LCQ8: General outpatient service used by elderly persons
Over the years, there have all along been elderly persons (i.e. persons aged 65 or above) complaining that the consultation quotas for public general outpatient clinics (outpatient clinics) are in short supply, and that they have encountered quite a number of difficulties in using the General Outpatient Clinics Telephone Appointment Service (e.g. being unable to complete the telephone appointment procedure due to failure to press the buttons as instructed within the time limit). On the other hand, the Government indicated in the Policy Agenda published in October last year that it would improve the elderly healthcare services, but it said little about improving the provision of public general outpatient services for elderly persons. In this connection, will the Government inform this Council:
(1) whether it knows the appointment quotas provided by each outpatient clinic under the Hospital Authority (HA), and the number and percentage of such quotas which were Elderly Appointment Quotas, in each of the past three years;
(2) given that the number of elderly persons has increased continuously in recent years, and the rates of elderly population growth in various districts vary, resulting in varied ratios of elderly person to consultation quota in various districts, whether the Government will request HA to review the resources allocated to the outpatient clinics in various districts, in order to meet the demand of elderly persons for general outpatient services; if so, of the details; if not, the reasons for that;
(3) as the Government has proposed in the 2018-2019 Budget that a sum of $300 billion be earmarked for improving the public healthcare system, whether the Government will allocate additional resources and manpower to improve the arrangements for making appointments for public general outpatient services (e.g. providing telephone appointment services answered by real persons), in order to facilitate the booking of services by elderly persons; if so, of the details; if not, the reasons for that; and
(4) as some of the elderly persons who have been unsuccessful in booking public general outpatient services will seek consultation from private doctors instead, of the authorities' measures in the coming year to encourage elderly persons to register on the Electronic Health Record Sharing System, with a view to their receiving better and more timely diagnoses and treatments?
My reply to the question raised by the Hon Regina Ip is as follows:
(1) and (2) The general out-patient services of the Hospital Authority (HA) are primarily used by the elderly, low-income persons and chronically ill patients. At present, a total of 73 general out-patient clinics (GOPCs) of the HA provide services for more than 1.5 million patients each year, of which one-third are elderly patients aged 65 or above. In 2016-17, the GOPCs served about six million attendances.
Patients under the care of the GOPCs fall into two major categories: chronically ill patients in a stable condition, such as those with diabetes mellitus or hypertension; and episodic disease patients with relatively mild symptoms, such as those suffering from influenza, cold or gastroenteritis. Chronically ill patients requiring follow-up consultations will be assigned a time slot for follow-up after each consultation and do not need to make a separate appointment. As for episodic disease patients, consultation time slots in the next 24 hours are available for booking through the GOPC telephone appointment system. HA's GOPCs provide Elderly Appointment Quotas by allocating appropriate portion of consultation quotas to patients aged 65 or above, making reference to information such as the distribution of target service users in a district and data on service utilisation. To strengthen support for chronically ill patients (including elderly patients), the GOPCs have rolled out a series of primary healthcare services for enhanced management of chronic diseases. These services include the provision of health risk assessments and targeted interventions for patients with chronic diseases such as diabetes mellitus or hypertension by multi-disciplinary teams of healthcare professionals, so as to reduce the risk of complications among these patients and the number of their attendances at clinics.
Currently, HA provides information on consultation quotas of each GOPC via its GOPC webpage. The average number of consultation quotas of each clinic for the preceding four weeks by district is shown on the webpage, and the information is updated on a weekly basis. The number of consultation quotas varies among the clinics due to the difference in geographical location and size of clinics. HA will slightly adjust the daily service capacity of a GOPC with regard to manpower availability and operational needs. As regards the Elderly Appointment Quotas, individual GOPCs have been closely monitoring their utilisation rates and will make timely adjustment to the consultation quotas to ensure their optimal use.
To meet the increasing service demand, the HA has been striving to strengthen its general out-patient services. With the implementation of various measures, the HA has increased the number of general out-patient attendances by a total of over 600 000 attendances from 2012-13 to 2017-18, including those of the evening and public holiday out-patient services. To cater for the demand for general out-patient services, the HA also plans to increase gradually the GOPC consultation quotas by more than 99 000 attendances in 2018-19 and 2019-20. In the coming years, it may be raised further if manpower and budget permit.
(3) The main purpose of providing the GOPC telephone appointment service is to allow patients to make appointments by telephone and save them from queuing for medical services. It can also reduce the risk of cross-infection among patients. At present, the system offers about 800 telephone lines providing 24-hour GOPC appointment booking service for patients. Given the huge volume of GOPC services, the automated appointment system assists patients by searching for consultation quotas and allocating available consultation slots within the shortest time possible, thereby achieving the efficient use of resources. It will involve substantial increase in recurrent expenditure if staff are to be deployed to handle calls from appointment hotlines or designated hotlines for the elderly. This will add to the pressure of GOPCs in terms of resources and manpower, and may reduce the efficiency of the appointment service and make the telephone lines even busier. Furthermore, GOPCs have set up help desks to provide suitable assistance to individuals who encounter difficulties in using the telephone appointment service (including some of the elderly).
Since the launch of the telephone appointment service, the HA has been listening to the views of the public on the service, conducting reviews on an on-going basis and introducing improvement measures. In the future, the HA will continue to consider in detail views collected through various channels and further improve the design of the telephone appointment system. The HA will also proactively explore various feasible options, including the development of a mobile application for making GOPC appointments so as to enhance the appointment service.
(4) To promote public-private collaboration and facilitate continuity of care for patients, the Government launched the Electronic Health Record Sharing System (eHRSS) in March 2016 to enable healthcare providers in the public and private sectors to view and share patients' data with patients' consent. As at end-March 2018, over 720 000 members of the public had registered with the eHRSS, of which nearly half were elders aged over 65.
The Government has been promoting the eHRSS in various ways, and has introduced measures to facilitate public registration. The Government will continue to arrange mobile registration teams to visit residential care homes for the elderly, day care centres for the elderly, district elderly community centres, and clinics under the HA and the Department of Health (including elderly health centres) to conduct on-site registration for the elderly. Furthermore, promotional materials and videos will be produced for distribution/showing at the above healthcare organisations and venues, and engagement meetings and briefings will be arranged for social welfare organisations providing elderly services. The Government will also upload the promotional videos on the eHRSS website and the social media. At the same time, to further facilitate members of the public (including the elderly) to register with the eHRSS, in addition to the existing channels of submitting applications online, by mail and by fax, the Government introduced enhancement measures at the end of last year to allow those in need (e.g. elderly persons with mobility difficulties) to authorise others to submit applications for them.
Ends/Wednesday, April 11, 2018
Issued at HKT 16:45
Issued at HKT 16:45