Replies to LegCo questions
LCQ2: Services of Accident and Emergency departments of public hospitals
Following is a question by the Hon Lau Wong-fat and a reply by the Secretary for
Health, Welfare and Food, Dr York Chow, in the Legislative Council today (June
13):
Question:
Will the Government inform this Council:
(a) of the current average queuing time for consultation in the Accident and
Emergency ("A&E") departments of public hospitals for patients of categories 4
and 5 under the triage system, whose conditions are not considered urgent,
broken down by hospital clusters of the Hospital Authority (HA);
(b) of the respective unit costs of treating patients in the A&E departments of
public hospitals and clinics under HA; and
(c) whether it will consider setting up 24-hour clinics operated by private
practitioners adjacent to the A&E departments of public hospitals, so as to
reduce the number of patients seeking A&E services and save medical expenditure
for HA?
Reply:
Madam President,
(a) According to the statistics collated by the Hospital Authority (HA) on
Accident and Emergency (A&E) attendances of public hospitals in 2006-07, the
average waiting time for cases in triage category 4 (semi-urgent) and category 5
(non-urgent) is 73 and 98 minutes respectively. A breakdown of average waiting
time for the cases by hospital clusters is set out in the Table.
(b) The unit cost per attendance at HA's A&E departments is $720. It is almost
two times higher than the unit cost per attendance at General Outpatient Clinics
of $260.
(c) In 2006-07, the A&E departments of public hospitals handled a total of 1.34
million attendances in triage category 4 (semi-urgent) and category 5
(non-urgent), which accounted for 68% of the total number of A&E attendances.
The HA is very concerned about the improper use of A&E services by patients with
non-emergency conditions. While it is understandable that some patients are not
able to determine whether their acute conditions require emergency or
non-emergency medical care, it is also true that others simply utilise A&E
departments as a convenient alternative to out-patient clinics, in particular
outside normal hours for consultation of clinics, resulting in a wasteful use of
public hospital resources. In addition, the use the services of A&E departments
by a large number of patients with non-emergency conditions would unduly add to
the workload of frontline staff. This affects the efficiency of care for
patients with genuine emergency conditions. Long waiting time for patients with
non-emergency conditions would also result in patient complaint and conflict
with frontline staff, which in turn will dampen staff morale.
In order to minimise improper use of A&E services by patients with non-emergency
conditions, we will continue to encourage the public to make better use of the
services of family doctors, who should be the first point of contact when
accessing medical services. An assessment on the urgency on the patient's
conditions should be made by the family doctors, and an attendance at A&E
departments should only be made when there is a genuine need to do so.
The HA has stepped up family medicine specialist training over the past few
years. It is hoped that more primary care doctors will put greater emphasis on
developing long-term relations with their patients and provide them with the
necessary medical care in times of need, for example, by providing patients with
a means of contact after consultation hours so as to enable them to seek medical
advice.
The HA has no plan to set up any 24-hour clinics to be operated by private
practitioners adjacent to the A&E departments. At present, most private
hospitals and some private clinics are providing round-the-clock services. We
will encourage the private sector to make further development in this direction.
For example, family doctors in solo practice within a district may collaborate
to take turns to provide service beyond normal clinic opening hours.
To facilitate the choice of services required by patients with non-emergency
conditions, information is made available in the A&E departments under the HA
about the private practitioners and 24-hour clinics in the districts where the
A&E departments are located. Such information includes, among others, the
specialties registered, means of contact and operating hours. Public hospitals
will also strengthen their liaison with private practitioners and 24-hour
clinics operating in their district so as to ensure that patients with emergency
conditions referred to the A&E departments by these practitioners and clinics
will receive prompt attention and care.
Ends/Wednesday, June 13, 2007
Issued at HKT 12:50
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Table to LCQ2