title: What makes the hospitalisation system more efficient? An application of the decomposition method to Hong Kong morbidity data.
abstract: OBJECTIVE
  To examine the efficiency of the Hong Kong hospitalisation system based on hospitalisation days.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Hospitalisation data (2000-2010) for all government-funded hospitals in Hong Kong.
  
  
  METHODS
  Hospitalisation data for the entire Hong Kong population (7.0 million in 2011).
  
  
  METHODS
  A decomposition method was used to determine the effects on total hospitalisation days during the period 2000-2010 of the following three factors: (i) hospitalisation rate per person; (ii) the number of visits per patient; and (iii) the mean duration of stay per visit.
  
  
  METHODS
  The decomposition method provides empirical measures of how the three factors contributed to the change in total hospitalisation days during the period 2000-2010 and identifies the most effective way to contain increases in hospitalisation days.
  
  
  RESULTS
  The results of decomposition analysis show that the decrease in mean duration of stay per visit (reducing from 6.83 to 4.58 days) is the most important factor in the reduction in the total number of hospitalisation days, despite increases in total population size (from 6.7 to 7.0 million), the number of individual hospital admissions (from 583 000 to 664 000) and the number of episodes (from 1.2 to 1.4 million) from 2000 to 2010. Hospitalisation days per person decreased from 1.18 in 2000 to 0.93 in 2010. The decline in the mean duration of stay per visit contributed 200.6% to this reduction but was offset by -51.1% due to a slight growth in the number of visits per patient and by -49.4% as a result of changed hospitalisation rates per person.
  
  
  CONCLUSIONS
  Better management of the duration of stay of per visit without compromising patient satisfaction levels or the quality of service is the most important factor for controlling increases in health expenditure in Hong Kong.
authors.affiliation: Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Paul S F
authors.initials: PS
authors.lastname: Yip
authors.forename: Carmen K M
authors.initials: CK
authors.lastname: Lee
authors.forename: Chun-Bong
authors.initials: CB
authors.lastname: Chow
authors.forename: William T L
authors.initials: WT
authors.lastname: Lo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D017048:Health Care Costs; D006723:Hong Kong; D006760:Hospitalization; D006779:Hospitals, Public; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D012189:Retrospective Studies; D055815:Young Adult
keywords: Statistics & Research Methods