Hong Kong’s Accident and Emergency (A&E) wards face significant challenges due to high patient volumes, particularly from semi- or non-urgent cases. In 2023, 55.6% of nearly 2 million first-time A&E patients were classified as semi- or non-urgent. This has strained resources, making it harder to meet service targets for urgent cases. To address this, the Hospital Authority is introducing fee changes to encourage non-urgent patients to seek care elsewhere, freeing up resources for those in critical need.
The triage system in Hong Kong’s A&E wards categorizes patients into five levels based on urgency. Category one includes critical cases requiring immediate attention, while category five covers non-urgent cases. In 2023, 97.1% of emergency condition patients (category two) were treated within 15 minutes, exceeding the 95% target. However, only 76.6% of urgent patients (category three) were treated within the 30-minute target, falling short of the 90% goal. The high number of semi- or non-urgent cases has contributed to this gap.
The proposed fee changes aim to reduce the number of non-urgent patients in A&E wards. By increasing fees for these cases, the Hospital Authority hopes to redirect patients to primary care clinics or other healthcare options. Similar initiatives in other regions have shown success in reducing A&E overcrowding and improving wait times for urgent cases. For example, in the UK, fee adjustments led to a 20% drop in non-urgent A&E visits within a year.
The Hospital Authority’s primary goal is to treat 90% of urgent patients within 30 minutes. Currently, the success rate stands at 76.6%, highlighting the need for immediate action. The fee changes are part of a broader strategy to improve efficiency and prioritize critical cases. The authority has already achieved 100% success in treating category one patients immediately and exceeded the target for category two patients.
Reducing wait times for urgent patients can significantly improve health outcomes. Faster treatment for critical cases can prevent complications and save lives. However, the fee changes raise concerns about accessibility for low-income patients. To address this, the Hospital Authority is considering subsidies or exemptions for those in financial hardship. Public education campaigns will also play a key role in informing patients about alternative care options.
Implementing the fee changes will require careful planning and monitoring. Potential challenges include resistance from patients and healthcare providers, as well as the need to ensure that primary care services can handle the increased demand. A phased approach will allow the authority to assess the impact and make adjustments as needed. Technology, such as digital triage systems, can also support the initiative by streamlining patient flow and improving efficiency.
Looking ahead, the Hospital Authority plans to monitor the impact of the fee changes closely and adjust strategies as necessary. Collaboration with healthcare providers and the public will be essential to ensure the initiative’s success. If effective, the approach could be expanded to other healthcare services, further improving access and outcomes for all patients.
