Abstract for: Systems modelling to support national healthcare system change: Experience in Singapore
"Faced with an older population, the Singapore health system, highly effective in addressing the needs of a young population with single acute or occasional complex chronic conditions through advanced acute services, is under stress. In response, Singapore is engaged in whole system change – Healthier SG. A central feature is assignment to a primary care provider. The challenge is to evaluate the potential consequences of Healthier SG. We developed a System Dynamic (SD) model, the Enhancing Primary Care (EPC) Model, of the Singapore health system under status quo and policy alternatives. The population is represented in terms of a continuously changing mix of health and social service needs. Enhanced primary care impacts this dynamic by meeting needs, conditional on the degree to which providers and patients are willing participants. This work has provided insights, such as how the status quo approach to expanding services in response to demand requires numbers of acute services disproportionate to the population increase, and that success of Healthier SG depends on the attractiveness of new care options. In addition, the EPC model has stimulated interest in use of SD in planning and monitoring Healthier SG. The challenge is to support growing enthusiasm for systems thinking with capacity development."