Hospital eases load at emergency dept

Each day, Changi General Hospital (CGH) manages to persuade around 20 patients who turn up at its emergency department to see a general practitioner instead.

After confirming that these are "Priority 3" or P3 patients, whose less serious ailments do not require urgent treatment, staff advise them it may take up to five hours to see a doctor and offer a brochure listing nearby clinics that they can visit instead.

The scheme, which began in February, has eased the load at the hospital's emergency department by about 5 per cent - a significant amount, said Mr T.K. Udairam, head of Eastern Health Alliance, which includes CGH.

The hospital also assures patients that should the GP refer them back to the hospital, they will be given priority. So far, none has returned since the start of the scheme.

"It's good for the hospital and it saves the patient $100," said Mr Udairam. That is the flat fee charged by the hospital for anyone who seeks treatment at the emergency department.

More than half the 400 to 500 patients who turn up at CGH's emergency department fall under the P3 category, in spite of repeated calls to not clog up public hospitals' emergency departments. How quickly a patient is treated depends on how sick he is.

Patients are assessed by nurses, with urgent cases getting a doctor's immediate attention. P3s, who suffer from less serious illnesses such as diarrhoea, are pushed behind in the queue.

Dr Lye Tong Fong, who works at one of the four 24-hour GP clinics listed on the brochure, said P3 patients often suffer from less serious ailments, such as vomiting and high fever.

His clinic in Pasir Ris, a six-minute drive from the hospital, charges between $25 and $90 for consultation, depending on the time of day, with the most expensive fees for consultations between midnight and 7am. Medicine can cost between $10 and $50 more.

Praising CGH's move to give out the information in brochures, Dr Lye said: "Some people might not know where to go on weekends or after hours."

CGH's latest scheme follows another to reduce the load on its specialist outpatient clinics. The hospital has discharged 1,700 patients to polyclinics and GPs since June 2008 under a scheme where those with stable chronic conditions are discharged to polyclinics which have the necessary resources, such as laboratory facilities. Those with more straightforward conditions are sent to GPs.

Mr Udairam said he tells such patients: "You want to come to my specialist clinic, you come on my time, based on my schedule, and you wait at my clinic based on my doctor's availability. You go to a GP, you can go any time you want - after office hours or on weekends."

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