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探索马来西亚完成癌症治疗激励措施:患者见解与实施挑战

Navigating the completing cancer treatment incentive in Malaysia: patient insights and implementation challenges.

作者信息

Halim Nur Hidayati Abdul, Zainuddin Nur Azmiah, Aminuddin Farhana, Naserrudin Nurul Athirah, Hassan Nor Zam Azihan Mohd

机构信息

Institute for Health Systems Research, National Institutes of Health (NIH), Ministry of Health, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, Shah Alam, Selangor, 40170, Malaysia.

出版信息

BMC Health Serv Res. 2025 Mar 26;25(1):435. doi: 10.1186/s12913-025-12544-9.

Abstract

BACKGROUND

Cancer diagnosis imposes a significant economic burden on healthcare systems, patients, and their families particularly those from low-income households. To mitigate these challenges, Malaysia introduced the completing cancer treatment incentive (CCTI) under the PeKa B40 healthcare scheme to support cancer patients in completing their treatment. This study explores patients' experiences with the CCTI program to provide insights for refining policy interventions and enhancing the program's effectiveness in meeting the needs of its beneficiaries.

METHODS

This qualitative study examined the experiences of cancer patients with the CCTI program in Malaysia. Semi-structured interviews were conducted with 23 respondents, both CCTI recipients and non-applicants, from eight public hospitals. Data were anlaysed using the RE-AIM framework, focusing on the dimensions of reach, adoption, and implementation.

RESULTS

Patients' awareness of the CCTI varied, with recipients mostly informed through acquaintances, media, or healthcare providers. Non-recipients lacked awareness, with limited information provided by healthcare personnel. While the CCTI was perceived as valuable for alleviating financial burdens, particularly transportation costs, it did not appear to significantly influence treatment-seeking behaviours, as most patients expressed willingness to continue treatment even without financial aid. Implementation challenges included a burdensome application process requiring mandatory health screening, lack of clarity regarding procedures, and inadequate communication about claim approvals. Patients frequently encountered delays and confusion, exacerbated by insufficient support from healthcare providers. Additionally, many were unaware that transport incentives could be claimed for every hospital visit, further limiting the program's usefulness.

CONCLUSIONS

The study highlights critical gaps in the CCTI program's design and delivery, including inadequate communication strategies, complex administrative processes, and a lack of transparency. Addressing these challenges are essential to improve program reach and ensuring equitable access to CCTI. Policymakers should prioritise streamlining application process, enhancing information dissemination, and leveraging digital tools to improve patient experiences. Future studies should assess the program's long-term sustainability and impact on treatment adherence and outcomes. The findings underscore the importance of adopting patient-centred approaches in designing financial aid programs to enhance healthcare equity and access.

摘要

背景

癌症诊断给医疗系统、患者及其家庭,尤其是低收入家庭带来了巨大的经济负担。为了应对这些挑战,马来西亚在“佩卡B40”医疗保健计划下推出了完成癌症治疗激励措施(CCTI),以支持癌症患者完成治疗。本研究探讨患者在CCTI计划中的经历,以便为完善政策干预措施和提高该计划满足受益者需求的有效性提供见解。

方法

这项定性研究考察了马来西亚癌症患者在CCTI计划中的经历。对来自八家公立医院的23名受访者进行了半结构化访谈,受访者包括CCTI受益者和未申请者。使用RE-AIM框架对数据进行分析,重点关注覆盖范围、采用情况和实施情况等维度。

结果

患者对CCTI的认知程度各不相同,受益者大多是通过熟人、媒体或医疗服务提供者得知该计划的。未受益者缺乏了解,医疗人员提供的信息有限。虽然CCTI被认为对减轻经济负担,特别是交通费用很有价值,但它似乎并没有显著影响患者寻求治疗的行为,因为大多数患者表示即使没有经济援助也愿意继续治疗。实施方面的挑战包括申请过程繁琐,需要进行强制性健康筛查,程序不明确,以及关于理赔批准的沟通不足。患者经常遇到延误和困惑,而医疗服务提供者的支持不足则使情况更加恶化。此外,许多人不知道每次医院就诊都可以申请交通补贴,这进一步限制了该计划的实用性。

结论

该研究突出了CCTI计划在设计和实施方面的关键差距,包括沟通策略不足、行政流程复杂以及缺乏透明度。应对这些挑战对于扩大计划覆盖范围和确保公平获得CCTI至关重要。政策制定者应优先简化申请流程,加强信息传播,并利用数字工具改善患者体验。未来的研究应评估该计划的长期可持续性及其对治疗依从性和治疗结果的影响。研究结果强调了在设计经济援助计划时采用以患者为中心的方法对于提高医疗公平性和可及性的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6185/11948719/6a187d5eb9c2/12913_2025_12544_Fig1_HTML.jpg

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