SINGAPORE – The healthcare system was initially designed for a “much younger population”, and Singapore needs to urgently transform the way it delivers care to provide appropriate and effective care for an ageing population, said Health Minister Gan Kim Yong on Friday (Feb 2).

Aside from a multidisciplinary, person-centric approach, funding arrangements must change.

“We need to move away from per-day or per-visit funding and move towards funding the bundles of services needed for an episode of care,” said Mr Gan at the Global Conference on Integrated Care at Resorts World Sentosa.

Funding arrangements must provide the flexibility to optimise care and allocate resources efficiently for the good of patients.

A programme called Hospital to Home, which supports the return of patients from hospital to home, is funded on a per-episode rate to give providers the flexibility to tailor care for each patient, he said.

The programme, launched in April 2017 and available at public hospitals, is administered by the Agency for Integrated Care. It consolidates the previous transitional care programmes offered by hospitals and integrates care provided by community partners.

Other factors that will enable integration of care include more community nurses, greater involvement of general practitioners and the National Electronic Health Record system.

Efforts to groom nurses in community care include new programmes such as the Specialist Diploma in Nursing (Gerontology) and Specialist Diploma in Community Gerontology Nursing, rolled out by Nanyang Polytechnic and Ngee Ann Polytechnic. The programmes took in about 20 nurses last year.

By 2030, one in four Singaporeans will be aged 65 and above. Seniors may have multiple health conditions that involve multiple specialists and multiple admissions to hospitals. Yet there are fewer caregivers because family sizes are shrinking, said Mr Gan.

Integrated care is also about connecting social and health services, he said. Seniors who are socially withdrawn may suffer from worse health if there is no one to remind them to take their medication, or to get them engaged in mind-stimulating activities, said Mr Gan. For this reason, the aged care functions of the Ministry of Social and Family Development were merged with that of the Ministry of Health, for better service planning at the national level and for new models to be piloted.