Page 138 - 20211214_OHKF_Health_Finance_Research_Report_E (1)

Some interviewees worried that the design of a chronic disease screening voucher and
scheme for subsequent management might be disease-centred and contradict the
health-centred model in the desired primary care-led system. Stakeholders suggested
that the Government should carefully define the services to be covered by
the vouchers to ensure that they are used in preventive services rather than solely
disease treatment.

Stakeholders’ voices

The difficulty of issuing a chronic disease voucher is the definition of
chronic disease. And the overall problem, as you have mentioned in the
report (OHKF, 2018), is about services being segmented, fragmented,
too disease-oriented, and so forth… If you (the Government) focus on
chronic disease assessment, screening, early identification, it might also
be disease-oriented instead of health-oriented.

Academic

You (patients) can have impaired function without
diseases, and this is still going to make you disabled,
right? You (the Government) could detect these things
before they become disabled... You can’t just target
NCDs (non-communicable diseases)… You have to
target both (NCDs and geriatric syndromes).
Academic

The goal is to shift the start of care from the time when they
are already sick to when they are still healthy; to shift the
whole timeframe earlier.
Private service provider

Regarding the scope of the Scheme, there were diverse opinions among stakeholders. Some
agreed with the HDH (hypertension-diabetes-hyperlipidaemia) approach, citing
its high prevalence in Hong Kong, while others suggested expanding the diagnostic tests to
uric acid, osteoporosis, and other health indicators, such as obesity. A few insisted on the
need to include Body Mass Index (BMI) measurements in the Scheme, which they regarded
to be a highly important indicator for risk factor for chronic diseases. However, stakeholders
who supported the HDH approach were also opposed to the expansion of the screening
scope due to feasibility concerns.

136