Ong Ye Kung 싱가포르 보건부 장관이 the Ministry of Health Committee of Supply Debate 2024에서 한 연설을 편집한 버전입니다.
일시: 2024.3.6
분량: 573단어(5분43초)
연사:Ong Ye Kung 싱가포르 보건부 장관
<Glossary>
1 | acute hospital | 급성환자 전문병원 |
2 | sub-acute patients | 아급성 환자 |
3 | Transitional Care Facilities | 전환관리 시설 |
*전환관리:지역사회 내에서 의료서비스를 연속적으로 제공해 환자의 재입원 방지, 건강상태 개선, 비용 절감 등의 효과를 얻고자 하는 이론
<Script>
Mr Chairman
I will devote a large part of my speech to address two pressing issues for healthcare. One is the hospital capacity crunch, and the other is healthcare cost. Then I will talk about the major transformation that we are bringing about in our healthcare system which will further address these two concerns.
Professors raised the issue of capacity and waiting times at hospitals. Post COVID-19, indeed, this is the experience of many countries around the world. Waiting times have gone up all around the world.
In Singapore, what is driving up hospital bed occupancy is the increased number of seniors with complex conditions. Post COVID-19, we saw a surge in the numbers. The average stay went up from about six days to seven days pre- and post-COVID. That alone represents a 15% increase in patient load.
This is happening against the backdrop of a rapidly ageing population, which compounds the problem, and makes it a long-term challenge.
To tackle the challenge fundamentally, we need to expand capacity, and catch up the time lost due to the COVID-19 pandemic.
We opened about 640 new acute and community hospital beds since June last year. They make up the over 11,000 public hospital beds that we have today.
We intend to add another 4,000 beds by 2030. We should see new capacity coming on stream every year from now to 2030.
Notwithstanding this plan to expand capacity, we should not be trapped in the mindset of ‘building hospitals’ when thinking about capacity. There is potential to better anchor care outside of hospitals, in the community.
Not all patients require high acuity care [여안1] and constant monitoring in a hospital throughout their treatment course.
That is why we have built more community hospitals for sub-acute and rehab patients, and Transitional Care Facilities for patients who are waiting for longer term care arrangements.
With our efforts, the number of long staying patients has come down. These are patients who are medically stable for discharge but have been staying in hospitals while waiting for longer term care, for longer than 21 days. They are what we refer to as long staying patients. Two years ago, it was about 300 such patients at any one time in our hospital system. Now, it is under 200 such patients at any one time, and there is still room for improvement.
To facilitate appropriate transfers from acute hospitals to community settings, we will also be making a few policy changes.
One, more funding for community hospitals. Acute hospitals have experienced friction in transferring suitable patients to community hospitals.
Why? For example, certain diagnostic services such as CT and MRI scans, and certain more expensive drugs, are not subsidised in community hospitals today. This is based on the consideration that these are recovering patients and they may not need these interventions.
Unfortunately, this means operational delays in transferring patients to community hospitals. There are patients who are medically ready to be transferred but they are just waiting for a follow-up scan. They should be transferred without delay, and do the scan at the community hospital.
Others worry that after transfer, what if I unexpectedly need a scan, for some reason. Hence they insist on staying in the acute hospital “just in case”.
To remove this friction, from the last quarter of this year, we will allow more diagnostic services like CT and MRI scans, and relevant drugs to be subsidised at community hospitals.
[여안1]집중치료