Authors (including presenting author) :
Lam WK (1), Chan HF (1), Chan KM (1), Poon YH (1)
Affiliation :
(1) Medical Fee Assistance Section, Allied Health Grade Department, Hospital Authority Head Office
Introduction :
Medical fees assistance programmes including Samaritan Fund (SF), Community Care Fund (CCF) Medical Assistance Programmes, and Medical Fee Waiver are means-tested programmes to support patients in need. Patients and household members have to submit financial documents to Medical Social Workers (MSWs) for assessment. Since enhancement measures on means test mechanism were rolled out in Feb 2019, total number of SF/CCF approved applications grew by 45% from 9,799 in 2018-19 financial year to 14,217 in 2023-24 and will continue to surge. The trend necessitates the optimisation of efficiency to process the application. Seizing the opportunity brought by technological advancement and corporate direction on smart initiatives, the application process has become more people-oriented and streamlined. With the rollout of Medical Fee Assistance App (MFA App) in HA Go in Apr 2022, patients could retrieve details of SF/CCF applications and relevant push notifications and upload documents. Besides positive patient feedback, a post-rollout evaluation demonstrated efficiency improvement.
Objectives :
To streamline, improve efficiency, enhance patients experience and empower patients applying for SF/CCF application by the MFA App in HA Go.
Methodology :
An in-app survey was rolled out in HA Go in late 2022 for MFA App users to rate functions of MFA App by a 4-point Likert scale and provide feedback. The SF Management System (SFMS) records key time points of every SF/CCF application throughout the process, including clinical referral made by doctors, completion of financial assessment by MSWs to final approval by SF/CCF. To evaluate efficiency of application process, processing time and document submission time for patients ever accessed MFA App against who did not were analysed. A retrospective cohort study was conducted, excluding applications from recipients of Comprehensive Social Security Assistance (CSSA), who do not have to provide financial documents for assessment. The study involved SF/CCF applications with approval date falling in reporting period from 29 Apr 2022 when MFA App was rolled out to 28 Apr 2023. These applications were traced for at least 1 year till 28 Apr 2024 for outcome analysis. Data from SFMS were used in the analysis after de-identification. Age-standardised analysis for all applications and patient contribution (PC)-standardised analysis for drug applications were conducted as PC for drug applications reflects patient's forthcoming annual disposable financial resources.
Result & Outcome :
As of 28 Apr 2024, prevalence of MFA App was 22% among all approved SF/CCF applications with application date falling between 29 Apr 2022 and 28 Apr 2023 totaling 12,672. 86% of patients accessed MFA App had positive feedback. Among non-CSSA applications with approval date falling in the reporting period, patients of 2,208 applications accessed MFA App as of 28 Apr 2024 while 6,813 did not. Those accessed MFA App were younger with mean age of 58.9 years compared to 65.6 years of those who did not. For drug applications, mean PC of those accessed MFA App was $21,210 versus $10,779. In evaluation of efficiency, document submission time and processing time of applications for patients aged between 40 and 64 accessed MFA App were 25.0 and 28.0 days respectively versus 30.3 and 33.0 days; patients with PC of drug applications over $2,000 accessed MFA App were 27.2 and 29.7 days respectively versus 30.7 and 33.6 days. Overall, for patients of the 2,208 applications accessed MFA App, 4,336 patient-day can be saved, which also streamlines MSWs' workflow. The effect would be more prominent now as prevalence of MFA App continues to grow. The outcomes reflect that MFA App improves not only patient experience but also efficiency of assessment. It effectively serves as a smart alternative to address the ever-growing service demand. With the promising results, MFA App was enhanced to support online self-application in Dec 2024 besides continuous feedback collection and function refinement.
