APPENDIX 2-(Contd.)
D-Tuberculosis
1. Discharge Rate. Now that greater effort is given to case-finding, more and more cases are being treated at an earlier stage. The present discharge and death rate of 2.4 per thousand should decline to 1.9 by 1982.
2.
--Considerable overall progress is being made in controlling this condition. ---The official treatment policy is ambulatory and the current emphasis is on making this more generally available and satisfactory and to curtail as much as possible the need for in-patient treatment. Hospital facilities are reserved largely for the acute or complicated cases, fall-outs of ambulatory treatment, drug addicts etc. as well as for research purposes.
Distribution. The declining incidence means that no new TB beds will be provided and thus the present distribution is likely to continue.
Government
Government-Assisted
Private
25% 70%
5%
E-Infectious Diseases
APPENDIX 2—(Contd.)
1. Discharge rate. With improved preventive measures, such as more widespread inoculation, the rate has declined over the past few years. This decline is expected to continue over the next 10 years.
2.
3.
4.
5.
Distribution. At present patients are admitted to two hospitals only (Sai Ying Pun and Lai Chi Kok Infectious Disease Hospitals) and this will be reduced to one when the Princess Margaret facilities are opened in 1974 and the two existing hospitals closed.
Length of stay has increased in recent years, probably largely due to a lack of pressure on the facilities. The future average stay is forecast to be 11.6 days. Occupancy rate. This should be kept low on average to maintain sufficient space to deal with possible epidemics. 65 per cent has been chosen as a suitable figure. Bed requirements. Requirements can be calculated from the above forecasts as follows:
4.
5.
3.
Length of Stay. The different lengths of stay displayed by the different hospital types reflect the different types of patient each receives, e.g. Government-Assisted stays are longer because of the high proportion of chronic cases. Future stays are likely to remain about the same.
Occupancy. The long stays mean that high occupancy rates can be achieved. For calculating requirements, a level of 90 per cent is assumed.
Bed requirements. Requirements for TB cases can be calculated from the forecasts as follows:
1972
1973
1974
1975
1976
1977
1978
Bed Requirements
1979
1980
Year
1981
Government
Government Assisted
1982
Private
Total
1972
153
1,411
48
1,612
1973
156
1,427
49
1,632
1974
153
1,411
48
1,612
1975
153
1,411
48
1,612
1976
153
1,411
48
1,612
1977
153
1,411
48
1,612
1978
152
1,397
48
1,597
1979
152
1,397
48
1,597
1980
152
1,397
48
1,597
1981
152
1,397
48
1,597
1982
152
1,397
48
1,597
1.
60
Year
:
Bed Requirements
128
128
128
122
122
117
117
112
112
108
108
Additional bed requirements arise under this heading for leprosy cases. When the Princess Margaret Hospital opens in 1974 the existing leprosarium at Hay Ling Chau will be closed. The initial provision at the Princess Margaret Hospital will be 98 beds, but over the 10-year period the requirement should reduce to about 80.
F-Psychiatric
In forecasting needs for psychiatric beds a different approach is necessary because little data is available on demand for the facilities. The present hospital at Castle Peak is heavily overcrowded (an average of 1,850 patients versus a design capacity of 1,242), but even so only copes with a proportion of cases needing treatment. Thus present dis- charge rates are no indicator of real demand.
A desirable provision has been estimated in three ways:
On the basis of the average provisions of developed countries a ratio of 2.8 beds per thousand or a minimum of 1.8 per thousand (W. Germany) seems desirable.
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