Page 27 - 20211214_OHKF_Health_Finance_Research_Report_E (1)

Box 1.4

Definition of “strategic purchasing”

Strategic purchasing is also known as “active purchasing”. It is defined as the
process in which funding and legal entitlements to health services are guided
by the scope and quality of services and the performance of providers,
based on the health needs of the population at large (Chapter 2). Its goals
align with the objectives of UHC—to enhance equity in the distribution of
resources, increase efficiency, manage expenditure growth, and promote
quality in health service delivery. Its ultimate goals are to maximise health
outcomes, equity in financing, and financial protection.

While demonstrating the potential for use of strategic purchasing for primary care services,
we emphasise this lever as a governance tool in a whole health system approach in
maximising health system performance. The tool enables the health system to
strategically prioritise what services to purchase, whether to provide or
purchase, for whom, from whom, who to purchase, and how. The report will
include insights gained from a scoping review of worldwide experience, key stakeholder
interviews, a population-based survey to gauge views of the general public, budget
implications related to the introduction of the proposed Scheme using a scheme for diabetes
as a proxy. It concludes with policy recommendations on strategic purchasing as an effective
tool to better meet health needs and promote health equity in Hong Kong.

1.3 PEOPLE ARE LIVING LONGER, BUT NOT
NECESSARILY BETTER

Population ageing and increasing chronic disease
prevalence

Figure 1.4
Hong Kong population projection, 2020–2069

85+ 2.9% 11.3%
80-84 2.3% 5.8%
75-79 2.5% 6.3%
70-74 4.5% 6.0%
65-69 6.1% 5.0%
60-64 7.9% 6.4%
55-59 8.6% 7.2%
50-54 7.4% 6.1%
45-49 7.8% 6.2%
40-44 7.6% 6.6%
35-39 8.1% 6.8%
30-34 7.4% 5.9%
25-29 6.4% 4.8%
20-24 5.1% 3.8%
15-19 3.6% 2.9%
10-14 4.1% 2.5%
5-9 4.0% 2.3%
0-4 3.5% 2.0%
15% 10% 5% 0 5% 10% 15%

2020
2069

Source: C&SD, 2020a
25