• Sun
  • Dec 21, 2014
  • Updated: 1:59pm
NewsHong Kong

Concern over high death rates in Hong Kong's public hospitals

Overcrowded wards and lack of intensive-care beds cited as report notes high mortality figures at three major public infirmaries

PUBLISHED : Wednesday, 08 January, 2014, 11:42pm
UPDATED : Thursday, 09 January, 2014, 4:37pm

Hong Kong's overstretched public medical sector has been dealt another blow with a major report revealing an "unsettling" death rate at one of the city's biggest public hospitals and expressing concern at the number of post-surgery deaths at two others.

The latest annual Hospital Authority report into surgical outcomes across the 17 public hospitals it oversees, found that the 25-year-old Tuen Mun Hospital recorded a "high" death rate for the fifth year in a row.

The hospital's continuing shortcomings led Dr Kenneth Fu Kam-fung, the head of the Public Doctor's Association, to pinpoint overcrowded surgical wards and a lack of intensive-care beds as potential problem areas.

He said the situation at Prince of Wales Hospital in Sha Tin and Queen Elizabeth Hospital in Yau Ma Tei, which recorded the highest death rates along with Tuen Mun, was due to the same problems.

Tuen Mun rated poorly in both emergency and non-urgent surgery in a 12-month period to June 30. Prince of Wales for the first time showed a split performance with its death rate in non-emergency surgery being one of the lowest, while that for emergency procedures had risen for the past four years.

Queen Elizabeth showed signs of improvement, according to the Hospital Authority's surgical outcomes monitoring and improvement programme, which has conducted the study since 2008.

"Tuen Mun Hospital has rated poorly for five consecutive years. This is unsettling to us," programme director Dr Yuen Wai-cheung said.

"What went wrong with Prince of Wales Hospital this year? The difference in its emergency and elective performances is very strange. No other hospital has had this difference and such polarisation is seen for the first time."

The death rates in the report were calculated by the ratio between actual and expected death rates in the 30 days after surgery. Yuen said this eliminated the effect of risks from the patient's condition before surgery.

The ratio of actual to expected deaths in emergency surgery was 1.33 at Prince of Wales and 1.28 at Tuen Mun, with figures below zero indicating a lower rate.

The report said Prince of Wales had the lowest rate of patients being sent to intensive care after emergency surgery, meaning some might not have received the care they needed. The rate was 19 per cent, compared with 54 per cent at Queen Mary Hospital in Pok Fu Lam.

Fu, president of the Public Doctors' Association and a urology surgeon at Queen Mary, said not all major emergency surgery required intensive care.

Yuen suggested that Prince of Wales consider introducing a high-dependency unit like that in Queen Mary for elective cases, to make room for emergency cases in intensive care.

The report found a strong correlation between the high death rate and high use of surgical beds in hospitals - with the average at Tuen Mun being 106 per cent, with the use of temporary beds the most of all hospitals.

Tuen Mun Hospital said it would add more beds in the surgical ward. Studies would be made on improvements to operating theatres and a reduction in the waiting time for operations.

Fu did not think crowded wards would increase the death rate but said a lack of experienced doctors or ample supervision of junior doctors could be factors.


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This article is now closed to comments

"The death rates in the report were calculated by the ratio between actual and expected death rates in the 30 days after surgery. Yuen said this eliminated the effect of risks from the patient's condition before surgery."
Surely this calculation will cause skewed results if you dont take into account the patient's condition before surgery? It would be interesting to see how they calculate the expected mortality rate as well before jumping to conclusions.
Also note that this article doesnt cover the all the main reasons for the problems - yes the public hospitals are overcrowded and maybe underfunded but what about the public abusing the services provided by the emergency services and the A&E departments? No wonder the doctors and staff are struggling if everyone with a cold goes to A&E... Factor in all the admin and bureaucracy that HK is infamous for and it will always be a mess. Throwing money at these problems wont fix them, its more an efficiency issue.
When will the govt stop the greedy and selfish agenda of the Medical Council in restricting foreign trained doctors to practise here?
World class city with billions in surplusses?
The private medical industry is also to blame for the current crises concerning mainland babies born here - can they help set up some kindys, contribute to their social assistance, etc?
How about investing/spending more in the geriatic department in anticipation of the surge in demand instead of spending billions on the new arrivals?
I agree with everything that you have said except why are you asking 'Donald'. You are not hinting at a 'lame duck administration' are you?



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