Navigating Integrated Medical Care and Financial Support for Renal Patients
Care Continuum
Care Process & Redesign
Yishun Health One Improvement Festival
National Healthcare Group
8 April 2025
To evaluate the positive impact of i. Financial Assistance (FA) structure (established in year 2020) for haemodialysis. The establishment of an FA structure as an island-wide effort, have allowed for equity and sustainability of treatment.
Year Submitted: 2025
Published Date: 08 April 2025
Tags: Care Continuum, Cost Saving, Workflow Redesign, Quality Improvement, Chronic Care, Productivity, Operational Management, Financial Management, Care Process ＆ Redesign
About this Content
Aims
To evaluate the positive impact of i. Financial Assistance (FA) structure (established in year 2020) for haemodialysis patients, and ii. Integrated Medical Clinic (IMC) through the evaluation of length of stay (LOS) and emergency department (ED) visit rates.
Background
IMC was set up to provide greater support for patients with medically advanced and chronic conditions, and complex psycho-social needs.
Methods
MSWs will apply for FA to support eligible renal patients. This increases patients’ propensity for treatment, despite their dire financial circumstances. To ensure sustainability of this lifelong costly treatment, MSWs will apply for subsidised dialysis treatment for long term support.
Results
35 patients (received FA upon dialysis initiation): 66% did not increase in their ED visits post-initiation. Amongst them, there was an average of 1.7 ED visit reduction. There was an 18-day reduction in average LOS, of which 77% had a reduction of 32 days. Average per FA patient cost savings is $8982.58, and hospital cost avoidance for all 26 patients is $1,236,592.00.
Conclusion
The establishment of an FA structure as an island-wide effort, have allowed for equity and sustainability of treatment. This had allowed for continuity of care from hospital to home. Together with IMC that focused on integrated care with community partners, patients’ safety and experience are enhanced through timely, coordinated and customised interventions.
Lessons Learnt
There was a lack of standardization and accountability pertaining to the period of and timeline for submission of FA, as well as subsidized dialysis applications for renal patients. This sense of uncertainty reduced patients’ and/or families’ willingness to be subjected to financial assessments. Further, organizations supporting renal patients were mostly working in silos, with little to no communication.
Additional Information
MSWs work closely with IMC and community care providers to link up, ensure proper handovers and improved communication. These allow for more comprehensive understanding of the patients’ circumstances, better alignment of assessments, expectations and improved coordination of care management via multi-agency case conferences whenever necessary.
Keywords
Renal, Financial Assistance, Integrated Care, Dialysis, Community Care
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Khoo Teck Puat Hospital |
Platform(s) | Yishun Health One Improvement Festival |
Healthcare Professional Group(s) | Healthcare Administration |
Applicable Specialty or Discipline | Nephrology, Medical Social Workers |
Project Lead(s) | Ong Phyllis |
Project Member(s) | Angie Lim Hui Yi |
Connect with this contributor!
KTPH & YCH Innovation & Improvement (I&I) Office - i-i@ktph.com.sg
Project Attachment
759_KTPH_OIF 2025_Navigating Integrated Medical Care and Financia.pdf