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Sunday, 16 February 2014

'Make way for real emergencies'

Patiently waiting: A crowd waiting in line to register at the HKL emergency department.

Patiently waiting: A crowd waiting in line to register at the HKL emergency department.

PETALING JAYA: Malaysians are treating the emergency room of government hospitals as a cheap one-stop centre for minor ailments, resulting in congestion and patients with serious injuries or illnesses having to vie for medical attention.

Of over 2.3 million patients seeking treatment at ERs – also known as emergency and trauma departments – in the first six months of last year, more than 70% or 1.6 million cases were non-critical.

The number is almost 19 times the number of critical cases (85,893) and about 2.7 times that of semi-critical cases (601,483).

Health Ministry deputy director-general Datuk Dr S. Jeyaindran said the high number of non-critical patients seeking ER treatment is putting a strain on the public health system which charges each patient only RM1.

“Non-life-threatening cases, like dog bites, account for some 70% of the patients congesting ERs,” he said.

According to ministry statistics, some 2,301,355 patients were treated in ERs nationwide from January to June last year. This works out to an average of 125,785 ER patients treated per night at 144 public hospitals across the country.

“The number of ER patients have risen with hospitals like Tengku Ampuan Rahimah Hospital in Klang seeing between 15% and 20% more cases over the last two years,” he said.

Dr Jeyaindran explained that patients entering ERs are categorised red (emergency), yellow (urgent) or green (non-life-threatening).

Red cases, he warned, could lead to death if there was no immediate intervention and include patients with cardiovascular diseases, severe infections, respiratory conditions and trauma.

He said that yellow cases are non-emergencies such as an injured limb that require treatment within the next few hours while green cases are non-critical ailments.

To cope with the rise in ER cases, the ministry is studying a proposal to extend the hours of government clinics permanently by getting doctors to work shifts.

Most government clinics open from 8am to 5pm. In clinics that are open until 10pm, the doctors are paid overtime, Dr Jeyaindran said.

“To optimise service without increasing costs, we are conducting a pilot project at a clinic in Putrajaya where doctors work shifts.

“If successful, doctors will be required to work shifts at selected government clinics nationwide,” he added.

On the increase in dengue cases nationwide, Dr Jeyaindran said the ER fever centres at hospitals in Sungai Buloh, Selayang, Ampang, Klang, Serdang, Tanjung Karang, Sabak Bernam, Banting, Kajang and Kuala Kubu Bharu saw 2,076 patients last weekend.

“If you feel feverish, go to a government clinic,” he said.

“There’s no need to go to an ER. These clinics are equipped to check and monitor your condition.”

Fomca secretary-general Datuk Paul Selvaraj advised patients to stop abusing ERs for non-emergency cases.

“Be considerate, ER treatment is based on need, not on a first-come-first-served basis,” he said.

Malaysian Medical Association president Datuk Dr N.K.S. Tharmaseelan said the ER resembled a primary care clinic because of a lack of civic consciousness among Malaysians.

“Many refused to brave the long queues at outpatient clinics during office hours so they take the easy way out by visiting the ER,” he said.

Penang Hospital board of visitors chairman Lim Thoon Deong said miscommunication sometimes caused misunderstanding among patients.

“For example, a patient with stroke symptoms must undergo medical tests and observation.

“If no one explains this to the patient, he will think that the hospital is not doing anything,” he said, advising non-emergency patients to seek treatment at 1Malaysia clinics if they could not afford private healthcare.

Patients calling for faster treatment at emergency rooms

Many private hospitals open 24hour primary clinics

Tags / Keywords: Health , long wait at emergency department


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