Integrated care: from policy to implementation – The Singapore Story

Abstract

Globally, healthcare systems have been largely cen-tered on acute care characterized by episodic, high-level (often expensive) care with sophisticated medical sub-specialization. There is now consensus globally that there should be a fundamental refocus by health-care systems towards more care outside of the acute setting so as to deal with the challenges of an aging population and increased prevalence of chronic dis-eases. Singapore has a resident population of some 5.5 million people and is also one of the fastest aging populations in the world today. This presents tremen-dous challenges and opportunities for designing and implementing different care delivery models that meet the needs of an aging population. In 2009, the Agency for Integrated Care in Singapore was formed. The Agency was created to drive care integration efforts nationally and to develop and link primary care and intermediate and long-term care pro-viders (ILTC) with the acute-focused public healthcare system, as well as to empower patients through edu-cation and help them to better navigate the healthcare system. The vision for healthcare delivery in Singapore is to develop integrated Regional Healthcare Systems, which are essentially geographically-defined patient-centric healthcare ecosystems comprising of partners from the primary, acute and community care sectors, working together to deliver comprehensive and holistic healthcare services to improve patient outcomes. Inte-grated clinical pathways (ICPs) will ensure continuity of