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

Because disease patterns differ for each age group, age differences in reduction of hospitalization should also be considered. [5] Hospitalization costs are a major component of healthcare expenditures in Hong Kong with a 7.0 million population. Healthcare expenditure has been increasing, accounting for 25% of Government expenditures which is relatively higher in comparing to other countries. [6] About 80% of inpatients come from public hospitals under the Hospital Authority. [7] The public healthcare sector currently accounts for over 90% of total secondary and tertiary care, while its subsidy from the Government has reached 95%. The public pays HK$100 (US$13) per day to receive inpatient services, while the average operating cost per hospital bed is about HK$3,300 (US$350) a day. Furthermore, Hong Kong is facing an acute ageing problem with a 14% of older In the present study, we use a decomposition method to examine and quantify the impact of the mean duration of stay on the other two factors: total number of patients per 1,000 people of the general population, and the mean number of visits per year in assessing its impact on the total number of hospitalization days. (Table 1) were collected from the Census and Statistics Department and Hospital Authority, respectively. The Census statistics include both sexes and ages for the whole population. The Hospital Authority provides the episode-based hospitalization data which contain information on age, gender, hospital, date of birth, district of residence, date of admission and discharge, disease code, duration of stay for each visit, and discharge destination. However, there are quite a significant proportion of the patient data with missing disease code and we will not examine the disease-code specific duration of stay in this analysis. Also, Although the capacity of the Hong Kong hospital system varies throughout the years and the overall occupancy rate is about 90% on average.. The hospital service model in Hong Kong remains relatively unchanged during the study period. It is assumed that mix of clinical services and patient case mix of the public hospital system has stayed constant over the 11-year period.