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The ecology of health care in Hong Kong


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


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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    References listed on IDEAS

    1. repec:aph:ajpbhl:2003:93:7:1082-1084_0 is not listed on IDEAS
    2. Rosen, Bruce, 1989. "Professional reimbursement and professional behavior: Emerging issues and research challenges," Social Science & Medicine, Elsevier, vol. 29(3), pages 455-462, January.
    3. Hsiao, William C., 1995. "Abnormal economics in the health sector," Health Policy, Elsevier, vol. 32(1-3), pages 125-139.
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    Cited by:

    1. 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.
    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. 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.
    4. 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.
    5. 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.
    6. 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.
    7. 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.


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