Summary

We determine the provision for dialysis treatment in Malaysia. There were 181 dialysis centres as at 1st June 1999 (161 HD and 20 CAPD centres), providing treatment for 5614 patients. This is equivalent to an estimated prevalence rate of 253 patients per million population(pmp) and new dialysis acceptance rate of 49 patients pmp. Dialysis facilities were widely distributed throughout the country though rather unevenly among states. Penang, Selangor/KL, Malacca led with number of dialysis patients pmp ranging from 417 to 480. Kelantan and Sabah had the lowest provision with 51 and 64 patients pmp respectively. There were more centres and HD capacity in the private sector while the NGO and public sectors had about the same capacity. However the public sector had more patients on account of availability of CAPD and home HD services, as well as low HD capacity to patient ratio. The number of centres, HD capacity and patients have increased rapidly especially since 1991; the estimated growth rates were 16.5 centres/year, 658 capacity/year, and 392 patients/year respectively. There was also a trend toward increasing over-capacity in the private and NGO sectors. In conclusion, the level of dialysis provision is increasing, this provides evidence for increasing accessibility of dialysis treatment in Malaysia. Over-capacity is a concern in the private and NGO sectors, which should encourage funding agency to source provision from those sectors. The public sector still has a crucial role to provide for under-served area in the country