Authors: Mary Cooke, Joel Wee Teck Quek, Nur Jelita Remie, Dawn Yeow and Jane Grffiths
Introduction and background: Long-term conditions (LTC) require long-term management. International policy indicates self-management in the home setting is the preferred option to maintain individual independence. Effective self-management reduces emergency department attendances and potential admissions to acute care. Aims: This paper aims to explore and compare the international models of long-term community care and the current policy development for LTC in Singapore. Method: We review and interpret the medical model and structures for health care delivery. We consider the diverse investment in the continued use of acute care delivery combined with the apparent intentions to focus on primary care services despite the patient preferences for traditional Chinese medicines and symptom relief. Discussion: Local research supports the implementation of the LTC self-management model but the medical model prevails as industrial numbers of in-patient beds are planned for the future. Investment in health care practitioner training for community multi-professional teams would support LTC care in the patient’s home, and patient preferences are to be supported in the community setting.
Keywords: long term conditions; self-management; policy; community care; primary care; nursing