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Utilization of Radiology Service at Dungun District Hospital in Malaysia

Introduction: District hospitals in Malaysia, like other district hospital all over the world, function as important gateway between primary and tertiary health care systems. Dungun hospital, one of the district hospitals in Terengganu state, provides services to accidents and emergency, inpatients and outpatients including referrals from community and primary health care services. In addition, it serves as referral hospital to get tertiary health care from Terengganu State hospital. Dungun hospital is equipped with three X-ray units and three ultrasound machines for 24-hour service. Being a district hospital, Dungun hospital can provide only the generalist service without radiologist. Yet the radiology service is accessible for all demands.

Objective: To explore the utilization of radiology services at Dungun District Hospital, Terengganu State, Malaysia.

Methods: Retrospective one-year record review study was conducted. X-ray request forms and registration books between 1st January 2011 and 31st December 2011 were reviewed and double checked by pediatrician, physician, surgeon, obstetric and gynecologist, radiologist, staffs from radiology unit of Dungun Hospital, public health professionals and matron who sit and made consensus altogether to enter data properly. Data management for 13649 X-rays cases was done within 4 months from September, 2012 to December, 2012.

Results: Dungun Hospital is a 100-bedded hospital in which (11) medical officers, (378) total staffs, (315) clinical staffs and (9) visiting specialists are attached. Radiology unit equipped with (1) Static X-ray machine, (2) Portable machines, (5) radiographers and additional (2) PPKs (Pembantu Perawatan Kesihatan) and (15) trainee radiographers. Out of a total of 13649 radiological examinations, the highest number (5603) was contributed by the extremities X-rays followed by the chest X-ray (5355), the spine X-ray (1090), the skull X-ray (1082) and the abdominal X-ray (519) respectively. Among the study group, 8451 were males, (3685) of them took extremities X-ray and (3063) took chest X-ray. Out of 5198 females, chest X-ray and extremities X-ray were taken by (2292) and (1918) respectively. The age range in the study group was from 1 to 99 years. The mean age was 32.01 years (32.01+ 20.92). Out of 13649 examinations, majority (6324) was requested from A & E Department, followed by (3438) from out- patient department, (1462) for Routine Medical Examination (RME), (1061) from specialist clinic referral, (822) for in-patients in various wards and (542) utilized as portable X-ray. Amongst total utilization of Chest X-ray, 75.3% had properly and completely filled the request form (properly given relevant information on request form). It was found that 71.9% in Abdominal X-ray utilization, 78.2% in skull X-ray utilization, 73.9% in Extremities X-ray request and 74.1% in Spine X-ray services filled the forms properly and completely as well.

Conclusion: According to operational definition of appropriateness of this study, findings can be concluded that the radiology services at Dungun District Hospital were appropriately utilized.

Author(s): San Thitsa Aung , San San Oo , M. Kamil , Zay Soe , Zaw Aung , Aung Zin Oo , Yin Moe Han

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