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Country Key Features of Health Strategic Purchasing Policies & Frameworks
Financing System
Singapore How is the healthcare system The Singapore General Hospital (SGH) Delivering on
financed? Target (DOT) Programme was launched in 2005 aims to
actively support the right-siting of clinically stable
Multipayer health system patients from the SGH Diabetes Centre to private DOT
known as 3Ms: GPs to reduce unnecessary utilisation of expensive
specialist resources, and to reduce waiting times for the
MediShield Life (mandatory large numbers of diabetic patients with complications.
universal SHI)
• Who is the purchaser?
MediSave (national medical
savings scheme to help cover The Singaporean government.
OOP)
• What to purchase?
MediFund (safety net Subsidised drug delivery; diagnostic tests; allied
scheme) healthcare; chronic disease management, e.g., lifestyle
behavior modification, healthy eating, etc.

• From whom to purchase?
Private GPs (accounting for 80% of all GPs in Singapore)

• How to purchase?
Fee-for-service

2.2.2.2 EVALUATING THE PROGRAMMES FROM STRATEGIC
PURCHASING FRAMEWORK

This section reviews the purchasing programmes/policies for chronic disease prevention and
management in each jurisdiction according to the synthesised framework of strategic
purchasing (Klasa et al., 2018). The framework consists of five components: population
health, citizen empowerment, strengthening government stewardship and capacity, developing
effective purchaser and provider organisations, and incorporating cost-effective contracting.

Population health

The framework incorporates population needs as a core element in strategic purchasing
decisions. Identifying population health needs and incorporating them into strategic
purchasing requests a strong public health infrastructure, availability or meaningful
population-level data and information, and the analytic capacity to use them in forecasting
future needs. Specifically, recent technological advances, such as the development of smart
phone and wearable devices, electronic health platform, as well as the big data sciences, all
largely enhances the availability and meaningful usage of population health data. Additionally,
from the perspective of equity, whether and how to identify the many individuals that are
most in need of healthcare services is also regarded as an important task of strategic
purchasing within the population health component.

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