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MOH to track outcome management of critically ill

SINGAPORE — The Ministry of Health (MOH) is setting up a national database on intensive care to keep track of the care and outcomes for the critically ill at public hospitals here.

MOH to track outcome management of critically ill

The Ministry of Health will be introducing a national intensive care registry solely to consolidate data from intensive care outcomes. Photo: Wee Teck Hian/TODAY

SINGAPORE — The Ministry of Health (MOH) is setting up a national database on intensive care to keep track of the care and outcomes for the critically ill at public hospitals here.

Announced by Health Minister Gan Kim Yong today (April 24) at the SG-ANZICS intensive care forum, it will be the Republic’s first database on intensive care.

Noting the “relatively high mortality and costs” associated with intensive care, Mr Gan said such data will allow for better understanding of the epidemiology — the patterns, causes and effects of diseases and health conditions — and the management and outcomes of the critically ill.

“It should also facilitate improvement of the quality and continuity of care, better capacity planning and optimise resource allocation,” he added.

Singapore, he stressed, has intensive care outcomes comparable with other developed countries. National data from 2009 showed that the survival rate of intensive care patients with severe sepsis, a severe form of blood infection that can lead to organ failure and death, was about 66 per cent. In other developed countries, this ranges between 50 and 70 per cent.

Dr Jason Phua, vice-chairman of the new database called the National Intensive Care Unit Registry, said data to be collected would include details such as type of disease, patient’s length of stay alongside patient’s characteristics such as age and gender. “This will give us some guidance on how to treat (critically ill) patients in future,” he said.

There are no plans to make the data collected public and it will be mainly used to guide clinical practices and allow hospitals to learn from one another, he added.

While public hospitals have long grappled with the issue of bed crunch, Dr Jonathan Tan, president of the Society of Intensive Care Medicine, said the data collected would not be used to make decisions on individual patient care. Instead, the data will be used for learning purposes, such as how intensive care here compares with other countries, and to find ways to improve. The society will be helping facilitate data collection.

The data collection began its pilot phase last year at the National University Hospital (NUH), Alexandra Hospital, Tan Tock Seng Hospital and Khoo Teck Puat Hospital (KTPH), and will be expanded to include other public hospitals. Currently, the team is analysing the data collected to standardise data collection norms moving forward. The MOH will also be conducting an IT study of data collection gaps to develop the database.

The Society of Intensive Care Medicine also announced three new studies starting this year. Dr Zudin Puthucheary from the NUH will be investigating the financial burden of critical care here, including the costs to patients and their families and the state.

Dr Thangavelautham Suhitharan from Singapore General Hospital will study whether the degree of acid imbalance in the blood could reflect severity of illness and affect outcomes. Patients who are critically ill will generate more acid due to the lack of blood flow and oxygen to the organs, and findings could help guide treatment.

The researchers could not be reached to provide more information on their studies.

Dr Shahla Siddiqui from the KTPH will examine the management and prevalence of Acute Respiratory Distress Syndrome, a condition common among intensive care unit (ICU) patients and associated with severe lung failure. “In Singapore, there is very little prevalence study on this condition,” Dr Shahla told TODAY. “It is expensive to treat and has a high mortality rate, so it will be good to know more about it.”

The one-month snapshot study aims to look at the number of people with this condition, treatment preferences of healthcare professionals and mortality rate of patients. It will include all the public hospitals and involve about 1,200 patients.

Mr Gan noted that enhancing the competency of ICU staff means more professional development, education and research. Just as important, he added, is training staff to be competent in all aspects of end-of-life care, which is “sensitive and emotive”. “It requires a good understanding when intensive care will not benefit patients, how best to communicate with families or surrogates, guiding and supporting them on making decisions on care options, and finally to ensure that patients’ and their families’ views are respected,” he said.

CORRECTION: In the report "MOH to track outcome management of critically ill" (April 25), we named Mr Jason Tan as the president of the Society of Intensive Care Medicine.  This is incorrect. The president of the society is Dr Jonathan Tan. We apologise for the error.

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