Hong Kong and Singapore face the same pressures when it comes to discharging patients and finding them viable transitional care and long-term discharge support services.
The key difference is that Singapore’s hospitals recognise the usefulness of home-care services in the private sector.
Medical social workers in Singapore’s public hospitals have a fairly open-minded and pragmatic approach and would not hesitate to consider all post-hospitalisation care options in the community.
Discharge advice is given based on what the patients need, instead of the nature of the service providers.
Whether a service provider is non-profit or profit-making should not be a primary criterion when it comes to discharge advice.
Most of the medical social workers I have talked to who are embedded in hospitals in Hong Kong have shown what can only be described as an overwhelming shyness as soon as they hear the phrase “private home-care company”. By contrast, medical social workers and care coordinators from public hospitals in Singapore go as far as inviting private home-care service providers to hold information sessions to educate themselves on what services in the community are available to patients who are leaving their hospitals.
In Hong Kong, patients are often referred to other NGO-run post-hospitalisation services or simply given a list of nursing or care homes in their residential areas. To many patients, these are simply not what they want.
I have seen hospital staff, who were oblivious to the fact that there were already viable home-care services available, telling a middle-aged patient that his only realistic prospect after discharge was a nursing home, possibly for life.
Perhaps to some, he was just another successful discharge to be included in a report. To the patient, his entire way of life was at stake.
The NGOs are providing vital support to patients but they simply cannot serve every single need.
With life expectancy, age dependency ratio and the population of seniors all on the rise, the number of patient discharges will undoubtedly increase.
We cannot stop what is coming our way. So we cannot keep doing the same things and expect different results.
Much like medical advice, it is the doctor’s responsibility to provide patients with an unbiased presentation of all available options.
Giving discharge advice should be no different.