Evidence map›Paper›PMID 39855658›Full record

ArticleBMJ open2025

Non-communicable diseases and their associations with outpatient services utilisation: insight from a population-based survey in Malaysia.

Awatef Amer Nordin, Suhana Jawahir, Adilius Manual, Jabrullah Ab Hamid, Iqbal Ab Rahim, Sarah Nurain Mohd Noh, Nur Elina Ab Mutalib, Nurul Salwana Abu Bakar

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Awatef Amer NordinInstitute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia.ORCID 0000-0002-1434-5136
Suhana JawahirInstitute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia suhana.jawahir@gmail.com.ORCID 0000-0001-5665-2479
Adilius ManualInstitute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia.ORCID 0000-0003-3851-4886
Jabrullah Ab HamidInstitute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia.ORCID 0000-0002-0223-1123
Iqbal Ab RahimInstitute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia.ORCID 0000-0002-6213-7753
Sarah Nurain Mohd NohInstitute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia.ORCID 0000-0003-2446-091X
Nur Elina Ab MutalibInstitute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia.ORCID 0000-0001-8953-8269
Nurul Salwana Abu BakarInstitute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia.ORCID 0000-0003-1271-939X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesMultimorbidity has been recognised as a global public health issue, and individuals with multimorbidity have been found to have high healthcare utilisation. This study aims to estimate the prevalence of non-communicable diseases among adults in Malaysia, identify factors associated with multimorbidity, and assess the association between the number of non-communicable diseases and outpatient services utilisation. DESIGN AND

settingA retrospective secondary data analysis using data from the National Health and Morbidity Survey 2019, a cross-sectional household survey among the population in Malaysia.

participantsAll adults aged 18 years and above. OUTCOME MEASURES: The two outcome variables were multimorbidity and outpatient services utilisation. Characteristics of respondents and those having multimorbidity were described using complex sample descriptive statistics. We used multivariable logistic regression to determine the associated factors of having multimorbidity and the association between the number of non-communicable diseases and outpatient services utilisation.

resultsOverall, 11 347 respondents were included in the analysis. This study found a prevalence of 11.4 (95% CI=10.43-12.39) for multimorbidity. Age, marital status and working status were the factors associated with multimorbidity. Adults with multimorbidity were high users of outpatient services (20.4%, 95% CI=17.5-23.7), approximately threefold of adults with no non-communicable diseases. In the final model, multimorbidity showed an adjusted OR of 3.28 (95% CI=2.48-4.32) for outpatient services utilisation.

conclusionUnderstanding factors associated with multimorbidity and the magnitude of the impact of having multimorbidity towards outpatient services utilisation could help in future planning for healthcare system transformation. The recently launched Health White Paper for Malaysia has emphasised primary healthcare as a critical component to achieve aspirations of the health system, which includes equity and responsiveness. Strengthening primary care services and improving patient navigation across healthcare levels are critical to supporting individuals with multimorbidity. Avenues for further research include exploring a wider range of conditions and assessing the longitudinal impact of multimorbidity on healthcare utilisation and health outcomes.

Indexed as

Ambulatory CareMultimorbidityNoncommunicable DiseasesPatient Acceptance of Health CareAdolescentAdultAgedCross-Sectional StudiesFemaleHumansMalaysiaMaleMiddle AgedPrevalenceRetrospective StudiesYoung AdultHealth ServicesHealth SurveysMultimorbidityPrimary Care

Identifiers

PMID39855658
PMCPMC11759202

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.