Back to the Hospital for Chronic Care: a Hybrid Generalist Model

Abstract

Singapore, like many countries, is attempting to meet the growing healthcare needs of an ageing population with a high burden of chronic diseases. Despite efforts to integrate and increase healthcare capacity, longstanding challenges remain difficult to overcome. Recently, policymakers have considered a new approach to building chronic and eldercare capacity—the Integrated General Hospital (IGH). The development of the IGH model is motivated by a combination of factors: the limit to which the primary care system can manage patients with increasingly complex chronic diseases, a longstanding preference of patients for hospital-based specialty services and patients experiencing fragmented care delivery. The IGH model links hospital care teams and community-based care providers, to facilitate the management of patients throughout the care continuum in a single integrated site. It is hoped that this hospital-led model for chronic care can meet patients’ needs and preferences and reduce fragmentation of care.