TNAG-0507-FCO40-572-Development-of-medical-and-health-services-in-Hong-Kong-1974 — Page 197

APPENDIX 2

THE ASSUMPTIONS ON WHICH THE TABLE OF BED REQUIREMENTS AT PARAGRAPH 9 HAS BEEN BASED, AND HOW THOSE REQUIREMENTS SUBDIVIDE INTO GOVERNMENT, GOVERNMENT-ASSISTED AND PRIVATE BEDS

A-Medical and Paediatric

1. Discharge rate. Over the past five years the average increase has been about 2.8 per cent per year. In future the rate is forecast to grow at 3.16 per cent per year for the following reasons.

-Throughout the world in the more developed countries, e.g., the U.K., U.S.A., the rate increases at two per cent per year due to rising expectations in the population and increasing capability in the medical profession to treat previously incurable conditions.

-The increase will be greater in Hong Kong because of the unusual age distribu- tion. At present the bulk of the population is below 25 whereas medical conditions tend to develop later in life. As the age distribution changes correspondingly more discharges per head can be expected. Based on age distributions in the future population and the current hospital patients, a further increase of 1.16 per cent per year seems likely.

APPENDIX 2-(Contd.)

.I.

5.

4. Occupancy Rate. For planning purposes a figure of 85 per cent is assumed. This is based on an average stay of 8.5 days and a turn-around period of 1.5 days while the facilities are made ready for another patient, etc. At present, in Government hospitals the occupancy rate is somewhat higher than 85 per cent, largely because the bed numbers can be varied from day to day by the use of camp beds. The figure will fall when these undesirable facilities are phased out. The occupancy figure in Government-Assisted is currently well below 85 per cent.

Bed Requirements. Requirements for Medical and Paediatric patients over the next ten years can be calculated on the basis of these forecasts:

Year

Bed Requirements

Government-

Government

Private

Total

Assisted

1972

1,789

2,788

1,107

5,684

1973

1,958

2,885

1,125

5,968

1974

2,078

2,977

1,180

6,235

1975

2,182

3,080

1,181

6,443

1976

2,293

3,178

1,179

6,650

1977

2,409

3,266

1,174

6,849

2.

Distribution. The distribution of patients between hospital types is likely to vary as follows:

1978

2,533

3,541

1,166

7,240

1979

2,665

3,837

1,153

7,655

Present

1981

1980

2,802

4,154

1,138

8,094

distribution

distribution

1981

2,949

4,372

1,198

8,519

1982

Government

Government-Assisted

Private

3,104

4,601

1,260

8,965

47%

50%

30%

35%

22%

15%

The shift in distribution will occur because:

--During the period several new hospitals will open, mostly Government-Assisted, e.g. United Christian (555 beds) in 1973, Tung Wah Centenary (424 beds) in 1974, and Yan Chai (100 beds) in 1973. Also the Tung Wah Eastern alteration (330 beds) will open in 1973. As far as is known no significant private hospital development will occur in the period.

--Steps may be taken to encourage a shift to Government-Assisted hospitals by

altering charges.

3. Length of Stay. The average length of stay in Government hospitals is currently

8.5 days and is forecast to remain at this figure.

-8.5 days is similar to the best performance in the U.K. but is short compared with the average for most countries. This is because some patients are transferred to Government-Assisted hospitals for convalescence, i.e. Sandy Bay Convalescent Hospital and Wong Tai Sin Infirmary.

The average stay in Government-Assisted hospitals will remain higher than in Government for the reason above, but some reduction is likely. The present 21 days is forecast to fall to about 18 days by 1981. In private hospitals the length of stay will remain between that of Government and that of Government-Assisted at about the current 11.5 days because few transfers take place.

56

B-Surgical and Gynaecological

1. Discharge Rate. The number of discharges in these specialities per thousand population has displayed a rapid growth over the past five years. This rate of increase is not expected to continue and for the future the growth is forecast at 3.16 per cent per year for the same reasons as those for Medical and Paediatric

2.

cases.

Distribution. The distribution of patients between hospital types is likely to vary as follows:

Government

Government-Assisted

Private

Present distribution

1981 distribution

61%

60%

25%

30%

14%

10%

This change in distribution is likely, again, for the same reasons as the change for Medical and Paediatric cases.

3. Length of stay. In Government hospitals the present average stay of 12 days com- pares favourably with other countries and is likely to remain at this level. The stay is longer than for Medical patients because there are very few chronic cases requir- ing long convalescence and therefore fewer transfers to other hospitals. For the

57