Health care system in Hong Kong

Hong Kong healthcare systems can be described as mixed structure where private, public and alternative traditional medical therapy.   Research estimates that the public hospitals offer about 90% of the inpatient and outpatient services. The private sectors cover 70% of the outpatient and in-patient services. The public sector obtains funds from the government taxation and complemented by little copayments amounts from the patients pocket.  Due to the high life expectancy, Hong Kong population consists of the elderly people; consequently, this translates to a high frequency of diseases associated with old age such as psychosocial disorders, increased frequency of disease, high morbidity and mortality as well as the rate of government dependency.  Consequently, the health care costs are high and has been anticipated to rise. This has increased pressure to avail quality care to the society and at affordable costs. There are numerous health care reforms and introduction of new policies to ensure that Hong Kong citizens are healthy (Huque, 2013). 

 Hong Kong healthcare system is robust and has provided quality care to the citizens for the longest time. The government has continued to strengthen the healthcare system so as to improve the system.  The life expectancy of the Hong Kong people is highest in world which is reported as 80.9 years in males and 86.6 years in female. The infant mortality is the lowest and is recorded at 1.6 per 1000 births.  The growth rate is slow and is reported to be between 0.4 to 0.6% in the last three decades. The proportion of youths has continuously reduced by 5% from 17% in the last three decades. On the other hand, the number of the elderly people has continuously increased. The age trend in this nation indicates higher elderly than the youth. Whereas it is a good thing, this acceleration in the increase of the elderly people is not only affecting the nation’s Economic growth but also attributed to the healthcare burden especially among the chronic diseases (Lueng Et al., 2015).

 Health care system in Hong Kong

 Healthcare reports estimates that about 50% of diabetes incidences in Hong Kong are from the elderly people. This metabolic syndrome has been listed as the leading cause of death as it accounted for 1.4% mortality in Hong Kong in 2013.  The psychological issues and mental health such as dementia has also been on the rise. These rates at which the psychological disorders are increasing seem to overburden the social workers making them seek for other alternatives.  Other non-communicable diseases such as thyroid cancer, respiratory disorders such as influenza, pneumonia and asthma have been reported to be the leading cause for hospitalization (Wong Et al., 2011). The most communicable disease which has been reported in Hong Kong is rotavirus and gastroenteritis. According to world health report in 2005, 35 million of 58 million deaths reported in the world are attributable to non-communicable (NCD) diseases such as cardiovascular diseases, cancer, accidents and injuries. The increases in these NCD are attributable to unhealthy lifestyle which involves consumption of unhealthy dietary, binge consumption of alcohol and sedentary lives. These brought forth increased burden among the families, the community and the government at large.

 With this background of health concerns in Hong Kong, it is evident that primary health care is the frontline factor that acts as an interface between the healthcare system and the population.  Effective primary care indicates that there are greater equity in healthcare and that care is easily accessible and at an affordable cost. Literature indicates that there effective partnership and collaboration between the healthcare  and  service users provides the best patient outcome including reduced  emergency visits, better preventive care, better self-management for diseases with chronic diseases and reduced   hospitalization cost.  With the increased cost of care; and the challenges facing the health systems in Hong Kong calls for reforms in the primary care. HK government has been striving to reform its primary care.  Fortunately, Hong Kong health care systems are among the best in the world (Kung Et al, 2014).

 However, NCD is the leading burden in Hong Kong and it is projected to continue to rise in the future years to come due to advancement in technology. This poses major challenge to the public health. Research indicates that improving primary care has economic benefits.  Promoting the primary health is a joint responsibility which requires everyone to participate in various sectors. The government major role is to provide legislative  policies and frameworks which regulate service user  and provider safety  by controlling the  hazards at the hazards; whereas  the business sector’s major responsibility is to improve  competitiveness  to facilitate  healthy choices. The Non-governmental   movements and community organizations role is to implement the programs that focuses on health promotion on subgroups and the vulnerable and underprivileged people in the society (Wong Et al., 2015). To achieve a high performance demands a healthcare system demands higher expenditure and efforts in fighting the NCD.   Investing in preventive care has been found to be the most the key factor in ensuring the economic development. For this reason, the government main objectives have been to provide the citizens with adequate support to enhance their sense of belonging and to maintain their dignity and enhance their worthiness. For the elderly and people living with disability, the government aims at providing cost effective care services. One of the systems that the government has embraced and is continuing to improve by expanding the home care based healthcare services as well as taking care through support such as “The Elderly Health Care Voucher Scheme (Yam Et al., 2011).”

 The new infrastructure that the government has continuously planned to improve is the provision of healthcare services. The government has begun its initiative by increasing the number of hospital beds and surgery operation rooms to ensure that the healthcare capacity is widely accessible and meets the increasing demands.  Additionally, the government has continued to promote   primary care because it is the main link between the citizen and the health and social care.  This involves expanding community healthcare facilities so that healthcare can be easily accessible. The government is also establishing frameworks specific for each NCD to promote the healthcare of individuals.

Secondly, the government has broadened the quota systems for both the general practitioners in the outpatient and in the in-patient services. There are ongoing strategies to improve the emergency department to ensure that waiting time for emergency care is reduced.  The government in a joint venture with the private developers has increased service volume at an affordable cost. Some of these ventures include procuring of new haemo-dialysis services to ensure that the treatments are eligible to most patients with chronic renal failure.  Radiology resources are also being outsourced for patients from underprivileged patients with chronic diseases (Liu & Yueng, 2013).

 The government has continued to strengthen the geriatric rehabilitation services and the outreach services at the community level. This is with the aim of improving quality of life of elderly, people with mental disorders and people living with disability. The government have also increased their regulations on the residential care for these people to ensure that the issue of safety and healthcare management. Currently, they are ongoing pilot study on the general outpatient Clinic and the impact of privatization of public program in Kwun Tong, Tuen Mun and Wong Tai Sin districts. This is with the effort to increase   the scope of care for the long term care of chronic diseases. The infrastructural development involves all the sectors in health including the mental health concerns. For example, the government is planning to increase the number of hospital beds in the largest mental health hospital in Siu Lam Hospital (Mercer Et al., 2010). This strategy aims at clearing up cases of severe complications of mental health associated with the prolonged waiting lists before the sick patients are attended to. This aims at strengthening the manpower of the mental health expertise through the introduction of peer support for patients with mental disorders. To promote the healthcare of its citizen, the government is also supporting other alternative traditional medicine. The Department of Health acknowledges this therapy and has funded several researches to evaluate the feasibility of these medicines.  Additionally, it has been indicated by the evidence based research that NCD is the major healthcare burden in Hong Kong. Therefore, the government has continued to regulate the nutrition and safety of the processes food. In fact, the food safety Laboratory in Pok Fu Lam is being expanded by the government to ensure that there is effective testing of packaged food product so as to safe guard the people safety (Owolabi Et al., 2013).

Additional to the establishment of these infrastructures that supports and promotes health, the department of health has implemented several pilot schemes that will provide financial care services   to the elderly. This includes implementation of discharge support program to the patients after they are discharged from the hospital and have challenges self-managing their health.  There are also on going pilot study to ensure that the elderly that need long the care such as Guangdong Residential care Service Scheme (Hui, 2010). These strategies are great and very beneficial to the   the society and the nation at large.  One cannot quantify the financial cost of any disease to the individual or even the community.  Economic analysis indicates that the cost of treatment for healthcare associated with NCD, injuries and poisoning is higher than the cost of NCD prevention and would save Hong Kong citizens from suffering and  reduce the death rates. The existing healthcare has limited focus on effective preventive strategies.  There needs more resources to establish systems that will inform the public as well as empowering the society. The voluntary organization and the department of health need to come together to integrate the necessary efforts towards both primary and secondary prevention strategies (Rashed Et al., 2014).

When socio economic evaluation was conducted on primary care in Hong Kong, it was found that most people use private health care as their main source of health care and often prefer to finance their health care costs from their pockets. The study indicated that Hong Kong citizen are more satisfied by the care quality compared to the public health care. The trend indicated that people who get quality care are those whose income is considerably high. This implies that only these people   who are above average as compared to those who used public clinics. Several other studies have found a stronger association between the qualities of care with the socio economic background of a person. The lower income group cannot afford primary care which attributes to the increase in NCD incidences and mortality rates. Even with the Voucher system which was established to help the elderly whose main aim was to provide financial assistance to the elderly so that they can also access care in the private sector. Such schemes are meant to reduce burden on the public health care facilities (Hui, 2010).

 This is particularly important because Hong Kong epidemiological studies indicate that NCD are at high prevalence’s among the old and the low income households. It is estimated that the prevalence rate for chronic illness in Hong Kong is five folds higher in individuals above 65 years than the youth. The level of education is also associated with better health care and lower incidences of overweight. People with low education reports higher rates of diabetes type 2, hypertension and cancer (So Et al., 2012). Despite the increase in health care disparities, the department of health has offered little if any solutions to rectify the prevailing social and health care disparities. Most studies indicate that much economic costs can be saved through collaboration and working in partnership between the service user, service provider and other stakeholders whose energy is geared towards healthcare protection and promotion. Through pooled knowledge and information sharing, the existing disparities can be reduced effectively by applying public regulations and policies and collaborative actions by the public actions. The actions could range from investing in human capital to quality education. These mechanisms are the best approaches to combat poverty through increased employment (Rashed Et al., 2014).

 The best strategy to reduce the prevalence of NCD is through an establishment of a clear vision which focuses on reminding people on the long term outcomes of their effort.   For a successful strategic framework, the Hong Kong must inform her citizens on the advantages of maintaining their health. This in turn will establish a caring community which integrates all the relevant stakeholders to ensure that the community sustains healthy lifestyle as guided by competent healthcare providers. Consequently, the country will establish a sustainable healthcare culture which aims at promoting health and incorporating strong elements of disease prevention with equal strength as the curative care among the public. This will significantly reduce the disease burden including premature mortality due to NCD or disability associated with NCD (Lam, Liu & Wong, 2012). 

However, not even the voucher scheme that has facilitated reduction of health care burden. The NCD still remains a burden to the health ministry. This implies that it is time the government seeks other approaches to promote cultural change which places higher value preventive care   than the curative care. It has been suggested that the financing healthcare reform is more of a political move than a strategy to help the healthcare industry. The problem of the aging population is here to remain and so is the issue of increase in healthcare expenditure. There needs a critical analysis in the health care to look into new approaches that will ensure that the society health is protected, promoted and sustained. There  are other numerous  non ambitious elements that the   government can explore  to promote  health  which will involve the health care providers, service users  and other relevant  stake holders  so that they can be collaboratively  reach to a consensus and  pave way for more improvements  in the future (Cheng Et al., 2013).

Conclusion

In summation, it important for the department of health to establish strategic framework that will facilitate establishment of an environment which will promotes the health of the citizens. The government must engage the population in promotion of their health, their relatives and the community at large.  It is important for the health care department to establish strategies that will prevent or even delay the onset or progression of NCD for the Hong Kong populations. Drawing together the strengths each stakeholder to a pooled knowledge and also skills from   various relevant stake holders in the society will ensure that each aspect of the society is represented adequately and prevailing gaps are adequately addressed. The determinants of health are very pervasive such that health promotion and prevention of disease   will require involvement of the community in all sectors and all realms of environment including education and work place. Partnership is the most effective strategy of working with people from diverse backgrounds, tradition, values and beliefs.  This is because collaboration maximizes the strengths and weaknesses prevailing in the healthcare with the aim of attaining the overall objective which is establishing a healthy nation.

References

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Huque, A. (2013). Can Public Management Contribute to Governance in Developing Countries?. Public Organization Review, 13(4), 397-409. doi:10.1007/s11115-013-0259-2

Kung, K., Wong, C., Wong, S., Lam, A., Chan, C., Griffiths, S., & Butler, C. (2014). Patient presentation and physician management of upper respiratory tract infections: a retrospective review of over 5 million primary clinic consultations in Hong Kong. BMC Family Practice, 15(1), 95. doi:10.1186/1471-2296-15-95

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