Public hospitals see 4,600 more warded compared with same period last year
THE six public acute hospitals warded 4,600 more patients – a 7.5 per cent jump – in the first three months of this year, compared with the same period last year. The demand for beds was already obvious last year when the hospitals had to cope with a 3.8 per cent increase of almost 10,000 inpatients from 2009. The opening of the 500-bed Khoo Teck Puat Hospital (KTPH) last August gave some relief, but the rise in inpatients in the first quarter of this year has put paid to that. Industry watchers attribute the high bed demand to the rapidly ageing population.
What is surprising is that this appears to have happened overnight. Inpatient increases in both 2008 and 2009 were less than 1 per cent a year. Associate Professor Thomas Lew, medical board chairman at Tan Tock Seng Hospital (TTSH) – which remains one of the worst-hit – said the busiest months are traditionally May to July, when patient loads go up by 5 per cent to 10 per cent.
Statistics for last week showed four of the six hospitals had more than 85 per cent of their beds occupied at midnight – when counts are taken – on most days. The exceptions were Singapore General Hospital (SGH), with occupancy rates hovering at 84 per cent, and Alexandra Hospital (AH), where more than one in four beds remained empty. At Changi General Hospital (CGH), the worst-hit of the six, bed occupancy topped 90 per cent on three days and 95 per cent on three other days last week. KTPH had occupancy at or above 90 per cent on five of the seven days last week.
Former health minister Khaw Boon Wan had said he wanted public hospitals to have average occupancy rates of 85 per cent for maximum mileage. Private hospitals generally prefer lower rates of 70 per cent, as anything above that could mean having to turn away patients on peak days. Some hospitals appear to be treating the demand better than others.
Last week, in spite of having the highest bed occupancy and emergency cases, CGH kept the median wait for a bed to under two hours. In fact, it often takes less than an hour for half its patients to get a bed this year. At TTSH, the median wait last week was more than two hours – the norm for this year. The worst was on Tuesday last week, when it was more than 61/2 hours. Of the more than 400 patients it gets at its emergency department each day, about a third need to be hospitalised.
A spokesman said the long wait that Tuesday was due to the closure of a ward to new admissions, taking 12 beds out of use. She would not reveal why the ward was closed. Prof Lew said the hospital has introduced various measures to cope. For example, a patient with a fracture that is not exposed would be asked to return within 72 hours to its “hot clinic” for assessment. If surgery is needed, he would be given an early day surgery slot. This way, he would not need to be hospitalised. About 180 patients have taken this route since it was introduced in March. Prof Lew does not plan to reintroduce “corridor beds”.
Early last year, TTSH added about 30 beds in ward corridors. Curtains and fans gave some privacy and comfort until the patient could be moved to a proper ward. Instead, it has started using a building meant for mass decontamination in the event of a chemical or biological accident to house up to 20 patients waiting for a bed. Though there are fans, the cement floor and lack of partitions have upset some patients, who also complain about the stuffy premises. TTSH also asks patients if they are willing to be transferred to AH, which has available beds. An AH spokesman said it started getting patients from other hospitals about four months ago, and gets 40 to 80 a month.