What factors really matter? Health-related quality of life for patients on kidney transplant waiting list.

INTRODUCTION: Waiting times for kidney transplant are long in Singapore. Healthrelated quality of life (HRQoL) of patients might be affected as a result of the stress of the long wait and the uncertainty of being called to undergo a surgical operation. This study aimed to measure the HRQoL of patients on the kidney transplant waiting list and to identify factors which could impact on the HRQoL scores in this group of patients. MATERIALS AND METHODS: This was a cross-sectional study of kidney transplant waiting list patients managed at a tertiary renal unit using the SF-36. A SF-36 normative calculator was used to generate HRQoL scores for the Singapore general population matched with the study cohort's age, gender and ethnicity. RESULTS: There were 265 respondents with a response rate was 81%. Our study shows that HRQoL scores for the kidney transplant waiting list patients were lower than the population norms across all subscales and were clinically significant for General Health, Role Physical, Bodily Pain, Social Functioning and Mental Component Summary scores. Factors such as being Chinese, married, employed and undergoing haemodialysis predicted better HRQoL scores after adjusting for possible confounders. Age, gender, educational level, household income, history of kidney transplant, duration on the transplant waiting list and years on dialysis did not significantly influence SF-36 across all subscales scores. CONCLUSION: Kidney transplant waiting list patients had worse HRQoL compared to the general population. Factors such as ethnicity, marital status, employment status, and type of dialysis treatment significantly influenced patients' perception of their HRQoL.

Public perceptions of healthcare in Singapore.

INTRODUCTION: Understanding public perceptions of healthcare delivery is important to guide policy formulation and practice as well as to identify areas where public health communication needs to be strengthened to overcome misconceptions and allay unfounded concerns. We conducted a survey of Singapore residents to determine perceptions of the affordability and quality of healthcare in Singapore. MATERIALS AND METHODS: A sampling frame was drawn from the 2005/2006 edition of the telephone directory. One thousand seven hundred and eighty-three respondents were interviewed via telephone and asked to rank their agreement with statements pertaining to healthcare cost and quality on a 5-point Likert scale. RESULTS: Respondents were representative of the general population in ethnicity and housing type but lower income households were over-represented. 79.6% of respondents agreed that Singapore had a good healthcare system and 57.5% agreed that the government provided good and affordable healthcare to Singaporeans. The majority agreed that healthcare was generally affordable, especially at polyclinics (78%) and restructured hospitals (50%) and that the quality of healthcare in Singapore was high. Comparing primary and tertiary care, there was uniformity in the perception of quality at both levels but respondents assessed tertiary healthcare to be less affordable (P <0.0001). CONCLUSION: Singaporeans are confident in the healthcare system. The quality of Singapore healthcare is generally regarded to be high although there are growing concerns regarding the affordability of healthcare.