Exploring Patients’ Experience on Hospital Merger: Have they benefited from Cluster Hospital Initiative in Malaysia?

Abstract

Cluster Hospital Initiative (CHI) in Malaysia is a hospital merger exercise to establish an integrated network of specialist and non-specialist hospitals. The resource sharing, services realignment, and better care coordination from this integration have been shown to improve operational efficiency and quality of care from the providers’ perspective. However, there are very limited studies which focus on the effects of hospital merger on patients. Therefore, this study aims to explore patients’ and caregivers’ experiences of CHI. A qualitative study using purposive sampling was conducted from July to August 2017 at the three pilot sites. Semi-structured in-depth interviews were conducted with 85 patients and caregivers who received healthcare services before and after CHI. Interviews were audio-recorded and transcribed verbatim. Data were analysed using thematic text analysis. Three main themes transpired from the analysis were changes in healthcare service delivery, time spent on healthcare-related activities, and financial implications. Firstly, participants were generally satisfied with the increased access to specialist services, better quality of care, and upgraded equipment and facilities. Secondly, many participants experienced a shorter waiting time and reduced travelling time after CHI. Thirdly, CHI led to financial savings for the participants in terms of reduced out-of-pocket expenditure and productivity loss. This study demonstrated that the implementation of CHI appeared to be well-received by the patients. The expected benefits brought on by hospital mergers were also acknowledged by the study participants. A follow-up study is recommended due to the short duration of CHI implementation and low awareness about the initiative among patients.