.7 in 1981 to 5.9 per 1000 live births in 2004, while the life expectancy of males and females were 70.4 and 76.2 years in the same year" (Statistics Department, 2004). That Malaysia is quickly transforming itself into a developed country, fully participating in both the benefits and the quagmires that come with such development is not news to the world, and certainly other countries can learn from such development, as well as Malaysia continuing to learn from other, more developed countries than itself.

There are a number of developments that the world has taken notice of however, including an international airport that is rivals the best that other, larger countries have to offer. "An international airport is an important place where overseas visitors' first impressions of a country are created. At night, light shines from KLIA's skylights, casting a pattern that is suggestive of a grove of graceful palm trees -- a major characteristic of this country. This beautiful lighting design evokes an extremely exotic atmosphere -- an atmosphere that makes visitors realize they are about to have a rare and exciting Malaysian experience" (Kurokawa, Takami, Cheriex, 1999, p. 42).

Malaysia cannot only boast of its international airport, it also has commercial buildings and banks that are also second to none.

"At 88 stories, or 1,483 feet, the Petronas Twin Towers in Kuala Lumpur are the tallest on earth -- and perfectly adapted to Malaysian soil" (Chowdhury, 1999, p. 110). That the towers are only partially filled with tenants lends an air of vulnerability to the project, and portends similar problems that will be faced by the health care industry in Lumpur, including the health care clinics there. That the country will need to upgrade and improve its health care facilities goes hand in hand with the growth and improvement of its financial wealth and economy. Lately the financial industry in Malaysia has become more adept at raising the capital necessary to attract investors, visitors and citizens to the small southeast Asia country. An example of the financial growth there is the amount of investment capital being raised by a few of Malaysia's investment bankers.

"First, it was 150 million shares, then 200 million, then 250 million shares...They kept raising the ante, and we kept saying, 'Okay, we will try.'" ECM Libra succeeded: It placed 260 million shares worth 1.33 billion ringgit ($350 million), easily the biggest equity placement in Malaysian capital markets' history" (Shameen, 2004, p. 69). This display of financial strength brings credence to the area, and provides the capital necessary for an infrastructure that will build on that strength. The citizens of Malaysia will benefit by witnessing the growth of their economy and the many advantages that such growth can bring to their country. Those benefits conceivably can include health care advantages for citizens, and especially if those citizens are looking forward to such health care benefits.

This anticipation may not be necessarily what the citizens of Malaysia have earmarked as their highest priorities. Much of the health care provided for them at any of the local clinics may not be what the citizens are looking for. The citizen's attitudes towards health care is likely to be different than the citizens from other developed countries.

This study will seek to discover those attitudes and how they affect health care coverage, and efficiency of the doctors, nurses and health care professionals at a health care facility in Kuala Lumpur. The study will seek to determine whether the attitudes affected by the citizens affects the health care coverage.

"Previous literature suggests that attitudes have critical effects on recovery outcomes. Yet mental health professionals' attitudes towards psychiatric rehabilitation principles (PRP) have not been fully addressed" (Song, 2007, p. 232). It is not just the citizen's attitudes that can be examined, but the health care professional's attitudes as well. "The question is whether mental health professionals agree with the values and principles proposed in the literature and to what extent they could enact these principles. Given the importance of attitude on outcomes, however, the topic has not yet been fully addressed" (Song, p. 233).

Professional and layman attitudes are especially important in Southeast Asia, since health care in general is looked at in a different light than in Western civilizations. Physicians are generally well respected in both Asia and in the West with one recent article stating that, "physicians in the U.S. still enjoy lofty professional status and high salaries" (Romano, 2006, p. 40). However, the professional status of the physicians does not mean that the physicians in Kuala Lumpur will not ultimately face the same problem(s) as those facing their counterparts in the United States and elsewhere including the fact that, "six of 10 have considered leaving the practice of medicine because of a long list of concerns, including low reimbursements, long hours, a loss of autonomy and the frustrating tangle of bureaucratic red tape" (Romano, p. 40). This type of scenario can affect the doctors and patients of the facilities in a variety of ways.

However, the health care clinics also face a number of problems that can either enhance or detract from patient's attitudes towards the clinic and the services provided there. Health care facilities, especially clinics, are under the gun in their efforts to become profitable entities.

One recent article states, "Whether it is HealthSouth, GM or anybody else, these companies' profits are predicated on their ability to stay competitive" (Zigmond, 2006, p. 6). The companies the article refers to are health care clinics in the United States. The article also espouses the fact that "underfunding could cause access issues for patients. But even more important, the ability to conduct research could be compromised, he said. "The question always becomes one of how do you focus on patient care when you're underfunded?" (Zigmund, p. 6). With the improving quality of care via the health clinics and hospitals currently being funded in Malaysia will come the expectations of that improved care and the accessibility that goes with it. If the accessibility is constrained at any point, then patient's attitudes and perceptions could suffer. Therefore the clinics will have to hire management that will forsee such problems and manage them in a proactive manner. One experts touts the fact that, "healthcare financial managers need to determine what is best for their particular facility" (Manson, 2002, p. 53). Healthcare facilities in Kuala Lumpur may not face the exact same situations or problems that similar facilities around the world are faced with, but if they are then the quality and accessibility of care will likely be affected as well.