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I. ANALYSIS OF RESULTS
1.1 Resident population
The resident population of Macao was estimated at 488 144 as at 31 December 2005, an increase of 4.9% compared with 2004. Among the resident population, 235 834 (48.3%) were male and 252 310 (51.7%) were female.
Table 1 : Population structure as at 31 December 2005
No. % Total resident population 488 144 100.0
Youth population (0-14 years old) 76 305 15.6 Adult population (15-64 years old) 371 490 76.1 Elderly population (65 years old and above) 40 349 8.3
1.2 Live births and mortality
In 2005, there were 3 671 cases of live births, up by 11.0% compared with 2004.
All deliveries of the live births were carried out in hospitals, of which 1 858 (50.6%) were delivered in Conde de S. Januario Hospital and 1 813 (49.4%) in Kiang Wu Hospital.
Table 2 : Indicators of live births
2003 2004 2005
Live births 3 212 3 308 3 671
Crude birth rate﹙‰﹚ 7.2 7.2 7.7
Year-on-year change﹙%﹚ 1.6 3.0 11.0
There were 1 615 mortality cases recorded in 2005, an increase of 5.3%
compared with 2004. Among these cases, 909 were male, sharing 56.3% of the total.
Mortality of those aged 60 and above was 1 199 (74.2% of the total). In addition,
General Information
Table 3 : Indicators of mortality
2003 2004 2005 No.
Mortality 1 474 1 533 1 615
≧60 years old 1 116 1 135 1 199
< 1 year old 2 10 12
< 28 days 1 6 8
Perinatal mortality 13 20 16
Fetal mortality
(28 weeks of pregnancy and above)
8 4 5
‰
Crude mortality rate 3.3 3.4 3.4
Infant mortality rate 0.6 3.0 3.3
Neonatal mortality rate 0.3 1.8 2.2
Perinatal mortality rate 4.0 4.5 4.3
Late fetal mortality rate 2.5 1.2 1.4
1.3 Notifiable diseases
There were 2 442 cases of notifiable diseases reported to the Health Bureau in 2005, a decrease of 16.3% over 2004, which included 1 411(57.8% of the total) cases of
“Varicella (Chickenpox)”. Other common causes included 362 cases of “Tuberculosis of lung” and 218 cases of “Enterovirus infection”.
1.4 Summary of Health Care Survey
In 2005, information was collected from 638 health care establishments, which included two hospitals providing hospital care, 425 establishments providing primary health care and 211 establishments providing Chinese medicine and therapy.
Within the 425 primary health care establishments, 412 (96.9%) were run by the private sector, among which 381 were private clinics.
General Information
1.5 The ratio of residents to medical resources
According to the information provided by the Health Bureau, number of doctors and nursesa were 1 105 and 1 134 respectively as at the end of 2005. The ratio of residents to doctor was 442:1 whereas the ratio of residents to nurse was 430:1. A further breakdown showed that the ratio of residents to doctor (excluding dentist) was 473:1, while the ratio of residents to dentist & odontologist was 3 170:1. In addition, the two hospitals provided 984 in-patient hospital beds (including beds for newborns) and the ratio of residents to hospital bed was 496:1.
a Doctors and nurses include:
- Doctors of western medicine, dentists and nurses working in the two hospitals and health care centres.
Primary Health Care
2.1 Persons engaged in primary health care b
Information collected from 425 primary health care establishments showed that 1 483 persons were engaged in primary health care, within which, 558 were doctors, 318 were nurses, 68 were dentists and 80 were odontologists.
Table 4 : Persons engaged in primary health care by gender and occupation, 2005
GenderOccupation No. %
M (%) F (%)
Total 1 483 100.0 37.8 62.2
Doctor 558 37.6 58.2 41.8
Dentist 68 4.6 64.7 35.3
Odontologist 80 5.4 82.5 17.5
Nurse 318 21.4 3.8 96.2
Medical laboratory technician 13 0.9 23.1 76.9 Diagnostic and therapeutic assistant 31 2.1 54.8 45.2
Technician of medical equipment 24 1.6 12.5 87.5
Sanitary agent 28 1.9 21.4 78.6
Health care assistant 182 12.3 19.8 80.2 Administrative staff 127 8.6 26.0 74.0
Others 54 3.6 29.6 70.4
Compared with 2004, the median age of the doctor decreased by 0.5 year to 47.6 when the median age of the nurse decreased by 0.2 year to 43.5.
2.2 Consultations
In 2005, primary health care establishments provided 2 073 103 consultationsc, an increase of 7.1% over 2004. The majority were of “General medicine” (472 440),
“Internal medicine” (299 281) and “Paediatrics/Neonatology” (183 444).
b Doctors and nurses working for more than one establishment are counted repeatedly.
Primary Health Care
As regards routine primary health care services, most of the consultations were related to Adult health care (250 430), Child health care (73 768) and Family planning (43 119).
2.3 Vaccinations
A total of 140 521 vaccinations were administered in 2005, which included vaccinations against “Influenza”(53 193), “Tetanus”(21 523) and “Anti-poliomyelitis”
(16 562).
2.4 Revenue and expenditure of private health care establishments
Based on the information provided by private primary health care establishments, the average revenue and expenditure per establishment in 2005 amounted to MOP 257 000 and MOP 221 000 respectively.
The principal source of revenue of these establishments was Provision of services, medicines and other medical products (85.6%). On the expenditure side, Operating expenses shared 44.8% of the total, which was followed by Employees’
salaries & other welfare (44.3%).
Hospital Care
3.1 Persons engaged in hospital care d
A total of 2 569 persons were engaged in hospital care in 2005, up by 5.6%
compared with 2004. Among them, 888 were nurses, 454 were doctors and 473 were health care assistants.
Table 5 : Persons engaged in hospital care by gender and occupation, 2005
GenderOccupation No. %
M (%) F (%)
Total
2 569 100.0 31.4 68.6
Director of hospital/administration
and management 15 0.6 60.0 40.0
Doctor 454 17.7 60.4 39.6
Dentist 11 0.4 72.7 27.3
Nurse 888 34.6 5.1 94.9
Diagnostic and therapeutic
assistant 284 11.1 47.9 52.1
Health care assistant 473 18.4 34.7 65.3
Administrative staff 155 6.0 28.4 71.6
Others 289 11.2 43.6 56.4
Compared with 2004, the median age of the doctors increased by 1.8 years to 38.8 in 2005; the median age of the nurses rose by 0.1 year to 34.6.
3.2 Out-patient and emergency services
In 2005, the Conde de S. Januário Hospital provided 251 676 out-patient consultations, up by 13.7% over 2004. The majority of the consultations were of Orthopedicsand traumatology (8.5%), Gynecology/Obstetrics(7.5%), Ophthalmology (7.5%), Dermatology (6.7%) and Paediatrics/Neonatology (6.5%).
In 2005, the number of emergency treatments totalled 298 449, a rise of 11.8%
compared with 2004. Over 40% of the emergency services users aged below 20;
those aged 65 and above accounted for 10.5%.
Hospital Care
3.3 In-patient
In 2005, the two hospitals had 1125 hospital beds, of which 984 were in-patient hospital beds. The hospital bed occupancy rate (ratio of the number of hospital beds occupied to the number of hospital beds available) was 73.9%, up by 1.1 percentage points compared with 72.8% recorded in 2004.
There were 38 326 hospital admissions recorded in 2005, of which 8 053 were admitted to Gynecology/Obstetrics, 7 350 to Paediatrics/Neonatology and 3 280 to General surgery. Total number of in-patients in 2005 was 38958, including the balance brought forward in 2004, while the number of discharge was 38 265;
therefore, the year-end balance of in-patients was 693.
Total number of in-patient bed days was 272722 in 2005, an increase of 11 329 bed days (4.3%) compared with 2004; the majority were patients of Paediatrics/Neonatology (33 247 bed days).
3.4 Deliveries
In 2005, the two hospitals had 5 pre-delivery rooms and 7 delivery rooms, providing 11 and 13 hospital beds respectively. Total number of deliveries increased by 11.2% over 2004 to 3 689 cases, of which 2 266 cases (61.4%) were eutocia.
Within the 1423 cases of dystocia, 1 274 cases were of caesarean sections, 71 cases of ventouse, 73 cases of forceps deliveries and 5 cases of breech deliveries.
3.5 Operations
In 2005, there were 11 446 surgical operations performed in the 15 operating theatres in the two hospitals, of which 9 062 (79.2%) were major and medium surgical operations.
Hospital Care
3.6 Auxiliary diagnostic and therapeutic examinations
In 2005, there were 3 178 678 auxiliary diagnostic and therapeutic examinations provided by the two hospitals and some of the primary health care establishments, up by 7.6% compared with 2004. Among the type of services provided, 77.5% attributed to Laboratory test, 5.9% Radiography and 5.6% Anatomic pathology.
3.7 Blood products
In 2005, there were 8 999 blood donors and 53.0% were male, an increase of 14.3% over 2004. Analysed by age group, 47.0% aged 17-24 and 25.6% aged 25-34;
the median age of the blood donors was 26.1, down by 1.8 years over 2004.
The Blood Donation Centre provided 17 707 units of blood and blood components to the two hospitals in 2005, up by 0.5% compared with 2004. Most of the components were Concentrated erythroblast (57.9%) and Platelet (18.0%).
3.8 Revenue and expenditure of hospitals
In respect of main source of revenue of the hospitals, Current transfers (subsidies or donations) and Provision of services accounted for 84.3% and 14.5% of the total.
As regards expenditure, Employees’ salaries and other welfare and Operating expenses accounted for 54.2% and 34.0% of the total respectively.
Hospital Care
Table 6 : Revenue and expenditure structure
% Revenue and expenditure 2003 2004 2005
Revenue
Provision of services 13.5 14.8 14.5 Current transfers
(subsidies or donations)
85.6 84.3 84.3
Other revenues 0.9 0.9 1.2
Expenditure
Employee’s salaries and other welfare 59.1 59.2 54.2
Operating expenses 30.4 29.0 34.0
Other expenses 10.5 11.8 11.8
Chinese Medicine and Therapy Services
4.1 Persons engaged in Chinese medicine and therapy services
In 2005, there were 447 persons engaged in Chinese medicine and therapy services, an increase of 73 persons (19.5%) over 2004. Chinese herbalists and Dispensers of Chinese medicine accounted for 40.5% and 25.1% of the total.
Table 7 : Persons engaged in Chinese medicine and therapy services by gender and profession, 2005
Gender Profession Total
M (%) F (%)
Total 447 62.0 38.0
Doctor of Chinese medicine 67 49.3 50.7
Chinese herbalist 181 80.7 19.3
Masseur* 16 87.5 12.5
Acupuncturist 6 83.3 16.7
Dispenser of Chinese medicine 112 55.4 44.6
Unpaid family worker 36 16.7 83.3
Others 29 37.9 62.1
* Services provided are more commonly known as “Tit-ta”.
The median age of doctors of Chinese medicine was 37.0, while the respective median age for Chinese herbalists was 58.0, 55.0 for masseurs and 50.0 for acupuncturists.
4.2 Type of establishments
Among the 270 doctors of Chinese medicine, Chinese herbalists, masseurs and acupuncturists in Macao, 68.1% of them provided services in private clinics, 27.0% in Chinese medicine stores, 1.1% in other establishments rendering Chinese medicine and therapy services, 2.8% in out-patient departments of hospitals and 1.1% in health care centres.
Chinese Medicine and Therapy Services
Table 8 : Doctors of Chinese medicine, Chinese herbalists, masseurs and acupuncturists by type of establishments, 2005
Type of establishments Total
Doctors of Chinese medicine
Chinese
herbalists Masseurs Acupunc-turists
Total 282* 71 187 17 7
Public health care centres 3 3 - - -
Out-patient departments in
hospitals 8 4 4 - -
Private clinics 192 48 123 15 6
Chinese medicine stores 76 15 60 - 1
Others 3 1 - 2 -
*
Including 12 Chinese medicine practitioners that provided services in more than one establishment.4.3 Professional qualifications and years of practice
With regard to educational attainment of the 270 doctors of Chinese medicine, Chinese herbalists, masseurs and acupuncturists, 62.6% had higher education in Chinese medicine and 26.3% had taken courses in Chinese medicine. Those who obtained professional knowledge from family or from masters accounted for 5.6% each.
Table 9 : Doctors of Chinese medicine, Chinese herbalists, masseurs and acupuncturists by means of acquiring professional knowledge, 2005
Gender Total Higher education in
Chinese medicine
or above
Other courses in
Chinese medicine
From family
From masters
Total 270 169 71 15 15
M 198 111 61 12 14
F 72 58 10 3 1
Chinese Medicine and Therapy Services
The median duration of practice in Chinese medicine and therapy services was 22.0 years, whereas the median duration of practice in Macao was 10.0 years. In addition, 55.9% had practiced Chinese medicine for 20 years or more; 41.5% had 20 or more years of practice in Macao and 48.1% had less than 10 years of practice in Macao.
Table 10 : Years of practice of doctors of Chinese medicine, Chinese herbalists, masseurs and acupuncturists, 2005
%
Years 0-9 10-19 20-29 ≧30
Total duration of practice 33.3 10.8 18.5 37.4 Duration of practice in Macao 48.1 10.4 35.6 5.9
4.4 Consultations
In 2005, the Chinese medicine practitioners provided 619 640 consultations in Chinese medicine and therapy services, 64.4% were general treatment, 25.3% were bone-setting (Tit-ta), 5.9% were acupuncture and 4.2% were therapeutic/ rehabilitative massage. Moreover, 70.2% of these services were provided at private clinics.
4.5 Consultation fees
The average consultation fees of acupuncture and therapeutic/rehabilitative massage were MOP 57 and MOP 74 per session respectively. The average consultation fees of general treatment and bone-setting were as follows:
Table 11 : Average consultation fees of general treatment and bone-setting, 2005
MOP Services Including Chinese medicine Excluding Chinese medicineGeneral treatment 58 32
Bone-setting 83 53