IMPROVING ASTHMA OUTCOMES WHILE REDUCING COSTS: A VALUE-DRIVEN CARE PATHWAY AT A SINGAPORE TERTIARY HOSPITAL
Author(s)
John A. Abisheganaden, MD, Jason Cheah, MD.
National Healthcare Group (NHG), Singapore, Singapore.
National Healthcare Group (NHG), Singapore, Singapore.
OBJECTIVES: To describe Tan Tock Seng Hospital’s decade-long journey in implementing a value-driven outcomes (VDO) framework for asthma care, integrating clinical outcomes and cost measurement to improve quality, efficiency, and sustainability within a tertiary hospital setting in Singapore
METHODS: The asthma VDO initiative was developed iteratively through stakeholder engagement, focus groups, and continuous service redesign. An evidence-based clinical pathway was implemented to standardize care, guide treatment decisions, and enable routine measurement of outcomes meaningful to clinicians and patients. In parallel, cost-of-care methodologies were applied to identify major cost drivers, uncover waste and redundancy, and support pathway redesign for greater efficiency and sustainability. The framework established a common language of value, aligning clinical, operational, and financial perspectives
RESULTS: Implementation of the asthma clinical pathway enabled systematic tracking of pathway utilization, length of stay, 30-day readmissions, and influenza vaccination uptake. The care pathway provided greater clarity and consistency in care delivery, supported timely interventions, and reinforced adherence to follow-up and preventive care. Cost analysis showed that 85% of costs associated with an average four-day admission were attributable to manpower, diagnostic investigations, emergency department services, and other related care components. These findings helped identify priority areas for redesign and efficiency gains
CONCLUSIONS: A value-driven outcomes approach to asthma care can support better alignment between patient outcomes and cost-efficiency in routine hospital practice. At TTSH, the use of an evidence-based clinical pathway, coupled with regular review of outcome and cost data, enabled the identification of care gaps, informed quality improvement, and supported more sustainable care delivery. This approach demonstrates how value-based care can align the interests of patients, providers, and payers. Future work will focus on strengthening the framework across the care continuum from hospital to home, with greater emphasis on outcomes that matter most to patients and the total costs required to achieve them
METHODS: The asthma VDO initiative was developed iteratively through stakeholder engagement, focus groups, and continuous service redesign. An evidence-based clinical pathway was implemented to standardize care, guide treatment decisions, and enable routine measurement of outcomes meaningful to clinicians and patients. In parallel, cost-of-care methodologies were applied to identify major cost drivers, uncover waste and redundancy, and support pathway redesign for greater efficiency and sustainability. The framework established a common language of value, aligning clinical, operational, and financial perspectives
RESULTS: Implementation of the asthma clinical pathway enabled systematic tracking of pathway utilization, length of stay, 30-day readmissions, and influenza vaccination uptake. The care pathway provided greater clarity and consistency in care delivery, supported timely interventions, and reinforced adherence to follow-up and preventive care. Cost analysis showed that 85% of costs associated with an average four-day admission were attributable to manpower, diagnostic investigations, emergency department services, and other related care components. These findings helped identify priority areas for redesign and efficiency gains
CONCLUSIONS: A value-driven outcomes approach to asthma care can support better alignment between patient outcomes and cost-efficiency in routine hospital practice. At TTSH, the use of an evidence-based clinical pathway, coupled with regular review of outcome and cost data, enabled the identification of care gaps, informed quality improvement, and supported more sustainable care delivery. This approach demonstrates how value-based care can align the interests of patients, providers, and payers. Future work will focus on strengthening the framework across the care continuum from hospital to home, with greater emphasis on outcomes that matter most to patients and the total costs required to achieve them
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD96
Topic
Clinical Outcomes, Health Service Delivery & Process of Care, Real World Data & Information Systems
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)