Chronic diseases are described as illnesses that persist a year or longer, necessitate continuing medical attention and long-term therapy, impede and affect everyday activities, or both. These medical conditions are often the cause of increasing rates of morbidity and mortality.
Behavioural Risk Factors (Modifiable)
1) Physical Activity
Lack of exercise or physical activity raises the risk of various serious health problems, including coronary heart disease, stroke, high blood pressure, and obesity. Your body can function well with regular physical activity. A lack of exercise can have negative consequences and may make you prone to identified conditions since it can lead to a person’s health deterioration.
2) Alcohol consumption
Excessive alcohol drinking increases the risk of chronic diseases such as cardiovascular disease, chronic kidney disease, type 2 diabetes mellitus, fatty liver disease, chronic hepatitis and cirrhosis.
3) Tobacco use
Tobacco usage is one of the significant causes for several health issues, including the development of complex identified chronic conditions. In high-income countries, it is still the main cause of death. Smoking can lead to fatal diseases such as cancer, stroke, lung disease such as chronic obstructive pulmonary disease (COPD), heart disease, and other chronic illnesses, as well as affecting the health of others through secondhand smoke.
A well-balanced diet is necessary for us to function efficiently on a daily basis, as the nutrients in our food provide us with the nutrients we need. A balanced diet is beneficial to children’s development and growth. In adults, proper nutrition and a healthy diet could help them live longer and have a lower chance of acquiring a chronic disease. Cardiovascular disease, high blood pressure, certain malignancies, and poor bone health are among illnesses linked to poor nutrition.
According to a World Health Organization assessment on the burden of chronic disease in Singapore, a balanced diet, regular exercise or physical activity, and avoiding tobacco products can prevent 80% of premature stroke, heart disease, and type 2 diabetes mellitus as 40% of cancer. Changing your lifestyle to remove behavioural risk factors is a type of prevention as well.
Background Risk Factors (Non-Modifiable)
Health problems are common as people age since many changes occur in the body. Alzheimer’s and Parkinson’s disease are two examples of age-related chronic diseases.
Even one’s gender can play a role in chronic disease development. Some disorders are more common in one gender than others, or only one gender can acquire a disease. Prostate cancer, for example, is diagnosable only in men, while ovarian cancer is diagnosable only in women.
3) Genetic Composition
A person’s genetic heritage also influences the likelihood of developing a chronic disease. If someone in your family has had a chronic ailment, there’s an increased risk you’ll acquire it as well. Heart disease, high blood pressure, arthritis, diabetes, and cancer are all examples of multifactorial genetic inheritance disorders.
The rising prevalence of chronic diseases in Singapore is due to its aging population and adaptation of bad habits and lifestyles. At least one chronic condition affects one out of every four Singaporeans aged 40 and up.
1) Diabetes Mellitus
Diabetes mellitus affects 1 out of 9 Singaporeans. It is a condition wherein the body doesn’t produce enough or is resistant to insulin resulting in blood glucose levels that remain abnormally high. This condition may lead to complications such as kidney failure, eye issues, diabetic foot ulcers, nerve difficulties, and stroke when left untreated and uncontrolled.
2) High Blood Pressure (Hypertension)
Less than 1 out of 4 Singaporeans aged 30-69 years old have hypertension. In the 60-69 years age group, more than 1 in 2 people have hypertension. It happens when the heart pumps blood at elevated pressure.
3) High Cholesterol (Hyperlipidemia)
High cholesterol, also known as hyperlipidemia, is present in 1 in 6 Singaporeans. This condition could lead to heart attacks, angina, stroke and peripheral vascular diseases.
Stroke accounts for more than 10% of all deaths in Singapore. 3.65% of Singaporeans have suffered from a stroke, and 26 new cases emerge daily. The aforementioned chronic conditions can cause this.
5) Heart Attack (Myocardial Infarction)
17 Singaporeans die from cardiovascular disease every day. And after cancer, is the second most common cause of death in Singapore. When left untreated, it could lead to heart muscle damage that causes abnormal heart rhythms, heart valve disease and, worse, heart failure.
Chronic disease accounted for 83% of all fatalities in Singapore in 2002, according to a World Health Organization (WHO) report. Furthermore, a substantial percentage of Singaporeans suffer from multiple chronic illnesses simultaneously. With such a high number, the Ministry of Health decided to start the Chronic Disease Management Program (CDMP) in October 2006.
The Chronic Disease Management Programme (CDMP) was created to enhance chronic disease patient care and lower medical expenses by making Singaporeans more easily and more affordably seek medical treatment. This was a national effort to improve the country’s overall chronic disease management.
The Chronic Disease Management Programme covers chronic physical and mental illnesses. CDMP includes the following conditions:
- Benign prostatic hyperplasia
- Bipolar disorder
- Chronic obstructive pulmonary disease (COPD)
- Diabetes mellitus (including pre-diabetes)
- Hyperlipidemia (lipid disorders)
- Major depression
- Parkinson’s disease
- Rheumatoid arthritis
According to the Senior Minister of State for Health Koh Poh Koon, gout, allergic rhinitis and hepatitis B will be added to the CDMP starting from July 1, 2022.
To guarantee that everyone may benefit from the CDMP, the Ministry has enlisted the help of over 1,250 GP clinics across Singapore to provide systematic, evidence-based chronic illness management. Including polyclinics, all public hospitals’ Specialist Outpatient Clinics (SOCs), and participating private specialist clinics offer the CDMP.
To access and join the program, here are the steps:
- Go to a participating clinic or medical institution.
- You may present symptoms of your chronic disease during your initial appointment, and medical personnel will conduct a clinical exam and tests.
- You may bring any necessary paperwork or past clinical records for your doctor to see; this may be used as a reference if you have already been diagnosed with a chronic disease.
MediSave is a nationwide medical savings program that allows people to set aside a portion of their salary to pay for hospitalisation, day surgery, and some outpatient setting charges for themselves or eligible dependents, as well as their long-term healthcare requirements such as their medical and healthcare needs in old age. MediSave’s principal goal is to assist Singaporeans in paying for expensive hospitalization expenditures.
The following services are eligible for MediSave:
- Medical check-ups if you have been diagnosed with a CDMP’s specified chronic disease or its complications.
- Evaluate the specified chronic illnesses, their consequences, and relevant investigations, including laboratory and radiographic tests such as X-rays.
- Therapies and medications treat and manage the chronic disease or its complications.
- Nursing, physiotherapy, occupational therapy, speech therapy, dietitian, and podiatry services are all allied health services referred by your doctor for chronic diseases.
The MediSave withdrawal restrictions have been carefully adjusted to ensure that Singaporeans have enough money to cover their basic healthcare expenses, especially when they age. The withdrawal restrictions are usually sufficient to cover most of the costs associated with subsidised inpatient and outpatient treatments.
Patients can utilise up to $500 per account each year for simple and complex chronic conditions under the MediSave500 program. They can even use their family member’s MediSave for up to ten accounts to cover their outpatient expenditures.
Each claim is subject to a 15% co payment in cash, regardless of whether the bill is for a package or a one-time visit. However, from January 1, 2021, a higher outpatient MediSave withdrawal limit for complex chronic conditions has been set to $700 and $500 for simple chronic conditions.
If a patient has undergone the following, he or she is considered a complex chronic patient:
- In a visit, received treatment for two or more CDMP conditions; or
- Was treated for at least one CDMP disease with known complications.
On the other hand, he/she is considered a simple chronic patient if:
- In a visit, received treatment for only one CDMP condition; or
- Outpatient care includes Vaccination for eligible patients under the National Adult/Childhood Immunization Schedule
- Co-Payment – Each claim is subject to a 15% co-payment on each outpatient bill.
- Annual Withdrawal Limit – The annual withdrawal limit has been switched from per-account to per-patient. Those who do not have enough money in their own MediSave account can continue to use money from a family member’s account up to the current withdrawal limit of $500 or $700.
Chronic illnesses have a long-term negative impact on the individual and society. If not addressed promptly, a decline in health, thus worsening the patients’ quality of life. Because these illnesses are present for a long time and are progressive, treatments can be costly. Everyone deserves proper treatment regardless of their role in society.
Managing chronic diseases and accompanying medical bills has become easier through programs like CDMP. Patients and their families are relieved of a significant financial burden. This also encourages patient self-management and gives them a sense of self-responsibility despite the difficulties.
In Singapore, there are a lot of financial schemes that could help deal with the cost of medical services. The Chronic Disease Management Programme (CDMP) and the Retire Genie services are just some of the numerous choices available to help chronic disease patients receive treatments with less financial burden.