The Hong Kong SAR Government is set to complete a review of public hospital charges, proposing a shift from a flat fee for emergency room patients to a system based on medical urgency. Under the new plan, critically ill and emergency patients will be treated for free, while the fees for urgent, semi-urgent, and non-urgent patients will be increased.
Dr. Tsui Sik-hon, a consultant at the Accident and Emergency Department of Queen Mary Hospital, revealed in an interview that currently, semi-urgent and non-urgent cases account for as much as 55% of visits to public hospital emergency rooms. The reform aims to enhance support for critically ill patients and change the habit of non-urgent patients seeking treatment in emergency rooms, emphasizing that "every minute counts in saving lives!"
The Hospital Authority will reinvest the additional revenue from the adjusted fees into improving related medical services, including expanding the safety net for patients in need. This means that some patients may qualify for reduced medical costs or access better-prescribed medications without additional out-of-pocket expenses.
Currently, the government subsidizes approximately 97% of the public healthcare system, with citizens only covering 2.2%. For example, the current flat fee for the emergency room is HK$180, while the average cost per patient is HK$2,400. The Secretary for Health, Dr. Lo Chung-mau, mentioned in an exclusive interview that the purpose of adjusting emergency room charges is to encourage citizens to value these resources and focus on genuinely urgent cases. Existing mechanisms for fee reductions for vulnerable groups, such as Comprehensive Social Security Assistance recipients and elderly individuals, will continue, with a further lowering of the thresholds for exemptions including those for critically ill patients.
Targeted Assistance for Patients in Need
Dr. Tsui stated that through the fee reform, the Hospital Authority hopes to provide more precise assistance to those in need while increasing protection for critically ill patients to avoid situations where "serious illness leads to poverty."
After the fee reform, more patients in need are expected to be included in the safety net. Their medical costs may be reduced, and the Hospital Authority will have more resources for medications, allowing more patients to access higher-quality prescriptions without extra costs.
Many citizens tend to use emergency rooms for convenience, leading to overburdened facilities and increased pressure on medical staff, which ultimately affects the treatment of patients who genuinely need urgent care. Dr. Tsui noted that currently, semi-urgent and non-urgent patients comprise as much as 55% of emergency room visits, while urgent and critically ill patients total about 45%. He pointed out that staffing is generally lower at night than during the day, but emergencies can occur at any time, necessitating a focus on the most critical cases during nighttime hours. As a result, semi-urgent and non-urgent patients may face longer waiting times and are advised to consider visiting private doctors or outpatient services during the day when their conditions are not as urgent.
"Time is of the Essence in Saving Lives"
Dr. Tsui emphasized the importance of treating critically ill patients as quickly as possible, stating, "For example, if someone suddenly experiences severe chest pain and is sweating profusely, they should call an ambulance immediately. Any delay in treating a heart condition can lead to severe consequences, so emergency staff must prioritize these patients."
He acknowledged that it would be difficult to change the habits of all semi-urgent or non-urgent patients, understanding that they may not always accurately assess their situations. For instance, someone experiencing severe abdominal pain at night may find their pain subsiding after a brief wait in the emergency room, leading to a reassessment of their case as semi-urgent, which is understandable.
Dr. Lo mentioned that the government will enhance public education to change citizens' healthcare-seeking habits, reduce the misuse of emergency services, and promote primary care services as the first choice for minor ailments. The Chief of Service in the Department of Family Medicine, Dr. Maria Leung, also encouraged citizens to adopt preventive healthcare measures to reduce the risk of emergencies, suggesting that individuals over 45 should have annual check-ups to monitor conditions like high blood pressure.
The government and the Hospital Authority have optimized appointment systems for outpatient services and the HA Go mobile app, aiming to help citizens better utilize primary care services.
Public Concerns Over Fee Increases
Yesterday afternoon, reporters observed long waiting times at the emergency room of United Christian Hospital. A 69-year-old man, Mr. Wan, visited due to prostate pain and mentioned he had been waiting for nearly four hours.
Mr. Wan supports increasing emergency room fees to shorten waiting times. "My prostate has been hurting for almost a month, but I couldn't get an appointment for outpatient services. I came to the emergency room because the pain became unbearable, only to find I still had to wait several hours. I hope that with the fee increase, I won't have to wait this long."
He shared that as a building manager, after deducting rent and living expenses, he only has HK$4,000 left each month. While he supports the fee increase, he hopes it won't be too high, as that might deter him from seeking help when he is unwell.
Chef Mr. Si visited the emergency room yesterday after accidentally cutting his finger with a knife. After initial bandaging, he waited nearly five hours in the emergency lobby. He supports an increase in emergency room fees but believes it should not be excessive, as many elderly individuals may refrain from seeking treatment due to high costs. "I think the emergency room fees at public hospitals could be half of what private hospitals charge."
Mr. Wan, who accompanied his mother suffering from abdominal pain to the emergency room, indicated he could accept an increase in public hospital emergency room fees but hopes the increase will not be too high, suggesting a fee of HK$200.
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