A Comparative Study of Hospital Staff Perception in the Implementation of Casemix System in two Teaching Hospitals in Malaysia and Indonesia

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ACKNOWLEDGEMENTS

I would like to take this opportunity to thank the people, who have helped me in completing this study and without whom this project may have not been possible. In particular, my gratitude goes out to friends, facilitator and family for extensive and helpful comments on early drafts. I am also deeply indebted to the authors who have shared my interest and preceded me. Their works provided me with a host of information to learn from and build upon, also served as examples to emulate.

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DECLARATION

I, (Your name), would like to declare that all contents included in this thesis/dissertation stand for my individual work without any aid, & this thesis/dissertation has not been submitted for any examination at academic as well as professional level previously. It is also representing my very own views & not essentially which are associated with university.

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ABSTRACT

This study is about the hospital staff perception regarding implementation of Casemix System in two teaching hospitals of Malaysia and Indonesia. The study focuses on the various aspects of the implementation of Casemix system. Controlling for variations in teaching hospitals casemix is a problem which confronts researchers working in a number of areas. The methodology that is used in this study is primary. Questionnaire was distributed to the 300 participants, but only 264 participants responded to the questionnaire survey. The participants are the employee of the two hospitals that are located in Malaysia and Indonesia. The study found that there is a difference in the KAP test scores between the two hospitals, which can be elaborated further by the fact that there is no significant relationship between age, sex, years of experience and hospital types with Knowledge and Perception. Knowledge was proven to be positively correlated with Perception.

CONTENTS

ACKNOWLEDGEMENTS2

DECLARATION3

ABSTRACT4

CHAPTER 1: INTRODUCTION8

1.1Background8

1.2Introduction8

1.3Problem Statement11

1.4Significance of the study11

1.5Objective(s) of the study11

1.6Scope and Limitation of the study12

1.7Theoretical framework12

1.8Hypotheses12

1.9Rationale of the Study13

1.10Research questions13

1.11Approach for completing literature13

CHAPTER 2: LITERATURE REVIEW14

2.1Introduction14

2.2Casemix System: Overview15

2.3The debate over payment adequacy19

2.4Assessing payment adequacy21

2.5Literary relationship of recent studies to the CMS24

2.6New technology27

2.7The proliferation of hospital health IT and Casemix systems28

2.8Technology Acceptance Model (TAM)29

2.9Technology Acceptance in Industry31

2.10Clinical Documentation31

2.11Redundancy32

2.12Text duplication without redundancy34

2.13Clinical Summarization35

2.14Information Duplication in Clinical Notes36

2.15Technology Acceptance in Healthcare36

2.16HIPAA and security38

2.17Conclusion of the literature review41

CHAPTER 3: METHODOLOGY43

3. 1Research design43

3. 2Source and type of data use43

3. 3Population and sample43

3.3 1Rumah Sakit Dr. M. Jamil (RSMJ)44

3.3 2University Kebangsaan Malaysia Medical Centre (UKMMC)44

3. 4Sampling Methods45

3. 5Procedure46

3. 6Data Analysis Methods47

3.6 1Knowledge48

3.6 2Experience48

3.6 3Perception48

3. 7Validity49

3. 8Significance50

3. 9Confidentiality50

3. 10Reliability/Dependability51

3. 11Ethical Issues51

CHAPTER 4: FINDINGS & DISCUSSION53

4. 1Background profile of respondents53

4.1 1Distribution of Respondents53

4. 2Descriptive Statistics on Knowledge, Perception and Experience55

4.2 1Knowledge55

4.2 2Experience57

4.2 3Perception59

4. 3Knowledge and Perception Relationship with Independent Factors60

4. 4Hypothesis testing (t-test)66

4. 5General Perceptions by Healthcare Professionals67

4. 6Analysis69

4. 7Electronic patient record71

4. 8Adaption of EHR74

4. 9Nurse perceptions of CMS76

4. 10Nurse self-efficacy with CMS77

4. 11Economic Impact78

4. 12Market failure/Imperfect Information80

4. 13Clinical Summarization81

4. 14Information Duplication in Clinical Notes82

4. 15Text Duplication without Redundancy82

4. 16Electronic Data System (EDS) Tools and ...