Debated in Parliament on 5 Jul 2023.
Dr Lim Wee Kiak asked the Minister for Health (a) when can the results from the measures announced to reduce waiting time for admissions to public hospitals be expected; (b) what is the longest projected waiting time for beds; (c) when will the Ministry start to mobilise private hospitals and healthcare facilities; and (d) what steps have been taken to ensure that patients who are not admitted within a day receive timely and quality care.
Mr Deputy Speaker, as we exit from the COVID-19 crisis, hospitals have found that average length of stay has increased significantly, from 6.1 days to seven days. This translates into 15% more utilisation of hospital beds and is the key driver for longer waiting times for admission. The patients who need longer stays are older with co-morbidities and complex conditions. The situation is aggravated by healthcare infrastructure projects being delayed due to COVID-19.
We are actively working on increasing acute bed capacity, community hospital bed capacity and Transition Care Facilities to address the capacity constraint. In the meantime, our hospitals will continue attending to life-threatening cases at the Emergency Departments (EDs) immediately and carry out urgent surgeries promptly. For non-life-threatening patients who require admissions, hospitals will activate inpatient teams to start investigations and treatments in the EDs, even before a ward bed is available. If need be, we will tap on the capacity of private hospitals, as we did during COVID-19.
Dr Lim.
Thank you, Sir. I would just like to ask a few supplementary questions regarding what is the main cause for the increase in hospitalisation stay from 6.1 days to seven days. What are steps taken now to tackle that? Can we go back to six days again? And lastly, how much is it due to the backlog from COVID-19 and when will this backlog clear?
Sir, I thank Dr Lim for his questions. The main cause of the increase is the increase in the complexity of care. We are seeing more aged patients, frailer patients and patients with more co-morbidities. And so, the main reason that it is taking longer for them to stay in hospital is because the amount of care they need is more. They are more unwell and it takes longer for them to recover. So, 6.1 days to seven days is a 15% increase. It is not small. It is a significant increase in the length of stay. And that is what has fundamentally affected the strain on our capacity.
We have not been able to increase as much as we have previously projected because of the delays and the infrastructure upgrading and roll-out of capacity because of COVID-19. But we are trying our best to catch up.
Can we go back, Dr Lim asked. I do not think there is a foreseeable way in which we can go back to shorter stays because our population is getting even older. So, you will have more patients with complex healthcare needs.
We do have to put in quite a lot of effort to keep us as healthy as possible for as long as possible to mitigate this burden. But once you need hospitalisation, the likelihood is that your care is likely to be more complex and longer than in the past.
What we have to do then is to optimise the use of the capacity we do have, which is to transfer patients to step-down facilities, community facilities and also, where possible, to recover at home, so that our hospital facilities are focused on those who need that complex acute care.
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