The Measure of Continuity of Care- Analysis and Application

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10% of the females that had ever detected any lumps in their breast, 77.8% of them had sought professional help. Conclusion: The practice of breast self examination among adult females in Malaysia depends much on the various socio-demographic characteristics especially the level of education and exposure to the knowledge of breast cancer.

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The Measure of Continuity of Care- Analysis and Application

Po Ju Chiu, Shou Hsia Cheng National Taiwan University, Taiwan

Objectives: 1. To seek for a suitable measure of “Continuity of Care”(COC) for Taiwan. 2. To apply the suitable measure to examine the relationship between COC and care outcome. Methods: We designed a questionnaire of COC measures assessment and sent out to 21 professors/doctors who were familiar with the research issue or healthcare quality. The data of association analysis came from National Health Insurance research database. Logistic Regression and Negative Binomial Regression were used to examine the relationship between COC and hospitalization and emergency department visit.

Results: According to the descriptive analysis of the questionnaire, there was no consensus about the best COC measure in Taiwan. However, among the COC measures based on claims data, COCI was the most stable indicator when taking the number of ambulatory visits into account. COCI and MMCI were used as COC indicators in the regression models. The analysis was carried-out by two separate subsamples: patients with non-chronic disease related visits (n=49803) and with chronic disease related visits (n=14172). Results from the regression models showed that people with high COC had lower likelihood and fewer number of utilization in hospitalization and emergency department visit for patients in both sub-sample.

Conclusions: There is no consensus on what kind of COC measure is the most suitable for Taiwan. Nevertheless, we suggest that COCI is good for researchers in Taiwan. Furthermore, this study also supports that higher COC is associated with lower risk and frequency in both hospitalization and emergency department visit.

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Effect of Fish Concentrate Capsule on Post-Op Patients at orthopedic Division, Wahidin Sudirohusodo Hospital, Makassar, Indonesia

Healthy Hidayanty, Nurpudji Taslim, Nurhaedar Jafar Hasanuddin University, Indonesia

A kind of fish called snakeheads contents higher albumin than other fishes. The study was to assess effect of fish concentrate capsule on albumin serum, nutrition intake,

mid upper-arm circumference (MUAC), and wound healing process. This was a quasi experiment pre-post test with control. The subject were post-op patients with open healing that divided into two groups(n=13 each), intervention group (IG) who received fish capsule and diet high calorie protein program from hospital, while the control group (CG) just obtained diet high calorie protein program. Measurements were conducted before and after ten days intervention including albumin, nutrient intake and MUAC. Data was analyzed using paired and independent t-test. The study showed that there was a significant different before and after at IG of albumin serum, intake of energy, protein, lipid, carbohydrate and zinc (p 0.05). On the other hand, there was not a significant different in CG on albumin serum and nutrient intake (p >0.05), except to MUAC (p < 0.05). By using, wound healing indicator, there was 4 days faster in intervention compared to control groups. Different changes between intervention and control groups for albumin, intake energy, protein, lipid, carbohydrate and zinc were 0.7g/dl, 654kcal, 25.2g, 22.8g, 89.5g, and 2.7mg respectively. We conclude that providing fish (snakeheads) capsules for ten days to post-op patients can increase albumin, nutrition intakes and wound healing.

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Impacts of a Government Social Franchise Model on Service Utilization and Client Satisfaction at

Commune Health Stations in Vietnam Anh D Ngo1, Dana Alden2

1. University of Queensland, Vietnam 2. University of Hawaii, USA

While franchising private RHFP services has been found to improve service quality and utilization in developing contexts, there is very little evidence to demonstrate that franchising RHFP services improves service utilization in the public health clinics. This evaluation study assesses the impact of a social franchise model of reproductive health and family planning services tested first time in the public communal health stations (CHSs) in two provinces of Da Nang and Khanh Hoa in central Vietnam. Data collected from CHSs’ client visit counts and surveys of 1181 users and would-be users in the communities conducted at baseline, six months, and 12 months following the full implementation of the model. Data on client visit counts indicate that franchise

membership is significantly associated with an additional 51% reproductive health clients, 40% general clients, and 45% family planning clients. Client survey found a positive association between franchise membership with community perceptions of service quality, client

satisfaction, and their likeliness to return and recommend others to low cost, community-based reproductive health and family planning services provided at the local CHS. This positive finding suggests that the integration of franchising into provision of reproductive health services

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