Welcome to the Centre for Health Services and Policy Research (CHSPR)!
CHSPR was established in April 2014 as a Centre for organizing health services to meet the health needs of a population. Health Services and Policy Research (HSPR) is the multidisciplinary field of scientific investigation that asks:
what works for whom, at what cost, and under which circumstances?
HSPR studies how social factors, financing systems, organizational structures and processes, health technologies, and personal behaviour affect access to healthcare, the quality and cost of healthcare, and ultimately our health and well-being. It also aims to conduct research into the use of data analytics to improve clinical care delivery and patient safety.
This new Centre aims to solve not only healthcare problems experienced by patients, but increasingly complex, multidisciplinary problems in healthcare, ultimately with the aim to improve the healthcare system in Singapore. This Centre approaches systems-level healthcare issues from a multidisciplinary perspective, connecting healthcare workers, patients, researchers, policy- and decision-makers to tackle complex themes in the fast-changing nature of health services delivery. It also aims to position the National University Health Systems to be a strategic partner to the Ministry of Health and the Agency for Integrated Care, and a strong player in the region to conduct Health Systems Research for informing policies and clinical practices.
The CHSPR team comprises a multi-domains team with representatives from National University Hospital, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine and Saw Swee Hock School of Public Health. The team possesses research excellence not only in the field of health systems research and data analytics, but also in the field of coordinated and integrated care development and research.
Our mission is to be the largest and most comprehensive Centre for Health Systems and Policy Research in Singapore and to be a leader among all health systems providing robust delivery of health services and influencing policy research, in Singapore and the regions beyond.
A/Prof. Teo Yik Ying
Director
Centre for Health Services and Policy Research (CHSPR)
Research Associates
Francisco Cervero |
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Health Informatics
PI: Tan Chuen Seng
- Project 1: Profiling patients with T2DM in an AMC with poor outcomes and developing predictors among these patients: a formative study using hospital administrative databases
Exec. Summary: To identify factors associated with higher hosp. costs, repeated admissions and longer length of stay with T2DM, and to develop a prediction model through data-mining the NUH administrative data related to healthcare cost and utilization.
Clinical/healthcare sign: The prediction model is expected to help to reduce the clinical burden of T2DM in the acute hospital setting, and to identify the low-risk patients that can be redirected to primary/community care.
| SPH experts |
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Tan Chuen Seng (PI) |
| NUHS experts |
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Tai E Shyong, Wee Hwee Lin, Eric Khoo |
- Project 2: Factors associated with glycemic control trajectories in T2D
Exec. Summary: To characterize trajectories of HbA1c for T2D patients using demographic and clinical characteristics, subsidy status and health service utilization information, through data-mining NUH clinical data for variables associated with glycemic control.
Clinical/healthcare sign: Accurate classification of glycemic control amongst T2D patients will allow a better T2D management and intervention programme to be tailored.
| SPH experts |
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Tan Chuen Seng (PI) |
| NUHS experts |
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Tai E Shyong, Wee Hwee Lin, Eric Khoo |
- Project 3: Outcomes of adult ECMO for community acquired pneumonia, poisoning and overdose in adult patients
Exec. Summary: To evaluate the risk factors for outcomes in adult ECMO patients of the three above conditions, through retrospective data-mining the ECMO registry.
Clinical/healthcare sign: ECMO use is inconsistent even though it is generally considered a useful therapy. By adopting an information-driven approach, this study will advise on best practices for treatment of patients who are severely poisoned, with consequent ARDS or refractory circulatory shock.
| SPH experts |
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Tan Chuen Seng (PI) |
| NUHS experts |
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Ramanathan K.R. |
- Project 4: Shared Care: Integrating rheumatology care in the community
Exec. Summary: To identify predictors for successful shared-care / right-siting of patients from tertiary hospitals to primary/community care, through analyzing the information generated from nine private family physicians and the period to first-return to tertiary hospital setting.
Clinical/healthcare sign: This study will identify the predictors for establishing a successful shared-care framework for the purpose of reducing the burden to tertiary hospitals.
| SPH experts |
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Tan Chuen Seng (PI) |
| NUHS experts |
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Anita Lim, Teng Gim Gee |
Health Technology Assessment
PI: Joanne Yoong
- Project 1: Early HTA of novel, non-invasive serum microRNA test for early detection of gastric cancer
(Jimmy So, Yeoh KG)
Exec. Summary: To adopt a data-driven decision-tree model for evaluating the cost-utility and returns-on-investment of a microRNA test for gastric cancer screening, and to assess the range of implementation scenarios to identify most favourable setting to yield cost-effective impact.
Clinical/healthcare sign: Early-stage HTA performed in tandem with basic technology development maximizes the clinical potential and widespread application.
| SPH experts |
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Joanne Yoong (PI), YY Teo, Ritika Kapoor |
| NUHS experts |
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Jimmy So, Yeoh Khay Guan |
| Panaxea |
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Lotte MG Steuten |
- Project 2: Cost-effectiveness of oral vs IV antibiotics for Klebsiella liver abscess treatment
(Sophia Archuleta)
Exec. Summary: To evaluate cost-effectiveness of different mode of antibiotics delivery, with primary data on patient/hospital costs over 12 weeks and through assessment of QoL.
Clinical/healthcare sign: Klebsiella penumoniae is the most common etiology of liver abscess, and there is limited evidence to guide oral delivery of antibiotics. Envisage this study will evaluate non-inferiority of oral delivery, over more costly/invasive IV delivery.
| SPH experts |
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Joanne Yoong (PI) |
| NUHS experts |
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Sophia Archuleta |
Health Services
PI: Professor Hubertus JM Vrijhoef
- Project 1: Measuring integrated care within NUHS RHS
(John Wong, Thomas Wee , E Shyong Tai, Helen Chen, James Yip)
Exec. Summary: To adapt the Netherlands integrated care measure consisting of 59 items (over 6 domains of integration) for a pilot of 50 individuals involved in the development/implementation of NUHS RHS, in order to provide baseline measurements for evaluating the RHS.
Clinical/healthcare sign: Implement a health systems approach for evaluating and increasing the efficiency of access, quality and continuity of healthcare services, in order to provide quality care at the most appropriate and cost-effective manner.
| SPH experts |
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Lim Yee-Wei (PI), Hubertus JM Vrijhoef |
| NUHS experts |
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John Wong, Thomas Wee, Tai E Shyong, Helen Chen, James Yip |
- Project 2: NUHS Outpatient Telehealth Initiative: Enabling Ageing-in-Place with Telehealth
(James Yip)
Exec. Summary: To access the willingness of ~800 NUH outpatients patients with chronic hypertension, diabetes or heart failure to pay for telemonitoring of vital signs, as an alternative to visits to the physicians in NUHS measured via the double-bounded dichotomous choice method and to access their satisfaction with an adjusted version of the Telemedicine Satisfaction and Usefulness Questionnaire.
Clinical/healthcare sign: Minimising the strain on existing healthcare resources through a telehealth approach to manage chronic care outpatients in their own communities and homes.
| SPH experts |
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Joanne Yoong (PI), Hubertus JM Vrijhoef, Lim Yee-Wei, Hildon Zoe Jane-Lara |
| NUHS experts |
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James Yip |
| Twente University |
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Lotte MG Steuten |
Quality and Safety
PI: Joanne Yoong
- Project 1: Economic burden of regulation to prevent harm - what does it cost to save a life?
(Sandhy Mujumdar, Sophia Ang, Bhuvaneshwari Mohankumar)
Exec. Summary: To cost the resources for detection of serious harm, analysis of root causes and "loop closing" to prevent recurrence in an AMC, by collecting/analyzing cost data between 2002-2013 for serious reportable events.
Clinical/healthcare sign: Significant relevance to MOH for AMC, due to revised directive on SREs, and many institutions have insufficient resources to analyze all events for loop closure and prevention. This project will provide quantitative evidence for healthcare administrators to understand health systems costs of harm prevention.
| SPH experts |
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Joanne Yoong (PI) |
| NUHS experts |
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Sandhy Mujumdar, Sophia Ang, Bhuvaneshwari Mohankumar |
- Project 2: Economic evaluation of improved structured clinical handover processes to ensure patient safety
(Sandhy Mujumdar, Sophia Ang, Heidi Mah)
Exec. Summary: To estimate economic impact of a structured clinical handover process to reduce sentinel events, by comparing benefits and costs from the intervention (including improvements in patient outcomes due to improvement in patient management), and evaluate the factors linked to handover-driven events.
Clinical/healthcare sign: Handing over of crucial information in complex hospital settings is vital to providing quality and appropriate healthcare and patient management. This study will evaluate the introduction of an intervention to improve handovers.
| SPH experts |
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Joanne Yoong (PI) |
| NUHS experts |
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Sandhy Mujumdar, Sophia Ang, Heidi Mah |
Publications
- Boyne, JJ, B VRIJHOEF, HJ Crijns, G De Weerd, J Kragten, AP Gorgels and; TEHAF investigators, "Tailored telemonitoring in patients with heart failure: results of a multicentre randomized controlled trial.". EUROPEAN JOURNAL OF HEART FAILURE, 14, no. 7 (2012) : 791-801. (Netherlands). PMID:22588319
Professor Chia Kee Seng
Dean, NUS Saw Swee Hock School of Public Health
Prof Chia is Professor and Dean of Saw Swee Hock School of Public Health, National University of Singapore and Director, Centre for Molecular Epidemiology. He is also an Adjunct Professor of Epidemiology at the Karolinska Institutet, Sweden.
He started his professional career as an occupational medicine specialist and is currently a member of the Workplace Safety and Health Council, chairs the Workplace Health Committee and is member of the WSH Institute Steering Committee.
His current research focus is in the molecular epidemiology of chronic diseases (cancer, cardiovascular disease, myopia, and diabetes mellitus) and the translation of these findings to preventive measures at the population level. In the last 5 years, Prof Chia has set up the Singapore Consortium of Cohort Studies for translational research to elucidate gene-environment interactions in disease causation, prevention and therapy.
Professor Satkunanantham s/o Kandiah
Chairman, Health Sciences Authority and former Director of Medical Services (DMS) of the Ministry of Health
Senior Consultant,
Division of Hip & Knee Surgery
Prof Satku is currently performing his clinical practice and teaching at the National University Health System (NUHS). He specialises in disorders of the knee, as well as general orthopaedics. His special areas of interest are the care, rehabilitation and surgical treatment of injuries and degenerative disorders of knee joint.
During his tenure as Director of Medical Services, Prof Satku made invaluable contributions to policy formulation, professional education, and standards, and healthcare innovations, MOH said.
Prof Satku oversaw a major transformation of the system for education and training of medical professionals, strengthened healthcare regulatory capabilities, significantly enhanced Singapore's pandemic emergency preparedness, and built a strong foundation for quality assurance and safety in our healthcare institutions, the Ministry said in a statement.
He notably introduced the Family Physician Register, championed the development of the primary care masterplan and led the development of a national mental health blueprint and policy for Singapore.
In the area of public health, Prof Satku's clinical leadership guided the healthcare community's response to crises, such as the influenza A (H1N1) pandemic in 2009.
Associate Professor Yeoh Khay Guan
Deputy Chief Executive
Dean, NUS Yong Loo Lin School of Medicine
A gastroenterologist by training, Prof Khay-Guan Yeoh (MBBS, MMed, FRCP) is Dean of the Yong Loo Lin School of Medicine. He is Associate Professor at the Department of Medicine, National University of Singapore, and Senior Consultant with the Department of Gastroenterology, National University Hospital.
Prof Yeoh's research interest is in the early detection of gastric and colorectal cancers, and has published over 100 peer-reviewed papers in international journals. He is the Lead Principal Investigator of the Singapore Gastric Cancer Consortium, a national flagship research group which aims to improve the survival outcomes for gastric cancer in Singapore. Prof Yeoh also chairs the National Colorectal Cancer Screening Committee of the Health Promotion Board, Ministry of Health which recommends guidelines for the national colorectal screening programme in Singapore.
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