Introduction: Primary healthcare providers play a crucial role in educating their patients on chronic
disease self-management (CDSM). This study aims to evaluate CDSM competency and satisfaction in
patients receiving their healthcare from public or private healthcare providers.
Methods: A cross-sectional household study was conducted in a public housing estate using a
standardised questionnaire to interview Singaporeans and permanent residents aged 40 years and above,
who were diagnosed with at least 1 of these chronic diseases: hyperlipidaemia, hypertension or diabetes
mellitus. CDSM competency was evaluated with the Partners In Health (PIH) scale and a knowledgebased
questionnaire. Satisfaction was evaluated using a satisfaction scale.
Results: In general, the 420 respondents demonstrated good CDSM competency, with 314 followed up
at polyclinics and 106 by general practitioners (GPs). There was no significant difference between
patients of polyclinics and GPs in CDSM competency scores (mean PIH score 72.9 vs 75.1, P=0.563),
hypertension knowledge scores (90.9 vs 85.4, P=0.16) and diabetes knowledge scores (84.3 vs 79.5,
P=0.417), except for hyperlipidaemia knowledge scores (78.6 vs 84.7, P=0.043). However, respondents
followed up by GPs had higher satisfaction rates than did those followed up at polyclinics (odds ratio 3.6,
confidence interval 2.28–5.78). Favourable personality of the doctors and ideal consultation duration led to
higher satisfaction in the GP setting. A longer waiting time led to lower satisfaction in the polyclinic group.
Conclusion: Polyclinics and GPs provide quality primary care as evidenced by high and comparable
levels of CDSM competency. Redistribution of patients from public to private clinics may result in
improvements in healthcare service quality.
Keywords: Care satisfaction, chronic disease self-management, primary care, Singapore