SINGAPORE — As Singapore transforms its healthcare model to be less reliant on hospitals, community care such as transitional care services will be a focus.

Transitional care involves caring for patients after their discharge with healthcare providers visiting them in their homes.

Since the programme started at Khoo Teck Puat Hospital in April 2012, there has been about a 30 per cent rise in the number of patients. The service used to see about 30 patients utilising it per month when it first started, and this number rose to 40 in April last year.

The service runs for a period of up to three months depending on the patients’ condition, following which, they may be handed over to a community care provider.

Currently, there are about 75 patients tapping on the service. And on average, three inpatients from Khoo Teck Puat Hospital are referred to the service daily.

But with more elderly suffering complex conditions, manpower remains a challenge to the team, especially during festive periods.

Dr Ang Yan Hoon, project director of transitional care services at Khoo Teck Puat Hospital, said: “We actually put in more manpower with effect from December, and it was quite timely because over the Christmas to New Year’s Eve period last year, there was a quite a severe bed crunch in the hospital. Normally we had three referrals a day, and during that period we had up to about 10 referrals a day.”

After suffering a stroke last August, 58-year-old Mdm Sa’odah Ahmad was in and out of Khoo Teck Puat Hospital for various treatments. In October, her family was recommended the transitional care service as her condition had stabilised.

Mdm Sa’odah Ahmad’s daughter and caregiver, Ms Lizawati Zakariah, was concerned about the delivery of medical care.

She said: “Hospital (has) everything. At home, she’s (Mdm Sa’odah Ahmad) comfortable but the thing is we don’t have everything. We only have medicines and milk. But since my mum always says ‘I want to go back’ and she wants me to take care of her, I (don’t have a) choice.”

In such situations, the team conducts caregiver training to help family members cope with the care of their loved ones.

Not only does this service allow patients to recover at home, it also frees up bed space for more acutely ill patients.

After subsidies, a visit by a nurse is priced at S$40, a visit by a doctor is priced at S$80, while a visit by therapist is priced at S$75.

The duties of a doctor include reviewing patients with medical conditions such as heart failure, respiratory problems and diabetes. Nurses will conduct physical assessments and nursing procedures such as changing of feeding tube, urinary catheter and wound dressing

A physiotherapist would discuss the treatment plan and duration with the individual or caregiver.

Transitional care service is in place at Changi General Hospital, Tan Tock Seng Hospital, Khoo Teck Puat Hospital, and Singapore General Hospital.

It will be launched at National University Hospital next month, and soon at Ng Teng Fong General Hospital. CHANNEL NEWSASIA