Health experts tackle hospital overcrowding

Long queues at clinics a persistent problem

Health officials are pinning their hopes on new measures to tackle overcrowding at state-run hospitals, an issue feared to have a catastrophic effect on the Thai healthcare system.

The problem was recently raised by Chulalongkorn Hospital doctor Thiravat Hemachudha, who supervises a scientific centre for emerging diseases, in a Facebook message.

He said a hospital in the Northeast was struggling to find beds for 70 inpatients, as it only has room for 28.

Responding to the reports, public health permanent secretary Sukhum Kanchanaphimai said some patients who do not get a bed are left sleeping on the hospital’s balconies or walkways without mosquito nets, which exposes them to mosquito-borne diseases such as dengue fever.

The recently-appointed permanent secretary admitted that overcrowding has persisted in state-run hospitals for more than 10 years.

Dr Sukhum said he will use a mix of measures designed to redistribute patients among hospitals and reduce their numbers at the same time.

These make up a package of measures which is to be incorporated in the 20-year national strategy. “But I don’t think we have to wait that long to see a successful outcome,” he said.

If authorities act quickly enough to implement the measures, the overcrowding might begin to ease in two to four years, he said.

Dr Sukhum explained the first measure involves better management of patient transfers between hospitals.

Instead of medical staff in one hospital being bombarded with patients, a new referral plan will be devised to transfer patients to nearby medical facilities in and outside of a province.

The second measure is sending those who are recovering from illnesses to smaller hospitals if they are no longer dependent on high-tech medical equipment.

This will keep patients from flooding better-equipped hospitals.

The ministry has experimented with the measures for six months with a satisfatory result. It has reduced overcrowding at the Sunpasithiprasong Hospital in Ubon Ratchathani by 10%, acting deputy permanent secretary for public health Praphon Tangsikiatkun said.

Sunpasithiprasong is among the regional hospitals adequately equipped to deliver complicated treatments, which are almost always fully occupied and have long waiting lists. But after it transferred patients who were in a recovery stage to Warin Chamrap hospital, its workload was reduced, Dr Praphon said.

Statistically, he said, inpatients overwhelm regional hospitals while at tambon health promotion centres, or those at the sub-district level, occupancy stands at an average of 68%.

The ministry has sent a team of doctors to villages under the Primary Care Cluster, or PCC, scheme. If they can gain people’s trust and provide useful advice, the sick will feel more confident about getting treated at facilities other than large hospitals, Dr Sukhum said.

Hospital queue management can also be improved by online appointments. This gives medical staff a better idea of how many patients will be meeting doctors or admitted to the hospital on a given day.

Patients are encouraged to take better care of their health. This, he said, will ultimately reduce the number of hospital visits.