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Number of nurses far below average

Nelson Moura

The average number of doctors and nurses per 1,000 inhabitants continues to rise and is above the average defined by the Organization for Economic Co-operation and Development (OECD) for the Asia-Pacific region. However, the ratio of nurses to doctors in Macao remains one of the lowest in the region.

At the end of 2022, there were a total of 1,965 doctors in Macau, 4.1 percent more than in 2021, or 2.9 doctors per 1,000 inhabitants, according to data on registered professionals provided by the Health Services.

At the same time, the city had 2,863 nurses, 4.4 percent more than the previous year, or 4.3 nurses per 1,000 inhabitants.

When compared to 2018, the percentage of doctors per 1,000 inhabitants increased by just 0.4 percentage points, with the percentage of nurses registering a greater increase of 0.8 percent.

About 906 doctors and 1,919 nurses worked in local hospitals, with 924 doctors and 487 nurses employed in primary care facilities.

Local hospitals had 559 specialist physicians, up 4.3 percent year-on-year, with 95 specialists in internal medicine and 74 in general surgery.

One cannot overlook the approximately 724 doctors of traditional Chinese medicine, employed in 337 establishments, half of which were polyclinics.

Regional comparisons

According to the World Health Organization, globally, the ratio of physicians to other healthcare professionals was about 1/1.5.

In a 2022 report, the Organization for Economic Co-operation and Development (OECD) pointed out that the number of physicians per 1,000 population varies greatly across Asia-Pacific countries and territories, but is generally lower than the OECD average.

In countries and territories with incomes defined as ‘low’ or ‘low-middle’ in Asia-Pacific, there were on average 1.1 physicians per 1,000 population, while a greater number of physicians – 1.6 per 1,000 population – are recorded in countries and territories of ‘medium-high’ incomes.

Mongolia, Australia and North Korea have the highest number of doctors per capita, with 3.9, 3.8 and 3.7 doctors per 1,000 population, respectively; slightly higher than the OECD average of 3.6.

In contrast, Papua New Guinea, Cambodia and the Solomon Islands have the lowest number of doctors equal to or less than 1 per 5,000 population.

At the same time, nurses in the Asia-Pacific region outnumber physicians, with 1.7 and 2.1 nurses per physician in ‘low-middle’, ‘low’ and ‘upper-middle’ income countries.

According to the OECD, Macau and mainland China have a ratio of 1.4 below the region’s average of 1.9 for ‘low-middle’ and ‘low’ income countries and well below the 3.0 recorded in Hong Kong.

“Asia-Pacific countries and territories need to respond to the ever-changing demand for health services and, therefore, the skill mix of health professionals in the context of rapidly aging populations,” points out the same WHO report.

The OECD definition of doctors includes general practitioners, including family and primary care practitioners, and specialist physicians, while the definition of nurses refers to practicing nurses who provide services directly to patients.

This includes professional nurses, professional associate nurses and foreign nurses licensed to practice and actively practice in the country.

With a view to helping different countries and territories to achieve universal health coverage by 2030, the World Health Organization has published global strategic guidelines that indicate how to strengthen services and human resources in health.

During 2022 in Macau, 1,227,235 individuals were seen in traditional Chinese medicine consultations at various health establishments, 6.2 percent less than in 2021.

The four hospitals in Macau provided a total of 1,721 inpatient beds at the end of 2022, 23 less than at the end of 2021, with 60,609 inpatients, 3.8 percent more year-on-year.

The average period of hospitalization of patients was 8.2 days, 0.5 more days compared to 2021.

Outpatient consultations in hospitals received 1,931,195 individuals in 2022, 1.6 percent less than in 2021, with each Macao inhabitant being seen an average of 2.9 times.

In 2022, around 373,080 individuals were seen in emergency services, with general illnesses being the main cause of admission to emergency services, representing 96.3% of the total, followed by pregnancy (7,298) and road accidents (2,239).

The MSAR also had 730 establishments providing primary healthcare (including health centres, private practices, etc.), six more than in 2021.

There were 717 private practices, of which 429 are polyclinics, and 13 Government health establishments.

In primary health care establishments, 3,134,849 individuals were seen, 8.2% less in annual terms, with each inhabitant being seen on average 4.6 times.

With a gross construction area of 420,000 square meters, seven buildings and around 1,100 beds, the new hospital complex on the Islands in Cotai is expected to gradually come into operation in the second half of this year.

Peking Union Medical College Hospital (PUMCH, Beijing Union College of Medicine Hospital) will manage the future hospital.

The first phase of entry into operation of the complex will be the center for oncology treatment, with a first phase of recruitment of local personnel, with vacancies for 10 to 20 people from the legal and IT areas, administrative officers, among other functions, to be started.

Preparatory work for the dispatch of local medical specialists to Pekin Union Hospital for pre-training before taking on specialist duties is also under way.

Help from Portugal

In its Report on the Lines of Governance Action for the Financial Year of 2023, the MSAR administration points out that the priorities for the year are the preliminary preparatory work for the opening of the Health Care Complex of the Islands, and the reinforcement of the regulation of the training of doctors specialists and specialist nurses.

On a recent visit to Lisbon, where she met with the Portuguese Minister of Health, the Secretary for Social Affairs and Culture, Elsie Ao Ieong, indicated that Macau plans to recruit doctors in Portugal.

According to the director of Health Services (SSM) Alvis Lo, currently around 35 percent of all physicians recruited outside the city come from Portugal.

The last time Macau launched applications to recruit doctors in Portugal was in 2017.

This post is also available in: Português 繁體中文

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