Hong Kong’s public hospitals aim to shorten waiting times in accident and emergency departments for the third most urgent group of patients following fee adjustments that will be announced in weeks.
The Hospital Authority said it hoped to meet its service target of treating 90 per cent of urgent patients in A&E, currently triaged as category three, within 30 minutes, instead of the 76.6 per cent in 2024.
Patients are divided into five categories according to their condition, with the top tier labelled as “critical”, followed by “emergency”, “urgent”, “semi-urgent” and “non-urgent”.
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“We have had to dedicate some resources looking after patients from categories four and five [of less urgent cases], which is why we couldn’t tend to some of the [category three patients] within half an hour,” said Dr Michael Wong Lap-gate, director of quality and safety at the authority.
Wong stressed that hospital staff met the service target of treating 100 per cent of the most urgent patients – category one or critical – immediately. They exceeded the 95 per cent target – reaching 97.1 per cent – for treating patients of emergency condition within 15 minutes.
“A significant proportion of patients who come to us are semi-urgent or non-urgent. The setting up of A&E was to handle patients who are critical, emergency or urgent,” said Dr Axel Siu Yuet-chung, chairman of the A&E coordinating committee at the authority.
According to the authority, 55.6 per cent – or 1,110,242 – of nearly 2 million first-time patients at A&E last year were triaged as semi- or non-urgent cases, with the government considering changing people’s habits through adjusting fees to ensure more resources are dedicated to those in urgent need.
The government last raised the fees for each A&E consultation from HK$100 (US$12.82) to HK$180 in 2017, with Wong saying the authority had observed a drop of about 5 per cent in patient numbers the following year, most of whom were semi-urgent and non-urgent cases.
The authority said the drop had remained in place since then and the fee changes were considered to have been successful in diverting some semi-urgent and non-urgent patients to seek medical services other than at A&E.
The government has always subsidised A&E consultation fees, from 87 per cent of HK$1,390 in 2017-18, to 91 per cent of HK$2,070 in 2023-24.
Health authorities are expected to announce big changes to the subsidy model “in weeks” to enable a more targeted use of resources and cut down on the abuse of services, with non-urgent patients set to pay separate charges for lab tests, scans and other specific items at public hospitals.
But sources said authorities would also widen the healthcare safety net to better support the neediest patients who were paying tens or sometimes hundreds of thousands of dollars to treat cancer and rare diseases.
In addressing the increased waiting time for semi-urgent patients from 110 to 167 minutes and for non-urgent ones from 129 to 190 minutes between 2015 and 2024 despite the rise in fees, Siu said increasingly sophisticated treatment procedures were a contributing factor.
He said in the past, A&E first diagnosed then passed the case onto staff at wards to follow up, but now more illnesses could be treated in the tight “golden hour” window with the advancement in medical technology.
“Sometimes this means our staff need to start their preparation before the patient arrives at the hospital,” Siu said. “Cases like these will take up more time and manpower, which unavoidably results in longer wait times for semi-urgent and non-urgent patients.”
Other major challenges facing A&E services include the loss of manpower and an ageing population accompanied by acute complications caused by chronic illnesses, according to the authority.
More from South China Morning Post:
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