Over the past three decades, Singapore’s healthcare system has evolved into one that comprises some 35 specialties which has helped to better manage the complexities of patient care and sophisticated treatment modalities. While this has generally improved the quality of healthcare within each specialty, it has caused fragmentation across our healthcare system. As patients “move” across these “fragments” of different specialties and different care settings, they are vulnerable to the breakdowns in care resulting in adverse events, low satisfaction with care and higher readmission rates. Elsewhere, there are successful transitional care models to help patients transit smoothly from one care setting to another. With increasing life expectancy and a projection that one in 5 Singaporeans will be aged 65 and above by 2030, there will be a higher prevalence of patients with chronic diseases and multiple comorbidities requiring medical attention across specialties, healthcare professionals and settings. In addition, the current “stresses” on the public acute care hospitals which are running at high bed occupancies means that the pressure is ever increasing to discharge patients into the community as rapidly as possible while not compromising on patient safety and outcomes. There is therefore a need for transitional care to ensure that the patient’s “journey” through the continuum is seamless and coordinated.
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