【社评双语道】公私合作纾缓急症室压力

2019-01-07 01:44:25  阅读 65 次 评论 0 条
■每逢假期,急症室都「爆满」。 资料图片
■每逢假期,急症室都「爆满」。 资料图片

  【原文】圣诞节假期加上冬季服务高峰期,联合医院、威尔斯亲王医院及伊利沙伯医院多间公立医院急症室,圣诞节当日非紧急病人候诊时间一度长达8小时,大批市民在医院大堂苦候看诊。每逢假期,急症室「爆满」现象一再重演,增加市民痛苦。医管局应增加假期维持服务的普通科门诊,为急症室分流,加强宣传发布急症室轮候时间的网上通报系统,让市民了解轮候时间,合理调整求诊安排。医管局还应通过公私合作,加快建设社区健康中心,让市民就近获得所需的医疗服务,减少对急症室不必要的使用,纾缓急症室的压力。

  圣诞节、农曆新年等节庆期间,大部分普通科门诊和私家诊所都不提供服务,这段时间通常又是冬季流感高峰期,发病的市民,即使病况轻微,在别无他选的情况下,只能前往急症室求诊,加重急症室压力,轮候时间有增无减。2017圣诞节、2018农曆新年,都出现过多间急症室高峰期非紧急病人需轮候逾8小时的情况,公院内科病床的佔用率「破百」。有市民通宵等候逾12小时仍未获安排见医生,更有人因为轮候时间太长而放弃求诊。

  急症室主要功能是抢救重大危急病症,并非医治普通伤风感冒。特首林郑月娥2017年10月发表的施政报告中表示,政府会投放资源改善医疗体系及服务,有关措施包括大力推动基层医疗健康,减少病人重複入院及纠正市民以急症服务作为求诊首个接触点的现象。但是急症室一到长假期就人满为患,前线医护人员超负荷工作,身心俱疲,市民长时间等候苦不堪言,怨声载道,这样的情况不见好转,反有恶化之势,医管局必须正视,下决心加以改善。

  现时医管局辖下全港73间普通科门诊,只有23间在星期一至五提供夜诊(即由下午六时至下午十时)服务,当中只有13间在提供夜诊服务之余,还提供星期日及公众假期诊症服务。因应急症室长假期的求诊需求越来越大,医管局应积极考虑增加公众假期继续服务的普通科门诊数目,为急症室分担压力。另外,医学会指出,不少私家诊所在假期都有营业,病情较轻的市民可先找私家医生。医学会正研究推出手机应用程式,透过即时定位功能,方便市民找到附近有营业的私家诊所。

  医管局2016年12月开始,于网上及手机应用程式「医管局与你」,发布各间公立医院的急症室轮候时间。可惜,至今大部分市民仍未认识有此网上通报系统,令系统未能有效发挥分流病人的作用,医管局应多做宣传推广,更应研究将假期仍继续服务的私家诊所资讯纳入系统中,让普罗大众透过系统选择更适合自己的医疗服务,无需稍有头晕身热,就第一时间涌到急症室。

  政府正全面检视基层医疗服务规划,构思建设以崭新形式运作的地区康健中心,由政府出资,利用地区网络购买服务,加强在社区内的医护及复康服务,使市民在社区内获得所需的照顾,减少对公立医院急症室的依赖。这项利民建设应加快,改变市民以急症室为首选求诊服务的习惯。 (标题为编辑所加) (摘录自香港文汇报社评26-12-2018)

  Ease the pressure on the A&E departments through the public-private partnerships

  【译文】Crowds of patients were forced to wait outside of emergency wards as the winter surge hits local hospitals during the Christmas holidays. On Christmas day, non-urgent patients visiting accident and emergency (A&E) wards at United Christian Hospital, Prince of Wales Hospital and Queen Elizabeth Hospital all had to wait for up to eight hours before being treated. A&E wards have been stretched to breaking point time and again during holidays, and it has added to the suffering of patients. The Hospital Authority (HA) should extend the number of general out-patient clinics that provide service during public holidays in order to divert patients from emergency wards. Publicity of its online platforms which show the A&E waiting time reference should also be stepped up, so as to enable the public to make more informed decisions when deciding where to seek medical attention. The HA should also hasten the development of community health centres through public-private partnerships with a view to making healthcare services more accessible to the public, for when the number of non-urgent patients visiting emergency wards is reduced, the pressure on A&E departments could be eased.

  During the Christmas and Chinese New Year holidays, most of the general out-patient clinics and private clinics are closed. As the winter flu season usually peaks between the same period of time, patients with even the mildest symptoms are often left with no choice but to visit emergency wards at public hospitals. This exacerbates the pressure on A&E units, and further stretches patients' waiting time. During the 2017 Christmas and 2018 Chinese New Year festive periods, non-urgent patients' waiting time at A&E wards had gone up to over eight hours, while the occupancy rate of public hospital medical wards was over 100 per cent. Some patients waited for over 12 hours and still could not see a doctor, while some other decided to give up due to the long queue.

  The primary function of A&E departments is to rescue those who are in critical conditions, not treating mild illnesses like common cold or flu. In her Policy Address delivered in October 2017, Chief Executive Carrie Lam Cheng Yuet-ngor said the government would allocate resources to improve the healthcare system and services. The relevant measures included vigorously promoting primary healthcare, reducing repetitive admission of patients to hospital, and rectifying the phenomenon where A&E services were regarded by members of the general public as the first point of contact in seeking medical consultation. However, emergency wards are still overflowed during every holiday season. Frontline medical workers are severely overworked and utterly exhausted, while patients have to suffer as they are made to endure long queues. Instead of seeing any improvements, the situation seemed to have deteriorated. The HA must take the problem seriously and commit to tackling it.

  Currently, among the 73 general out-patient clinics under the HA, only 23 of them provide evening consultation services (i.e. from 6pm to 10pm) from Mondays to Fridays, and only 13 of them provide, in addition to evening consultation services, consultation services on Sundays and public holidays. As the demand for healthcare services during holiday seasons is growing, the HA should actively consider increasing the number of general out-patient clinics that open on public holidays, so as to alleviate the pressure on A&E departments. In addition, the Hong Kong Medical Association have pointed out that many private clinics are still open for business during holidays. Patients with milder conditions can seek medical care from the private sector first. The Association is now designing a mobile application that aims to assist the public in finding a private clinic through GPS.

  Via the internet and its mobile app "HA Touch", the HA has started to publish emergency ward waiting time references for public hospitals since December 2016. However, most people are still not aware of this online notification system, rendering it ineffective in diverting patients. The HA should step up promotion and publicity work, and look into the possibility of adding private clinics that open for business on holidays into its notification system. By doing so, the general public could better choose the medical service that is more suitable for them via the system, and in turn, patients will no longer need to rush to A&E wards with even the slightest sickness.

  The government is conducting a comprehensive review of the planning for primary healthcare services. A District health centre with a brand new operation mode and funding from the government is being planned. This centre will make use of the local network to procure services for strengthening medical and rehabilitation services in the community, so that the public can receive the necessary care in the community, and unwarranted use of public hospital services can be reduced. This idea would be beneficial to the public and should be expedited, so that patients will be less likely to consider A&E departments as their first choice for medical services.■Jeffrey Tse (ywc_jeffrey@hotmail.com)

  Exercise

  1. 普通科医生

  2. 基层医疗

  3. 专科门诊

  4. 分流/分诊

  5. 救护员

  Answer

  1. general practitioner (GP)

  2. primary care

  3. specialist out-patient clinics

  4. triage

  5. paramedic

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