Ages and Stages: Five Decades of Community and Residential Services in Singapore

Wong, Loong; Tan, Nixon; Toh, Kong Chian; Cheah, Jason

doi:10.1142/9789814696067_0026

Cited by 2 publications

(13 citation statements)

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“… 7 , 8 The movement of doctors to private hospitals further exacerbated the manpower shortage in public hospitals. 3 , 9 Consequently, one-third of the total number of physicians who remain in the public sector struggle to provide services for two-thirds of the total number of hospital beds in the country. 10…”

Section: Current Status and Challenges Of The Malaysian Healthcare Symentioning

confidence: 99%

“…11 Vacancy of medical posts especially in hospitals built with special budget allocations in rural areas, however, adds to allocation and service inefficiency as the facilities do not have the required number of healthcare professionals, especially certain speciality services, required by patients. 9 …”

Section: Current Status and Challenges Of The Malaysian Healthcare Symentioning

confidence: 99%

“…13 The average out-of-pocket spending of 72.2% (as percentage of private expenditure) in 2011 was twice that of high-income countries. 4 , 9 High out-of-pocket payments will give rise to equity issues and impose higher financial burden on lower income groups which tend to have lower health status and higher health risks. 14 …”

Section: Current Status and Challenges Of The Malaysian Healthcare Symentioning

confidence: 99%

“…The previous focus of the health policy in Malaysia to allocate resources proportionally to rural areas has led to overcrowding at metropolitan hospitals while underutilization of small district hospitals. 9 , 29 – 33 This is apparent when a midterm review of the Fourth Malaysian Plan reported that the bed occupancy rate for the Pekan District Hospital (a small district hospital) went as low as 26.1% compared to 89.1% at the Kuala Lumpur General Hospital, the largest hospital in the country. 9 A large number of private hospitals and clinics in Kuala Lumpur have partially alleviated the problem.…”

Section: Demographic Shift Disease Pattern Transition and Urbanizatimentioning

confidence: 99%

“… 9 , 29 – 33 This is apparent when a midterm review of the Fourth Malaysian Plan reported that the bed occupancy rate for the Pekan District Hospital (a small district hospital) went as low as 26.1% compared to 89.1% at the Kuala Lumpur General Hospital, the largest hospital in the country. 9 A large number of private hospitals and clinics in Kuala Lumpur have partially alleviated the problem. Health planning, therefore, should consider the population shift and channel the resources appropriately to more densely populated urban areas.…”

Section: Demographic Shift Disease Pattern Transition and Urbanizatimentioning

confidence: 99%

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Quality use of medicine in a developing economy: Measures to overcome challenges in the Malaysian healthcare system

Tahir

Paraidathathu

2015

SAGE Open Medicine

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Malaysia inherits a highly subsidized tax-based public healthcare system complemented by a fee-for-service private sector. Population health in Malaysia has considerably improved since independence using a relatively small amount of gross domestic product (~4%). Brain drain of highly specialized personnel, growth in healthcare spending, demographic and disease pattern changes and increase in patients’ demands and expectations towards better medical care are exerting pressure on the sustainability of the system to continuously provide efficient and effective services at relatively low cost. Malaysia has adopted and implemented some of the quality use of medicine concepts such as National Essential Medicine List, health technology assessment and promotion of generic medicines in their health policy, but so far the results may not be optimal. Activities to further promote these strategies are needed for successful implementation to achieve more positive and sustained beneficial outcomes. Better strategic planning, management and collaboration between various stakeholders, considering the needs and barriers of the strategies, are important to ensure effective implementation of the strategies. More emphasis should be placed upon more equitable and rational distribution of healthcare resources to cater for rapid urbanization. Additionally, a sustainable health financing structure that is more progressive and does not encourage moral hazard should be established. In conclusion, Malaysia has achieved good outcomes in population health with relatively low financial inputs since independence. However, changes in the overall environment have created issues which would threaten the long-term viability of the healthcare system if not tackled properly. The numbers of internationally trialled strategies could be used to deal with these challenges. In addition, coordinated implementation of these strategies and effective engagement and communication between various stakeholders are necessary to further strengthen the Malaysian healthcare system effectively.

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Section: Current Status and Challenges Of The Malaysian Healthcare Symentioning

confidence: 99%

Section: Current Status and Challenges Of The Malaysian Healthcare Symentioning

confidence: 99%

Section: Current Status and Challenges Of The Malaysian Healthcare Symentioning

confidence: 99%

Section: Demographic Shift Disease Pattern Transition and Urbanizatimentioning

confidence: 99%

Section: Demographic Shift Disease Pattern Transition and Urbanizatimentioning

confidence: 99%

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Quality use of medicine in a developing economy: Measures to overcome challenges in the Malaysian healthcare system

Tahir

Paraidathathu

2015

SAGE Open Medicine

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Financing Long‐Term Services and Supports: Ideas From Singapore

Graham

Bilger

2017

Milbank Quarterly

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Policy Points: In Singapore, long‐term services and supports (LTSS) are financed through a mix of public and private sources comprising tiered means‐tested public subsidies and government grants to care providers, charitable donations, voluntary long‐term care insurance, and other private resources.Singapore's high take‐up rate of voluntary long‐term care insurance is explained by plans offering partial coverage, medical underwriting, early automatic enrollment, direct debit of insurance premiums, and defined cash benefits.Singapore's experience in long‐term care financing is relevant to the US debate, as it provides policy ideas that may be transferable to the American context.We recommend maximizing the population's total contribution to voluntary long‐term care insurance by striking the right balance between coverage adequacy and take‐up rate while targeting subsidies to low‐income individuals. ContextFinancing long‐term services and supports (LTSS) for the elderly is a pressing issue in the United States with reforms of long‐term care insurance (LTCI) presently being explored. Singapore, with 65% of residents aged 40 to 83 covered by basic LTCI, including 22% with supplementary LTCI plans, has the highest voluntary LTCI rate in the world. This article contributes to the discourse by presenting the case of LTSS financing in Singapore.MethodsWe first reviewed Singapore's LTSS policies through a comprehensive search of academic papers, governmental reports, parliamentary debate transcripts, print media, and official websites of LTSS providers. We then estimated the LTSS financing mix, conducted an in‐depth analysis of the main policies, and illustrated the financial protection they procure for the elderly using realistic hypothetical scenarios.FindingsThe main principles governing Singapore's LTSS policies are shared responsibility for long‐term care financing, targeted assistance for the poor, centralized governance and administration, separation from other income and housing policies, and limited intergenerational cross‐subsidizing. We estimate the financing mix to consist of out‐of‐pocket spending (40%), government spending (42%), long‐term care insurance (9%), and charitable donations (9%). Assuming a monthly LTSS bill of US$1,545 to US$2,575, between 11% and 19% of LTSS expense is offset by LTCI for severely disabled individuals with basic coverage. Overall, 63% of care recipients are eligible for public subsidies that amount to 20% to 80% of their expenses.ConclusionsThe high take‐up of voluntary LTCI in Singapore is explained by the high prevalence of plans offering partial coverage, medical underwriting, early automatic enrollment, direct debit of insurance premiums, and defined cash benefits. We recommend setting the coverage of voluntary long‐term care insurance plans at levels that maximize the population's total contribution by striking the right balance between coverage adequacy and take‐up rate while targeting subsidies to low‐income individuals.

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Ages and Stages: Five Decades of Community and Residential Services in Singapore

Cited by 2 publications

References 0 publications

Quality use of medicine in a developing economy: Measures to overcome challenges in the Malaysian healthcare system

Quality use of medicine in a developing economy: Measures to overcome challenges in the Malaysian healthcare system

Financing Long‐Term Services and Supports: Ideas From Singapore

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