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New integrated care model for elderly patients under trial


It does not matter whether the patient suffers from a single medical condition or has several ailments. Or whether he needs acute care or has moved on to rehabilitation.

Under a new model of care, being piloted in Singapore for the first time at Alexandra Hospital, patients will be cared for by the same team from admission to discharge and stay under the same hospital roof, instead of being moved from an acute hospital to a community one.

Called the integrated general hospital model, it aims to better meet the needs of a growing group of elderly patients, many of whom have multiple medical conditions, said Alexandra Hospital and the Ministry of Health's Office for Healthcare Transformation (MOHT), which collaborated on the initiative.

If successful, the model could be implemented at other hospitals.

Since June this year, 2,500 patients at the hospital have experienced the new model, which integrates acute, sub-acute, rehabilitative and community care.

The patients are cared for by the same team, led by a lead doctor, throughout their admission, treatment, rehabilitation and discharge.

The rest of the team is made up of nurses, pharmacists, therapists, dietitians, medical social workers, care managers and administrators.

This new model can be a game changer, said the hospital's chief executive Jason Phua.

Patients are rehabilitated at the acute hospital instead of at a community hospital, and do not need to be transferred from one to the other. The plan is for acute and rehabilitative care to eventually take place even in the very same ward.

Over time, it is hoped that more patients who require acute hospital care but not complex tertiary specialist treatment can be managed through this new model.

"The lessons we are getting from Alexandra Hospital - we are bringing them back to the National University Hospital (NUH) and Ng Teng Fong General Hospital," said Professor John Eu-Li Wong, chief executive of the National University Health System, which includes Alexandra Hospital.

He added that Ng Teng Fong General Hospital and Jurong Community Hospital could be managed in future as one integrated hospital, while NUH - which is scheduled to be rebuilt - will also take in the lessons from Alexandra Hospital.

Professor Tan Chorh Chuan, MOHT's executive director, said that even with the new integrated general hospital model, the current system of acute and community hospitals is still needed.

"Hospital bed demand is still rising and the current system of acute and community hospitals is serving a current need because without it, we are going to have very congested acute hospitals and possibly, people may not get the rehabilitation we have that they need," he added.

And with more acute and community hospitals located next to each other, it provides options for the integrated general hospital model to be implemented in the future.

The new model is being trialled in the Queenstown area, which has one of the highest concentrations of elderly people in the western part of Singapore - 19 per cent of its nearly 100,000 residents are aged 65 and above.

Singapore, too, is ageing rapidly, with 15.2 per cent of its citizens aged above 65, according to the latest estimates.

MOHT was set up this year to address fundamental issues critical for healthcare transformation.

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