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Box 5.1

Summary of who, for whom, what, from whom, and how
of strategic purchasing demonstrated by the Chronic
Disease Screening Voucher and Management Scheme

Who to purchase? The Government should identify a purchaser
responsible for the provision of primary care in
Hong Kong
For whom to purchase? Adults between the ages of 45–54 at the
beginning of the Scheme
What to purchase and from • HDH Screening, re-screening, and follow-up
whom? management services in the private sector,
administered by primary care service providers,
including allied health professionals and family
doctors. Re-screening should be purchased at
intervals calibrated for individuals without HDH.
• Chronic Disease Management for adults
diagnosed with conditions co-morbid with HDH
in the private sector.
• Follow-up consultations with family doctors on
lifestyle modification for users who are
not diagnosed with HDH and referral to
re-screening.
How to purchase? Demand-side instrument: fully subsidised voucher
updated annually.
Supply-side instrument: performance-based
payment to providers for management services,
with financial flexibility for co-payment determined
by the purchaser.

5.2.1 RESEARCH FINDINGS THAT INFORM THE DESIGN
OF THE CHRONIC DISEASE SCREENING VOUCHER
AND MANAGEMENT SCHEME

Three separate studies were conducted to explore the perceived applicability of strategic
purchasing to Hong Kong’s health system and feasibility of the proposed Scheme. We
garnered insights from key stakeholders of Hong Kong’s health system, surveyed members
of the general public, and conducted an economic analysis to better understand financial
implications of the proposed Scheme. These research efforts to determine the design of the
Scheme aim to build a model for ways in which other programmes may be
designed and implemented in the context of strategic purchasing.
The collective insights gained from these studies have important implications for the
implementation of the proposed Scheme to enhance primary care uptake in the general
population and for strategic purchasing in Hong Kong, and are summarised as follows.

The voices of key stakeholders

Key stakeholders acknowledged the importance of primary care development for alleviating
the demands on the overburdened health system and agreed that health system
fragmentation poses a problem for addressing the growing healthcare demand. In particular,
stakeholders expressed that the Government ought to play a role in bridging the public and
private sectors and that the capacity within the private sector could be better leveraged to
achieve overall health system goals. Stakeholders welcomed our proposed Scheme that was
deemed beneficial in propelling primary healthcare development in Hong Kong, particularly in
promoting preventive care, early detection, and continuous chronic disease management.
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