Health Ministry gives weekly figures on waiting times

DO YOU expect to wait several hours for a bed at a public hospital?

You don’t have to, going by the figures released by the Ministry of Health (MOH).

Last week, the median waiting time was 30 minutes to three hours at most hospitals here.

Since March 14, MOH has been providing weekly figures to show median waiting times for ward admission from the emergency departments at the five general hospitals here.

These are Tan Tock Seng Hospital (TTSH), National University Hospital (NUH), Changi General Hospital (CGH), Singapore General Hospital (SGH) and Alexandra Hospital (AH).

Figures from the previous week were not very different.

Overcrowding
Last month, Health Minister Khaw Boon Wan said in Parliament that at TTSH – consistently the most crowded hospital in Singapore – half of the emergency department admissions in January were admitted to their assigned wards within two hours.

Another 35 per cent of patients waited two to four hours. But five per cent of patients had to wait for more than eight hours.

TTSH has the highest number of admissions from its emergency department because it serves a large population catchment, from the north and central parts of Singapore.

To relieve the overcrowding, other hospitals have chipped in to handle the overflows of ambulance cases and other admissions.

But the problem has in turn spread to the other hospitals, especially to CGH, which hit a bed-occupancy rate of 91 per cent at the end of February.

With the Khoo Teck Puat Hospital in Yishun slated to open in July, waiting times can be expected to be further shortened. Mr Khaw said the hospital would “add 555 beds to our capacity”.

MOH has also started to provide weekly snapshots of bed occupancy rates as well as attendances at the hospitals’ emergency departments.

The different hospitals had varying occupancy rates from 60 per cent at AH to about 90 per cent at TTSH and CGH last week.

An MOH spokesman said it is the ministry’s ongoing practice to publish key statistics on various aspects ofhealthcare delivery, including pricing, performance indicators and outcomes to keep the public informed.

An MOH spokesman said: “There is no ideal bed-occupancy rate as hospitals try to balance the demand for beds with the optimal usage of beds, taking into account the case mix of their patients.”

The key is to ensure that the right care is provided for patients whether the bed-occupancy rate is high or low, she added.

So what are hospitals here doing to shorten waiting times?

At SGH, there is a higher proportion of patients who suffer from high-risk, complex multiple-medical conditions, as well as older patients who are more ill and require longer periods of stay, said its chief operating officer, Dr Wong Yue Sie.

No patient is turned away even when there is a shortage of beds.

Timely discharges
Dr Wong said: “When there are unanticipated surges of patients requiring admission at A&E, patients may have to wait longer for a bed. Patients have the option of transferring to other hospitals if they have beds available.”

Treatment will be initiated for patients who are waiting for admission at the A&E and they are cared for by the admitting department’s doctors to ensure there are no delays and for continuity of care after admission, he added.

SGH has taken several measures, including timely discharges, tracking and anticipating, to manage its bed situation.

To create beds for new patients, the hospital actively reviews the cases of existing inpatients who are ready for discharge or awaiting transfers to nursing homes.

Where necessary, non-urgent elective surgery may be postponed to provide capacity for those in acute need of care, said Dr Wong.

At NUH,outpatient intravenous antibiotic treatment for patients who have had surgery was started in 2006.

Before that, patients had to be admitted for this.

An NUH spokesman said: “In FY08, we saved more than 4,500 bed days with this service.”

Medical social workers at NUH also work closely with organisations such as the Agency for Integrated Care to identify appropriate step-down care facilities for patients who are clinically fit to be cared for in such an institution.

The A&E at NUH was also expanded last year.

The spokesman said: “For example, our Extended Diagnostic Treatment Unit beds have been doubled from 8 to 16.”

The unit admits patients who are not well enough to go home but whose condition is not serious enough for them to be admitted to the regular wards.

Patients admitted into these wards usually go home within 24 hours of admission, once their conditions stabilise, or they may also be admitted to the regular wards if their condition warrants further treatment or observation.

■To check out the new weekly snapshots of bed occupancy and waiting times for hospital admission, logon to the MOH website.