3.PATIENT AND PROVIDER PERSPECTIVES ON HYPERTENSION, DIABETES AND DYSLIPIDAEMIA SCREENING IN A LOW-INCOME SINGAPOREAN RENTAL-FLAT COMMUNITY
Liang En Wee ; Gerald Choon-Huat Koh
The Singapore Family Physician 2016;42(3):75-87
Aims:
Patient and provider barriers to cardiovascular disease
screening in disadvantaged Asian populations are
under-studied. We conducted a qualitative study of
attitudes to hypertension/diabetes/dyslipidaemia
screening within low-income communities in Singapore.
Methods:
Interviewers elicited barriers/enablers to blood
pressure measurement/fasting blood glucose/fasting
blood lipid amongst residents and healthcare providers
serving low-income communities. Transcripts were
analysed thematically and iterative analysis carried out
using established qualitative methodology.
Results:
Twenty patients and nine providers were interviewed.
Comments were grouped into seven content areas:
primary care characteristics (PCC), procedural issues,
knowledge, costs, priorities, attitudes, and information
sources. For hypertension screening, procedural issues
were enablers; however, for fasting blood tests,
procedural issues were perceived as both enablers and
barriers, including issues of pain, needle and blood
phobia, and lag between tests and results. Costs of
screening and treatment were cited as issues for
diabetes and cholesterol screening, but for
hypertension screening, concerns about cost of
treatment dominated. While blood pressure
measurement using sphygmomanometers and fasting
lipid tests were generally perceived as the accepted
screening tests for hypertension and hyperlipidaemia,
fasting glucose tests were not perceived as the accepted
screening test for diabetes. Barriers and enablers to
cardiovascular screening, as perceived by patients and
providers, were largely concordant.
Conclusion:
Procedural issues predominated in patients’ percept
ions of hypertension screening, while knowledge and
attitudes played a more significant role for diabetes
and dyslipidaemia. Interventions to raise screening
uptake in these disadvantaged communities must be
tailored to the main barriers for each modality.
5.House calls in Singapore – A Qualitative Study
Ling Ling Soh ; Gerald Choon-Huat Koh ; Rakhi Mittal
The Singapore Family Physician 2018;44(4):35-42
Background Historically, physicians routinely delivered medical care to sick patients in patients' homes. While house calls accounted for 40% of all doctor-patient encounters In the 1940s, the rate has since dwindled to less than 1%. Based on some studies done overseas, the reasons for the unpopularity of house calls were the lack of time and unsatisfactory remuneration. The aim of this study was to explore the attitudes of general practitioners (GPs) currently practicing in Singapore towards house calls. Design A qualitative study using phenomenological methodology was done by conducting one-to-one in-depth interviews with 12 GPs. Results All the GPs interviewed were aware of the benefits of house calls in the healthcare scene of Singapore. The commonest barrier was concern about the limitations perceived to be present during a house call and their possible medicolegal implications. GPs also struggled with charging appropriately for house calls and found them disruptive to their practices. Conclusion: The study shows that GPs recognize the value of making house calls but at the same time struggle with perceived limitations in the home setting as well as remuneration issues.
6.Singapore Gp Fee Survey 2013: A Comparison With Past
Andrew Epaphroditus Tay Swee Kwang ; Choo Kay Wee, Gerald Koh Choon Huat Koh
The Singapore Family Physician 2017;43(1):42-51
Introduction: The rising cost of healthcare in Singapore has resulted in calls for greater price transparency. With the GP (General Practitioner's) fees surveys done in 1996 and 2006, we undertook a similar survey in 2013 to investigate the change in GP fees and GP operating costs over the years.
Methods: The 2013 GP Fee Survey involved 992 GPs and solo clinic practitioners. Results from the 2013 GP Fee Survey were compared against the 1996 and 2006 GP Fees Surveys. Compound Annual Growth Rate (CAGR) was used to reflect the change in price data over the years and compared against the CAGR of the Consumer Price Index (CPI) and CPI-Health over the same periods.
Results: 113 participants (11.5%) responded. Between 1996 and 2013, the CAGR for CPI was 1.84% and CPI-Health was 2.97%. In comparison, the CAGR for the median patient fee was 3.12%; staff salary was 1.95%; property cost was 2.47%; and total monthly practice cost was 9.21%.
Conclusion: Between 1996 and 2013, the rise in the patient fee matched the rise in CPI-Health but the rise in practice cost outpaced CPI-Health by more than three-fold. However, the low response rate limits the generalizability of the data.
10.A review of geriatric education in Singapore.
Annals of the Academy of Medicine, Singapore 2007;36(8):687-690
The United Nations has identified the training and education of healthcare professionals and care providers involved in the care of older persons as a global priority. Singapore is no exception as it faces a rapidly ageing population. Older people have many medical needs of varying dimensions and their care requires a multidisciplinary healthcare team. The current status of geriatric education of health professionals involved in elderly care in Singapore is discussed in this paper. Important issues raised include the disparity between professions in the stages of development of geriatric education, questions on the adequacy of numbers and training of healthcare professionals providing geriatric care, as well as the need for geriatric education of caregivers.
Aged
;
Geriatric Nursing
;
education
;
Health Personnel
;
education
;
Humans
;
Singapore
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