Abstract
It is crucial to adapt and improve the (primary) health care systems of countries to prepare for future patient profiles and their related needs. The main aim of this study was to acquire a comprehensive overview of the perceptions of primary care experts in Singapore about the state of primary care in Singapore, and to compare this with the state of primary care in other countries. Notwithstanding ranked 2nd in terms of efficiency of health care, Singapore is facing significant health care challenges. Emails were sent to 85 experts, where they were asked to rate Singapore’s primary care system based on nine internationally adopted health system characteristics and six practice characteristics (response rate = 29%). The primary care system in Singapore received an average of 10.9 out of 30 possible points. Lowest ratings were given to: earnings of primary care physicians compared to specialists, requirement for 24 hr accessibility of primary care services, standard of family medicine in academic departments, reflection of community served by practices in patient lists, and the access to specialists without needing to be referred by primary care physicians. Singapore was categorized as a ‘low’ primary care country according to the experts.
Highlights
All health care systems across the world include primary care
The nine health system characteristics include: 1) how much the distribution of resources throughout the country is controlled by the system, 2) how primary care services are financed, 3) the main type of primary care practitioner in the country - a higher percentage of generalists would receive a higher score, 4) the percentage of physicians in primary care as compared to specialty care, 5) the ratio of professional earnings of primary care physicians in contrast to specialists, 6) the extent of cost shared by patients, 7) reflection of community served by practices in patient lists, 8) 24 hr accessibility of primary care services, and 9) the academic strength of primary care or general practice departments
Lowest ratings were given to: earnings of primary care physicians as compared to specialists, requirement for 24 hr accessibility of primary care services, standard of family medicine in academic departments, reflection of community served by practices in patient lists, and “first contact”
Summary
The level of development of primary care as part of the health care system varies substantially. Lessons can be learned from other countries This has become increasingly important as various countries are instituting policies to hold primary care practices accountable for managing chronic conditions and meeting clinical standards. Health care systems of countries focused on acute, episodic care, addressing the needs of inpatients. An ageing population would need regular care that should be available in acute hospitals, In general, the primary care system should and has to become the mainstay in the long term management of patients, such as those with diabetes, heart failure or chronic lung diseases. The strength of a country’s primary care system is reliant on how well the above primary care dimensions develop within the context of a country’s health care system [7]
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