Quest for quality care and patient safety: the case of Singapore

Lim, Meng-Kin

doi:10.1136/qshc.2002.004994

Cited by 27 publications

(9 citation statements)

References 7 publications

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“…Established in 2001, coordinates national health promotion efforts and disease management programs to reduce NCDs, by engaging multiple sectors. ( 31 ) It adopts a settings based approach for health promotion activities to prevent NCDs, complemented by screening and treatment of those with clinical diseases. Public education through media, food labeling, and tobacco control policies has facilitated adoption and practice of healthy choices by communities.…”

Section: International Experiences In Multi-sectoral Partnerships To mentioning

confidence: 99%

Multi-Sectoral Action for Addressing Social Determinants of Noncommunicable Diseases and Mainstreaming Health Promotion in National Health Programmes in India

Arora¹,

Chauhan²,

John³

et al. 2011

Indian J Community Med

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Major noncommunicable diseases (NCDs) share common behavioral risk factors and deep-rooted social determinants. India needs to address its growing NCD burden through health promoting partnerships, policies, and programs. High-level political commitment, inter-sectoral coordination, and community mobilization are important in developing a successful, national, multi-sectoral program for the prevention and control of NCDs. The World Health Organization's “Action Plan for a Global Strategy for Prevention and Control of NCDs” calls for a comprehensive plan involving a whole-of-Government approach. Inter-sectoral coordination will need to start at the planning stage and continue to the implementation, evaluation of interventions, and enactment of public policies. An efficient multi-sectoral mechanism is also crucial at the stage of monitoring, evaluating enforcement of policies, and analyzing impact of multi-sectoral initiatives on reducing NCD burden in the country. This paper presents a critical appraisal of social determinants influencing NCDs, in the Indian context, and how multi-sectoral action can effectively address such challenges through mainstreaming health promotion into national health and development programs. India, with its wide socio-cultural, economic, and geographical diversities, poses several unique challenges in addressing NCDs. On the other hand, the jurisdiction States have over health, presents multiple opportunities to address health from the local perspective, while working on the national framework around multi-sectoral aspects of NCDs.

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Section: International Experiences In Multi-sectoral Partnerships To mentioning

confidence: 99%

Multi-Sectoral Action for Addressing Social Determinants of Noncommunicable Diseases and Mainstreaming Health Promotion in National Health Programmes in India

Arora¹,

Chauhan²,

John³

et al. 2011

Indian J Community Med

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“…Although it is not in the form of national health insurance, Singapore’s healthcare system has successfully achieved the goal of providing good and affordable basic medical care to all Singaporeans. Nevertheless, as a fast aging country with high public hospitals bed occupancy, Singapore is also facing the challenge of growing concerns over quality of care transition [ 26 , 27 ]. Therefore, there is a need to have a measure of care transition to assess the quality of care of patients in transition between care settings in Singapore.…”

Section: Introductionmentioning

confidence: 99%

Validation of the care transition measure in multi-ethnic South-East Asia in Singapore

Bakshi

Wee

Tay

et al. 2012

BMC Health Serv Res

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BackgroundThe 15-item Care Transition Measure (CTM-15) is a measure for assessing the quality of care during transition from the patients’ perspective. The purpose of this study was to test the psychometric properties of the CTM-15 and CTM-3 (a 3-item version of the CTM-15) in Singapore, a multi-ethnic urban state in South-east Asia.MethodsA consecutive sample of patients was recruited from two tertiary hospitals. The subjects or their proxies were interviewed 3 weeks after discharge from hospital to home in English or Chinese using the CTM-15 questionnaire. Information about patients’ visit to emergency department (ED), non-elective rehospitalisation for the condition of index hospitalisation, and care experience after discharge was also collected from respondents. Psychometric properties of CTM-15 and CTM-3 based on the five-point response scale (i.e. strongly disagree, disagree, neutral, agree, and strongly agree) and the three-point response scale (i.e. [strongly] agree, neutral, and [strongly] disagree) were tested for English and Chinese versions separately. Internal consistency reliability was assessed using Cronbach’s alpha and construct validity was tested with T-test or Pearson’s correlation by examining hypothesised association of CTM scores with ED visit, rehospitalisation, and experience with care after discharge. Exploratory factor analysis was performed to examine latent dimensions of CTM-15.ResultsA total of 414 (proxy: 96.1%) and 165 (proxy: 84.8%) subjects completed the interviews in English and Chinese, respectively. Cronbach’s alpha values of the different CTM-15 versions ranged from 0.81 to 0.87. In contrast, Cronbach’s alpha values of the CTM-3 ranged from 0.42 to 0.63. Both CTM-15 and CTM-3 were correlated with care experience after discharge regardless of survey language or response scale (Pearson’s correlation coefficient: 0.36 to 0.46). Among the English-speaking respondents, the CTM-15 and CTM-3 scores based on both the three- and five-point response scales discriminated well between patients with and without ED visits or rehospitalisation for their index condition. Among Chinese-speaking respondents, no difference in CTM scores was observed between patients with and without ED visits or patients with and without rehospitalisation. The English and Chinese versions of the CTM-15 items demonstrated a similar 4-factor structure representing general care plan, medication, agreement on care plan, and specific care instructions.ConclusionsThe care transition measure is a valid and reliable measure for quality of care transition in Singapore. Moreover, the care transition measure can be administered to proxies using a simpler response scale. The discriminatory power of the Chinese version of this instrument needs to be further tested in future studies.

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“…Overall, almost all the participants reported a positive experience and were satisfied with the various aspects of improvement brought on by its implementation. This echoed other studies in the United Kingdom, Hong Kong, and Singapore that reported increased patient satisfaction after integrated care between various healthcare facilities were introduced (Baxter et al, 2018;Lim, 2004;Wong et al, 2012). Malaysia shares similarities with these countries whereby the hospital services are mainly funded and provided by the government.…”

Section: Discussionmentioning

confidence: 55%

“…From the patients' perspective, in a systematic review, Baxter et al (2018) analysed hospital merger activity among member countries of the Organisation for Economic Collaboration and Development revealed that the intervention increased patient satisfaction level. Patients also reported enhanced treatment experience and better contact with healthcare personnel (Lim, 2004;van Veghel et al, 2019). Other advantages appreciated by patients through hospital merger was the convenience and reduced cost in receiving healthcare treatment as seen in the qualitative study conducted by McGrath (2015) on cancer patients in Australia.…”

Section: Introductionmentioning

confidence: 99%

Exploring Patients’ Experience on Hospital Merger: Have they benefited from Cluster Hospital Initiative in Malaysia?

Ng¹,

Mohamed²,

Anuar³

et al. 2020

JSSH

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Cluster Hospital Initiative (CHI) in Malaysia is a hospital merger exercise to establish an integrated network of specialist and non-specialist hospitals. The resource sharing, services realignment, and better care coordination from this integration have been shown to improve operational efficiency and quality of care from the providers’ perspective. However, there are very limited studies which focus on the effects of hospital merger on patients. Therefore, this study aims to explore patients’ and caregivers’ experiences of CHI. A qualitative study using purposive sampling was conducted from July to August 2017 at the three pilot sites. Semi-structured in-depth interviews were conducted with 85 patients and caregivers who received healthcare services before and after CHI. Interviews were audio-recorded and transcribed verbatim. Data were analysed using thematic text analysis. Three main themes transpired from the analysis were changes in healthcare service delivery, time spent on healthcare-related activities, and financial implications. Firstly, participants were generally satisfied with the increased access to specialist services, better quality of care, and upgraded equipment and facilities. Secondly, many participants experienced a shorter waiting time and reduced travelling time after CHI. Thirdly, CHI led to financial savings for the participants in terms of reduced out-of-pocket expenditure and productivity loss. This study demonstrated that the implementation of CHI appeared to be well-received by the patients. The expected benefits brought on by hospital mergers were also acknowledged by the study participants. A follow-up study is recommended due to the short duration of CHI implementation and low awareness about the initiative among patients.

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Quest for quality care and patient safety: the case of Singapore

Cited by 27 publications

References 7 publications

Multi-Sectoral Action for Addressing Social Determinants of Noncommunicable Diseases and Mainstreaming Health Promotion in National Health Programmes in India

Multi-Sectoral Action for Addressing Social Determinants of Noncommunicable Diseases and Mainstreaming Health Promotion in National Health Programmes in India

Validation of the care transition measure in multi-ethnic South-East Asia in Singapore

Exploring Patients’ Experience on Hospital Merger: Have they benefited from Cluster Hospital Initiative in Malaysia?

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