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Despite an impressive ever-use rate of 98% of all eligible individuals in 2020, the actual
voucher claim patterns suggest usage that do not align with initial goals to share health
demand between the public and private sectors (HKSARG, 2021b). Although the EHCVS
seeks to promote the older population’s use of preventive primary care, such services are
underutilised amongst voucher users. DH released a review report in which synthesised
information from various sources, including studies conducted in collaboration with
The Jockey Club School of Public Health and Primary Care of the Chinese University of
Hong Kong (CUHK-JCSPHPC) to assess the knowledge and attitudes of elderly persons
and healthcare professionals on the EHCVS, and the impact of voucher usage on primary
healthcare services for elderly persons. The results demonstrated that whilst 42% of EHCVS
users had visited enrolled healthcare service providers (EHCPs) for preventive healthcare
services in 2019, a greater portion of elders (68%) used vouchers for managing acute
episodic conditions rather than preventive care (42%) (FHB, 2019). There is also no evidence
of significant behavourial change from public to private primary care service usage amongst
voucher users (Yeoh et al., 2020). On the other hand, the cost for the Government in
providing primary care services is HKD 3.1 billion in year 2018/19 for the whole population, as
compared with the total voucher amount claimed (for elderly population aged 70 or above) at
HKD 2.8 billion in 2018. Effectively, the public investments in primary care has increased by
90% with the voucher programme, but without significant changes to end-users’ behaviours.
Box 3.8 further illustrates major findings from the EHCVS review report.

Studies on the EHCVS affirm the long-standing belief that concerted efforts from the
Government and the healthcare sector in Hong Kong are needed to further cultivate a culture
of primary care and its preventive benefits. Also, a designated voucher for preventive care
services would help to enhance the uptake for early disease detection and management.

Figure 3.11
Percentage of elders using Elderly Health Care Vouchers who had made
at least one visit by principal reason for visit, 2009–2015

100% 4.4% 4.7% 4.5% 4.5% 6.2% 5.2% 4.8%
90% 12.9% 13.4%
19.1% 15.9% 13.5% 14.7% 16.6%
80%
70%
60%
50%
40% 76.5% 82.4% 79.5% 82.1% 80.2% 80.0% 78.5%
30%
20%
10%
0%
2009 2010 2011 2012 2013 2014 2015
n=341 n=490 n=621 n=794 n=1,299 n=1,772 n=1,902

Management of acute episodic condition
Follow-up/Monitoring of long term conditions or Rehabilitation
Preventive

Note: Figures do not add up to 100% as the elders can seek services from more than one category of service in a year
Sources: FHB, 2019; HKSARG, 2020c

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