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I. ANALYSIS OF RESULTS
1.1 Resident population
aThe resident population of Macao was estimated at 513 427 as at 31 December 2006, an increase of 6.0% compared with 2005. Among the resident population, 252 475 (49.2%) were male and 260 952 (50.8%) were female.
Table 1 : Population structure as at 31 December 2006
No. % Total resident population 513 427 100.0
Youth population (0-14 years old) 75 372 14.7 Adult population (15-64 years old) 402 028 78.3 Elderly population (65 years old and above) 36 027 7.0
1.2 Live births and mortality
In 2006, there were 4 058 live births, up by 10.5% over 2005. All the deliveries were carried out in hospitals, of which 2 002 (49.3%) were delivered in the Conde de S.
Januario Hospital and 2 056 (50.7%) in the Kiang Wu Hospital.
Table 2 : Indicators of live births
2004 2005 2006
Live births 3 308 3 671 4 058
Crude birth rate﹙‰﹚ 7.3r 7.8r 8.1
Year-on-year change﹙%﹚ 3.0 11.0 10.5
There were 1 566 mortality cases recorded in 2006, a decrease of 3.0% over 2005, of which 887 were male, sharing 56.6% of the total.
a The 2001 to 2005 population estimates and the respective indicators on mortality rate, birth rate, etc. have been revised according to the results of By-census 2006.
General Information
Number of mortality aged 60 and above was 1 129 (72.1% of the total). In addition, 11 infants died under the age of 1; the infant mortality rate was 2.7‰.
Table 3 : Indicators of mortality
2004 2005 2006 No.
Mortality 1 533 1 615 1 566
≧60 years old 1 135 1 199 1 129
< 1 year old 10 12 11
< 28 days 6 8 7
Perinatal mortality 20 16 17
Fetal mortality
(28 weeks of pregnancy and above)
4 5 9
‰
Crude mortality rate 3.4 3.4 3.1
Infant mortality rate 3.0 3.3 2.7
Neonatal mortality rate 1.8 2.2 1.7
Perinatal mortality rate 4.5 4.3 4.2
Late fetal mortality rate 1.2 1.4 2.2
1.3 Notifiable diseases
The Health Bureau received 3 897 cases of notifiable diseases in 2006, an increase of 59.6% over 2005, including 2 067 (53.0% of the total) cases of “Varicella (Chickenpox)”, 1 023 cases of “Enterovirus infection” and 379 cases of “Tuberculosis of lung”.
General Information
1.4 Summary of Health Care Survey
The 2006 Health Care Survey collected information from 651 health care establishments, comprising three hospitals providing hospital care, 434 establishments providing primary health care and 214 establishments providing Chinese medicine and therapy.
Within the 434 primary health care establishments, 421 (97.0%) were operated by the private sector, of which 369 were private clinics.
1.5 The ratio of residents to medical resources
According to the information provided by the Health Bureau, the number of doctors and nursesb were 1 149 and 1 212 respectively as at the end of 2006. The ratio of residents to doctor (excluding dentists) was 447:1 and the ratio of residents to nurse was 424:1, while the ratio of residents to dentist and odontologist was 3 093:1. In addition, the two hospitalsc provided 980 in-patient hospital beds (including beds for newborns) and the ratio of residents to hospital bed was 524:1.
b Doctors and nurses consist of:
- Doctors of western medicine and nurses working in the three hospitals and health care centres.
- Doctors of western medicine and nurses who are in private practice and registered with the Health Bureau.
Every doctor or nurse is counted once regardless of the number of establishments they work for.
c One of the three hospitals that rendered hospital care services in Macao did not provide in-patient services.
Primary Health Care
2.1 Persons engaged in primary health care
dInformation collected from 434 primary health care establishments showed that 1 577 persons were engaged in primary health care, including 606 doctors, 347 nurses, 75 dentists and 72 odontologists.
Table 4 : Persons engaged in primary health care by gender and occupation, 2006
GenderOccupation No. %
M (%) F (%) Total 1 577 100.0 36.7 63.3
Doctor 606 38.4 56.9 43.1
Dentist 75 4.8 60.0 40.0
Odontologist 72 4.6 83.3 16.7
Nurse 347 22.0 2.9 97.1
Medical laboratory technician 12 0.8 33.3 66.7 Diagnostic and therapeutic assistant 58 3.7 37.9 62.1 Technician of medical equipment 11 0.7 45.5 54.5
Sanitary agent 38 2.4 15.8 84.2
Health care assistant 168 10.7 20.2 79.8 Administrative staff 143 9.1 20.3 79.7
Others 47 3.0 40.4 59.6
Compared with 2005, the median age of the doctors decreased by 3.5 years to 44.1 when the median age of the nurses decreased by 1.6 year to 41.9.
2.2 Medical consultations
In 2006, primary health care establishments provided 2 279 774 medical consultationse, an increase of 10.0% over 2005. The majority related to “General medicine” (493 556), “Internal medicine” (292 154) and “Paediatrics/Neonatology”
(171 984).
d Doctors and nurses working for more than one establishment are counted repeatedly.
Primary Health Care
As regards regular primary health care services, most of the medical consultations pertaining to adult health care (246 815), child health care (70 692) and oral health care (44 213).
2.3 Vaccinations
A total of 126 214 vaccinations were administered in 2006, which included vaccinations against “Influenza” (39 282), “Hepatitis B” (17 920) and
“Anti-poliomyelitis” (15 727).
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 2006 amounted to MOP 313 000 and MOP 279 000 respectively.
The principal source of revenue of these establishments was provision of services, medicines and other medical products(81.4%). On the expenditure side, employees’ salaries and other in-kind payments shared 43.1% of the total, which was followed by Operating expenses (41.3%).
Hospital Care
3.1 Persons engaged in hospital care
fIn 2006, a total of 2 778 persons were engaged in the 3 hospitals in Macao, comprising 946 nurses, 490 doctors and 513 health care assistants.
Table 5 : Persons engaged in hospital care by gender and occupation, 2006
GenderOccupation No. %
M (%) F (%)
Total 2 778 100.0 31.0 69.0
Director of hospital/administration
and management 14 0.5 50.0 50.0
Doctor 490 17.6 59.0 41.0
Dentist 13 0.5 69.2 30.8
Nurse 946 34.1 5.5 94.5
Diagnostic and therapeutic
assistant 307 11.1 47.9 52.1
Health care assistant 513 18.5 32.4 67.6
Administrative staff 268 9.6 29.5 70.5
Others 227 8.2 49.8 50.2
Compared with 2005, the median age of the doctors decreased by 0.9 year to 37.9 and the median age of the nurses decreased by 0.8 year to 33.8.
3.2 Out-patient and emergency services
In 2006, the Conde de S. Januário Hospital provided 256 274 out-patient consultations, up by 1.8% over 2005. The majority of the consultations related to Orthopedics and traumatology (9.0%), Gynecology/Obstetrics (7.3%), Ophthalmology (7.3%), Psychiatry (7.1%), Dermatology (6.6%) and Paediatrics/Neonatology (5.6%).
The number of emergency treatments totalled 295 215 in 2006, down by 1.1%
compared with 2005; 38.6% of the emergency services users aged below 20 and 10.4% aged 65 and above.
Hospital Care
3.3 In-patient
In 2006, the two hospitals provided a total of 1 120 hospital beds, including 980 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 76.4%, up slightly by 0.5 percentage points compared with 2005.
There were 39 197 hospital admissions recorded in 2006, of which 8 664 were admitted to Gynecology/Obstetrics, 7 230 to Paediatrics/Neonatology and 3 647 to General surgery. Including the number of in-patients brought forward from 2005, the total for 2006 was 39 890, while the number of discharge was 39 190, the year-end balance of in-patients for 2006 was 700.
Total number of in-patient bed days was 273 404 in 2006, up slightly by 0.3%
compared with 2005; the majority were patients of Gynecology/Obstetrics (33 523 bed days).
3.4 Deliveries
In 2006, 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 9.6% over 2005 to 4 044 cases, of which 2 447 cases (60.5%) were eutocia.
Within the 1 597 cases of dystocia, 1 493 cases were of caesarean sections, 70 cases of ventouse and 34 cases of forceps deliveries.
3.5 Operations
There were 12 059 surgical operations performed in the 15 operating theatres in the two hospitals in 2006, of which 9 716 (80.6%) were major and medium surgical operations.
Hospital Care
3.6 Auxiliary diagnostic and therapeutic examinations
In addition, there were 3 434 834 auxiliary diagnostic and therapeutic examinations provided by the two hospitals and some of the primary health care establishments, up by 8.1% compared with 2005. Among the types of services provided, 77.0% attributed to Laboratory test, 6.4% Radiography and 5.5%
Anatomic pathology.
3.7 Blood products
In 2006, the number of blood donors increased by 1.4% over 2005 to 9 122 and 51.2% were male. Analysed by age group, 50.3% of the donors aged 17-24 and 21.9% aged 25-34; the median age of the blood donors was 24.4, down by 1.7 years over 2005.
The Blood Donation Centre provided 16 544 units of blood and blood components to the two hospitals, a decrease of 6.6% compared with 2005. Most of the components were concentrated erythroblast (61.0%) and platelet (19.8%).
3.8 Revenue and expenditure of hospitals
Current transfers (subsidies and donations) and provision of services were the main sources of revenue of the hospitals, which accounted for 83.2% and 15.0%
respectively of the total.
As regards expenditure, employees’ salaries and other in-kind payments and operating expenses accounted for 46.8% and 32.9% of the total respectively.
Hospital Care
Table 6 : Revenue and expenditure structure
% Revenue and expenditure 2004 2005 2006
Revenue
Provision of services 14.8 14.5 15.0 Current transfers
(subsidies and donations)
84.3 84.3 83.2
Other revenues 0.9 1.2 1.8
Expenditure
Employees’ salaries and other in-kind payments
59.2 54.2 46.8
Operating expenses 29.0 34.0 32.9
Other expenses 11.8 11.8 20.3
Chinese Medicine and Therapy Services
4.1 Persons engaged in Chinese medicine and therapy services
In 2006, there were 503 persons engaged in Chinese medicine and therapy services, an increase of 56 (12.5%) over 2005. Chinese herbalists and Doctors of Chinese medicine accounted for 33.0% and 23.7% of the total.
Table 7 : Persons engaged in Chinese medicine and therapy services by gender and profession, 2006
Gender Profession Total
M (%) F (%)
Total 503 59.8 40.2
Doctor of Chinese medicine 119 52.9 47.1
Chinese herbalist 166 80.7 19.3
Masseur* 16 87.5 12.5
Acupuncturist/therapist 6 83.3 16.7 Dispenser of Chinese medicine 116 50.9 49.1
Unpaid family worker 39 17.9 82.1
Others 41 46.3 53.7
* Services provided are more commonly known as “Tit-ta” or “Bone-setting”.
The median age of doctors of Chinese medicine was 35.5, the median age was 58.0 for Chinese herbalists, 53.0 for masseurs and 55.0 for acupuncturists/therapists.
4.2 Type of establishments
Among the 307 doctors of Chinese medicine, Chinese herbalists, masseurs, acupuncturists and therapists in Macao, 60.7% provided services in private clinics, 23.9% in Chinese medicine stores, 13.5% in out-patient departments of the hospitals and 1.3% in health care centres.
Chinese Medicine and Therapy Services
Table 8 : Doctors of Chinese medicine, Chinese herbalists, masseurs, acupuncturists and therapists by type of establishments, 2006
No.
Type of
establishments Total
Doctors of Chinese medicine
Chinese
herbalists Masseurs Acupunc-
turists Therapists
Total 318* 123 172 17 5 1
Public health care
centres 4 4 - - - -
Out-patient departments in hospitals
43 34 6 1 1 1
Private clinics 193 62 113 14 4 -
Chinese medicine
stores 76 23 53 - - -
Others 2 - - 2 - -
* Including 11 Chinese medicine practitioners that provided services in more than one establishment.
4.3 Professional qualifications and length of practice
With regard to educational attainment of the 307 doctors of Chinese medicine, Chinese herbalists, masseurs, acupuncturists and therapists, 72.3% had higher education or above in Chinese medicine and 19.2% had attended other courses in Chinese medicine. Those obtaining professional knowledge from family or from masters accounted for 4.2% each.
Table 9 : Doctors of Chinese medicine, Chinese herbalists, masseurs, acupuncturists and therapists by means of acquiring professional knowledge, 2006
Gender Total Higher education in
Chinese medicine
or above
Other courses in
Chinese medicine
From Family
From masters
Total 307 222 59 13 13
M 216 144 50 10 12
F 91 78 9 3 1
Chinese Medicine and Therapy Services
The median length of practice of the Chinese medicine practitioners was 19 years, whereas the median length of practice in Macao was 7 years. In addition, 49.9% had been practicing for 20 years or more while 35.6% had 20 or more years of practice in Macao and 55.0% had less than 10 years.
Table 10 : Years of practice of doctors of Chinese medicine, Chinese herbalists, masseurs, acupuncturists and therapists, 2006
%
Years 0-9 10-19 20-29 ≧30
Total length of practice 39.1 11.1 17.3 32.6 Length of practice in Macao 55.0 9.4 30.3 5.3
4.4 Consultations
In 2006, the Chinese medicine practitioners provided 669 040 consultations in Chinese medicine and therapy services; 64.3% were general treatment, 24.5% were bone-setting (Tit-ta), 6.8% were acupuncture and 3.5% were therapeutic/rehabilitative massage. Moreover, 65.3% of these services were provided at private clinics.
4.5 Consultation fees
The average consultation fees of acupuncture and therapeutic/rehabilitative massage were MOP 66 and MOP 80 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, 2006
MOP Services Including Chinese medicine Excluding Chinese medicineGeneral treatment 62 32
Bone-setting 92 70