disease has become as much a social as a clinical problem, and with the gradual expansion of the service the scope of social assistance has been considerably extended and now reaches the patient in his home. All social services are concentrated under the control of the Almoner who also directs the activities of the tuberculosis Workers. As there is no general social security scheme in the Colony prolonged sickness constitutes economic disaster and while it is not possible with the available resources to assist all tuberculosis sufferers careful selection of cases is done on purely clinical grounds necessitating very close cooperation between the social and medical side. All patients on first diagnosis are interviewed by the almoner or her assistants and subsequently as indicated. All hospital admissions to the 521 available beds and transfers between the various hospitals in the scheme, assessment of hospital charges where necessary, examination of contacts, re-employment of patients, assistance in cash and in kind, repatriation, care of children etc. are the respon- sibility of the almoner. Below is set out an abbreviated list of the main activities of the Almoner's Department.
The result of treatment in Government Hospitals were as follows:
1950
1949
(a) No. of patients remaining in hospital at last day of
previous year
291
221
(b) Admissiona:
Admitted direct through Almoner's Department.
400
466
(c) Discharges:
(i) Improved
296
119
(1) Completed treatment
(ii) In same condition. (iii) Worse
46
59
2
Total:
317
181
(2) Discharged against medical advice
(3) Died
(4) Transferred to other hospitals
26
143
98
54
19
18
Total number of patients discharge during year
(d) Number of patients remaining in hospital as at last
day of year
KANKAN A
398
396
Total number of interviews
293
291
The substantial increase in the number of patient discharged "improved" is to some extent due to the more careful selection of cases for admission,
A particularly satisfactory feature is the drop in the number of those discharged against medical advice which may be accounted for by improved hospital conditions and management, and improved service by the Almoner's Department.
The average duration of inpatient treatment was 267 days.
The results of treatment in Buttonjee Sanatorium are contained In the Annual report of the Hong Kong Anti-Tuberculosis Association.
In addition, admissions of a number of cases with advanced disease were arranged to the Tung Wah Group Hospitals through the clinic but full details are not available.
SOCIAL WORK.
It is obvious that with the development of a tuberculosis service under existing conditions emphasis must be laid on the social side as the
$4
Number of patients recommended for admission to hosp.
Hospital admission
1
(1) Govt. Hospitals
(2) Ruttonjee Sanatorium
Transfers between hospitals
Cases still on the waiting list
7,562
1,193
400
186
149
850
Number of families assisted with weekly grants
107
Average weekly grants
$29.38
44
30
9,425 lbs.
602
Number of patients repatriated
Number of hawkers licences obtained for patients or
relatives
Milk powder issued (one pound per patient per week) Number of home visits
In addition the Almoner's Department attempts to secure employ- ment for patients or relatives, arranges isolation of children in the contact home, provides domestic assistance, arranges schooling of children, refers cases to other social organizations and generally looks after the patient and his family before, during and after treatment.
Continued contact with the patients in their homes is maintained by the Almoner through the Tuberculosis Workers.
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