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Singapore's health-care system: key features, challenges, and shifts.

Publication ,  Journal Article
Tan, CC; Lam, CSP; Matchar, DB; Zee, YK; Wong, JEL
Published in: Lancet
September 18, 2021

Since Singapore became an independent nation in 1965, the development of its health-care system has been underpinned by an emphasis on personal responsibility for health, and active government intervention to ensure access and affordability through targeted subsidies and to reduce unnecessary costs. Singapore is achieving good health outcomes, with a total health expenditure of 4·47% of gross domestic product in 2016. However, the health-care system is contending with increased stress, as reflected in so-called pain points that have led to public concern, including shortages in acute hospital beds and intermediate and long-term care (ILTC) services, and high out-of-pocket payments. The main drivers of these challenges are the rising prevalence of non-communicable diseases and rapid population ageing, limitations in the delivery and organisation of primary care and ILTC, and financial incentives that might inadvertently impede care integration. To address these challenges, Singapore's Ministry of Health implemented a comprehensive set of reforms in 2012 under its Healthcare 2020 Masterplan. These reforms substantially increased the capacity of public hospital beds and ILTC services in the community, expanded subsidies for primary care and long-term care, and introduced a series of financing health-care reforms to strengthen financial protection and coverage. However, it became clear that these measures alone would not address the underlying drivers of system stress in the long term. Instead, the system requires, and is making, much more fundamental changes to its approach. In 2016, the Ministry of Health encapsulated the required shifts in terms of the so-called Three Beyonds-namely, beyond health care to health, beyond hospital to community, and beyond quality to value.

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Published In

Lancet

DOI

EISSN

1474-547X

Publication Date

September 18, 2021

Volume

398

Issue

10305

Start / End Page

1091 / 1104

Location

England

Related Subject Headings

  • Singapore
  • Primary Health Care
  • Noncommunicable Diseases
  • Humans
  • Healthcare Financing
  • Health Facilities
  • Health Expenditures
  • Health Care Reform
  • Gross Domestic Product
  • General & Internal Medicine
 

Citation

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ICMJE
MLA
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Tan, C. C., Lam, C. S. P., Matchar, D. B., Zee, Y. K., & Wong, J. E. L. (2021). Singapore's health-care system: key features, challenges, and shifts. Lancet, 398(10305), 1091–1104. https://doi.org/10.1016/S0140-6736(21)00252-X
Tan, Chorh Chuan, Carolyn S. P. Lam, David B. Matchar, Yoong Kang Zee, and John E. L. Wong. “Singapore's health-care system: key features, challenges, and shifts.Lancet 398, no. 10305 (September 18, 2021): 1091–1104. https://doi.org/10.1016/S0140-6736(21)00252-X.
Tan CC, Lam CSP, Matchar DB, Zee YK, Wong JEL. Singapore's health-care system: key features, challenges, and shifts. Lancet. 2021 Sep 18;398(10305):1091–104.
Tan, Chorh Chuan, et al. “Singapore's health-care system: key features, challenges, and shifts.Lancet, vol. 398, no. 10305, Sept. 2021, pp. 1091–104. Pubmed, doi:10.1016/S0140-6736(21)00252-X.
Tan CC, Lam CSP, Matchar DB, Zee YK, Wong JEL. Singapore's health-care system: key features, challenges, and shifts. Lancet. 2021 Sep 18;398(10305):1091–1104.
Journal cover image

Published In

Lancet

DOI

EISSN

1474-547X

Publication Date

September 18, 2021

Volume

398

Issue

10305

Start / End Page

1091 / 1104

Location

England

Related Subject Headings

  • Singapore
  • Primary Health Care
  • Noncommunicable Diseases
  • Humans
  • Healthcare Financing
  • Health Facilities
  • Health Expenditures
  • Health Care Reform
  • Gross Domestic Product
  • General & Internal Medicine