Longer hospital stays for older patients a major reason for high bed occupancy: MOH
https://www.straitstimes.com/singapore/longer-hospital-stays-for-older-patients-a-major-reason-for-high-bed-occupancy-moh
2023-04-30
SINGAPORE – The delay in opening new hospital facilities and patients being hospitalised for longer are key reasons behind the current bed crunch at public hospitals.
The Ministry of Health (MOH) said that the crowded wards are caused partly by the delay in the opening of new hospital facilities.
The Covid-19 pandemic had led to construction delays in many sectors, including healthcare.
The other reason is the changing patient profile.
A ministry spokesman said that between 2019 and 2022, patients are staying 15 per cent longer on average. In terms of days in hospital, this has gone up from 6.1 days to seven days.
“This is because we are seeing more older patients with complex conditions, who require longer stays. The proportion of senior patients aged 65 and above has risen from 39 per cent in 2019 to 43 per cent in 2022.”
The longer stays have caused higher bed occupancy rates.
Health Minister Ong Ye Kung told Parliament in March: “We cannot rule out that this could be the after-effects of being infected with Covid-19 for some, or a rebound in other types of infections post-crisis. It may also simply be a result of our population ageing rapidly.”
Ng Teng Fong General Hospital (NTFGH), Khoo Teck Puat Hospital (KTPH) and Changi General Hospital had at least one day in the week of April 16 that they could not find beds for even half the patients who needed to be admitted within a 24-hour period.
Such patients are left in the emergency department till a bed is found. However, their treatment is begun immediately and does not wait till they have been sent to a ward.
KTPH, for example, has been facing 100 per cent occupancy on most days.
It is no longer uncommon for less sick patients needing to be hospitalised to be kept waiting at the emergency department for a couple of days or more.
MOH provided The Sunday Times with this information as assurance that the current bed crunch at several public hospitals is not caused by foreign patients coming here for treatment, and that these institutions care predominantly for local patients.
“The proportion of foreign patients who are admitted to our public hospitals remains very low, constituting less than 0.5 per cent of total admissions,” the MOH spokesman said.
This is far lower than the 1.5 per cent figure for 2017 – or 10,900 foreign patients – given by the ministry in Parliament in 2018.
Professor Lim Tock Han, medical board group chairman of the National Healthcare Group (NHG), which runs KTPH and Tan Tock Seng Hospital, said: “Both hospitals manage a very heavy emergency volume, and are seeing very few returning foreign patients.”
He said patients in central and northern parts of Singapore, which NHG caters to, are generally more elderly and “require specialised care for their more complex conditions”. He added: “Much of the two hospitals’ resources and capacity are prioritised for the care of these emergency and elderly patients.”
SingHealth, which operates hospitals in eastern Singapore, said it does not turn away any patient who requires treatment, foreigner or local.
Its deputy group chief executive of medical and clinical services, Professor Fong Kok Yong, said patients “in the region may come to us as a port of hope when treatment is either not available in their home country, or when their condition is very complex”.
He added: “With the breadth and depth of expertise offered by SingHealth institutions, it is understandable that people from the region may want to come and seek treatment.”
The group offers speciality services that not all countries have. The Burn Centre at Singapore General Hospital, for instance, is the only one available in South-east Asia.
Prof Fong said: “For all who seek care from us, we will provide timely and safe care, based on clinical assessment and urgency.”
The National University Health System (NUHS), which runs public hospitals in the west, said the healthcare needs of Singaporeans come first and “foreign visitors do not impact our delivery of services to Singaporeans or pose a significant stress on our hospital beds”.
It added: “In the event of medical exigencies, we have a duty of care towards all those who come through our door, and no individual will be denied timely treatment, regardless of citizenship status.”
Two NUHS hospitals, National University Hospital and NTFGH, had put up signs at their emergency departments in April, telling patients they may have to wait as long as 60 hours for a bed.
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