Replies to LegCo questions
LCQ6: Charge for Accident and Emergency services
Following is a question by the Hon Michael Mak and a reply by the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, in the Legislative Council today (February 19):
Question:
The charge for Accident and Emergency ("A&E") services at public hospitals was introduced on November 29 last year. In this connection, will the Government inform this Council:
(a) of the respective average daily numbers of attendances in A&E departments in the months before and after the introduction of the A&E service charge: whether it has assessed the impact of the service charge on the number of attendances;
(b) of the number of payment notices issued so far to A&E patients or their family members who were unable to settle the payment forthwith; the number and percentage of payment notices which remain unsettled one month after the date of their issue; whether the Government will make up for the loss of the Hospital Authority in this respect; and
(c) of the number of A&E patients who have applied for fee remission so far, together with the number and percentage of the applications approved?
Answer:
Madam President,
(a) The average daily attendance of all Hospital Authority (HA's) A&E departments for November 2002 was 6,442. This figure includes the first two days after the A&E charge was introduced on November 29, 2002. Meanwhile, the average daily attendance for December 2002 was 5,709. The average daily attendance for December 2002 is hence 11.4 per cent lower than the November 2002 figure.
The utilisation rate of A&E service is affected by a number of factors, in particular the seasonal effect which could have a significant bearing on the usage pattern. Therefore it would also be useful to compare the utilisation rate of A&E service of the month after the charge was introduced (i.e., December 2002) with the same month a year ago (i.e., December 2001). In December 2001, the average daily attendance of all HA's A&E departments was 6,313. The average daily attendance for December 2002 is therefore 9.6 per cent lower than the December 2001 figure.
From the above figures, it is evident that after the introduction of A&E charge, the A&E utilisation rate has shown a significant decrease irrespective whether it is compared with the preceding month or the same month a year ago.
(b) Experience of payment collection from December 2002 to January 2003, i.e., the first two full months after the A&E charge was introduced, reveals that 85 per cent of patients settled their A&E charge immediately upon registration. Patients who were unable to settle their payment upon registration were issued a payment advice and they could settle the payment at any public hospital at a later date. In this respect, from December 2002 to January 2003, 68 per cent of patients who were issued payment advices had already settled their A&E charge. Only 4.7 per cent of the total attendance remained unsettled, and HA will initiate its usual debt recovery procedures to handle these outstanding bills.
There is already an established mechanism to determine the Government's subsidy level to HA, which has taken into account the revenue collected by HA from its services. Nevertheless, revenue that has to be ultimately written off after debt removal procedures normally accounts for an insignificant proportion of HA's operating budget.
(c) From December 2002 to January 2003, a total of 1,105 applications for waiving of A&E charge were received, representing less than 0.3 per cent of the total number of attendance during that period. About 92 per cent of these applications were approved (i.e., 1,012 cases).
End/Wednesday, February 19, 2003
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