Lee Rance Pui-leung 李沛良

Research Projects

  • Explaining the Phenomenon of Hospital Readmission: A Social Analysis Approach
  • LEE Pui Leung Rance, WONG Kam Yuet Frances*, CHOW Susan*, CHANG Katherine*, LEE Wai Man*, CHAN Cecila*, CHAN Kit Choi*
    1 April 2001
    Hong Kong Polytechnic University Direct Grant

    This is an exploratory study for developing an explanatory model of the factors contributing to hospital readmission. Data are to be collected from patients readmitted in the Medical Departments of two acute hospitals in Hong Kong. Specifically, the hospital admission patient profile will be a major source of information for constructing measures for analyzing the relationships among the environmental factors (health care environment), population characteristics (predisposing factors, enabling resources, needs), health behavior (personal health practices, use of health services), and the outcome variables (perceived health status, evaluated health status, consumer satisfaction). A phenomenological approach involving in-depth interviews will also be used to uncovering the internal meaning structures of the lived experiences of the readmitted patients. (SS00839)

  • Exploring the Phenomenon of Hospital Readmission: A System Analysis Approach
  • LEE Pui Leung Rance, WONG Kam Yuet Frances*, CHANG Katherine*, CHOW Susan*, LEE Wai Man*, CHAN Kit Choi*, CHAN Cecilia*
    1 September 2002
    Research Grants Council (Coll. with PolyU ERG)

    Cost containment is an important agenda of the health care delivery system in Hong Kong. One means of reducing costs is to minimize unnecessary hospitalization. The average hospital readmission rate for medical patients, within 28 days, is 15%. Hospital readmissions are a concern because they suggest that patients are discharged with unresolved problems, or reflect the quality of care or operational efficiency of the hospital. Considering that the Hospital Authority of Hong Kong is responsible for over one million admissions annually, a 15% readmission rate imposes a heavy burden on our health services. The Hospital Authority has set a performance indicator of 7.2% for the overall unplanned readmission rate within 28 days in the general setting. Researches on hospital readmissions have mainly used biomedical variables to offer a limited explanation of why patients repeatedly use hospital services. This proposal endeavours to include biomedical and non-biomedical variables at both the individual as well as the contextual level, to build a model to better explain the phenomenon of hospital readmission. Also, this study introduces community nurse follow-up as a variable of social support. It helps to test whether a different level of care in the community, as compared to hospital care, will achieve similar health outcomes. Specifically, we question how predisposing characteristics (e.g. age, gender, education), enabling resources (e.g. social economic status, social support, discharge follow-up), need (e.g. health status, perceived needs) directly affect the repeated use of hospital services (readmission rate) and mediate the effects of health outcome (e.g. self-reported health, ADL index), which in turn affect readmission rates. We seek to discover whether improved health outcomes (self-reported health, ADL index, consumer satisfaction) tend to be related to the amount and type of health care services utilized. The study will recruit 320 sets of subjects in two acute care hospitals in Hong Kong over a twelve month period. Andersen’s health care utilization model will be used as the conceptual framework for analysis. The data will be analysed using the strategy of Latent Variable Structure Equation Modeling. (SS02790)

Research Publications

* Name of external researcher
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