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未来的社区医院:新加坡社区医院在减轻卫生系统负担方面的作用。

Community hospitals of the future: the role of community hospitals to mitigate health system burden in Singapore.

作者信息

Foo Chuan De, Chia Hui Xiang, Tan Sherianne Yen Tze, Lai Yi Feng, Khoo Jia En Joy, Tee Shi Yun, Lim Cher Wee, Teo Ken Wah

机构信息

Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.

Duke NUS Graduate Medical School, Singapore, Singapore.

出版信息

Front Health Serv. 2024 Jul 23;4:1407528. doi: 10.3389/frhs.2024.1407528. eCollection 2024.

Abstract

In Singapore, an ageing population with increasing chronic disease burden and complex social circumstances have strained the healthcare system. For the health system to run more efficiently, patients should be appropriately sited according to their medical needs. In Singapore, community hospitals serve as an intermediate inpatient facility managing patients with sub-acute and rehabilitation care needs. Our policy brief uncovers the gaps in transforming community hospital care models and offers actionable steps to unlock the community hospital chokepoints in Singapore's health system. The future community hospitals can accommodate higher acuity but medically stable patients, while patients who do not require inpatient rehabilitation care can be appropriately sited to community partners, if policy, resourcing and technology factors are addressed. An evidence-based, stepwise approach involving all stakeholders will be required to pilot and evaluate new models before large-scale change.

摘要

在新加坡,人口老龄化、慢性病负担加重以及复杂的社会环境给医疗系统带来了压力。为了使医疗系统更高效地运行,患者应根据其医疗需求被安置到合适的地方。在新加坡,社区医院作为一种中级住院设施,负责管理有亚急性和康复护理需求的患者。我们的政策简报揭示了社区医院护理模式转变中的差距,并提供了可行的措施来消除新加坡医疗系统中社区医院的瓶颈问题。如果政策、资源和技术因素得到解决,未来的社区医院可以收治病情较重但病情稳定的患者,而不需要住院康复护理的患者可以被妥善安置到社区合作伙伴处。在进行大规模变革之前,需要一种基于证据的、涉及所有利益相关者的逐步方法来试点和评估新模式。

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本文引用的文献

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Healthier SG: Singapore's multi-year strategy to transform primary healthcare.健康新加坡:新加坡转变基层医疗的多年战略。
Lancet Reg Health West Pac. 2023 Jul 27;37:100861. doi: 10.1016/j.lanwpc.2023.100861. eCollection 2023 Aug.
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An ethical analysis of policy dialogues.政策对话的伦理分析。
Health Res Policy Syst. 2023 Jan 27;21(1):13. doi: 10.1186/s12961-023-00962-2.
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Meeting today's healthcare needs: Medicine at the interface.满足当今医疗保健需求:界面医学。
Ann Acad Med Singap. 2022 Dec;51(12):787-792. doi: 10.47102/annals-acadmedsg.2022196.
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Singapore's health-care system: key features, challenges, and shifts.新加坡的医疗保健系统:主要特点、挑战和转变。
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