Replies to LegCo questions

LCQ3: Demand for beds in public hospitals

Following is a question by the Dr Hon Tang Siu-tong and a reply by the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, in the Legislative Council today (March 3):

Question:

It has been reported that while the beds in the medical wards of a hospital under the Hospital Authority (HA) have long been in short supply, the surgical wards, paediatric wards, obstetric and gynaecological wards and private wards of that hospital were often redeployed as medical wards. In this connection, will the Government inform this Council whether it knows:

(a) the average monthly occupancy rates of the beds in various wards of HA's hospitals over the past three years, and the average waiting time for admission to various wards at present;

(b) whether the staff side of HA has reflected to HA's management the problems arising from the shortage of beds in the medical wards of HA's hospitals; if so, of the response of HA's management; and

Reply:

Madam President,

(a) The average monthly occupancy rates of beds in medical wards, surgical wards, paediatric wards, obstetric wards and gynaecological wards in public hospitals between 2001 and 2003 were 90.3 per cent, 75.1 per cent, 63.3 per cent, 69.4 per cent and 81.2 per cent respectively.

Admissions to hospitals can be broadly divided into elective admissions and emergency admissions. Elective admissions refer to the admission of patients who have been receiving care at outpatient clinics. Patients who require hospitalisation are prioritised and scheduled to present themselves to the wards for admission and treatment on specific dates depending on the relative urgency of their medical conditions. Patients in urgent medical conditions will be admitted into a hospital immediately. The Hospital Authority (HA) does not routinely collate information on the waiting time of patients in less urgent medical conditions. The elapse time between consultation and hospitalisation is affected by many factors including patient preference and varies from case to case. Emergency admissions refer to the admission of patients through the Accident and Emergency Departments (A&ED). Clinicians in the A&EDs assess the medical conditions of the attending patients and determine their need for immediate hospitalisation. Once such a need is identified, the patient would be admitted immediately and there is usually no waiting time as such.

(b) HA management and hospital management monitor the occupancy rate closely. The management has also received feedback from staff on these matters. The management has taken measures to meet the higher demand for admission to medical wards in the winter months including augmenting medical beds and deferring non-urgent services. Measures to alleviate the demand for admissions, such as strengthening the medical support to elderly residential homes, have also been implemented.

(c) For the annual winter influx of patients, the HA has devised a structured plan for changing the bed mix for winter. The relevant measures include scheduling cyclical reduction of non-urgent services and increasing the number of medical wards during each winter based on the assessment of the prevailing bed situations. For this winter, additional measures implemented by the HA include the Influenza Vaccination Program for staff and patients to reduce incidences of Influenza and the strengthening of medical support to residential homes through the collaborative efforts of Community Geriatric Assessment Teams and the Visiting Medical Officers to minimise hospital admissions. In the long run, the HA will also continue its efforts in strengthening the manpower in medical departments and promoting its ambulatory care to reduce reliance on inpatient services. In respect of the latter, the HA will:-

(i) Reducing the need for hospitalisation as inpatients through the use of advanced technology such as endoscopic procedures or new drugs, and quality improvement initiatives in infection control and nursing care etc.;

(ii) Enhance quality of ambulatory/ outreach services in terms of the breath and depth of the encounter. By taking a holistic approach, doctors and nurses will put greater emphasis on, among other things, discussing with patients on choices of appropriate treatment, enhancing their awareness on the proper use of medications and educating the caregivers in a bid to reduce the demand for inpatient services;

(iii) Promote care in the community and by the community through new collaborative programs with the private sector and non-government organisations; and

(iv) Introduce disease management programs for selected chronic diseases, supplemented by other efforts on health promotion, disease prevention and early detection.

Ends/Wednesday, March 3, 2004

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