Nursing home patients could benefit from fewer beds in wards: Study

Nursing home patients could benefit from fewer beds in wards: Study

At least one nursing home has seen patients living in single- to four-bedded rooms deteriorate than residents in wards with more beds, according to the “Economics of Singapore Nursing Home Care” study.

SINGAPORE: While nursing homes in Singapore typically have six to eight beds in a ward, a new study looking at global best practices in nursing homes recommends that single- and twin-bedded wards become the norm.

In the Economics of Singapore Nursing Home Care study commissioned by Lien Foundation and Khoo Chwee Neo Foundation and unveiled on Thursday (Jul 27), global strategy consultancy Oliver Wyman evaluated the best practices of new models of care and what it would take to offer these types of care in Singapore.

An example of a facility that has seen good results with wards with fewer beds is the Peacehaven Nursing Home run by the Salvation Army. The nursing home has had a facility specifically for the elderly with dementia since 2006, and patients live in single to four-bedded rooms.

The home said that compared to their other residents in six-bedded wards the conditions of patients in these wards deteriorated at a slower rate. Executive director of the nursing home, Low Mui Liang, noted: "You do not see them lying down in bed like you would see in a hospital setting. With them having to do their own things, you get them walking and attending to their own needs rather than the staff having to attend to them."

The study comes after plans to replicate this success with a 60-bed, S$15 million home in Changi came to a halt last year when it failed to secure government subsidies.

Jade Circle Nursing Home, jointly developed by Peacehaven, the Lien Foundation and Khoo Chwee Neo Foundation, had estimated fees of between S$2,800 and S$3,500 per month before means testing.

The Health Ministry had said there was a need to ensure the long-term sustainability of such care models and instead offered to provide financial support if the home included rooms with four beds. It also said it was prepared to consider offering a "portable subsidy scheme", under which the home would set aside a certain proportion of their beds for patients who met the means test criteria for Government subsidies.

According to the study commissioned to look into the costs of the new care model, nursing homes incur an average cost of S$106 per resident per day, excluding government subsidies and grants.

It would cost just an additional S$8 to S$13 per resident per day for the elderly in Singapore to have the option of single or twin-bedded rooms, and S$19 million more or 0.2 per cent of the Health Ministry's 2016 healthcare expenditure of S$11 billion each year, the study found.

Oliver Wyman partner and head of health and life sciences Jeremy Lim said a single room in a private nursing home could cost thousands of dollars a month.

Compared to the current estimated costs of S$106 a day, the care model proposed by Lien Foundation with single or twin-bedded rooms would have costs of about S$114 to S$119, according to the study's estimates.

"It is not a significant rise," Mr Lim said, "And there will be cost savings downstream but these cost savings will be difficult to currently quantify."

The team behind the report added that cost savings would also be generated through lower hospitalisation rates as the proposed living arrangement would ensure the elderly had opportunities to be more mobile.

In response to media queries, the Health Ministry said it recognised the privacy single-bedded rooms offered but such efforts had to be sustainable and affordable. It added that it would study the report carefully and hoped to discuss the findings with the Lien Foundation.

The foundation is also gathering views from the public on the type of eldercare services they would like to see in the future. The online survey will be open from Thursday to Aug 18.

Source: CNA/mz