Hong Kong public hospitals urged to retain refund scheme for ‘non-urgent’ patients who drop out of A&E queue

The Hospital Authority said last week that 1,032 people who went to A&E departments over that period gave up waiting and asked for refunds. They made up almost 2 per cent of all A&E patients and most were in a stable condition when they chose to leave.

As a result, overall pressure on public hospitals was eased and the waiting times were reduced for those being admitted to wards through the emergency departments, the authority said.

Alex Lam Chi-yau, chairman of Hong Kong Patients’ Voices, a concern group, urged the authority to consider making the refund scheme permanent.

Patients at A&E departments are divided into five categories based on their medical condition. Non-urgent cases are usually asked to pay a HK$180 (US$23) attendance fee before seeing a doctor, while urgent ones pay after treatment.

Under the special arrangement, those categorised as “semi-urgent” or “non-urgent” can receive an attendance fee refund if they change their mind within 24 hours of registering and leave. The money will be reimbursed within a month by cheque or through their credit card.

“The beauty of this arrangement is that patients have the option to get a refund and go home to rest or visit a clinic,” Lam said.

He felt the scheme had achieved its purpose as more than 1,000 people ended up not using the emergency services.

Patients’ rights advocate Tim Pang Hung-cheong said making the refund arrangement permanent could help ease the burden on public A&E departments.

He suggested that the authority implement the measure gradually, starting with long holidays such as the coming four-day Easter break, or during the current flu surge, as these were periods when demand for public hospital services tended to be higher than usual.

Hong Kong public hospitals to offer refunds to residents who give up waiting

The authority’s data showed that an average of 4,759 people turned up daily at emergency departments from February 6 to 12 and the number rose to 5,902 the following week.

Hospital wards had to add extra beds to cope as occupancy rates exceeded 100 per cent.

Pang said the refund measure could be made a regular feature once the authority had enough experience implementing it and if it drew positive feedback.

But he also suggested doing more to encourage patients with non-urgent medical issues to seek treatment elsewhere.

“If a patient has decided to leave and applies for a refund, can they go to another private clinic directly and use the money paid at the emergency department to help cover the medical cost there?” he said.

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Dr David Christopher Lung, president of the Public Doctors’ Association, was also in favour of continuing the refund arrangement as a measure to ease the burden on public A&E departments, noting it did not require extra manpower or expense.

Latest data from the Centre for Health Protection showed that both Covid-19 and flu cases were on the rise. Between February 11 and 17, public laboratories handled 1,056 specimens that tested positive for Covid-19, almost double the 578 in the previous week.

There were 44 severe Covid-19 infections including 20 deaths from February 11 to 17, up from 25 severe infections including 10 deaths the week before.

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The city recorded 17 Covid-19 outbreaks, all in care homes for the elderly or people with disabilities, between February 11 and 17. Over the first four days of last week alone, 16 outbreaks were reported.

A similar trend was seen among flu infections, although the rise was less sharp than for Covid-19.

Public laboratories found more than 600 specimens were positive for flu viruses over the same period. They accounted for 6.6 per cent of all specimens tested, slightly up from 6.38 per cent the previous week.

The number of people admitted to hospital with flu was also slightly up.