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.,
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).
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.
Cheng, V., Tai, J., Wong, Z., Chen, J., Pan, K., & Hai, Y. et al. (2013). Transmission of
methicillin-resistant staphylococcus aureus in the long term care facilities in Hong Kong.
BMC Infect Dis, 13(1), 205. doi:10.1186/1471-2334-13-205
HUI, E. (2010). Perceptions of ethical practices in Hong Kong public hospitals: inter- and intra-
professional similarities and differences. Journal Of Nursing Management, 18(6), 746-756.
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
Lam, W., Lui, P. L & Wong, W. (2012). Contemporary Hong Kong government and politics.
Hong Kong: Hong Kong University Press.
LEUNG, R., CHUNG, K., LI, V., CHEUNG, R., LAM, C., & ZIEA, E. (2015). Development of
Electronic Health Record for Chinese Medicine eHR(CM) Sharing System in Hong Kong.
Integrative Medicine Research, 4(1), 115. doi:10.1016/j.imr.2015.04.205
Liu, S., & Yeung, P. (2013). Measuring fragmentation of ambulatory care in a tripartite
healthcare system. BMC Health Services Research, 13(1), 176. doi:10.1186/1472-6963-13-
Mercer, S., Siu, J., Hillier, S., Lam, C., Lo, Y., Lam, T., & Griffiths, S. (2010). A qualitative
study of the views of patients with long-term conditions on family doctors in Hong Kong.
BMC Family Practice, 11(1), 46. doi:10.1186/1471-2296-11-46
Owolabi, O., Zhang, Z., Wei, X., Yang, N., Li, H., & Wong, S. et al. (2013). Patientsâ€™
socioeconomic status and their evaluations of primary care in Hong Kong. BMC Health
Services Research, 13(1), 487. doi:10.1186/1472-6963-13-487
Rashed, A., Wilton, L., Lo, C., Kwong, B., Leung, S., & Wong, I. (2014). Epidemiology and
potential risk factors of drug-related problems in Hong Kong paediatric wards. British
Journal Of Clinical Pharmacology, 77(5), 873-879. doi:10.1111/bcp.12270
So, W., Chan, C., Choi, K., & Chan, D. (2012). Perspectives on the use of and service needs of
cancer preventive services for ethnic minorities in Hong Kong: a study protocol. J Adv
Nurs, 69(9), 2116-2122. doi:10.1111/jan.12067
Wong, E., Coulter, A., Hewitson, P., Cheung, A., Yam, C., & Lui, S. et al. (2015). Patient
Experience and Satisfaction with Inpatient Service: Development of Short Form Survey
Instrument Measuring the Core Aspect of Inpatient Experience. Plos ONE, 10(4),
Wong, F., Chan, F., You, J., Wong, E., & Yeoh, E. (2011). Patient self-management and
pharmacist-led patient self-management in Hong Kong: A focus group study from different
healthcare professionals’ perspectives. BMC Health Services Research, 11(1), 121.
Wong, J., Cheung, E., Cheung, V., Cheung, C., Chan, M., & Chua, S. et al. (2004).
Psychological responses to the SARS outbreak in healthcare students in Hong Kong. Med
Teach, 26(7), 657-659. doi:10.1080/01421590400006572
Yam, C., Liu, S., Huang, O., Yeoh, E. K & Griffiths, S. M. (2011). Can vouchers make a
difference to the use of private primary care services by older people? Experience from
the health care reform program in Hong Kong. BMC Health Services Research, 11, 255.