Transcript Health Care in Hong Kong Dr Margaret Chan Director of Health

Health Care Reform in Hong Kong Department of Health’s Perspective
Dr Constance Chan
Assistant Director of Health
May 2001
1
Current Organization of
Health Care System
Dual public-private system
Public sector
Private sector
•Health & Welfare Bureau
•GP (solo/group) practice
•Department of Health
•Private hospitals and
•Hospital Authority
nursing homes
2
Provision of Health Services

Public Health Services
 Ambulatory Care
 Inpatient Care
 Chinese Medicine
3
Public Health Services
Department of Health is
 Health advisor to the Government and
other sectors
 Law enforcement agency for all public
health ordinances
 Responsible for preventive programmes
4
Ambulatory Care

85% by private sector physicians
 15% by public sector
Inpatient Care

92% of total bed days by public sector
 8% of total bed days by private sector
(Reference : Harvard’s Report P 27-8)
5
Health Care Financing
Trends in Total Domestic Health Expenditures, 1989/90 – 96/97
5.0%
% of GDP
4.0%
3.0%
2.0%
1.9%
1.7%
2.0%
2.5%
2.3%
2.2%
2.1%
2.0%
2.1%
2.0%
1.0%
2.1%
2.1%
2.1%
2.0%
2.1%
2.1%
Public
sector
Private
sector
Fiscal Year
7
/9
96
19
6
19
95
/9
5
19
94
/9
4
/9
93
19
3
/9
92
19
2
/9
91
19
1
/9
90
19
19
89
/9
0
0.0%
(Ref : Harvard’s Report Special Report No.1 P. 20)
In 1996/97 Total domestic health expenditures: HK$56,237 millions (US$7,210 millions)
Per capita spending: HK$8,911 (US$1,142)
Health spending as a share of GDP: 4.6%
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Regulation of Health Services

Regulation of Professional Standards
 Regulation of Hospital Standards
 Regulation of Pharmaceutical Industry
 Regulation of Chinese Medicine
7
Health Care System: Strengths
 Relatively
equitable
 Improvements in quality of
care and technical efficiency
with setting up of HA
 Cost-effective
8
Health Care System: Weaknesses

Long waiting time in public sector
 Inequitable fee structure
 Variable quality of health care
 Hospital-dominant services
 Inadequate interface and
compartmentalization
 Issue of long-term financial
sustainability
9
10
Consultation Document on
Health Care Reform

Review of the 3 pillars of our health care
system

11 strategic directions
11
Pillars of the Health Care Systems

Reforms to the Health Care
Delivery System
 Improvements to the System of
Quality Assurance
 Options for Financing Health Care Services
12
Health Care Delivery System

Strengthen preventive care
 Re-organize primary medical care
 Develop community-based integrated
services
 Improve public/private interface
 Facilitate dental care
 Promote Chinese Medicine
13
System of Quality Assurance

Enhance quality assurance

Improve patient complaint mechanisms
14
Health Care Financing

Reduce costs and enhance productivity

Revamp public fees structure

Establish individual
Health Protection Account
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Role of Department of Health

Strengthen preventive care
 Reorganize primary medical care
 Facilitate dental care
 Promote Chinese medicine
 Enhance quality assurance
 Improve patient complaint mechanism
16
Strengthen Preventive Care (1)
Health Promotion & Disease Prevention
– Enhance health promotion capacity
– Adolescent Health Program
– Cervical Screening Program
– Men’s Health Program
– Tobacco Control Office
17
Strengthen Preventive Care (2)
Disease Surveillance & Control
– Cancer Coordinating Committee
– Public Health Information System
– Regular reports on the health status of the
community
18
Reorganize Primary Medical Care
 Transfer
General Out-Patient Clinics
to the Hospital Authority
19
Facilitate Dental Care

Continue educational and promotional
efforts
 Set oral health goals and standards
 Conduct surveillance programmes
 Encourage Non-governmental
Organizations to offer affordable care
20
Promote Chinese Medicine

Introduce Chinese medicine into the public
sector
 Establish a regulatory framework and assist
to enhance standards
 Develop models of collaboration between
western and Chinese medicine
21
Enhance Quality Assurance
Take up the role as the coordinator or
regulator to ensure quality
Review regulations relating to
–
–
–
–
private hospitals
health care facilities
health claims
use of medical devices
22
Improve
Patient Complaint Mechanism

Set up a Complaint Office in DH
 Work with the Legislative Council Special
Sub-Committee in drawing up the
complaint mechanism
 Devise improvement measures which are
user-friendly, transparent and unbiased
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Advantages





More effective health promotion
and disease prevention
Improved oral health
More choices of health care service available with
the promotion of Chinese medicine
Patients’ safety and quality of service assured
More transparent and unbiased complaint
mechanism
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Conclusion
People of HK are enabled to
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