Assoc Prof Jamus Jerome Lim asked the Minister for Health for each year over the past 10 years (a) how many cases of non-emergency and non-critical admissions to public hospitals took place; (b) how many of such cases claimed hospital stays from their MediSave or MediShield Life insurance policies; (c) how many of such patients are deemed to have “overstayed”; and (d) whether the Ministry has plans to discourage unnecessary hospitalisations by offering cash incentives for those who do not make hospitalisation insurance claims for the entire year.
The Senior Parliamentary Secretary to the Minister for Health (Ms Rahayu Mahzam) (for the Minister for Health): Mr Speaker, hospital admissions are based on clinical necessity. Some patients have medical conditions that are non-urgent and yet inpatient care is medically necessary. They account for about 20% of all public hospital admissions, which has been a stable percentage over the past 10 years. As these admissions are medically necessary, they can tap on MediSave and/or MediShield Life.
Some patients stay longer in our hospitals as their homes are not ready to receive them. To minimise such over-staying in hospitals, we try our best to right price and right site patients. This includes improving and expanding our Transitional Care Facilities and home care services to provide post-discharge care.
We need to be very careful about offering incentives to reward non-claims. It can discourage some, especially the lower-income, from seeking medically necessary care.
Mr Speaker: Assoc Prof Lim.
Assoc Prof Jamus Jerome Lim (Sengkang): I thank the Senior Parliamentary Secretary for the response. My question builds a little bit on the discussion in the last Sitting by Senior Minister of State Janil Puthucheary about transition care. Hence, I am wondering to what extent the Ministry has an intent to ramp up transition care and hence, this notion of discouraging excessive hospitalisation by shifting those who would otherwise be staying in hospitals because there is not sufficient Transitional Care Facilities. I am wondering to what extent some kind of incentives, like I suggested in the Parliamentary Question, are being considered by the Ministry of Health (MOH)?
Ms Rahayu Mahzam: Firstly, I would like to thank the Member for recognising the need to prioritise beds in the public hospitals for those who really them. Indeed, this is something that we need to grapple with. The concern, though, in respect of the suggestion of incentives, is that we put incentives in place to nudge the right behaviours. We are really concerned if we put the wrong incentives, because then, there may be a perverse reaction of people not getting the treatment they need if they are actually being rewarded for not making a claim.
Having said that, I think the larger part of the question is an important one, in relation to transitional care. Indeed, it is something that we have been looking into, as mentioned in my reply. I had said that we are already ramping up and looking into our Transitional Care Facilities – which are already in place, but we are ramping up and expanding.
We are also making sure that there is a suite of homecare services that will help address some of the needs, post-discharge. This is something we would continually have to look at, as you can see there is a larger shift towards preventive care, towards Healthier SG. This is something we want to encourage – for more residents to look at the larger picture. We really want to shift care within the community, get people to stay healthy within the community so that we can shift a lot more of these concerns away from the hospitals.
Ministry of Health
16 February 2024
https://sprs.parl.gov.sg/search/#/sprs3topic?reportid=oral-answer-3462
Office of the Leader of the Opposition 