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The ecology of health care in Hong Kong

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  • Leung, Gabriel M.
  • O.L. Wong, Irene
  • Chan, Wai-Sum
  • Choi, Sarah
  • Lo, Su-Vui

Abstract

To better understand the distribution of resources and health care consumption patterns in different geo-ethnic and socio-economic settings, we sought to describe the patterns of illness, care-seeking behavior and health services utilization in Hong Kong compared to the US and UK. Data were derived from the 2002 Hong Kong Thematic Household Survey covering 31,762 non-institutional and institutional residents, representing 6,504,255 persons after applying population weights. Of 1000 individuals during a 1-month period, 567 reported symptoms, 512 of whom considered seeking health care. Four hundred and forty persons visited western allopathic medical practitioners, with 372 (84.5%) in primary care and 68 (15.5%) in specialty care. There were 54 visits to traditional Chinese medical practitioners and 16 emergency room episodes. Seven individuals were hospitalized in community hospitals and on average one in 1000 were admitted to a tertiary medical center. Ninety out of the 567 who experienced symptoms undertook self-management strategies, which included over-the-counter western allopathic medications (n=54) or traditional Chinese remedies (n=14) or both (n=2), dietary modification (n=1) and rest (n=15). We have mapped the ecology of health care in Hong Kong. Monthly prevalence estimates were remarkably similar to US figures for hospital-based events, whereas there was evidence of apparent, substantial "over-consumption" of ambulatory, community-based care. Our results also indicate that the local community's care-seeking orientation still very much favors western allopathic medicine over traditional Chinese therapy, at least for acute illness episodes.

Suggested Citation

  • Leung, Gabriel M. & O.L. Wong, Irene & Chan, Wai-Sum & Choi, Sarah & Lo, Su-Vui, 2005. "The ecology of health care in Hong Kong," Social Science & Medicine, Elsevier, vol. 61(3), pages 577-590, August.
    • Handle: RePEc:eee:socmed:v:61:y:2005:i:3:p:577-590
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    1. Yam, Ho-Kwan & Mercer, Stewart W. & Wong, Lai-Yi & Chan, Wan-Kin & Yeoh, Eng-Kiong, 2009. "Public and private healthcare services utilization by non-institutional elderly in Hong Kong: Is the inverse care law operating?," Health Policy, Elsevier, vol. 91(3), pages 229-238, August.
    2. Wong, Irene O.L. & Cowling, Benjamin J. & Lo, Su-Vui & Leung, Gabriel M., 2009. "A multilevel analysis of the effects of neighbourhood income inequality on individual self-rated health in Hong Kong," Social Science & Medicine, Elsevier, vol. 68(1), pages 124-132, January.
    3. Martin Wong & Michael Leung & Caroline Tsang & S. Lo & Sian Griffiths, 2013. "The rising tide of diabetes mellitus in a Chinese population: a population-based household survey on 121,895 persons," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(2), pages 269-276, April.
    4. Roger Y Chung & Stewart Mercer & Francisco T T Lai & Benjamin H K Yip & Martin C S Wong & Samuel Y S Wong, 2015. "Socioeconomic Determinants of Multimorbidity: A Population-Based Household Survey of Hong Kong Chinese," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-15, October.
    5. Leung, Gabriel M. & Tin, Keith Y.K. & Chan, Wai-Sum, 2007. "Hong Kong's health spending projections through 2033," Health Policy, Elsevier, vol. 81(1), pages 93-101, April.
    6. Chung, Vincent C.H. & Hillier, Sheila & Lau, Chun Hong & Wong, Samuel Y.S. & Yeoh, Eng Kiong & Griffiths, Sian M., 2011. "Referral to and attitude towards traditional Chinese medicine amongst western medical doctors in postcolonial Hong Kong," Social Science & Medicine, Elsevier, vol. 72(2), pages 247-255, January.
    7. Adam Wagstaff, 2007. "Health systems in East Asia: what can developing countries learn from Japan and the Asian Tigers?," Health Economics, John Wiley & Sons, Ltd., vol. 16(5), pages 441-456, May.
    8. Wong, Irene O.L. & Lindner, Michael J. & Cowling, Benjamin J. & Lau, Eric H.Y. & Lo, Su-Vui & Leung, Gabriel M., 2010. "Measuring moral hazard and adverse selection by propensity scoring in the mixed health care economy of Hong Kong," Health Policy, Elsevier, vol. 95(1), pages 24-35, April.
    9. Xiaoxue Liu & Chuanhua Yu & Yongbo Wang & Yongyi Bi & Yu Liu & Zhi-Jiang Zhang, 2019. "Trends in the Incidence and Mortality of Diabetes in China from 1990 to 2017: A Joinpoint and Age-Period-Cohort Analysis," IJERPH, MDPI, vol. 16(1), pages 1-14, January.
    10. Lu, Tsung-Hsueh & Chou, Yiing-Jenq & Liou, Chien-Shian, 2007. "Impact of SARS on healthcare utilization by disease categories: Implications for delivery of healthcare services," Health Policy, Elsevier, vol. 83(2-3), pages 375-381, October.
    11. Lu, Jui-fen R. & Leung, Gabriel M. & Kwon, Soonman & Tin, Keith Y.K. & Van Doorslaer, Eddy & O'Donnell, Owen, 2007. "Horizontal equity in health care utilization evidence from three high-income Asian economies," Social Science & Medicine, Elsevier, vol. 64(1), pages 199-212, January.
    12. Fernández Coves, Andrea & Yeung, Karene Hoi Ting & van der Putten, Ingeborg M & Nelson, E. Anthony S, 2022. "Teleconsultation adoption since COVID-19: Comparison of barriers and facilitators in primary care settings in Hong Kong and the Netherlands," Health Policy, Elsevier, vol. 126(10), pages 933-944.
    13. Gabriel M. Leung & Keith Y. K. Tin & Owen O'Donnell, 2009. "Redistribution or horizontal equity in Hong Kong's mixed public–private health system: a policy conundrum," Health Economics, John Wiley & Sons, Ltd., vol. 18(1), pages 37-54, January.

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