Not just closer to home – but care at home

Not just closer to home – but care at home

Although most health systems have bought into the idea of moving care out of hospitals and into the community, few have made the next leap towards true, home-based care.

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Prof. Ivy Ng – Group CEO, Singapore Health Services

Although most health systems have bought into the idea of moving care out of hospitals and into the community, few have made the next leap towards true, home-based care. Hospitals cannot cope with soaring numbers of (mainly elderly) patients, often suffering from multiple conditions, yet simply shifting them from hospital to local primary and community services would leave those providers overloaded.

Any new care model has to have the patient’s home at its center, something that is recognized in Singapore, where integration stretches beyond traditional institutions.

The various assets of the community – acute hospitals, specialty centers, nursing homes, primary clinics, polyclinics, senior care centers and community hospitals – should ‘surround’ the patient’s home, offering appropriate care and support. Many community assets are under-utilized, and medical professionals need to rethink how they can be employed to improve the quality of life for patients, along with remote monitoring and communications technology.

In the UK and US this is referred to respectively as ‘hospital at home’ and ‘the medical home.’ Geisinger Health System’s ProvenHealth Navigator is one example of a network of advanced medical homes, which has led to reduced hospital readmissions and improved care coordination.

Case study - Singapore’s strategy for health integration

The set of pressures on healthcare in Singapore are similar to many other countries:

  1. rapid growth in population
  2. rapid ageing of the population
  3. increasing burden of chronic diseases
  4. rising cost of healthcare
  5. limited health workforce with competing demands
  6. rising expectations of patients
  7. rising standard of healthcare.

Singapore recognizes that the full range of healthcare interventions need to be organized around the home, rather than traditional institutions.

Transformation care models

“The purpose of each of the different interventions around the home is to ensure that more high acuity patients spend more time safely in their own home rather than within a healthcare institution. An organogram such as this asks every location that delivers healthcare to recognize that their crucial role is making the home a more efficient location for high acuity care".

Professor Ivy Ng – Group CEO, Singapore Health Services

KPMG model for integrated care

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