Page 224 - 20211214_OHKF_Health_Finance_Research_Report_E (1)

5.5 CONCLUSION

Primary healthcare development in Hong Kong has been incremental but is now gaining
momentum. In our 2018 research report Fit for Purpose: A Health System in the 21st Century,
we highlighted that “strategically purchasing services, allocating resources
appropriately and utilising purchasing and payment mechanisms can enable
coordination and integration between service providers.” The present report elaborates on
strategic purchasing and showcases how this health financing tool can be a lever to propel
PHC development in Hong Kong’s pluralistic health system. We have demonstrated how the
strategic allocation of resources, particularly through strategic purchasing in PPPs,
can potentially contribute to promoting primary care uptake, improve the
health of the population and generate cost savings for the health system.
Specifically, we have evaluated the feasibility of the proposed Chronic Disease
Screening Voucher and Management Scheme that will enhance
accessibility of chronic disease screening and management, incentivise the
uptake of primary care services in a targeted manner, and leverage private sector capacity to
complement the public sector. The Scheme applied WHO health financing principles and
strategic purchasing criteria in its design for prevention and early intervention of HDH in an
increasingly high-risk but currently underserved population (targeted age group: 45 to 54
years). The Scheme is particularly novel against a backdrop of a myriad of PPPs in Hong
Kong, and has a potential for large-scale impact in propelling the development of primary
healthcare development in Hong Kong in the following ways:

1) Targeted design with a primary strong focus on
prevention

Many existing PPP programmes have predefined eligibility patient criteria within clinical
protocols in the HA, rendering the scope of beneficiaries limited. The Scheme targets an
underserved younger population among whom the prevalence of chronic diseases has been
rising, with the aim to promote chronic disease prevention earlier on in the life course. The
Scheme provides chronic disease screening services for all eligible individuals within
the targeted age group, regardless of prior diagnosis or risk factors.
On that note, further studies will need to be conducted to estimate the take up rate of the
target population, and beyond that, research the disease profile of newly detected patients
for a more precise allocation of resources required to operate and sustain the Scheme.
Beyond the initial screening process for diagnosis, we also recommended that the
Government fund access to regular screening services for individuals without a DM
diagnosis, operationalising preventive healthcare among the wider public and not putting
financially vulnerable populations at risk of delaying care. Further studies are needed for
more precise projections of natural disease progression as well as on the proposed model of
care that has largely been based on the Hospital Authority RAMP for supplementary
interventions that may be warranted.

222