Fees charged for transit wards in hospitals

BY GERALD GIAM -- Article first appeared on http://geraldgiam.sg

USE OF MEDISAVE FOR PATIENTS IN TRANSIT WARDS OF ACCIDENT AND EMERGENCY DEPARTMENTS IN HOSPITALS

The following question stood in the name of Mr Zainal Sapari –
10 To ask the Minister for Health (a) what is the average length of time that a person will be in the transit ward of the Accident and Emergency Department of a public hospital before getting a bed at the subsidised wards; and (b) whether the Ministry can allow patients who are in transit wards to use their Medisave for payment during their stay there.

11 Mr Gerald Giam Yean Song asked the Minister for Health (a) which public hospitals charge patients for (i) temporary beds in tents; (ii) beds in the corridors outside the wards; or (iii) beds in the ward corridors but not in ward rooms; (b) how all these rates differ from beds in the ward room; and (c) whether stays in temporary beds in tents and in the corridors, outside and inside the ward, qualify for Medisave use or MediShield Life claims.

Mr Zainudin Nordin (Bishan-Toa Payoh): Question No 10.

The Minister for Health (Mr Gan Kim Yong): Madam, may I take both Question Nos 10 and 11 together.

Mdm Speaker: Yes, please.

Mr Gan Kim Yong: Madam, for 2013, the median time for admission to a ward from the Emergency Department was about 2.5 hours.

Patients at the Emergency Departments are prioritised and attended to based on the severity of their conditions. While patients wait to be admitted to an inpatient bed, they will continue to receive medical treatment, nursing care, clinical monitoring and other services, as well as meals that they may require during this transit period. Their safety and care remain the focus of our care teams at the Emergency Departments.

During the transit period, patients would be charged for services that have been rendered. Medisave and MediShield can be used for these charges if the patients are subsequently warded, subject to the prevailing daily and other limits, and the number of inpatient days of stay.

We have received appeals and queries earlier about the computation of Medisave and MediShield claims for patients who received treatment before their inpatient beds were ready. Some hospitals commence inpatient charges only when the patients are transferred to a ward and taken care of by the inpatient team. Ward charges are not imposed during the transit period at the Emergency Department and, consequently, the transit period does not count towards the inpatient days in the computation of Medisave and MediShield claims. Other hospitals consider patients as inpatient once they are taken care of by the inpatient team, even during the transit period. The time during this period contributes towards the length of stay and patients will benefit from higher claims for Medisave and MediShield.

We are reviewing these two ways of computation to see how we can streamline the practices across public hospitals to minimise confusion.

Mr Gerald Giam Yean Song (Non-Constituency Member): A few supplementary questions. I think the Minister basically has said that different hospitals have different practices right now. Can the Minister clarify which are the hospitals that do charge for the temporary beds and which are those that do not?

For the hospitals that charge for the temporary beds, do they charge at the same rate as for beds inside the wards or do they have a discounted rate? The patients on temporary beds are already putting up with a fair degree of discomfort and inconvenience. Would the Minister agree that as long as the bed is not inside the ward, and inside a room, that they should be eligible for a lower rate, and should be allowed to use their Medisave and MediShield where eligible, as well as receive all the C Class ward subsidies? Thank you.

Mr Gan Kim Yong: Madam, I thank the Member for the questions. Firstly, he asked which are the hospitals that charge for temporary beds in the transit area. The Changi General Hospital and the Singapore General Hospital consider the patients as inpatients once they are taken over by the inpatient team and, therefore, their stay during the Emergency Department after they have been taken over by the inpatient team will be charged according to the wards.