What makes the hospitalisation system more efficient? An application of the decomposition method to Hong Kong morbidity data

Yip, Paul S F; Lee, Carmen K M; Chow, Chun-Bong; Lo, William T L

The total number of hospitalization days is the most crucial factor in determining financial funding and planning of the public hospital system in Hong Kong. Reducing hospital patient days has become one of the major health care policy and practice all over the world. [5, 16] Comparing with 26 OECD countries, the average length of stay for all diagnosis causes in Hong 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 However, the workload for the medical and health staff due to the shorter stays has not been properly measured and reflected in cost considerations. For example, arranging for day surgery, rather than admitting the patient overnight, implies that medical and health workers would have less time to do the preparation and provide the necessary services for operation as reflected by the frontline medical and health personnel to the authors. A recent survey in Hong Kong public hospitals indicated a very high burnt-out rate and increasing workload was one major factor. [22] Certainly, if the hospitals can add additional investment in human resources and, equipment and as well as utilization of newer technologies, those are measures that can counteract the effect of volume of patients volume on health care workers workload. These are important service quality considerations elements and are consistently neglected in in assessing the "cost-effectiveness" of shorter stays in the hospital. 16 There are some limitations in applying the decomposition method as described in this study.