The Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, proudly congratulates Devi Peramalah on the successful defence of her Doctor of Philosophy thesis entitled: “Association Between Diabetes and Healthcare Utilisation in Malaysia: Heterogeneity by Sociodemographic, Socioeconomic and Comorbidity Factors” held on 15 May 2026.
Short Summary of the Thesis
Diabetes continues to pose a significant public health challenge in Malaysia, with prevalence rates projected to rise steadily in the coming years. In her doctoral research, Devi Peramalah explored how diabetes influences healthcare utilisation among Malaysian adults within the country’s mixed public-private healthcare system.
The study combined a comprehensive scoping review with empirical analysis using data from the National Health and Morbidity Survey (NHMS) 2015 involving 18,616 adults. Through robust statistical analyses, the research examined patterns of outpatient and inpatient healthcare utilisation among individuals with diabetes, while also investigating how utilisation differed according to sociodemographic, socioeconomic, and comorbidity factors.
The findings revealed that adults with diabetes were significantly more likely to utilise both outpatient and inpatient healthcare services compared to those without diabetes. Importantly, the study identified substantial inequalities linked to ethnicity, income level, educational attainment, marital status, and coexisting conditions such as hypertension and hypercholesterolaemia. The research further demonstrated a pro-poor utilisation pattern, highlighting persistent disparities in healthcare access and service use in Malaysia.
Overall, the thesis provides critical evidence to support more equitable, preventive, and integrated healthcare policies for diabetes management in Malaysia.
Highlight of the Candidate’s Achievements
Devi Peramalah’s doctoral work represents a significant scholarly achievement in the field of public health and health services research. Her research successfully addressed a complex and nationally relevant issue by integrating epidemiological analysis, healthcare utilisation research, and socioeconomic inequality assessment within a single comprehensive study.
Among the notable achievements of this thesis are:
- Conducting a rigorous scoping review on healthcare utilisation patterns in mixed healthcare systems.
- Analysing nationally representative NHMS 2015 data involving over 18,000 Malaysian adults.
- Identifying key sociodemographic and socioeconomic determinants influencing healthcare utilisation among people with diabetes.
- Demonstrating income-related inequalities in healthcare access and utilisation.
- Generating evidence-based recommendations to improve healthcare integration and equity in Malaysia’s healthcare system.
- Contributing valuable local evidence to the growing body of diabetes and health systems research in Southeast Asia.
Her work reflects strong methodological expertise, critical analytical thinking, and a deep commitment to addressing public health inequities.
Contribution to Public Health
This research makes an important contribution to public health policy and healthcare planning in Malaysia. By uncovering the heterogeneous patterns of healthcare utilisation among people living with diabetes, the study provides policymakers and healthcare providers with actionable evidence to improve service delivery and resource allocation.
The findings underscore the urgent need to:
- Strengthen preventive and primary healthcare services for diabetes management.
- Reduce socioeconomic and ethnic disparities in healthcare access.
- Enhance integration between public and private healthcare sectors.
- Develop targeted interventions for vulnerable populations with higher healthcare burdens.
As diabetes prevalence continues to rise nationally, this research offers timely insights that can guide more equitable and efficient healthcare strategies for the Malaysian population.
Acknowledgement
We wish to acknowledge the invaluable guidance and mentorship provided by Devi Peramalah’s supervisors, Professor Dr. Sanjay Rampal A/L Lekhraj Rampal and Dr. Ainol Haniza Kherul Anuwar, whose expertise and support were instrumental in the completion of her thesis.
We extend our sincere gratitude to Professor Dr. Eun Seok Kang, Yonsei University College of Medicine, Professor Dr. Hung Chi-tim, The Chinese University of Hong Kong, and Professor Dr. Noran Naqiah Mohd Hairi.
We would also like to thank the Committee of Examiners for their thorough evaluation and insightful feedback, including Professor Dr. Jamunarani a/p S Vadivelu, the Chairperson of the viva voce session; Professor Dr. Victor CW Hoe Chee, Head of Department, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya.
Congratulations and Future Expectations
Congratulations once again to Dr. Devi Peramalah on this remarkable academic accomplishment. The successful completion of a doctoral journey reflects years of perseverance, dedication, intellectual curiosity, and commitment to advancing knowledge in public health.
We are confident that her research will continue to contribute meaningfully to diabetes prevention, healthcare policy development, and health equity initiatives both in Malaysia and internationally. We look forward to witnessing her continued success in academia, research, and public health leadership in the years ahead.
Best wishes for a bright and impactful future ahead.
You must be logged in to post a comment.