Continuity of care essential for good health outcomes

I WOULD like to respond to the letter “Neglected aspect of care” by Abdul Rahman Abdullah that appeared in The Star on May 28 (online at

The narrative of neglect, or a lack of continuity of care, of patients discharged from a hospital has been a faultline in our healthcare services, be they public or private, for decades. It is indeed sad. The silver lining is that there are medical personnel in hospitals who do care about what happens to discharged patients, and in the community, there are individuals and organisations, formal or ad hoc groups, who come forward to help when they become aware of persons needing help of one kind or another. This feature of helping, akin to the good Samaritan, is a global phenomenon for which we humans must, ironically, thank the Covid-19 pandemic.

How many discharged patients in the country fall into this category of a lack of continued care is anyone’s guess. I do not think it is important to do a survey to find out the numbers. The reality is it is indeed happening in Malaysia.

My suggestion is that healthcare personnel find out from the patient, or the family, prior to discharge if they are aware of a local community organisation that can help. Then get the patient’s (or family’s) permission to inform the organisation of the patient’s needs. Patients who agree would have the organisation documented in their hospital file, and the organisation informed, if possible a day or two before discharge.

Where the patient and family are unaware of any organisation, health personnel can contact institutions where the patient lives, such as the adun’s (state assemblyman) office, residents’ associations, or ketua kampung (village chief). In addition, an advisory from the state medical director that is endorsed by the state government and sent to hospitals and adun offices would help.

We are going through rather troubled times with much uncertainty as the threat to our lives and livelihoods is likely to continue for some months. A solution is for the government and the public to work together.

This pandemic is seeing a growing call globally for humanity to change to a new normal that respects persons and the environment and that works towards equitable communities of people and nations. In this respect, and relating to our healthcare services, we in Malaysia must grasp this opportunity to correct this lack of continuity in care.

Far too long our medical services have focused on institutional care – hospitals and clinics – disregarding the fact that medical care can be given in the community and even in homes, and that continuity of care, or seamless care, is essential for good outcomes.

We must thank Abdul Rahman for drawing attention to this much neglected aspect of care.



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