A contribution from Professor Dato Dr Hanafiah Harunarashid and Dr Husyairi Harunarashid
The implications of the COVID-19 pandemic on surgical waiting lists are profound, including a dramatic rise in cost and further delay in the waiting times for elective surgical procedures. New measures were put in place to counter the significant increased risk of mortality following surgery in patients with active COVID-19 infection, which was reported recently in a global study.
Whilst the professional community of surgeons have already made a call for action and urged for better investment to improve the service provision for elective operations, there is also another area that is in desperate need for adequate funding and leadership that has yet to feature in any COVID-19 response agenda.
Need for Funding to Improve Data on Health Service Provision
Although there are initiatives in research specifically addressing the pandemic both on the local and international front, many tend to preferentially fund investigative work for cures and solutions highly specific to the contagion and its related disease processes. Though this may be seen as a good prioritization of funds with the best return of investment potential, the skewed favouritism diverts away most of research funding from exploratory work in practice development and quality improvement projects.
The current ecosystem of funding for research locally is arguably lacking support for initiatives to collect better data on health service provision, particularly for surgery.
This is not unique only to Malaysia, as evidenced by the motivations to set up an international network of research hubs in low- and middle-income countries for global health research on global surgery in 2017.
Haphazard and uncoordinated gathering of service data yields little potential to provide the needed insight to create a better solution for the rakyat when it comes to surgical lists.
Funding to Study Impact of COVID-19 on Surgical Waiting Times
There is a great need now to create a source of funding for research in the influence of the COVID-19 pandemic on surgical waiting times that can be tapped equally by all parties, whether in the public or private sector. There is also a need for a strategic research master plan, with the leadership and political will to carry it through.
An open data environment is advantageous, allowing for relatively free flow of information within acceptable security parameters for researchers, practitioners and policy makers.
There can be many solutions proposed, but all must go through rigorous review with the appropriate objective measures as to add to the body of evidence generated locally. How this can be achieved is still uncertain, at least until there is a momentum to push for change.
Better Quality Data Yields Benefits
Should the country become successful in overcoming the potential problem of rising cost and longer waiting times, this may in fact be a boon to the healthcare travel industry (more popularly known as medical tourism) as many patients from other countries too are equally affected by the pandemic.
The race is now on for a more efficient and cost effective method to streamline elective surgical procedures, but Malaysia may be left behind if there were no move to initiate, support and promote more high quality, data-driven research in this area.
About the Authors
Professor Dato Dr Hanafiah Harunarashid is a vascular surgeon and the Director of Hospital Canselor Tuanku Muhriz, the teaching hospital of Universiti Kebangsaan Malaysia.
Dr Husyairi Harunarashid is a clinical epidemiologist serving in Hospital Canselor Tuanku Muhriz.