Integration of primary care with hospital services for sustainable universal health coverage in Singapore

Abstract

—Primary care services have been developed and extended, with the support of the Singapore government, in order to address the increasing needs of the aging population and non-communicable diseases and to achieve the goal of universal health care. Though countries across the Asia Pacific aspire to achieve universal coverage, there is no set pathway. In Singapore, various service models, quality assurance methods, and financing mechanisms have been piloted and some have been scaled up. Significant effort has also gone into building links and establishing networks between hospitals and local primary care providers, including dental and allied health professionals. Several initiatives have also been introduced to support professional development, provide financial safety nets, and integrate and resource community clinics to provide family-oriented care. Social support has also been improved for isolated elderly through formalized networks linking government agencies, health providers, and community welfare groups. Ongoing challenges include integration of private providers, maintaining affordability of out-of-pocket charges, resources to meet increasing chronic disease management needs, and achieving economies of scale to sustain universal health coverage (UHC).