Transforming Singapore's healthcare delivery system: health care integration in Singapore

PURPOSE: The vision for transforming healthcare delivery in Singapore is to develop integrated Regional Health Services (RHS) to provide healthcare from prevention to palliation. Under the RHS concept, each region would be anchored by an acute-care hospital working in close partnership with other healthcare providers in the region, e.g. general physicians (GPs), polyclinics, community hospitals (CHs), nursing homes (NHs) and home care providers. Formalized partnerships, integrated clinical pathways and care coordinators working with a multi-disciplinary team over the patient's lifetime would help keep the care continuous, seamless and appropriate. Achieving this vision will require us to (i) significantly build up the ILTC and primary care sectors; and (ii) restructure our public healthcare system and strengthen the enablers and linkages between providers in each region to better integrate care and enable the entire system to work as it should. AGENCY FOR INTEGRATED CARE: A key part of achieving this vision is the development of a national care integrator: the Agency for Integrated Care (AIC). Formed in 2008, the AIC coordinates referrals to intermediate and long-term care services as well as facilitates discharge planning for patients discharged from acute-care hospitals through hospital-based ACTION Teams. To support the development of integrated RHS, its role will be expanded progressively to include a focus on developing the capabilities of local healthcare service providers as well as patient education. (Please see separate item presented by AIC that will focus on the work of the ACTION Teams—to show that ACTION teams through care coordination helps to reduce Average Length of Stay (ALOS) in acute settings, foster interagency collaboration and improve access to services for patients.) CONTEXT: In Singapore as in other countries, we face the twin challenges of an aging population and the growing burden burden of chronic disease. The current model of acute-care centered provision of healthcare has to transform and new services and linkages need to be developed to cater for the health needs of the elderly population and improve overall population health. DATA SOURCES: MOH/healthcare providers. CASE DESCRIPTION: Development of integrated Regional Health Services. DISCUSSION: Implementation of an integrated RHS model and challenges.