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Public and private healthcare services utilization by non-institutional elderly in Hong Kong: Is the inverse care law operating?

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  • Yam, Ho-Kwan
  • Mercer, Stewart W.
  • Wong, Lai-Yi
  • Chan, Wan-Kin
  • Yeoh, Eng-Kiong

Abstract

Objectives To assess the factors associated with healthcare services utilization by the non-institutional elderly across five types of service utilization (Western medicine doctors in Government clinics, private Western medicine doctors, Chinese medicine practitioners, Emergency Units, and hospitalization).Methods A secondary data analysis of a territory-wide cross-sectional survey collected by the Government among a representative sample of 4812 elderly (aged 60 and above) in Hong Kong.Results Our analysis, based on Anderson's behavioral framework, shows that need factors (relating to actual or perceived illness and diseases) are significantly related to the healthcare services utilization examined. However, enabling factors, such as monthly household income per capita, play a significant role in determining the utilization. Although the lower-income elderly consult more Government clinics and less private clinics than the more affluent, they have a lower total utilization of healthcare services despite having significantly greater healthcare needs.Conclusions This suggests a mismatch of need and supply within the mixed economy of private and public healthcare services and suggests the existence of an 'inverse care law' in Hong Kong amongst elderly citizens. The findings raise concerns of inequities in Hong Kong's healthcare system, raising implications for future healthcare reforms.

Suggested Citation

  • 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.
    • Handle: RePEc:eee:hepoli:v:91:y:2009:i:3:p:229-238
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    References listed on IDEAS

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    Cited by:

    1. Mozhaeva, Irina, 2022. "Inequalities in utilization of institutional care among older people in Estonia," Health Policy, Elsevier, vol. 126(7), pages 704-714.
    2. Yeoh, Eng-Kiong & Yam, Carrie H.K. & Chong, Ka-Chun & Chow, Tsz-Yu & Fung, Valerie L.H. & Wong, Eliza L.Y. & Griffiths, Sian M., 2020. "An evaluation of universal vouchers as a demand-side subsidy to change primary care utilization: A retrospective analysis of longitudinal services utilisation and voucher claims data from a survey coh," Health Policy, Elsevier, vol. 124(2), pages 189-198.
    3. He, Alex Jingwei & Tang, Vivien F.Y., 2021. "Integration of health services for the elderly in Asia: A scoping review of Hong Kong, Singapore, Malaysia, Indonesia," Health Policy, Elsevier, vol. 125(3), pages 351-362.

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