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  1. Article ; Online: Evaluating the Effects of Capacity Building Initiatives and Primary Care Networks in Singapore

    Andrew Teik Hong Chen / Gerald Choon-Huat Koh / Ngan Phoon Fong / Jeremy Fung Yen Lim / Zoe Jane-Lara Hildon

    International Journal of Environmental Research and Public Health, Vol 20, Iss 2192, p

    Outcome Harvesting of System Changes to Chronic Disease Care Delivery

    2023  Volume 2192

    Abstract: The high tertiary healthcare utilisation in Singapore due to an ageing population and increasing chronic disease load has resulted in the establishment of primary care networks (PCNs) for private general practitioners (GPs) to provide team-based, ... ...

    Abstract The high tertiary healthcare utilisation in Singapore due to an ageing population and increasing chronic disease load has resulted in the establishment of primary care networks (PCNs) for private general practitioners (GPs) to provide team-based, community care for chronic diseases. A total of 22 PCN leaders and programme managers from 10 PCNs participated in online group discussions and a survey. Outcome harvesting was used to retrospectively link the intended and unintended outcomes to the programme initiatives and intermediate results (IRs). The outcomes were generated, refined and verified before shortlisting for analysis. About 134 positive and 22 negative PCN outcomes were observed since inception in 2018. By establishing PCN headquarters and entrusting PCN leaders with the autonomy to run these, as well as focusing policy direction on GP onboarding, GP engagements and clinical governance, the programme successfully harnessed the collective capabilities of GPs. Developments in the organisation (IR1) and monitoring and evaluation (IR4) were the top two contributors for positive and negative outcomes. Sustainable practice and policy changes represented 46% and 20% of the positive outcomes respectively. Sustainable positive outcomes were predominantly contributed by funding, clear programme policy direction and oversight. Conversely, most negative outcomes were due to the limited programme oversight especially in areas not covered by the programme policy.
    Keywords outcome harvesting ; PCN ; chronic disease management ; chronic disease registry ; ancillary services ; team-based care ; Medicine ; R
    Subject code 690
    Language English
    Publishing date 2023-01-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: The Effect of Health Check-Ups on Health Among the Elderly in China

    Dantong Zhao / Zhongliang Zhou / Chi Shen / Xiaohui Zhai / Yaxin Zhao / Dan Cao / Qiwei Deng / Guanping Liu / Jeremy Fung Yen Lim

    International Journal of Public Health, Vol

    Evidence From 2011–2018 Longitudinal Data

    2022  Volume 67

    Abstract: Objectives: To assess the effect of health check-ups on health among the elderly Chinese.Methods: The first dataset was panel data extracted from the 2011, 2014, and 2018 waves of the Chinese Longitudinal Health Longevity Survey (CLHLS). The second ... ...

    Abstract Objectives: To assess the effect of health check-ups on health among the elderly Chinese.Methods: The first dataset was panel data extracted from the 2011, 2014, and 2018 waves of the Chinese Longitudinal Health Longevity Survey (CLHLS). The second dataset was cross-sectional data come from CLHLS 2018 linked with the lagged term of health check-ups in CLHLS 2011. Health check-ups were measured by a binary variable annual health check-up (AHC). Health was assessed by a binary variable self-rated health (SRH). A coarsened exact matching method and individual fixed-effects models, as well as logistic regressions were employed.Results: AHC attendance among the elderly increased from 2011 to 2018, with higher utilization of AHC also detected in the rural group. AHC had positive effects on SRH among rural respondents (short-term effect: OR = 1.567, p < 0.05; long-term effect: OR = 3.385, p < 0.001).Conclusion: This study highlights a higher utilization of AHC in rural area, and the effectiveness of AHC in SRH improvement among rural participants. It indicates enhanced access to public healthcare services in rural area and underlying implications of health check-ups for reducing urban–rural health inequalities.
    Keywords health ; elderly ; urban-rural difference ; health check-ups ; preventive care ; Public aspects of medicine ; RA1-1270
    Subject code 360 ; 796
    Language English
    Publishing date 2022-08-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Putting Health Services Research into Practice

    Wai Ling Chow GDFM (Singapore), MBBS (Singapore) / Jeremy Fung Yen Lim MBBS, MPH

    Proceedings of Singapore Healthcare, Vol

    2011  Volume 20

    Abstract: Health services research (HSR) seeks to shed light on healthcare as a system, focusing on the cost of, the quality of and access to health services. While there is recognition that the practice of medicine should be evidence-based, there has been limited ...

    Abstract Health services research (HSR) seeks to shed light on healthcare as a system, focusing on the cost of, the quality of and access to health services. While there is recognition that the practice of medicine should be evidence-based, there has been limited progress in implementing evidence-based healthcare management. This review proposes a conceptual framework of putting HSR into practice through culture change; human capability capacity building and sustaining change via a supportive environment and reinforcing infrastructure
    Keywords Medicine ; R
    Language English
    Publishing date 2011-03-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Is simultaneous pancreas kidney transplant the most cost-effective strategy for type 1 diabetes patients with renal failure?

    Siew Chin Ong / Victor Tswen-Wen Lee / Jeremy Fung Yen Lim / Wai Leng Chow / Shao Chuen Tong / Terence Yi-Shern Kee / Krishnakumar Madhavan

    Proceedings of Singapore Healthcare, Vol

    2016  Volume 25

    Abstract: Introduction: Simultaneous pancreas kidney transplant (SPK) has shown beneficial outcomes in type 1 diabetes patients with renal failure (IDDM-RF). The objective of this study was to assess its cost-effectiveness compared with other treatment strategies ... ...

    Abstract Introduction: Simultaneous pancreas kidney transplant (SPK) has shown beneficial outcomes in type 1 diabetes patients with renal failure (IDDM-RF). The objective of this study was to assess its cost-effectiveness compared with other treatment strategies for IDDM-RF. Methods: A decision analytic model was developed for IDDM-RF treatment with four possible strategies: deceased donor kidney transplant (DDKT), living donor kidney transplant (LDKT), SPK and dialysis. A cost-utility analysis from the healthcare provider perspective was conducted based on a five-year model. Local data were used whenever possible except for SPK survival variables, wherein data from United Network for Organ Sharing and Scientific Registry of Transplant Recipients were used. Sensitivity analyses were performed to evaluate the impact of uncertainties around key variables. Results: In the baseline analysis, LDKT was the most cost-effective strategy with the lowest cost per quality-adjusted life year gained, i.e. SGD77,068, followed by SPK (SGD82,991), DDKT (SGD92,432) and dialysis (SGD181,192). The DDKT was extended dominated by dialysis and LDKT strategies. Incremental cost-effectiveness ratios with dialysis as a reference for LDKT and SPK strategies were SGD43,094 and SGD56,201, respectively. Both strategies are considered highly cost-effective under World Health Organization (WHO) guidelines. In the sensitivity analysis, a 6% increase in both SPK kidney graft survival and patient survival would make SPK the most cost-effective strategy. Conclusions: Both LDKT and SPK are highly cost-effective strategies in the treatment of IDDM-RF. SPK is potentially the most cost-effective strategy if a 6% increase in both SPK kidney graft survival and patient survival is achieved.
    Keywords Medicine ; R
    Subject code 616
    Language English
    Publishing date 2016-06-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Assessing the Performance of Operating Rooms

    Hong Choon Oh MEng, PhD (Chem Eng) / Tien Beng Phua BSc (Dietetics), MSc (Health Science Management) / Shao Chuen Tong BSc (Biomedical Engineering), Master (Health Administration) / Jeremy Fung Yen Lim MBBS, MPH

    Proceedings of Singapore Healthcare, Vol

    What to Measure and Why?

    2011  Volume 20

    Abstract: There are multiple indicators that measure different aspects of operating room (OR) performance such as OR productivity, satisfaction of patients and staff involved. The choice of these indicator(s) used for monitoring the performance of ORs often ... ...

    Abstract There are multiple indicators that measure different aspects of operating room (OR) performance such as OR productivity, satisfaction of patients and staff involved. The choice of these indicator(s) used for monitoring the performance of ORs often impacts how the processes of ORs are organised and managed. However, there is still no consensus in literature on which indicator(s) should be used for monitoring OR performance. In an effort to promote consensus within the healthcare community, this paper discusses potential performance metrics which may be employed for evaluation of ORs, their rationale and their limitations, and explains why a multidimensional approach is critical in assessment of OR performance.
    Keywords Medicine ; R
    Language English
    Publishing date 2011-06-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Innovative Proven Clinical-Research Strategies for Participant Recruitment and Retention

    Shao Chuen Tong MHA, BSc (Biomedical Engineering) / Aung Soe Tin MMedSc Public Health (Myanmar), MMed Public Health (Singapore) / Jeremy Fung Yen Lim MPH, MRCS (Edin) / Wai Leng Chow MBBS (Singapore), GDFM (Singapore)

    Proceedings of Singapore Healthcare, Vol

    2010  Volume 19

    Abstract: The ability to successfully recruit and retain research participants is an important precursor to conducting a successful clinical trial. With respect to participant recruitment, we discuss potential strategies used in well-known and successful research ... ...

    Abstract The ability to successfully recruit and retain research participants is an important precursor to conducting a successful clinical trial. With respect to participant recruitment, we discuss potential strategies used in well-known and successful research studies to reach out to the targeted populations, including public education on the importance of clinical trials and the use of new media in reaching out to a wider population. The measures used by research studies to engage their participants and their healthcare providers to optimise participant retention are also examined. We conclude by discussing how these strategies may be adapted for use in Singapore.
    Keywords Medicine ; R
    Language English
    Publishing date 2010-03-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Inter-library loan at ZB MED

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