Residents of Singapore will be encouraged to enroll with a family doctor as their primary care provider.
The Ministry of Health (MOH) announced on Wednesday that residents will be able to enroll with a general practitioner (GP) or polyclinic doctor of their choosing as their primary care provider beginning in 2019. (Mar 9). Theresa Seah
SINGAPORE: The Ministry of Health (MOH) announced on Wednesday that residents will be able to enroll with a general practitioner (GP) or polyclinic doctor of their choosing as their primary care provider beginning in 2019. (Mar 9).
MOH stated in a press release that the GPs and polyclinic doctors, also known as family physicians, will support these individuals throughout their lives for various health needs to ensure continuity of care.
During a debate in his ministry’s Committee of Supply, Health Minister Ong Ye Kung stated that the MOH will likely begin with people in their forties and older.
We will have to gradually increase participation,” Mr. Ong stated.
Residents will be enrolled according to their residence. Currently, close to nine out of ten residents visit a nearby family doctor or hospital.
However, people can choose physicians who are located far from their homes, the MOH said, citing the example of those who continue to see their pediatrician.
Even after enrollment, individuals can make necessary changes, such as when they move to a new residence.
The initiative is a significant component of the new Healthier SG strategy, which outlines a “major reform of the healthcare sector” that includes the integration of general practitioners into the public healthcare ecosystem and a focus on preventive care.
Mr. Ong stated, “Studies have shown that people who consistently visit the same family doctor are generally healthier and have fewer hospitalizations and emergency department visits.”
He added that this is because the physician and care team know the patient well and can detect early warning signs of any problems more quickly and accurately.
He noted that only three in five Singaporeans currently have a primary care physician.
Mr. Ong stated that the remaining patients tend to visit multiple doctors, such as one for hypertension medication and another for a medical certificate for cough and cold.
COORDINATION BY HEALTHCARE CLUSTERS The Ministry of Health (MOH) will collaborate with the three healthcare clusters – National University Health System (NUHS), National Healthcare Group (NHG), and SingHealth – to support the GPs operating within their region and integrate them into the overall health system, such as by facilitating data sharing and establishing team-based care.
The national enrollment program will be coordinated by the three healthcare clusters, each of which will be responsible for up to 1.5 million residents.
The clusters will collaborate with general practitioners and other regional partners to engage residents and improve their care.
MOH stated that family physicians may collaborate with polyclinics or hospitals in the management of patients with more complex needs.
To ensure continuity of care, the Department of Health added that, upon discharge, hospitals would refer patients to their family doctor.
According to the MOH, more specifics of Healthier SG are being developed.
Over the next few months, the ministry will consult stakeholders, such as the general public, general practitioners, healthcare workers, and community partners, to gather their opinions.
It will then provide more information about Healthier SG in a White Paper and table it for debate in Parliament, the government said, adding that when ready, it will share additional information about the public consultation plans.
CHANGE IN HEALTHCARE CLUSTERS’ FINANCING
MOH also announced that its funding of the three healthcare clusters will transition to a capitation model, under which NUHS, NHG, and SingHealth will receive a predetermined fee for each resident of the region they oversee.
MOH added that the new model will give them “greater flexibility” in determining how they will support residents.
Currently, funding for clusters is determined by the volume of services they provide, such as the number of surgical procedures and patient load.
The scope of the model will be “gradually expanded as various aspects of cluster operations become ready,” according to the ministry.
Mr. Ong stated that a set of key health outcomes will complement this new funding structure. He stated that some “prominent indicators” include the quality of care, the adoption of healthy lifestyles and habits, the prevalence of chronic disease, and the cost-effectiveness of treatments.
Mr. Ong added that under the new system, the absolute budgets of each healthcare cluster will not be impacted.
In fact, the budgets will increase slightly. What will change is the basis for budget calculation,” he said.
STAFFING AND TECHNOLOGY
To support the necessary healthcare reform and shifts, the Department of Health has stated that it will invest more in personnel and develop “critical support pillars in technology and data.”
In recent years, the government has placed a significant emphasis on family medicine training and education, according to the MOH.
“We will explore additional measures to broaden the experience of new graduates,” the report stated, adding that postgraduate training in family medicine is also being strengthened.
The ministry will investigate how it can provide better data support for family physicians, such as giving them access to their patients’ medical records and tools such as clinical dashboards to better monitor their patients’ conditions and health trends over time.
In support of this, the Department of Health (MOH) cited the National Electronic Health Record (NEHR) system it has been developing to synchronize information and facilitate access by the care team across settings.
MOH stated that new legislation, the Health Information Bill, will be enacted to govern this.
MOH stated, “With more people accessing shared data and handling individual records, it is necessary to ensure and facilitate secure data sharing, and for users to assume greater responsibility for data access.”
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