LCQ8: General out-patient services
Hong Kong (HKSAR) - Following is a question by the Dr Hon Pierre Chan and a written reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (January 10):
At present, members of the public may book consultation time slots at general out-patient clinics (GOPCs) within the coming 24 hours through a telephone appointment system of the Hospital Authority (HA). Some residents of different districts have relayed that there is currently a shortfall in the consultation quotas of various clinics, resulting in them often being unsuccessful or having difficulty in making appointments for general out-patient services through the telephone appointment system. In this connection, will the Government inform this Council:
(1) whether it knows the following information about each GOPC in 2016-2017 (to be set out in a table):
(i) the average number of doctors who staffed at the clinic in each consultation time slot;
(ii) the total numbers of consultation time slots and consultation quotas for the whole year, and among such quotas, the respective numbers of those reserved for episodic disease patients (and, among them, the respective numbers of those reserved for civil servants and serving HA staff) and patients seeking follow-up consultations;
(iii) among the respective attendances of patients using the consultation quotas for episodic disease patients and those seeking follow-up consultations for the whole year, the respective attendances of patients who were (a) aged 65 or above, (b) recipients of Comprehensive Social Security Assistance, (c) serving civil servants and their dependents, and (d) serving HA staff and their dependents; and
(iv) the top 10 categories of diseases (as classified by the International Classification of Primary Care 2) which accounted for the highest attendances for the whole year and the respective percentages of such attendances in the total attendance;
(2) whether it knows if HA conducted in the past five years any survey on the use and effectiveness of the telephone appointment system; if HA did, of the details; if not, the reasons for that; and
(3) given that users of the telephone appointment system may choose to receive voice instructions in English, Putonghua or Cantonese only, whether it knows if HA has measures in place to (i) help ethnic minority patients who do not understand such languages/dialect make appointments for general out-patient services and (ii) allow them to book for the provision of telephone or on-site interpretation services when attending their appointments; if HA does, of the details; if not, whether HA will make improvements?
My reply to the questions raised by Dr Hon Pierre Chan is as follows:
(1) The general out-patient services under the Hospital Authority (HA) are primarily targeted at the elderly, low-income groups and chronically ill patients. At present, general out-patient clinics (GOPCs) under the HA provide services for more than 1.5 million patients, of which one-third are elderly patients aged 65 or above. In 2016-17, the GOPCs served about six million attendances, and about 70 per cent of the consultations were provided for the key service users (i.e. elderly patients aged 65 or above, chronically ill patients and Comprehensive Social Security Assistance recipients).
Patients under the care of the GOPCs comprise two major categories: chronically ill patients in stable medical condition, such as patients with diabetes mellitus or hypertension; and episodic disease patients with relatively mild symptoms, such as those suffering from influenza, cold or gastroenteritis. Currently, for episodic disease patients, consultation time slots in the next 24 hours are available for booking through the GOPC telephone appointment system. As for chronically ill patients requiring follow-up consultations, they will be assigned a time slot for follow-up by the GOPCs after each consultation and do not need to make separate appointment. Over half of the consultations are provided for chronically ill patients in stable medical condition (such as patients with diabetes mellitus or hypertension).
In addition, according to the agreement between the HA and the Civil Service Bureau, the HA provides medical benefits for civil servants through the service units (including the GOPCs) of its clusters. At present, a number of priority discs are reserved for serving civil servants at the beginning of day sessions (excluding Sundays and public holidays) at 65 GOPCs of the HA to enable civil servants, where their health condition permits, to return to work as early as possible in order to maintain the normal operation of government departments.
In 2016-17, over 550 000 priority discs were reserved at the GOPCs for serving civil servants, and the utilisation rate was about 60 per cent. As priority discs for serving civil servants are given out on a first-come-first-served basis, civil servants will generally arrive at the GOPCs earlier than the designated registration time to get a disc. Any unused priority discs for serving civil servants will be released to members of the public after the registration hours. The public may book the consultation time slots through the GOPC telephone appointment system. GOPCs do not reserve consultation quotas for serving HA staff and/or their dependents.
The HA also provides information on GOPC consultation quotas via its GOPC webpage, on which the average number of consultation quotas of each clinic for the preceding four weeks by district is shown. This information is updated on a weekly basis so that the public can have an overview of the number of consultation quotas of various GOPCs and the general service capacity of each clinic.
In 2016, there were about 429 HA doctors working at the GOPCs. The common diseases among patients attending the GOPCs included hypertension, lipid disorder, diabetes mellitus, upper respiratory tract infection, gout and benign prostatic hypertrophy. In view of the fact that some patients may seek medical consultations for more than one disease at a time, the percentage of total attendance by individual disease types would not reflect the actual proportion of the corresponding patient numbers.
To meet the increasing service demand, the HA has been striving to strengthen its general out-patient services. With the implementation of various measures, there has been an increase of a total of over 600 000 general out-patient attendances from 2012-13 to 2016-17, including evening and public holiday clinic services. To cater for the demand for general out-patient services, the HA also plans to increase gradually the GOPC consultation quota by more than 44 000 attendances in 2017-18 and 2018-19.
(2) 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. The HA has commissioned an independent research centre to conduct focus group studies and solicit public views on the GOPC appointment service so as to form the basis for enhancing the appointment system. Enhancement measures include simplifying data entry procedures and increasing the number of telephone lines. In the future, the HA will continue to consider in detail the views collected through various channels and further improve the design of the GOPC telephone appointment system. The HA will also proactively examine various feasible options, including exploring the development of a mobile application for making GOPC appointments.
(3) The existing GOPC telephone appointment system offers three language options, namely Cantonese, English and Putonghua. Help desks have also been set up in the GOPCs to provide suitable assistance for individuals who may encounter difficulties in using the telephone appointment service. 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, for instance, exploring adding pre-recorded ethnic minority language options to the GOPC telephone appointment system. Moreover, if patients seeking consultation ask for interpretation service, the clinic staff will offer assistance or make appointments for them as necessary in accordance with the relevant hospital procedures.
Published on: 2018-01-10
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