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Table 3 Impact of financial disincentives on public ED attendances in Singapore, 1985–1997

From: Impact of health care system interventions on emergency department utilization and overcrowding in Singapore

Period of financial disincentive Monitoring periods Average monthly attendances Average monthly emergency attendances Average monthly non-emergency attendances
1 April 1987 (fee increased from Singapore $8 to $2) Before increase (Jan to Mar 1987) 28,836 23,357 5,479
After increase (Apr to May 1987) 31,365 25,092 6,273
% Change +8.8% +7.4% +14.5%
1 September 1989 (fee increased from Singapore $2 to $5) Before increase (Jun to Aug 1989) 40,255 26,568 13,687
After increase (Sep to Nov 1989) 40,982 27,458 13,524
% Change +1.8% +3.3% -1.2%
June to December 1992 (attendance fee increased from Singapore $5 to $28 for emergencies and $32 for non-emergencies). Additional itemized fees for services (up to $5) and prescription (up to $4) Before increase (1991) 43,075 26,276 16,799
After increase (1993) 39,928 27,151 12,772
% Change -7.3% +3.3% -23.9%
1 October 1997 (single fee of Singapore $70) Before increase (Jul to Sep 1997) 45,740 37,460 8,280
After increase (Oct to Dec 1997) 40,325 32,759 7,566
% Change -11.8% -12.5% -8.6%