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Economic analysis

Our economic model projects, as a proxy measure, that if we were to fully implement the
Scheme for only diabetes over the course of 30 years for individuals aged 45 to 54 years of
age at the start of the scheme, the health system would spend approximately 28% less on
direct healthcare expenses, compared to if no such scheme were implemented. Additionally,
we found that participation in the Scheme is projected to prevent over 47,000 premature
mortalities over the course of 30 years. Comparing the benefits of a screening-only
programme, the combined benefits of implementing the Scheme outweigh the additional
marginal financial gains derived from implementing a screening voucher-only programme.

A comparison of costs from our projections shows that the health system may expect a
higher level of expenditure during the first decade of implementation relative to projected
spending in the later years given that the costs of chronic condition management does not
change during the 30 years. Savings therefore are concentrated in later years of the Scheme
wherein patients are more likely to develop complications that require costly hospital-based
care services had they not received timely management services.

Findings are detailed in Chapter 4.3.

5.2.2 DETAILS OF THE PROPOSED CHRONIC DISEASE
SCREENING VOUCHER AND MANAGEMENT
SCHEME

The Scheme is designed to leverage public funds and private sector service provision to
overcome system segmentation in making primary care services more accessible and
affordable to Hong Kong citizens. Designed to meet the most immediate needs of our rapidly
ageing population based on lessons learned from existing PPP schemes, and in particular,
the Elderly Health Care Voucher Scheme (EHCVS), the Scheme aims to promote the uptake
of specific primary care services and shift care burden from the largely hospital service-
centric public sector to the private sector.

The Chronic Disease Screening Voucher and Management Scheme

1. We recommend that the Scheme consists of two principal components:
chronic disease screening voucher and a disease management
scheme.

Global research and our economic analysis indicate that screening coupled with
coordinated management for chronic diseases, such as through the Hospital Authority
Risk Assessment and Management Programme (RAMP) for Diabetes Mellitus, can lead
to better health outcomes on a population scale and cost-savings for the Government.
Therefore, we suggest that the Scheme should include both a screening
voucher and a disease management scheme to encourage early detection
and chronic disease care continuity. The screening voucher is constructed in the vein of
a demand-side instrument to incentivise screening, while the chronic disease
management programme which contracts private services is set up as a supply-side
instrument. Disease management services, in particular, are offered through a supply-
side incentive as opposed to a healthcare voucher in order to accommodate the
varying needs of each patient that is potentially complex in nature
and to offer sufficient flexibility in care access.

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