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iii. Acceptability
The third dimension of accessibility revolves around the acceptability of healthcare services.
In the context of Hong Kong’s health system, we predict limited acceptability of the Scheme
through two measures: the low level of participation in regular screening and the low actual
utilisation of private sector services. Regarding the former, there remains a gap between
respondents’ awareness of the importance of prevention through routine health
screenings and their actual behaviour.

Our data shows that unnecessary or non-urgent need is the main reason for reluctance to
join the Scheme, despite providing the knowledge of the dangers of late disease detection. In
fact, of the 24.7% of respondents who reported being unsure or unwilling to participate in the
Scheme (Question 8), 37.0% were not willing to change their decision even when informed
that undetected and untreated HDH could result in an array of chronic health diseases
(Question 8b). Upon inquiring about their reluctance to participate, 69.9% of respondents
whose unwillingness persisted and provided at least one reason
attributed their primary or secondary reason to unnecessary or non-
urgent need (Question 8c) (Figure 4.4).

Figure 4.4

Breakdown of respondents by willingness to join the Scheme, persisted
stance, and reasons for not joining

24.7% 37.0% 69.9%

Not willing to join Persisted stance after Attributed to
voucher scheme informing dangers of unnecessary or
late detection non-urgent need of
health checks

We also found that health education may be key to influencing health-seeking behaviours.
Amongst respondents, only a low proportion of respondents (≤5%) were able to correctly
identify that elevated levels of blood pressure, sugar and lipid levels will put an individual at
higher risk for other chronic diseases such as heart diseases, stroke, retinopathy,
neuropathy, and nephropathy (Question 7). However, after receiving further
information on the dangers of undetected and untreated HDH, 46.2%
of the respondents who initially were not willing to participate in the Scheme shifted their
opinions to being in favour of participating (Question 8b). This decision shift
highlights the facilitative effect of health literacy, which can be improved by creating a fuller
picture of the benefits of screening as well as the adverse consequences of not screening,
through which individuals can gain health knowledge and turn knowledge into action
(Box 4.5).

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