Healthier SG is implementing the preventive care strategy for healthcare services. It will be a long-term, multi-year effort, as it takes time, probably eight to ten years, to see the initial results of a healthier population. Notwithstanding, we will monitor the progress and outcomes of Healthier SG through appropriate outcome indicators in the short, medium and long term, and review these indicators over time.
Short-term (1-3 Years)
- Resident enrolment rate
- Proportion of General Practitioner (GP) clinics offering enrolment
- Screening rates for chronic disease, cancer, etc
- Vaccination rate
- Proportion of diabetes mellitus patients with appropriate screening done
- Level of physical activity
- Active usage of Healthy 365 app
Medium-term (3-10 Years)
- Proportion of enrolled residents who stay with selected family doctor
- Proportion of healthcare clusters’ capitation budgets allocated to health promotion and primary care
- Proportion of diabetes mellitus, hypertension and dyslipidemia patients with optimal control, e.g. HbA1c, blood pressure, low-density lipoprotein
- Healthier eating habits
- Obesity rate
- Health plan completion rate
- Growth rate of healthcare real unit cost
- Avoidable emergency department attendance rate
- 365-day re-admission rate (overall, asthma, acute myocardial infarction, congestive heart failure, chronic obstructive pulmonary disease, diabetes mellitus, stroke, pneumonia)
- Growth rate of age-specific utilisation of healthcare services
- Average bed days per capita
- Admission rate of fall-associated injury among elderly
Long-term (>10 Years)
- Proportion of elderly with Clinical Frailty Score > 6
- Disease prevalence for diabetes mellitus, hypertension, dyslipidemia, dementia and poor mental health
- Disease incidence for stroke, acute myocardial infection, cancer
Conclusion
Healthier SG is a major transformation of our healthcare system. Everyone involved, including healthcare providers, the Government and residents will need to do things differently.
Next Steps
Healthcare Providers
Healthcare providers, including clinicians, will need to constantly think of ways to prevent residents from falling sick, against instincts trained to treat as many suffering patients as possible. They must also constantly embrace the use of technology, innovation and digital solutions to help patients improve their health and quality of life.
When conducting upstream health screening, we will have to deploy less precise but more scalable solutions, to identify residents in the population who have higher risks of falling ill.
Policy Planners
Policy planners need to think long term, to develop and evaluate programmes and initiatives across a multi-year budget cycle, consciously investing in preventive care now to avoid years of pain and suffering later.
Every player in the system needs to work closely, increasing the extent and depth of integration of their services. Together with investments in critical support systems such as IT, we will ensure seamless and holistic care across all settings.
Government
Most importantly, Healthier SG represents a refreshed compact between the Government, healthcare providers and the people. The Government and healthcare providers will do their part, but aging will effect a complex and far-reaching change to our society. We will need more than just spending more on public health programmes and expanding healthcare capacity. All hands must be on deck.
Individuals
Individuals must take charge of their own health, adopt healthier behaviors, build relationships of trust with their family doctors, and manage their chronic diseases proactively. Concurrently, healthcare providers will re-orientate towards preventive care, while the Government sets up systems, programmes and incentives to support individuals’ effort. Nonetheless, the success of Healthier SG ultimately rests on whether and how individuals change their social and health seeking behavior.
It is similar to how Singapore responded to the COVID-19 pandemic. Individuals took responsibility to observe the rules on safe management and got themselves vaccinated; healthcare providers did their best to take care of those who fell sick; while the Government led with policies and strategies, beefed up healthcare facilities, and communicated with the people openly to bring everyone on board.
Reference: Healthier SG Whitepaper Page 66-69
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