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. 2024 Oct 4;24(4):2.
doi: 10.5334/ijic.7747. eCollection 2024 Oct-Dec.

Measuring the Maturity of Integrated Care in Singapore with the SCIROCCO Exchange Tool

Angeline Woon Kee Lim  1   2 , Clive Tan  1   3 , Jason Chin Huat Yap  1
Affiliations

Measuring the Maturity of Integrated Care in Singapore with the SCIROCCO Exchange Tool

Angeline Woon Kee Lim et al. Int J Integr Care. .

Abstract

Background: How have we progressed and where are the gaps of integrated care in Singapore? Social-health care provision in the context of an ageing population is critical in the city-state's management of the unprecedented demand as the proportion of seniors with multiple complex medical needs have almost doubled in the past decade.

Objective: This study measures the maturity level of Singapore's integrated care, identifies key gaps and discusses their implications using the SCIROCCO Exchange tool, an online self-assessment tool consisting of the 12 dimensions necessary for the provision of integrated care.

Methods: A three-step mixed method Delphi study was used to derive expert consensus. Participants across the social-healthcare sector as well as representatives from all three public healthcare delivery networks with at least five years of experience were included. Participants rated each of the twelve dimensions of the SCIROCCO Exchange tool on a six-point ordinal scale and provided justifications for each rating. Criteria from the RAND UCLA appropriateness method and thematic analysis were adopted for the analysis.

Results: All participants completed the study. The study found five dimensions in the "Initial" maturity level and five dimensions in the "Progressing" maturity level. There were two dimensions which were "Uncertain" because of split responses, possibly due to their differing vantage points and conceptualisations of integrated care. The overall medians were plotted on a spider diagram. The absence of a systematic approach for integrated care was the most common subtheme across all dimensions. This is foundational for integrated care as this would enable stakeholders across health and social care to identify with a common goal.

Implications: The findings emphasise the imperative to reshape social-health care delivery by focusing on foundational dimensions (such as structure, governance and citizen empowerment) to enable progress in other dimensions. Following the conclusion of this study, Singapore initiated a primary care reform with the launch of Healthier SG in July 2023. Future research may wish to explore the impact of Healthier SG on maturity of integrated care in Singapore.

Keywords: SCIROCCO; Singapore; health systems; integrated care.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Diagram illustrating the B3 Maturity Model for Integrated Care, showcasing the various stages of maturity in integrated care systems
Figure 1
B3-Maturity Model [22].
Planning for a Maturity Assessment Process
Figure 2
Planning for a Maturity Assessment Process [32].
The composite diagram summarises the overall median for each dimension
Figure 3
Maturity of Integrated Care based on Overall Median.
Overall responses of self-assessment tool over time
Appendix 2
Overall responses of self-assessment tool over time.
Responses of SCIROCCO tool by stakeholder groups over time
Appendix 3
Responses of SCIROCCO tool by stakeholder groups over time.
Comparison of SCIROCCO Exchange outcomes across regions
Appendix 4
Comparison of SCIROCCO Exchange outcomes across regions.
See this image and copyright information in PMC

References

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