2 in 3 Older Adults Do Not Consult a Regular Family Doctor, New Study Finds

• New research unveiled by SMU’s Centre for Research on Successful Ageing (ROSA) shows that only 35% of older adults in Singapore have a regular family doctor
• Having a regular family doctor ensures ‘continuity of care’ and is key to preventive health, as well as to identifying and addressing health conditions early
• Study recommends for more efforts to encourage older adults to enrol in the Healthier SG initiative launched by Singapore’s Ministry of Health

Singapore, 27 July 2022 (Wednesday) – A new study by SMU’s Centre for Research on Successful Ageing (ROSA) revealed that only about a third of older adults surveyed (35%) currently have a regular family doctor. Registering with a regular family doctor, which is a key component of the Healthier SG (HSG) initiative launched by Health Minister Ong Ye Kung in March 2022, helps to achieve ‘continuity of care’ and improved health outcomes among Singaporeans.

According to ROSA’s study, titled “Older Adult Healthcare Utilisation Patterns and Receptiveness towards Healthier SG Initiative”, a large majority of respondents (85%) would still want to see other doctors even if they had registered for HSG, citing the desire for a second opinion on their health conditions. 14% of older adults surveyed do not visit polyclinics for health screenings

HSG places greater emphasis on preventive healthcare rather than reactive treatments. Instead of ‘doctor hopping’, or visiting multiple doctors over time, HSG encourages Singaporeans to visit a primary physician for most of their healthcare needs. This results in ‘continuity of care’, a sustained and prolonged relationship between an individual and their family physician or healthcare practitioner over time.

Continuity of care could result in care that is tailored to an individual’s needs and likely improved health outcomes among the Singapore population. Continuity of care has been shown to be important for older adult populations, given the greater likelihood for older adults to be in poorer health and to suffer from chronic conditions.

“The results of our study illustrate both the timeliness of the introduction of the Healthier SG initiative and that most older adults are receptive to this new healthcare approach. We see the merits of those with a regular physician, particularly when it comes to adhering to preventive health check-ups.  As preventive health care is critical in ensuring successful ageing, we should continue to encourage those who remain apprehensive, especially in terms of raising awareness of the need for regular health check ups,” said Professor Paulin Straughan, Director, ROSA.

ROSA’s research was conducted using data from the Singapore Life Panel®, a population representative monthly survey of Singaporeans aged 57-76 (inclusive) in 2022, that has been conducted since 2015. A total of 6,418 older adults participated in the survey which was fielded in April 2022.

Key findings and recommendations:

1. Slightly less than half of older adults surveyed were aware of HSG (46%). Respondents with a higher socioeconomic status (SES) were more likely to be aware of HSG.
2. Slightly more than half of older adults surveyed visit polyclinics for health screenings (51%), while 14% stated that they do not go for health screenings.
3. Only about a third of older adults surveyed (35%) currently have a regular family doctor.
4. A large majority of older adults surveyed (86%) expressed willingness to enroll in HSG. However, a large majority of respondents also expressed that they would still want to see other doctors even if they registered for HSG (85%). The most popular reason cited for wanting to still see other doctors was the desire for a second opinion on their health conditions (67% of respondents who would see other doctors even if enrolled selected this).
5. Among older adults surveyed, SES, perceptions of the importance of regular health checkups, and current healthcare utilisation patterns (whether they visit general practitioners (GPs) or polyclinics) were found to be important possible factors shaping both the willingness of respondents to register for HSG, as well as whether respondents currently have a regular family doctor.

Based on the findings listed above, ROSA makes the following policy recommendations for the implementation of the HSG initiative:

1. Efforts to encourage older adults to enroll in HSG should be targeted at older adults with lower SES profiles (i.e older adults living in 1-3 room HDB flats and lower educated respondents)

• This may include raising awareness among such older adults about the importance of having a regular family physician, as well as efforts to increase the accessibility of such services for older adults who may not be able to afford them.

2. Efforts to encourage older adults to enroll should also emphasise the importance of regular health checkups for their health

• It is possible that some older adults may not understand the importance and value of preventive health.
• As such, authorities should try to raise awareness about how these initiatives can benefit their health in the long run.

3. Polyclinics will play a large role in ensuring the effective implementation of HSG

• This is based on the finding that respondents who visited polyclinics more frequently when in need of healthcare advice were found to be less likely to have a regular family doctor, as well as less likely to want to register for HSG.
• Polyclinics are thus likely to be important avenues through which authorities can raise awareness about the importance of having a primary doctor.
• Efforts to encourage older adults to register for HSG should be targeted at older adults who visit polyclinics regularly, as these older adults are observed to be less willing to register for HSG.