Abstract
Background and Problem Context: Singapore faces the dual challenge of an aging population and high chronic disease burden. [1,2] In 2023, a national program to increase coverage, equity and healthcare capacity for chronic disease management was launched – HealthierSG. This collaborative public-private partnership between community health posts (polyclinics) and general practitioners (GPs), aimed to integrate GPs into the subsidised primary care network, thereby leveraging each GP’s locality to expand affordable chronic disease management. [3]
Approach: This study seeks to explore the patient experience within the new care model of chronic disease management with the inclusion of GPs, using a mixed methods approach. Quantitatively, we surveyed patients for demographic characteristics and attitudinal variables, measured using the Likert scale from 1 to 5. Qualitatively, we conducted semi-structured in-depth interviews to explore uptake and adherence of care using the health belief model.
Preliminary Results: Key motivating themes include greater self-efficacy, enabled by ease of geographical access, flexibility for consultations around work hours and continuity of care with a constant care provider. This was reflected in survey findings of high levels of motivation (5, IQR 4-5), appreciation for geographical proximity (5, IQR 4-5) and acceptability of services under the new care provider (5, IQR 3.5-5). Notably, price sensitivity to medication cost remained a significant theme for barriers to adoption and continued care under HealthierSG. Despite this, most patients were satisfied with healthcare cost (5, IQR 4-5) under HealthierSG. Finally, greater public awareness and promotion emerged as a key theme to facilitate greater uptake of HealthierSG.
Implications: This study aims to shed light on key patient factors that encourage retention within the healthcare system and compliance to care amidst transformations of care delivery within integrated care networks. As new care providers are incorporated, maintaining standards of care and affordable healthcare costs prove to be key attributes for effective integration to support subsequent scaling of programs in the primary care setting. Reducing barriers to access of health services and understanding preferences of patients and their care providers (eg. Working class) are crucial, particularly for chronic disease where compliance, patient participation and ownership of treatment plans have significant impacts for long term outcomes. Community engagement, media campaigns, and targeted educational initiatives are also pivotal for raising public awareness and creation of an environment where integrated care thrives.
Citations:
1.Moh.gov.sg. 2024. Available from: https://www.moh.gov.sg/resources-statistics/action-plan-for-successful-ageing
2.MOH | National Population Health Survey 2023 [Internet]. Moh.gov.sg. 2023. Available from: https://www.moh.gov.sg/resources-statistics/reports/national-population-health-survey-2023
3.MOH | News Highlights [Internet]. www.moh.gov.sg. Available from: https://www.moh.gov.sg/news-highlights/details/healthier-sg-enrolment-programme-to-commence-on-5-july