Overcrowded hospitals leave patients out in the cold

Nov 21, 2008 - 7:00:00 AM

Patients have died waiting for a doctor as some hospitals are filled with 10 times more patients than they can handle. Without enough money, doctors or plans, urban hospitals are filled to the brim with patients they have neither the time nor facilities to treat. HCM City Children Hospital No.2 is now operating at 10 times its regulated capacity, said deputy director Nguyen Van Thao. Thao says that each doctor at the hospital consults with between 100 and 120 patients per day. The overloading is especially heavy on Mondays when some 5,000 children show up on average, he said, adding that the hospital only had room to examine 500 patients a day. A department head at the hospital who requested anonymity said each doctor could only help 15-25 patients each night. But he said that on some nights, each doctor was in charge of some 100 children. At the Tumor Hospital, patients commonly wait for three days to complete a medical examination and some patients have to wait several months for surgery. Director Le Hoang Minh said the hospital received 231,777 patients in 2003 but that the figure last year had increased by nearly 100,000. Preliminary statistics from the first 10 months of this year show higher numbers than for all of last year, according to Minh. The Tumor Hospital currently has only 1,100 beds for its 1,577 patients. At full capacity, the hospital is only designed to accommodate some 6,500 people per year. But 10,995 patients received surgery there last year. Gia Dinh People's Hospital received 745,268 inpatients last year, over 50% more than it did in 2000. Even at HCM City's Cho Ray Hospital, largely regarded as the country's best public hospital, many patients wait in the hallways for three or four days before receiving examinations or treatment. Two patients often share one bed, or even lie on stretchers in the corridors. Former director of the HCM City Cardiology Institute Dr Nguyen Ngoc Chieu said some patients at his centre wait a full year for surgery. He said several patients have died waiting. Last year, local hospitals' beds were filled to 122.4% of their capacity on average, the Ministry of Health reported at a national conference held early this year in Hanoi. Cause and effect Overcrowding is partially due to the expertise gap between doctors at provincial and district-level hospitals and those who work at city hospitals, said Minh. He also said the smaller hospitals outside the city lacked facilities, infrastructure and staff. Due to these reasons, rural citizens often bypass their local hospitals and flood city medical centres instead, he said. As for the shortage of doctors, a report released at a conference on the hospital overpopulation problem held mid-year in HCM City said the city needs 2,000 more doctors than it has. There were just seven doctors in the city for every 10,000 patients last year, said the report. The number is closer to 20/10,000 in several regional countries. Another problem is that most hospitals don't recognise the results of tests done at other hospitals. So transferred patients often spend a lot of time and money re-testing when they switch hospitals, clogging up facilities. Thao said the overloading makes it hard for doctors to do their jobs effectively. Dr Nguyen Thanh Giang from Children Hospital No.2 said mistakes take place much more often when facilities are overcrowded. Suggesting solutions Tumour Hospital deputy director Pham Xuan Dung said the health sector needed more investment to build more modern hospitals and health centres. But he said doctor training was the most important solution needed. He also suggested adjusting fees to make city and provincial hospitals- especially specialised ones- more expensive while making district commune health centres cheaper. Hospital fees are currently the same at all public hospitals. However, Dung said such a solution would need careful consideration because it could make access to medicine unfair, Dung said. Other solutions include the transfer of treatment technologies from central hospitals to district-based hospitals to lessen the overloading at the former. In a recent meeting with National Assembly representatives, the Ministry of Health reported that the overloading of province and city-level hospitals nationwide had decreased by over 5% year-on-year after new hospitals were built and many existing hospitals added beds and expanded their facilities.