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Apart from the annual planning process which provides a broad basis for each hospital to indicate the service volume, quality and performance targets in the form of a service agreement, some major reviews on service utilisation carried out by the Hospital Authority are set out below:
medical audit provides a peer review mechanism in which the entire clinical care process, including length of hospitalisation and method of treatment, is critically appraised to evaluate and improve the standard of service.
drug utilisation review committees have been established at both the hospital and head office levels to contain expenditure through dissemination of data on consumption patterns, prudent introduction of new drugs and implementation of good prescription practices.
accident and emergency service is reviewed at periodic intervals to monitor the utilisation pattern and trend of admission, as well as to identify pressure points for better demand management, service reorganisation and staff deployment.
value for money studies are carried out in respect of selected clinical support services, including diagnostic procedures, to promote the use of best practices and optimal utilisation.
specialty costing is conducted each year to generate service utilisation profile as an agreed benchmark for each clinical specialty.
in line with the corporate strategy of "outcome focused service delivery" and evidence based medical practice, information on patient's casemix, treatment outcome and costing is systematically collected and analysed to formulate clinical guidelines/protocols.
New initiatives arising from the above reviews cover "continuous quality improvement" and "outcome management" projects to enhance clinical outcome and optimise resource utilisation, more vigorous public education on the proper use of accident and emergency services, rationalisation of service induced by unfavourable variance compared with the benchmark set by specialty costing, as well as efforts to minimise variations in clinical management among different hospitals through clinical guidelines and protocols. Although the impact of these improvement measures cannot be clearly quantified, they have contributed significantly towards enhancing the effectiveness and efficiency of services delivery.
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