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Medical Nutrition Reimbursement in Singapore: Who are the Patients Receiving MediFund Assistance? An Audit of Clinical Outcomes and Issues Pertaining to Reimbursement in a Public Hospital in Singapore.

BACKGROUND
Financial reimbursement (MediFund) of medical nutrition products (MNP) was recently implemented in some of the public hospitals in Singapore for patients with financial difficulties. This study aimed to investigate the sustainability of this policy, and the benefits conferred.


METHODS
A one-year retrospective audit of patients in a tertiary hospital who received MediFund was performed. Demographics, pre and post support clinical outcomes, and cost of support was determined and analyzed.


RESULTS
A total of 129 patients received MediFund for MNP. The median length of financial support was 115 days (IQR: 37, 269). Overall, body mass index (BMI) increased after nutritional support (20.9 ± 5.1 vs 20.4 ± 5.3 kg m-2 , p = 0.012). There was a significant decrease in the number of malnourished patients (Final: 55.1% vs Initial: 86.8%, p<0.001) and a significant increase in 7-point SGA scores (Final: 4.9 ± 1.3 vs Initial: 4.1 ± 1.3 p<0.001) after MNP support. MNP adherence was high for 88.5% of patients who returned for follow-up appointments. Patients who defaulted follow-up appointments were more likely to have 30-day readmission (50% vs 19.5%, p<0.001) and had higher mortality rates (35.7% vs 10.3%, p<0.001). Total reimbursement of S$108,960 was provided to subsidize MNP over one year.


CONCLUSION
Supporting patients with financial difficulties led to an improvement in their nutritional status. Regular dietitian reviews of patients and monitoring compliance to consumption of MNP is essential to ensure patients benefit from the support. This article is protected by copyright. All rights reserved.