Transforming healthcare system: Outcomes of Healthier-SG from a large tertiary-care hospital in Singapore

•The Healthier-SG model was associated with significantly reduced HLOS and number of bed-days, along with decreased in-hospital mortality, ICU admission, and 30-day all-cause readmission during the early phase of Healthier-SG.•The number of bed-days post Healthier-SG was also reduced for patients under the care of the Eastern cluster.•Further monitoring and improvement is needed for the expected shift away of the chronic disease conditions from acute hospitals. Healthier-SG is a major transformation of the healthcare system which focuses on proactively preventing individuals from falling ill. We aimed to determine if the introduction of Healthier-SG was associated with changes in outcomes of admitted patients. Retrospective cohort study of patients aged ≥21 who were admitted 18 months prior to (January 2022 to June 2023) and 6 months post (Jul to Dec 2023) implementation of Healthier-SG. Relevant patient information was also extracted. 109,451 inpatients were included overtime with 30,692 (28.0%) patients admitted post Healthier-SG. For medical conditions that could be managed in the community, admissions for dementia (0.2% vs. 0.1% P=0.003) and peripheral vascular disease (0.4% vs. 0.3% P=0.011) decreased significantly after Healthier-SG, but no differences for most other conditions (all p>0.05). The patient's hospital length of stay [HLOS, geometric means (GM), prior to 3.8 vs. post Healthier-SG 3.5 days] and in-hospital mortality (3.7% vs. 2.9%, all P