Integrated care for diabetes: the Singapore approach
File(s)
Published version
Author(s)
Yeo, S
Harris, M
Majeed, A
Type
Journal Article
Abstract
Background: The prevalence of diabetes mellitus is 12.7% in Singapore. Managing people with diabetes in the community may be needed to reduce unnecessary utilisation of expensive specialist resources and to reduce hospital waiting times for patients with complications.
Care practice: The Singapore General Hospital (SGH) Delivering on Target (DOT) Programme was launched in 2005 to right-site clinically stable diabetic patients from the hospital to private DOT GPs. The Chronic Disease Management Office (CDMO) was established and a fully customised DOT information technology (IT) system was developed. Three initiatives were implemented: (i) Subsidised drug delivery programme, (ii) Diagnostic tests incentive programme, and (iii) Allied healthcare incentive programme.
Discussion: Right-siting was enabled through patient incentives that eased the burden of out-of-pocket expenditure. Right Siting Officers (RSOs) maintained a general oversight of the patient pathway. The integrated system supported shared care follow-up by enabling DOT GPs to share updates on the patients' health status with the referring specialists.
Conclusion: A coherent process across all healthcare providers similar to the SGH DOT Programme may facilitate efforts to shift the care for people with diabetes to the community and to provide integrated care. Successful integration may require incentives for institutional partners and patients.
Care practice: The Singapore General Hospital (SGH) Delivering on Target (DOT) Programme was launched in 2005 to right-site clinically stable diabetic patients from the hospital to private DOT GPs. The Chronic Disease Management Office (CDMO) was established and a fully customised DOT information technology (IT) system was developed. Three initiatives were implemented: (i) Subsidised drug delivery programme, (ii) Diagnostic tests incentive programme, and (iii) Allied healthcare incentive programme.
Discussion: Right-siting was enabled through patient incentives that eased the burden of out-of-pocket expenditure. Right Siting Officers (RSOs) maintained a general oversight of the patient pathway. The integrated system supported shared care follow-up by enabling DOT GPs to share updates on the patients' health status with the referring specialists.
Conclusion: A coherent process across all healthcare providers similar to the SGH DOT Programme may facilitate efforts to shift the care for people with diabetes to the community and to provide integrated care. Successful integration may require incentives for institutional partners and patients.
Date Issued
2012-03-06
Date Acceptance
2012-01-10
Citation
International Journal of Integrated Care, 2012, Volume 12, 6 March 2012, 12, pp.e8-e8
ISSN
1568-4156
Publisher
Igitur publishing
Start Page
e8
End Page
e8
Journal / Book Title
International Journal of Integrated Care
Volume
12
Copyright Statement
© 2012, International Journal of Integrated Care (IJIC)
This work is licensed under a (http://creativecommons.org/licenses/by/3.0) Creative Commons Attribution 3.0 Unported License
This work is licensed under a (http://creativecommons.org/licenses/by/3.0) Creative Commons Attribution 3.0 Unported License
Identifier
PII: URN:NBN:NL:UI:10-1-112785 / ijic2012-8
Subjects
Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Health Policy & Services
integrated care
integration
diabetes management
PREVALENCE
1117 Public Health And Health Services
1110 Nursing
Edition
Volume 12, 6 March 2012
Publication Status
Published