While the Singaporean healthcare system has been ranked as one of the most efficient worldwide, Singaporeans appear to think differently. In fact, 72% of Singaporeans have been feeling like their healthcare system is failing them. This can be attributed to a number of reasons, ranging from more hospital attendance to longer wait times and a decline in medical resources such as hospital beds. In this study, we explore whether hospitals in Singapore are actually facing an overcrowding issue.
Is the Number of Hospital Beds Keeping Up With the Rate of Hospitalisations?
Due to the growing population and a growing number of Singaporeans getting admitted to hospitals, it can seem like hospitals are getting more crowded simply because there are now more people seeking care. For instance, recent data suggests that while the total population grew around 1.4% between 2015 and 2017, admissions to acute hospitals (which comprise both of general hospitals and specialty hospitals but barring psychiatric hospitals) increased by 13.6%. Even when we include psychiatric and community hospitals in our analysis, we can see that the change in hospital admittances per year has been growing at a faster rate than the population starting from 2010 onwards. Due to a variety of factors like an aging population, increasing mortality rates (death rates grew by 3.2% compared to the total population growth of 2.5% between 2014 and 2016) and medical tourism, a growing portion of people in Singapore are seeking hospital care, which could be causing hospital overcrowding especially if the supply of medical resources has not kept up.
Indeed, additional factors from the hospital's side may also be contributing to the feeling of overcrowding. For instance, one such factor could be that hospitals are struggling to add enough medical resources fast enough to supply the increase in demand. Overall, we found that the annual number of acute hospital patients per bed has increased sharply from 51 patients per bed in 2015 to 55 patients per bed in 2017. This increase was true for both public and private hospitals, indicating that the rate of growth for hospital beds has not been fast enough to keep up with the number of ailing Singaporeans.
Singaporean Hospitals Face Overcrowding in the Middle of the Week
While there is an overall increase in hospital admissions, there are times when hospitals experience an especially high level of congestion. Generally, our data shows that hospitals are more overcrowded on weekdays than on weekends. For instance, while the annual average is stated to be 85%, 2018 weekly data showed that 6 public hospitals in Singapore experienced the highest occupancy rates from Monday to Thursday.
Furthermore, long wait time is another good indicator of overcapacity in hospitals, since they often occur when there is not enough medical personnel or resources available for the number of patients. Data from the Ministry of Health's July 2018 weekly sample of 6 public hospitals found that the average wait time to be admitted to a ward from the emergency department is 2.5 hours. Furthermore, we found that hospitals have the longest wait times during the middle of the week, with an average wait time of 3.2 hours between Tuesdays and Thursdays compared to an average wait time of 1.6 hours on weekends and 2.3 hours on Monday or Friday. This further supports our findings that patients who are admitted to a hospital on a weekday will have a greater perception of overcrowding than those admitted on weekends.
Which Hospitals are the Most Overcrowded?
According to the weekly data from the Ministry of Health, Khoo Tek Phuat Hospital had the highest bed occupancy rate of 96%, with one day of the sampled week even going over 100% occupancy. However, it also had the lowest waiting time, indicating that turnover in the hospital may be fairly quick.
On the other hand, Tan Tong Seng Hospital had the longest waiting time average of 4.5 hours on a weekly basis. It also had the second highest bed occupancy rate of 95%, making it the most crowded hospital on average. On the other hand, the hospital that seems to be the least crowded would be Changi General Hospital, as it had the lowest bed occupancy rate of 85% and the second shortest wait time of 1.7 hours.
What This Means for Singaporeans
Unfortunately, because the geriatric population is growing more quickly than hospital facilities can realistically keep up with, it seems like more and more Singaporeans will experience overcrowding at hospitals. Furthermore, there may still be a chance that upcoming projects may not provide enough relief if the rate of hospitalisations continues to increase, especially because these projects take several years to be completed.
In the meantime, while age can lead to health issues regardless of lifestyle, younger Singaporeans can focus on disease prevention to prevent illnesses that will require hospital treatment. This includes eating healthy, exercising regularly and managing stress levels. However, those who are currently experiencing frequent trips to the hospital can consider purchasing a private hospital Integrated Shield Plan (IP) for the opportunity to stay at the more private A Wards or private hospitals with possibly shorter wait times. However, it is worth noting that IP's for private hospitals are around 127% more expensive than Ward A plans, implying a cost increase of anywhere from S$118 to S$1,527 depending on your age. Thus, you should weigh the increase in cost against the added convenience, especially as you get older and your premiums become more expensive.