Assessing the efficiency of Malaysia health system in COVID-19 prevention and treatment response.

Malaysia was faced with a life-threatening crisis in combating COVID-19 with a number of positive cases reaching 5305 and 88 deaths by 18th April 2020 (the first detected case was on 25th January 2020). The government rapidly initiated a public health response and provided adequate medical care to manage the public health crisis during the implementation of movement restrictions, starting 18th March 2020, throughout the country. The objective of this study was to investigate the relative efficiency level of managing COVID-19 in Malaysia using network data envelopment analysis. Malaysia state-level data were extracted from secondary data sources which include variables such as total number of confirmed cases, death cases and recovered cases. These variables were used as inputs and outputs in a network process that consists of 3 sub processes i) community surveillance, ii) medical care I and iii) medical care II. A state-level analysis was performed according to low, medium and high population density categories. The efficiency level of community surveillance was highest compared to medical care processes, indicating that the overall inefficiency is greatly influenced by the inefficiency of the medical care processes rather than the community surveillance process. Results showed that high-density category performed well in both community surveillance and medical care II processes. Meanwhile, low-density category performed better in medical care I process. There was a good overall performance of the health system in Malaysia reflecting a strong preparedness and response level to this pandemic. Furthermore, resource allocation for rapid response was distributed effectively during this challenging period.