THE HONG KONG MEDICAL ASSOCIATION

Transcription

1 THE HONG KONG MEDICAL ASSOCIATION REPORT OF DOCTORS FEES SURVEY 2006 May 2006 PREPARED BY THE HONG KONG MEDICAL ASSOCIATION

2 BACKGROUND The Hong Kong Medical Association has been conducting the Survey on Doctors Fees regularly since 1991 aiming at gathering information on the prevailing charges of medical services in the private sector. It has been four years since the last survey on doctors fees in private practice. Recently, some insurance companies attempted to set fees for various medical procedures. It was against this background that the Association considered it timely to conduct another survey on fees for the reference of both the profession and the public. This report outlines the results of the survey conducted from March to April 2006, which was the eighth exercise ever since. METHODOLOGY Two batches of questionnaires with serial numbers labeled from to were printed. The first batch was sent to 2,736 HKMA members who were private practitioners in Hong Kong on 15 March 2006 (Wednesday). Respondents were asked to return their feedback by 25 March questionnaires were returned in the first round. The questionnaires with serial numbers returned were sorted out and the rest (2,274 copies) were sent again on 3 April 2006 (Monday) with revised and extended deadline as 25 April Another 241 were returned in the second round. Thus, a total of 703 questionnaires were received. The response rate was 25.7%. RESULTS A. Mode of Practice 658 respondents had indicated their mode of practice. Among them, 358 (54.4%) indicated that they were general practitioners while 212 (32.2%) indicated that they were in specialist practice only. 88 (13.4%) of the respondents indicated they practised both as GP and specialists. Frequency Percent 13% GP or Specialist GP Specialist Both Total Table 1. Statistics for General Practitioners and Specialists 32% 55% General Practice Specialist Practice Both GP and SP Fig. 1. Pie Chart for General Practitioners vs. Specialists B. Daily Hospital Attendance Charge Median 1,500 1, th Percentile 1, th Percentile 3,000 1, Table 2. Statistics of Respondents Daily Hospital Attendance Charges 1

3 C. Bedside Procedures Median 3,200 2,000 1, th Percentile 1, th Percentile 8,000 6,000 4,000 Table 3. Statistics of Respondents Bedside Procedure Charges The commonest bedside procedures listed include: Chest tapping Lumbar puncture Chemotherapy infusion Echocardiorgram Joint aspiration D. Ultra-major, most frequently performed in-theatre/laboratory operative procedure This category was not surveyed in Median 80,000 60,000 40, th Percentile 40,000 30,000 10, th Percentile 162, ,000 65,500 Table 4. Statistics of Respondents Charges on Ultra-major, most frequently performed in-theatre/laboratory operative procedure The commonest ultra-major operative procedures listed include: Total joint replacement Oesophagectomy Wertheim s operation (radical abdominal hysterectomy) Radical prostatectomy Whipple operation (radical pancreatoduodenectomy) E. Major, most frequently performed in-theatre/laboratory operative procedure Median 45,000 30,000 20, th Percentile 30,000 20,000 14, th Percentile 80,000 60,000 35,000 Table 5. Statistics of Respondents Charges on Major, most frequently performed intheatre/laboratory operative procedure The commonest major operative procedures listed include: Hysterectomy Caesarean section Laminectomy Thyroidectomy Angioplasty Mastectomy Laparoscopy cholecystectomy 2

4 Nephrectomy Mastoidectomy F. Intermediate, most frequently performed in-theatre/laboratory operative procedure Median 29,000 18,000 12, th Percentile 12,900 10,000 7, th Percentile 45,000 30,000 20,000 Table 6. Statistics of Respondents Charges on Intermediate, most frequently performed intheatre/laboratory operative procedure The commonest intermediate operative procedures listed include: Ovarian cystectomy Arthrocopic surgery Cardiac catheterization Cataract Breast biopsy Herniorrhaphy Hemorrhoidectomy Tympanoplasty Tonsillectomy Laparoscopy ovarian cystectomy G. Minor, most frequently performed in-theatre/laboratory operative procedure Median 8,000 6,000 4, th Percentile 4,000 3,000 2, th Percentile 15,000 10,000 6,000 Table 7. Statistics of Respondents Charges on Minor, most frequently performed intheatre/laboratory operative procedure The commonest minor operative procedures listed include: D & C Excision of Sebaceous cyst, other cysts Endoscopy (OGD, colonoscopy, nasopharynx & larynx, bronchoscopy) Circumcision Incision & curettage H. General Practitioners For respondents who had answered the section on General Practitioners, the results of their various charges are shown below. Regular Consultation ($) Days of medication Charges for therapeutic Additional charges ($) Included procedures ($) Median th Percentile th Percentile ,000 Table 8. Statistics for General Practitioners Charges 3

5 Examples of therapeutic procedures performed by general practitioners in their clinics include: Excision of lumps & bumps Suturing Dressing Ear syringing Cauterization ECG Incision & drainage Circumcision I. Specialist Practice For respondents who had answered the section on specialist practice, the results of their various charges are shown below. Regular Consultation ($) Days of medication Charges for therapeutic Additional charges ($) Included procedures ($) Median th Percentile th Percentile ,000 Table 9. Statistics for Specialists Charges Examples of therapeutic procedures performed by specialist in their clinics include: Excision of sebaceous cyst ECG Cauterization IUCD insertion Ultrasound examination Chemotherapy Incision & curettage Application of cast Endoscopy (gastroscopy, larynx & nasopharynx) Wound dressing J. Vaccines Charges for various vaccines were indicated in the table and figure that follow. Antitetanus Chickenpox Hep. A 2 dose Hep. A 3 dose Hep. B Adult Hep. B Child Influenza Median th Percentile th Percentile Table 10. Statistics for Respondents Usual Charges on Various Vaccines K. Medical Reports Charges for different types of medical reports were indicated in the table below. Simple Patient Detailed Patient Simple Medical Insurance Company Detailed Medical Insurance Company MMR Medical Insurance Company with assessment of disability Median , th Percentile th Percentile 659 1,500 1,000 2,000 10,000 Table 11. Statistics for Charges for Medical Reports 4

6 L. Insurance Claim Forms Charges for simple and complex insurance claim forms were indicated in the table below. Results showed that most of the respondents did not charge for completing the forms. Simple Insurance Claim Form Complex Insurance Claim Form Median th Percentile th Percentile Table 12. Statistics for Charges for Completing Insurance Claim Forms M. Fee Adjustment Results showed that 78% of the respondents did not adjust their fees in the past 12 months. 18% increased while only 4 % reduced their fees. Pattern of response and changes were indicated in the figure and table below. Decreased 4% Increased 18% Fee Adjustment No Change 78% Increased (%) Decreased (%) Median th Percentile th Percentile Table 13. Statistics for Percentage Changes in Fees Over the Past 12 Months Fig. 2. Fee Adjustment Pattern compared with the Past 12 Months For those who did not change their fees, the reasons were: No reason or need to change Poor economy, number of patients falling Competition Fresh start of practice No adjustment of reimbursement by insurance company For those who raised their fees, the reasons included: Increase in rent Increase in drug costs Increase in MPS insurance Increase in salaries Increase in overall cost expenses For those who lowered their fees, the reasons included: Competition Poor economy Exploitation by HMO Patient number falling 5