Ageing: socio-economic implications for health care in Singapore.

In planning for the health of the population, especially of the aged, demographic variables which interact with social and economic factors must all be considered to assess their impact on the health services. Demographic trends such as the dependency ratio, sex ratio, marital status and family formation would also have a bearing on the care of the elderly at home. Trends in labour force participation and the extent of financial security among the elderly can therefore affect policy implications concerning public subsidy of health care and social services. As health needs are expected to rise in relation to the increasing proportion of the elderly as well as the survival of the older population itself, hence the urgency for innovative approaches to the organization and financing of health care. The aged accounts for a major share of the utilization and expenditure for hospitalization and medical services and yet have inadequate coverage. In Singapore, the Medisave Scheme was implemented to impose compulsory savings for medical care and to promote family support for the elderly. Pressures can be expected to emphasize the development of cost-effective programmes for the aged, such as community-based primary care, disease prevention and health promotion.