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Following is a question by the Hon Lui Ming-wah and a reply by the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, in the Legislative Council today (July 9):
Question :
In early May this year, the Government invited two Chinese medicine experts from Guangdong Province to Hong Kong to examine if the method which integrates Chinese and western medicine ("the integrated method") is more effective than the method which uses western medicine alone ("the WM method") in the treatment of patients suffering from Severe Acute Respiratory Syndrome ("SARS"). In this connection, will the Government inform this Council:
(a) how SARS patients treated with the integrated method compare to those treated with the WM method in terms of length of stay in hospital, mortality rate, relapse rate and lung function;
(b) how the medication cost of the integrated method compares to that of the WM method; and
(c) as the mortality rate of SARS patients in Hong Kong has been the highest in the world, whether the authorities have assessed if such a high mortality rate is related to treatment methods and medication or some other reasons?
Answer :
Madam President,
(a) All SARS patients admitted into public hospitals have been treated with western medicine. In addition, the Hospital Authority ("HA") has drawn up protocols on the use of Chinese medicine ("CM") in conjunction with western medicine in the treatment of SARS to provide an option for those patients who wish to seek such treatment. So far, 51 patients at the acute phase and 76 patients in convalescence have been treated with an integrated western medicine/Chinese medicine approach. HA has also arranged the use of prophylaxis Chinese medicines for its frontline staff.
HA has structured a mechanism for evaluating the effectiveness of integrated western and Chinese medicine for the prevention of SARS, and in the management of convalescent SARS patients as well as in the management of acute SARS patients. Preliminary findings should be available in two to three months' time.
(b) The cost of the integrated approach in utilising Chinese and western medicine requires a computation of the costs of medicines, consultations, investigations and ancillary care. HA has not at this stage carried out these costing computations.
(c) The mortality rates of SARS patients is affected by three sets of variables:
(i) the inclusion and exclusion criteria applied in the case definition and the consistency and completeness of surveillance and reporting.
(ii) patient clinical profiles. According to studies performed in Hong Kong and reported in the World Health Organisation workshop, patient clinical profiles which influence mortality include : (a) age - persons over the age of 65 have a 12.7-fold risk of death as compared to those aged 35-64 ; (b) sex - men have a 2.5-fold risk as compared to women ; (c) co-morbidity - patients who have certain chronic illnesses co-existing with SARS also have a 10.9-fold risk of mortality as compared to those without co-existing chronic illnesses ; and (d) severity of illness - patients with more severe disease inferred by such variables as oxygen desaturation also have a high mortality.
(iii) the effectiveness of clinical treatment provided.
Based on the reports in the literature, the case fatality rate ("CFR") of SAR patients in Hong Kong is at least at par with levels achieved in other places. In Hong Kong, 70 per cent of deaths are associated with co-morbidity and aged above 65. Latest statistics reveal that the co-morbidity CFR of local SARS patients is 50 per cent. Patients aged 65-74 have a CFR of 47 per cent and the rate for those aged 75 and above is as high as 66 per cent. Valid comparisons of mortality rates of SARS patient in different jurisdictions can only be made if the three sets of variables influencing mortality, set out above, are standarised.
Ends/Wednesday, July 9, 2003
Issued at HKT 16:40
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