By Grace Chua
It has drawn up list of benchmarks for public health institutions
THE Ministry of Health (MOH), responding to the Auditor-General's criticisms that the health-care targets it was shooting for were inadequate, has drawn up a list of benchmarks.
Public sector health institutions will henceforth measure their performance on scorecards listing a range of key goals, which are being fine-tuned.
To measure access to health care, for example, one criterion would be how long patients wait to get treated.
Clinical quality will be measured in terms of adherence to protocols, patient safety and clinical outcome; affordability will be assessed, for example, in terms of the portion of the bill covered by Medisave and MediShield.
The permanent secretary for health, Ms Yong Ying-I, said the scorecards will enable MOH to answer the question: 'What is the realistic standard of care we commit to deliver to subsidised patients, which we can be proud of and yet bears in mind the resource constraints we have to manage within?'
She was speaking yesterday to an audience of health-care professionals and scientists at the opening of the eighth annual scientific congress of the National Healthcare Group (NHG) at the Suntec convention centre.
The challenge for health-care planners, she said, is to strike a balance between cost, quality and access to health care, and the system here has not always succeeded in doing this.
The critical Auditor-General's report in July took MOH to task for inadequately set Budget targets.
For example, it did not spell out what would constitute 'low' infant and maternal mortality, 'good' health-care services for the aged and 'quality' health professionals and institutions.
Ms Yong, in a wide-ranging speech that reflected the many dimensions of excellence in the quality of health care, said the ministry was working with public hospital chief executives and medical boards to finalise the criteria to be applied in the scorecards.
National University Hospital (NUH) chief executive Joe Sim said that with public sector health care reaching eight in 10 in-patients here, a move by public hospitals to measure and publish their clinical outcomes would put the heat on the private institutions to do the same.
NUH had its own internal targets, but a national scorecard would enable hospitals to align themselves with MOH's health priorities and goals, he said.
National Healthcare Group chief executive Lim Suet Wun remarked that comparing data required electronic records to be available.
The first phase of a national electronic health record system is slated to go live only in November next year.
Ms Yong noted that once the data is collected, it can be put to several uses:
Data from specific treatments and their costs can be analysed for meaningful discussions weighing their effectiveness against their cost, so expensive and unnecessary therapies can be dropped.
The information can also put a focus on the specific diseases or topics - relevant to Singapore - which clinical researchers should look at.
The statistics on treatment outcomes and patient survival rates here can also be compared with those of other countries.
For example, Singapore tends to fall behind in the provision of integrated care for patients with chronic conditions, Ms Yong noted.
To smooth out the transition patients may need to make from a stay in an acute hospital to one in a community hospital, a nursing home, a day rehabilitation centre or at home for their recovery, the Agency for Integrated Care has been revamped and put under the leadership of Dr Jason Cheah from the NHG, she said.
The Government is also practising integration in its delivery of mental health services, which will be needed in an ageing population, she added.
Efforts will be made in prevention, early identification and treatment in the community; community groups, including schools and grassroots agencies will be roped in to build awareness.