SOCIAL SECURITY ORGANISATION OF MALAYSIA THE SOCSO HEALTH SCREENING PROGRAM – TREND AND USAGE DR. AZLAN DARUS MPH MPH(Occ Health) MFOM CIME AOEMM Manager Prevention and Health Promotion Unit Medical and Rehabilitation Section SOCSO 9/2/2014 DR. AZLAN DARUS 9/2/2014 1 1 2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR SOCIAL SECURITY ORGANISATION OF MALAYSIA Non-Communicable Diseases • The burden of non-communicable diseases in Malaysia is high. (National Health Morbidity Survey 2011) – Fifteen percent of Malaysians above the age of 18 years old was found to be diabetics. The prevalence among those above 40 years old was 17.6%, steadily increasing according to age groups, reaching 31.6% once they reach age 55 years old. – The prevalence of hypertension among those aged 40 years and above was 35.8%, with increasing trend as they aged. – Similarly within the same group were the prevalence of hypercholesterolaemia (40.5%), obesity (31.6%) and pre-obese (41.0%). 9/2/2014 DR. AZLAN DARUS 9/2/2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 2 2 INITIATING EMPLOYEES’ HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA SURVIVOR’S PENSION REPORTED FOR NCD CASES: YEAR 2000 - 2013 INVALIDITY PENSION BENEFIT REPORTED FOR NCD CASES YEAR 2000 - 2013 6,000 5,000 5,000 4,000 4,000 YEAR Cardiovascular Diabetes Cancer Mental disorders YEAR Cardiovascular Diabetes Cancer Mental disorders Respiratory Total 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2013 2012 2011 2010 2009 2008 2007 2006 0 2005 0 2004 1,000 2003 1,000 2002 2,000 2001 2,000 2002 3,000 2001 3,000 2000 NUMBER 6,000 2000 NUMBER 7,000 SOCIAL SECURITY ORGANISATION OF MALAYSIA NCD constitutes large percentage of claims… SURVIVORS PENSION 2010-2012 INVALIDITY 2010-2012 17552 10950 12000 10000 9174 8672 8167 16000 14000 12000 8000 6000 18000 4149 4179 4514 4959 11972 12814 13615 10000 8000 6000 4000 5734 4252 4222 4572 4000 2000 51 % 48 % 46 % 49 % 0 0 2010 2011 2000 2012 2013 Total Survivors Pension Survivors Pension due to NCD 36 % 2010 33 % 2011 34 % 33 % 2012 2013 Total invalidity Invalidity due to NCD SOCIAL SECURITY ORGANISATION OF MALAYSIA General health screening • Has long been a common element of health care in some countries • Intended to reduce morbidity and prolong life – Possible benefits • Preventive treatment reducing morbidity and mortality • Detection of precursors of disease e.g cervical dysplasia • Detection of sign and symptoms of manifest disease otherwise not considered important • Some may improve lifestyle following screening and counselling Lasse T Krogsbøll , Karsten Juhl Jørgensen , Christian Grønhøj Larsen, Peter C Gøtzsche ; BMJ 2012;345:e7191 doi: 10.1136/bmj.e7191 9/2/2014 DR. AZLAN DARUS 9/2/2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 5 5 INITIATING EMPLOYEES’ HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA General Health Screening • In the UK, publicly funded NHS check programme in 2009. Full implementation in England in 2013 – Have so far offered the screening to 1.3 million people. – Almost 650 000 had gone through the screening – Despite criticism from the certain parties’ the UK government is continuing the effort; with good participation rates ‘We could save 650 lives a year, prevent 1,600 heart attacks and strokes, and prevent over 4,000 new cases of diabetes if there was full take-up,’ Norman Lamb- Health Minister http://www.healthcheck.nhs.uk/ 9/2/2014 DR. AZLAN DARUS 9/2/2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 6 6 INITIATING EMPLOYEES’ HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA General Health Screening • In Japan; nationwide health screening programme targeting metabolic syndrome since April 2008. – Screening and risk based counselling – Raise public awareness on metabolic diseased and promote better lifestyles Kohro, Furui, Mitsutake et al. ; Int Heart J March 2008 • In S. Korea; national screening program introduced in 1995. – Enhanced to “National Screening Program for Transitional Ages” in 2007 – Target two age groups; 40 and 66 years old – About 55.5% participation rates in 2009 Hyun Su Kim, Dong Wook Shin, Won Chul Lee et al. ; J Korean Med Sci 2012; 27: S70-75 9/2/2014 DR. AZLAN DARUS 9/2/2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 7 7 INITIATING EMPLOYEES’ HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA General Health Screening • In Singapore; – Integrated Screening Programme • nation-wide programme for Singaporeans aged 40 years and older • screened for diabetes, high blood pressure, high blood cholesterol, obesity and cervical cancer at registered GP clinics. • Subsidized screening cost; user pays for consultation • In Malaysia; – Free health screening for government employees age 40 years old at government health clinics • Since 1969 (managerial and professionals) • 2003 to include all employees • Not mandatory, but “strongly encouraged” – NGOs – For private employees; • Depends on medical benefit provided by companies 9/2/2014 DR. AZLAN DARUS 9/2/2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 8 8 INITIATING EMPLOYEES’ HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA The SOCSO Health Screening Programme • Offered to all insured persons by SOCSO at the age 40 years old. • As a way to provide benefit token to all active employees • To increase insured persons awareness of noncommunicable diseases • Promote healthy lifestyle and health empowerment via early detection and counseling by the doctors 9/2/2014 DR. AZLAN DARUS 9/2/2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 9 9 INITIATING EMPLOYEES’ HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA • Health Screening as a means; not the end – ENABLING employees in the country to take charge of their health • By knowing their own health status 9/2/2014 DR. AZLAN DARUS 9/2/2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 10INITIATING EMPLOYEES’10HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA 9/2/2014 DR. AZLAN DARUS 9/2/2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 11INITIATING EMPLOYEES’11HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA USAGE AND TRENDS 9/2/2014 DR. AZLAN DARUS 9/2/2014 12 12 2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR SOCIAL SECURITY ORGANISATION OF MALAYSIA The SOCSO Health Screening Program • Roll out Jan 2013 • 1 900 000 active employees are eligible for the year 2013 • All eligible employees are invited through vouchers sent via their employers • In 2014; a further 250 000 employees became available – Vouchers had already been sent 9/2/2014 DR. AZLAN DARUS 9/2/2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 13INITIATING EMPLOYEES’13HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA The SOCSO Health Screening Programme (31 Dec 2013) 327 685 94 Employees underwent the health screening 109 019 Women used the mammogram voucher Mammogram centers 9/2/2014 DR. AZLAN DARUS 9/2/2014 215 3048 Laboratories Registered clinics SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 14INITIATING EMPLOYEES’14HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA The SOCSO Health Screening Programme (August 2014) 389,315 102 Employees underwent the health screening 133,403 Women used the mammogram voucher Mammogram centers 9/2/2014 DR. AZLAN DARUS 9/2/2014 226 3163 Laboratories Registered clinics SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 15INITIATING EMPLOYEES’15HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA Trend Penggunaan Baucar HSP 69,049 34749 35786 33938 24874 26938 23406 21427 20666 18815 15120 12397 5000 1353 0 0 0 0 9/2/2014 DR. AZLAN DARUS 9/2/2014 0 0 0 0 0 0 0 0 2422 10308 4809 2918 16 7322 2829 2422 2422 1398 2422 16 2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR SOCIAL SECURITY ORGANISATION OF MALAYSIA Trend of use by state percentage 80000 70000 60000 50000 40000 30000 20000 10000 0 9/2/2014 DR. AZLAN DARUS 9/2/2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 17INITIATING EMPLOYEES’17HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA Trend of use by state percentage 35 30 25 20 15 10 5 0 9/2/2014 DR. AZLAN DARUS 9/2/2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 18INITIATING EMPLOYEES’18HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA Gender Used 150999 54% 173871 Used vs Distributed 46% 1400000 Male 1200000 Female 1000000 800000 600000 400000 16% 24% male female 200000 0 9/2/2014 DR. AZLAN DARUS 9/2/2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 19INITIATING EMPLOYEES’19HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA 150,145 Ethnicity 140000 120000 111,264 160000 100000 7,600 40000 20000 3,298 60000 9,702 39,994 80000 0 Malay 9/2/2014 DR. AZLAN DARUS 9/2/2014 Chinese Indian Bumiputera Bumiputera Sabah Sarawak SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 Others 20INITIATING EMPLOYEES’20HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA Number of unused vouchers and employers # employers 1343 53 40648 <5 5-100 154,305 9/2/2014 DR. AZLAN DARUS 9/2/2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 100-1000 >1000 21INITIATING EMPLOYEES’21HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA HSP Voucher Until 2014 450,000 400,000 ? 350,000 300,000 250,000 200,000 150,000 100,000 50,000 0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2013 2014 Actual 9/2/2014 DR. AZLAN DARUS 9/2/2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 22INITIATING EMPLOYEES’22HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA 9/2/2014 DR. AZLAN DARUS 9/2/2014 23 23 2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR SOCIAL SECURITY ORGANISATION OF MALAYSIA ISSUES • Don’t know that such benefit exists • Voucher not received by employers • Voucher not distributed by employers – Distance / extra task – Employer have better program • Employees received voucher – Interested and use – Interested but not suitable time / procrastinate • Leave issues • Time off work issues – Have done it at other times – Not interested 9/2/2014 DR. AZLAN DARUS 9/2/2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 24INITIATING EMPLOYEES’24HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA Would these work? • Employer – provide time assistance. – Integrate into current medical benefit system • Clinics – Close work with employer • Mass workplace screening • Reporting agreement • More clinics participation 9/2/2014 DR. AZLAN DARUS 9/2/2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 25INITIATING EMPLOYEES’25HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA Pre conclusion • Nearly 400 000 employees nationwide had gone through the health screening program nationwide • There has been adequate enrolment by participation clinics • About 20% or less utilisation rate so far – Have we reached a plateau? • THE HSP is here to stay – We need higher usage! – Use it! 9/2/2014 DR. AZLAN DARUS 9/2/2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 26INITIATING EMPLOYEES’26HEALTH SOCIAL SECURITY ORGANISATION OF MALAYSIA azlan.darus@perkeso.gov.my 9/2/2014 DR. AZLAN DARUS 9/2/2014 SOCSO WORKERS’ HEALTH PROMOTION SEMINAR 2014 27INITIATING EMPLOYEES’27HEALTH