Resource management for full paying patient service in Malaysia: issues and challenges

Full paying patient service (FPP) in the Ministry of Health Malaysia (MOH) hospitals was established as one of the specialist retention initiatives in 2007. FPP hospitals experience significant challenges in managing their resources while serving the public as their utmost priority. A semi-structured guide was used in 17 focus group discussions and 12 in-depth interviews with specialists, hospital directors, and supporting staff exploring issues and challenges in managing hospitals' resources. Four sub-themes were identified (ward/facility, medical equipment, drugs/consumable, workforce). Some of the issues include no dedicated FPP ward/equivalent ward, sharing of medical equipment and specialists' medication quota between public and FPP patients, inability to charge unlisted drug/consumables in the Fee Act. Limited human resources, especially among the support group to run FPP, lead to an increase in workload and dissatisfaction. Proper planning and close monitoring by MOH and individual hospitals are crucial to overcome these issues and improve the service.