Linking Medical and Social Care
- Author:
Christine Hindarto Lim
;
Matthew Ng Joo Ming
- Publication Type:journal article
- Keywords:
Complex Patient;
Multi-disciplinary Team;
Care Resources
- From:The Singapore Family Physician
2016;42(4):39-54
- CountrySingapore
-
Abstract:
Singapore has a rapidly ageing population with an increasingly complex chronic disease burden. The number of seniors living alone has also tripled in the last 15 years. Primary care physicians will have to change the way that we delivery primary care. Patients have multi-comorbidities and are sicker. Family Physician Practice has to enhance the coordination of medical and social care and the provision of comprehensive care across the entire cycle of care. This can be achieved by being connected to the health system and resources, making additional efforts in providing care coordination to navigate the health system, and optimising clinical social care around the patient’s needs with a multi-disciplinary team (MDT). There has been an increase in the number of services in the community but gaps still exist, especially in the coordination of healthcare and psychosocial care services. The team will need to tap on all available services to ensure patients’ medical and social needs are taken care of and they are enabled to age gracefully in place.
