ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 238
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Evaluation of GP primary care networks in Singapore by
patients with diabetes: Is care consistent with the chronic
care model?
Dr Lay Hoon Goh1,2, Doris Young1,2, Prof Jose Maria Valderas Martinez1,2, E Shyong Tai1,2
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E
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National University Health System, 2National University of Singapore
Background
General practitioner (GP) primary care networks (PCNs) in Singapore are networks of GPs with nurse
counselling and health screening support. Three organisational types exist: single-handed clinics,
regional health system-led clinics and corporate medical group practices. One of the PCNs’ roles is
to provide care for patients living with chronic diseases. The PCNs comprise about 600 clinics and
100,000 patients with type 2 diabetes.
Aim
To address the information gap on PCNs’ performance by conducting a structured evaluation using
the chronic care model (CCM), an evidence-based approach to designing chronic care delivery.
Hypothesis
There are differences in CCM elements across PCN types.
Methodology
A convenience sample of patients with diabetes was recruited from clinic waiting rooms and GP
lists. The Patient Assessment of Chronic Illness Care (PACIC) questionnaire, which was specifically
developed for appraising CCM components, was administered. The mean and standard deviation of
each subscale and an overall score were calculated. Linear regression was used with the overall score
as the outcome in both unadjusted and adjusted models.
Results
In all, 343 patients completed the PACIC (197 from single-handed clinics, 97 from regional health
system-led clinics and 49 from group practices). There was no difference in overall scores between the
PCN types. The Delivery System Design subscale attained the highest scores (mean 3.81, SD 0.76),
followed by Patient Activation (mean 3.44, SD 1.04), Problem Solving/Contextual (mean 3.36, SD 0.93),
Goal Setting/Tailoring (mean 3.10, SD 0.83) and Follow-up/Coordination (mean 2.71, SD 0.90). Younger
patients and spending longer time with the GPs were associated with higher PACIC scores.
Conclusions
There are differences in CCM elements among the PCNs in Singapore, as perceived by patients with
diabetes, but not between PCN types. With the sampling method being a limitation, future work can
focus on systematic sampling and using qualitative research to explain the findings.
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