Tackling low-value care in Singapore: progress, pitfalls, and prospects.

Abstract

Low-value care is an important challenge for healthcare systems globally, contributing to unnecessary healthcare use and inefficient resource allocation. In Singapore, reducing low-value care is increasingly relevant given an ageing population, resource constraints and rising healthcare expenditure. However, local evidence on its prevalence, manifestations and underlying drivers remains limited. Available studies have identified potentially low-value practices in selected areas, while mechanisms established internationally, including patient expectations, clinician behaviours, financial incentives and organisational factors, may also be relevant locally but remain insufficiently characterised. Singapore has introduced initiatives to improve value and appropriateness of care, although publicly documented efforts have largely centred on public-sector and hospital-based settings, with less evidence from primary care and the private sector. Healthier SG may provide opportunities to support appropriate care through strengthened longitudinal primary care, although its impact on low-value care requires evaluation. International approaches, including evidence-based recommendations, measurement and feedback, payment mechanisms, and patient engagement provide potential lessons for local adaptation. Addressing low-value care in Singapore will require locally grounded research and coordinated, multi-component strategies across public and private sectors, accompanied by evaluation of appropriate care, outcomes, access and equity.