Integrated care for diabetes—a Singapore approach

An article in the International Journal of Integrated Care by Su Qian Yeo and colleagues discusses the integrated care approach to managing diabetes in Singapore. The number of individuals with diabetes worldwide has increased from about 153 million in 1980 to about 347 million in 2008, due in part to population growth, ageing, urbanisation, and a rising prevalence of risk factors for type 2 diabetes such as obesity and physical inactivity. This rise in prevalence causes considerable burden on health systems and national economies.This has made developing new models of diabetes care a priority for many health systems.

The Singapore General Hospital (SGH) Delivering on Target (DOT) Programme was launched in 2005 to site clinically stable diabetic patients from the hospital to general practitioners (GPs). The Chronic Disease Management Office (CDMO) was established and a fully customised DOT information technology (IT) system was developed. Three initiatives were implemented: (i) subsidised drug delivery programme, (ii) diagnostic tests incentive programme, and (iii) allied healthcare incentive programme.

The authors concluded that a coherent process across all healthcare providers similar to the SGH DOT Programme may facilitate efforts to shift the care for people with diabetes to the community and to provide integrated care. Successful integration may also require incentives for institutional partners and patients.

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