Two-day wait for a bed

PETALING JAYA: With the emergency department at some government hospitals bursting at their seams, some doctors have said that the wait for beds can stretch to two days or more.

Speaking to The Star on condition of anonymity, doctors say the shortage of inpatient beds, overstretched resources and manpower crunch are the cocktail of reasons that have driven up the congestion at hospitals.

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At a government hospital in Sabah, an emergency physician said the wait time could go up to two days and stretch to beyond four to five on bad days.

“The main cause is there are insufficient inpatient beds. Therefore, patients have to wait in the emergency department to be admitted,” the doctor said.

While the long wait cannot be attributed as the cause of deaths among patients, it does indirectly contribute to further deterioration of the patient’s condition.

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“Indirectly I would say it is possible. For instance, the lack of intensive care unit (ICU) beds meant that patients stay longer in the emergency department rather than being transferred to the ICU where they will get better care,” he added.

However, the patients are treated while they wait for beds.

The emergency department crowd could get worse during a dengue outbreak, festive seasons, school holidays and long weekends.

Meanwhile, at a hospital in Kuala Lumpur, a doctor said the emergency department was already crowded at the time of writing.

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“The waiting time for patients to be seen can go up to three hours but waiting for admission can even be more than a day,” he said.

“In government hospitals they deal with multiple problems. This does not only include clinical issues but also poor infrastructure, lack of human resources, social issues and lack of specialists even.

“For a mere RM1, a patient is registered at the emergency department waiting to be seen. If admitted, then the patient is taken to the ward.

“However, there may be pending admissions which require more critical care. Hence, a patient may end up waiting longer at the emergency department as beds are limited and at times patients are managed in different wards,” he said.

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He added that while specialist care was given once the patient was admitted to the ward, some might require further intervention and sub-specialist review.

“In the process of specialist care, some hospitals don’t even have enough medical officers and house officers, hence the discharge process is delayed. Once the patient is planned for discharge, some families refuse to answer calls or take their family member back home. Now it has become a social issue,” he added.

He said staff quit when they become overburdened and could no longer manage.

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“This cycle repeats itself but statistics often are portrayed differently.

“For example, if a patient is admitted for a surgical procedure and the specific surgical treatment is delayed. What can be done is intravenous drip or medication first. Sometimes there is a treatment delay due to overload,” said the doctor.

Patients and their next of kin have also taken to social media to share their experiences on the delays of getting a bed that some have alleged that had claimed lives.

Meanwhile, Malaysian Medical Association president Dr Muruga Raj Rajathurai said the whole emergency department system needed to be looked into and this would involve the planning of human resources, facilities and admission system for each public hospital to address the issue of overcrowding at the emergency departments, manpower issues and unavailability of beds.

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“MOH will have the necessary data to address these issues and we believe it is being looked into as the Health Minister (Dr Zaliha Mustafa) has stated her strong commitment to address the issue of overcrowding at public healthcare facilities,” he said.

He added that while it was known that the country had been under-spending on healthcare, the government must ensure there are enough beds at hospitals.

On Jan 22, Dr Zaliha said the ministry would seek comprehensive solutions with stakeholders to address the issue of overcrowding at hospital emergency departments.

The Health Minister said this included extending working hours, streamlining bed management systems, and adding more healthcare providers.

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