Background: Financial reimbursement (MediFund) of medical nutrition products (MNPs) 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: We performed a 1-year retrospective audit of patients in a tertiary hospital who received MediFund. Demographics, presupport and postsupport clinical outcomes, and cost of support were determined and analyzed. Results: A total of 129 patients received MediFund for MNPs. The median length of financial support was 115 days (interquartile range, 37-269). Overall, body mass index increased after nutrition support (20.9 ± 5.1 vs 20.4 ± 5.3; P = .012). There was a significant decrease in the number of malnourished patients (final, 55.1% vs initial, 86.8%; P < .001) and a significant increase in 7-point subjective global assessment scores (final, 4.9 ± 1.3 vs initial, 4.1 ± 1.3; P < .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 < .001) and had higher mortality rates (35.7% vs 10.3%; P < .001). Total reimbursement of S $108,960 was provided to subsidize MNPs over 1 year. Conclusion: Supporting patients with financial difficulties led to an improvement in their nutrition status. Regular dietitian reviews of patients and monitoring compliance to consumption of MNPs are essential to ensure patients benefit from the support.

Health literacy (HL) sets on the ability and motivation of individuals to appraise, understand, access, and utilise information in ways that promote and maintain good health. Poorer health outcomes and incurs higher healthcare expenditures can be the cause of limited HL. Sabah public health facilities conducted a cross-sectional study between February and October 2020. A 12-item Short-Form Health Literacy Survey (HLS-SF12) comprising three domains (healthcare, disease prevention, and health promotion) was used to measure HL. The HL index score was categorised as ‘limited’ (0 – 33), ‘sufficient’ (>33 – 42), and ‘excellent’ (>42 – 50). Among 337 patients recruited, half were male (51%) with a mean age of 52.6 ± 12.3. The top 3 comorbid were hypertension (84.6%), dyslipidaemia (58.2%), and diabetes mellitus (47.8%). Health information was mainly accessed from television (84.6%), smartphones (75.1%), and radio (47.8%). The median HL index score was 31.94 (IQR 25 – 37.5), with 54.6% of patients having limited HL. The lowest median score was found in disease prevention, 11 (IQR 10 – 13) and 8 (IQR 7 – 9) when judging health information. The HL index was associated with age, educational level, household income, insurance ownership, and accessing health information with a smartphone or computer. In Sabah, the limited HL level observed the need to tailor interventional programmes to vulnerable groups. Digital platforms shouldbe enhanced in disseminating health-related information and educating the public on critical judgement skills.

No abstract