{"id":"https://openalex.org/W7224223253","doi":"https://doi.org/10.47102/annals-acadmedsg.2026448","title":"Acute medicine at the hospital front door: A Singapore health system priority","display_name":"Acute medicine at the hospital front door: A Singapore health system priority","publication_year":2026,"publication_date":"2026-10-30","ids":{"openalex":"https://openalex.org/W7224223253","doi":"https://doi.org/10.47102/annals-acadmedsg.2026448"},"language":"en","primary_location":{"id":"doi:10.47102/annals-acadmedsg.2026448","doi":"https://doi.org/10.47102/annals-acadmedsg.2026448","is_oa":true,"landing_page_url":"https://doi.org/10.47102/annals-acadmedsg.2026448","pdf_url":null,"source":{"id":"https://openalex.org/S134891020","display_name":"Annals of the Academy of Medicine Singapore","issn_l":"0304-4602","issn":["0304-4602","2972-4066"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-b","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-40","russia-white-list-1"],"host_organization":"https://openalex.org/P4310317082","host_organization_name":"Academy of Medicine, Singapore","host_organization_lineage":["https://openalex.org/P4310317082"],"host_organization_lineage_names":["Academy of Medicine, Singapore"],"type":"journal"},"license":"cc-by-nc-sa","license_id":"https://openalex.org/licenses/cc-by-nc-sa","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Annals of the Academy of Medicine Singapore","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://doi.org/10.47102/annals-acadmedsg.2026448","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5073158165","display_name":"John Tshon Yit Soong","orcid":"https://orcid.org/0000-0003-4235-8505","observed_orcids":["https://orcid.org/0000-0003-4235-8505"]},"institutions":[{"id":"https://openalex.org/I4210146690","display_name":"National University Hospital","ror":"https://ror.org/04fp9fm22","country_code":"SG","type":"healthcare","lineage":["https://openalex.org/I165932596","https://openalex.org/I4210146690","https://openalex.org/I4210150261"]}],"countries":["SG"],"is_corresponding":false,"raw_author_name":"John Tshon Yit Soong","raw_affiliation_strings":["Advanced Internal Medicine, National University Hospital, Singapore"],"raw_orcid":"https://orcid.org/0000-0003-4235-8505","affiliations":[{"raw_affiliation_string":"Advanced Internal Medicine, National University Hospital, Singapore","institution_ids":["https://openalex.org/I4210146690"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5108803142","display_name":"Nick R Murch","orcid":"https://orcid.org/0009-0009-2922-4714","observed_orcids":["https://orcid.org/0009-0009-2922-4714"]},"institutions":[{"id":"https://openalex.org/I2801138448","display_name":"The Royal Free Hospital","ror":"https://ror.org/01ge67z96","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I169248724","https://openalex.org/I2801138448"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Nick Murch","raw_affiliation_strings":["The Royal Free Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Royal Free Hospital","institution_ids":["https://openalex.org/I2801138448"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5085313289","display_name":"Derek Bell","orcid":"https://orcid.org/0000-0002-9944-1097","observed_orcids":["https://orcid.org/0000-0002-9944-1097"]},"institutions":[{"id":"https://openalex.org/I47508984","display_name":"Imperial College London","ror":"https://ror.org/041kmwe10","country_code":"GB","type":"education","lineage":["https://openalex.org/I47508984"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Derek Bell","raw_affiliation_strings":["Imperial College London"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Imperial College London","institution_ids":["https://openalex.org/I47508984"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":3,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.8946876,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"12","issue":"55","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11095","display_name":"Emergency and Acute Care Studies","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11095","display_name":"Emergency and Acute Care Studies","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12174","display_name":"Hospital Admissions and Outcomes","score":0.0006000000284984708,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13896","display_name":"Health Services Management and Policy","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/acute-medicine","display_name":"acute medicine","score":0.9599999785423279},{"id":"https://openalex.org/keywords/hospital-overcrowding","display_name":"hospital overcrowding","score":0.7310000061988831},{"id":"https://openalex.org/keywords/older-adults","display_name":"older adults","score":0.6480000019073486},{"id":"https://openalex.org/keywords/medically-complex-patients","display_name":"medically complex patients","score":0.8050000071525574},{"id":"https://openalex.org/keywords/discharge-planning","display_name":"discharge planning","score":0.5130000114440918},{"id":"https://openalex.org/keywords/hospital-bed-capacity","display_name":"hospital bed capacity","score":0.46299999952316284},{"id":"https://openalex.org/keywords/health-system-redesign","display_name":"health system redesign","score":0.49300000071525574},{"id":"https://openalex.org/keywords/singapore-health-system","display_name":"Singapore health system","score":0.5329999923706055},{"id":"https://openalex.org/keywords/multidisciplinary-assessment","display_name":"multidisciplinary assessment","score":0.640999972820282},{"id":"https://openalex.org/keywords/rapid-diagnostics","display_name":"rapid diagnostics","score":0.5350000262260437},{"id":"https://openalex.org/keywords/workforce-planning","display_name":"workforce planning","score":0.3540000021457672},{"id":"https://openalex.org/keywords/health-governance","display_name":"health governance","score":0.3709999918937683}],"concepts":[{"id":"https://openalex.org/C2991694339","wikidata":"https://www.wikidata.org/wiki/Q4677936","display_name":"Acute medicine","level":2,"score":0.7476000189781189},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7459999918937683},{"id":"https://openalex.org/C2781385661","wikidata":"https://www.wikidata.org/wiki/Q4677918","display_name":"Acute care","level":3,"score":0.7215999960899353},{"id":"https://openalex.org/C22467394","wikidata":"https://www.wikidata.org/wiki/Q849359","display_name":"Multidisciplinary approach","level":2,"score":0.6284000277519226},{"id":"https://openalex.org/C20387591","wikidata":"https://www.wikidata.org/wiki/Q930752","display_name":"Specialty","level":2,"score":0.608299970626831},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.6075999736785889},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.45249998569488525},{"id":"https://openalex.org/C3017977530","wikidata":"https://www.wikidata.org/wiki/Q557429","display_name":"Acute hospital","level":3,"score":0.4131999909877777},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.38589999079704285},{"id":"https://openalex.org/C2780724011","wikidata":"https://www.wikidata.org/wiki/Q1295316","display_name":"Emergency department","level":2,"score":0.3849000036716461},{"id":"https://openalex.org/C2988170871","wikidata":"https://www.wikidata.org/wiki/Q11000047","display_name":"Healthcare system","level":3,"score":0.3434999883174896},{"id":"https://openalex.org/C194051981","wikidata":"https://www.wikidata.org/wiki/Q1337691","display_name":"Economic shortage","level":3,"score":0.33169999718666077},{"id":"https://openalex.org/C111852164","wikidata":"https://www.wikidata.org/wiki/Q1414679","display_name":"Handover","level":2,"score":0.32749998569488525},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.3228999972343445},{"id":"https://openalex.org/C545288138","wikidata":"https://www.wikidata.org/wiki/Q860447","display_name":"Emergency medical services","level":2,"score":0.3192000091075897},{"id":"https://openalex.org/C3018838755","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Medical care","level":2,"score":0.29580000042915344},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.2915000021457672},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.2890999913215637},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.2818000018596649},{"id":"https://openalex.org/C2779662365","wikidata":"https://www.wikidata.org/wiki/Q5416694","display_name":"Event (particle physics)","level":2,"score":0.28139999508857727},{"id":"https://openalex.org/C2777551076","wikidata":"https://www.wikidata.org/wiki/Q842332","display_name":"Front (military)","level":2,"score":0.27889999747276306},{"id":"https://openalex.org/C3020166492","wikidata":"https://www.wikidata.org/wiki/Q12202","display_name":"Acute stroke","level":3,"score":0.2775999903678894},{"id":"https://openalex.org/C2991972916","wikidata":"https://www.wikidata.org/wiki/Q5690807","display_name":"Medical assessment","level":2,"score":0.2757999897003174},{"id":"https://openalex.org/C2780358146","wikidata":"https://www.wikidata.org/wiki/Q5908738","display_name":"Hospital medicine","level":2,"score":0.27070000767707825},{"id":"https://openalex.org/C89623803","wikidata":"https://www.wikidata.org/wiki/Q12184","display_name":"Pandemic","level":5,"score":0.2689000070095062},{"id":"https://openalex.org/C68991459","wikidata":"https://www.wikidata.org/wiki/Q11700776","display_name":"Value proposition","level":2,"score":0.26840001344680786},{"id":"https://openalex.org/C2781403576","wikidata":"https://www.wikidata.org/wiki/Q4384456","display_name":"Front line","level":2,"score":0.267300009727478},{"id":"https://openalex.org/C2778605646","wikidata":"https://www.wikidata.org/wiki/Q223729","display_name":"White paper","level":2,"score":0.2639000117778778},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.2538999915122986}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.47102/annals-acadmedsg.2026448","doi":"https://doi.org/10.47102/annals-acadmedsg.2026448","is_oa":true,"landing_page_url":"https://doi.org/10.47102/annals-acadmedsg.2026448","pdf_url":null,"source":{"id":"https://openalex.org/S134891020","display_name":"Annals of the Academy of Medicine Singapore","issn_l":"0304-4602","issn":["0304-4602","2972-4066"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-b","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-40","russia-white-list-1"],"host_organization":"https://openalex.org/P4310317082","host_organization_name":"Academy of Medicine, Singapore","host_organization_lineage":["https://openalex.org/P4310317082"],"host_organization_lineage_names":["Academy of Medicine, Singapore"],"type":"journal"},"license":"cc-by-nc-sa","license_id":"https://openalex.org/licenses/cc-by-nc-sa","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Annals of the Academy of Medicine Singapore","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.47102/annals-acadmedsg.2026448","doi":"https://doi.org/10.47102/annals-acadmedsg.2026448","is_oa":true,"landing_page_url":"https://doi.org/10.47102/annals-acadmedsg.2026448","pdf_url":null,"source":{"id":"https://openalex.org/S134891020","display_name":"Annals of the Academy of Medicine Singapore","issn_l":"0304-4602","issn":["0304-4602","2972-4066"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-b","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-40","russia-white-list-1"],"host_organization":"https://openalex.org/P4310317082","host_organization_name":"Academy of Medicine, Singapore","host_organization_lineage":["https://openalex.org/P4310317082"],"host_organization_lineage_names":["Academy of Medicine, Singapore"],"type":"journal"},"license":"cc-by-nc-sa","license_id":"https://openalex.org/licenses/cc-by-nc-sa","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Annals of the Academy of Medicine Singapore","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.9763000011444092,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":14,"referenced_works":["https://openalex.org/W1526394715","https://openalex.org/W2047238020","https://openalex.org/W2081753990","https://openalex.org/W2147383644","https://openalex.org/W2438693500","https://openalex.org/W2746934277","https://openalex.org/W2806503569","https://openalex.org/W2899448691","https://openalex.org/W2923603207","https://openalex.org/W2951435220","https://openalex.org/W2987515419","https://openalex.org/W3120883776","https://openalex.org/W3176449715","https://openalex.org/W4313258829"],"related_works":["https://openalex.org/W2899448691","https://openalex.org/W7165946691","https://openalex.org/W2025978900","https://openalex.org/W2006646869","https://openalex.org/W2183478544","https://openalex.org/W2428009918","https://openalex.org/W2903423427","https://openalex.org/W2433468744","https://openalex.org/W2015520461","https://openalex.org/W7097294649"],"abstract_inverted_index":{"Hospital":[0],"crowding":[1],"in":[2,104,108,115,132],"Singapore":[3,105],"is":[4],"often":[5],"experienced":[6],"at":[7],"the":[8,26,85,98,144],"emergency":[9,37,126],"department":[10],"front":[11],"door,":[12],"but":[13,114],"for":[14,150],"many":[15],"older":[16],"and":[17,38,45,58,81,125,142,147],"medically":[18],"complex":[19],"adults,":[20],"it":[21],"may":[22],"signal":[23],"vulnerabilities":[24],"across":[25],"early":[27],"acute":[28,91,102,135],"care":[29,51,127],"pathway.":[30],"Delayed":[31],"senior":[32,75],"decision-making,":[33],"fragmented":[34],"handover":[35],"between":[36],"inpatient":[39],"teams,":[40],"limited":[41],"alternatives":[42],"to":[43,49,54,67],"admission,":[44],"weak":[46],"transitions":[47],"back":[48],"community":[50],"create":[52],"risks":[53],"safety,":[55],"patient":[56],"experience,":[57],"bed":[59],"capacity.":[60],"Acute":[61],"medicine":[62,103,136],"offers":[63],"a":[64,110],"practical":[65],"way":[66],"redesign":[68],"this":[69],"interval":[70],"by":[71],"concentrating":[72],"diagnostic":[73],"breadth,":[74],"review,":[76],"rapid":[77],"diagnostics,":[78],"multidisciplinary":[79],"assessment,":[80],"disposition":[82],"planning":[83],"during":[84],"first":[86],"48\u201372":[87],"hours":[88],"of":[89,101,140],"undifferentiated":[90],"medical":[92,124],"illness.":[93],"This":[94],"commentary":[95],"argues":[96],"that":[97],"policy":[99],"value":[100],"lies":[106],"not":[107],"replicating":[109],"UK":[111],"specialty":[112],"model":[113],"defining":[116],"how":[117],"its":[118],"core":[119],"functions":[120],"can":[121],"complement":[122],"existing":[123],"pathways.":[128],"It":[129],"examines":[130],"progress":[131],"Singapore,":[133],"distinguishes":[134],"from":[137],"adjacent":[138],"models":[139],"care,":[141],"identifies":[143],"workforce,":[145],"governance,":[146],"measurement":[148],"requirements":[149],"further":[151],"development.":[152]},"counts_by_year":[],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2026-10-30T00:00:00"}