Comparison between primary care service delivery in Malaysia and other participating countries of the QUALICOPC project: a cross-sectional study

BMJ Open. 2021 May 5;11(5):e047126. doi: 10.1136/bmjopen-2020-047126.


Objectives: Most countries including Malaysia have set goals to incorporate a strong primary care into the healthcare system. The aim of this study was to evaluate the strength of service delivery process dimensions in Malaysia and compare it with England, the Netherlands, Spain, North Macedonia, Romania and Turkey which participated in the Quality and Costs of Primary Care (QUALICOPC) study.

Methods: This cross-sectional study utilised the QUALICOPC study data on primary care performance, which was conducted in 2011-2013 (QUALICOPC in Europe Australia, New Zealand and Canada) and 2015-2016 (Malaysia). A standardised questionnaire was completed by primary care practitioners from participating countries. Multilevel regression analysis and composite scores were constructed to compare the performance of primary care on four process dimensions: accessibility, comprehensiveness, continuity of care and coordination.

Results: The high-income countries with strong primary care performed better in comprehensiveness, continuity and coordination but poorer in accessibility to services compared with upper-middle-income countries. Among the upper-middle-income countries, Malaysia scored the best in comprehensiveness and coordination. None of the studied countries were having consistent performance over all indicators either in their respective best or worst primary care services delivery dimensions.

Conclusions: There is a wide variation in primary care services delivery across and within the studied countries. The findings indicate room for quality improvement activities to strengthen primary healthcare services. This includes addressing current healthcare challenges in response to the population health needs which are essential for more integrated and efficient primary care services delivery.

Keywords: health services administration & management; primary care; quality in health care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Australia
  • Canada
  • Cross-Sectional Studies
  • Delivery of Health Care*
  • England
  • Europe
  • Humans
  • Malaysia
  • Netherlands
  • New Zealand
  • Primary Health Care*
  • Romania
  • Spain
  • Turkey