X1000307-1957-58_Part01 — Page 27

Preumo-peritoneum

Phrenic operation Thoracoplasty

Wadge resection

Segmental

Lobectomy

Decortication

Pneumonectomy

1956

1957

{

Induction Refills

42

18

1.349

432

63

76

21

3

32

36

24

35

2

200. It will be seen that there has been a marked swing away from collapse measure, both temporary and permanent, in favour of surgical resection. The total number of major operations has, however, fallen by almost 30% due to the reduction in the number of thoracoplasties performed.

The Tuberculosis Almoner Service

201. The Almoner's department, consisting of the Tuberculosis Almoner, one other Almoner, six Assistant Almoners and thirty seven Tuberculosis Visitors, is responsible for all social work in connexion with patients attending the clinics, in Government hospitals, in the hospitals operated by the Hong Kong Anti-Tuberculosis Association and in the Sandy Bay Convalescent Home-a total of 929 beds.

202. The work in this section is increasing rapidly, 316 beds having been added during the year in addition to the great increase in the number of clinic patients. Clerical assistance has now been made available but the continuing general shortage of Assistant Almoners has more than offset any advantage gained thereby.

Interviews with patients

203. Every diagnosed case of tuberculosis or other chest disease in need of treatment is interviewed by the Almoner at the commencement of treatment, periodically thereafter as necessary and as further treat- ment is recommended. Details of the social and economic background are recorded at the first interview; after a visit by the Tuberculosis Visitors, the home circumstances are noted and the record is amended from time to time as necessary. The total number of interviews with patients was 28,540, an increase of 20% compared to last year.

Admissions to hospital

204. Hospital waiting lists are maintained, patients being divided into the categories of chest medical, chest surgical, and orthopaedic cases. Admission is arranged according to the various priorities of the

40

patients and according to the types of bed available. Details of the work done in connexion with hospital treatment were:

Admitted to hospitals

Transfer between hospitals

Awaiting admission as at 31st December, 1957 Referred to Chinese Charity Hospitals

1,078

226

240

54

205. The number of patients awaiting admission at the end of the year is much lower than for any previous year, and is made up almost entirely of cases awaiting admission for surgical treatment. As almost one quarter of the cases at present occupying beds in hospital are also awaiting surgical treatment, further admission of surgical cases serves no useful purpose. The policy regarding surgical admissions has had therefore to be changed and medical cases, who would be expected to respond satisfactorily to ambulatory treatment, are being admitted instead until such time as more surgical facilities become available.

Visits to patients in Hospital

206. Every patient admitted to hospital through the Chest Clinics is visited in hospital, whether in a Government hospital or under the care of the Hong Kong Anti-Tuberculosis Association. Visits are paid at regular intervals by a member of the almoner staff in connexion with domestic or financial problems.

Distribution of Drags

207. The Almoners are responsible for ensuring that all patients on ambulatory chemotherapy attend for drugs issued according to the instructions of the medical staff. It has accordingly been arranged that drugs will now be distributed by the Almoners, mainly through the Almoners' clerks. As the number of patients under treatment at the end of the year was 9,132 the magnitude of this undertaking will be appreciated, as packages of drugs in suitable quantities have to be prepared in advance. It is hoped that the suppliers will soon arrange for drugs to be suitably packed for issue in the requisite quantities.

Assistance to patients

208. The Tuberculosis Almoner had at her disposal during 1957/58 the sum of HK$200,000 for the provision of assistance to tuberculosis patients and their families.

209, Assistance in cash in the form of weekly grants may be made to patients who give up work in order to undergo treatment. The assistance given bears a direct relationship to the patients' previous income but in accordance with certain agreed maxims During the year

IF