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1.4 KEY SYSTEM CHALLENGES IN

ACHIEVING A FIT-FOR-PURPOSE
HEALTH SYSTEM IN HONG KONG

The current health system is unable to meet the challenges arising from an ageing
population and an increasing prevalence of chronic diseases. Major barriers to achieving a
fit-for-purpose health system are public-private healthcare segmentation, an underdeveloped
primary healthcare system, and inadequate medical-social collaboration, which are
discussed below.

Public-private healthcare segmentation

Hong Kong has a pluralistic health system, in which segmentation between the
types of healthcare services provided and funded by the public and
private sectors contributes to a comparatively lower utilisation of private
sector services. Approximately 70% of outpatient services are provided by the private
sector, while more than 70% of inpatient services are obtained from the public sector
(Figure 1.10) (C&SD, 2019). This public-private split also illustrates that the public sector
currently has limited capacity in providing needed outpatient care. In contrast, the private
sector has more capacity to provide outpatient services and has advantages of allowing
patient choice and faster access, but the higher expenses disincentivise the use of private
outpatient care—including primary care deemed increasingly necessary to reduce the
demand for specialist and hospital care.

Figure 1.10

Inpatient and outpatient consultation split by public and private sectors,
2019

100%
90%
80% 32%
70%
72%
60%
50%
40%
30% 68%
20%
28%
10%
0
Inpatient Consultation [1] Outpatient Consultation [2]

Private
Public

Notes: [1] Last admissions into hospitals in Hong Kong during the 12 months before enumeration by type of hospitals admitted
[2] Consultations made during the 30 days before enumeration by type of medical practitioners consulted, wherein
public services are the sum of consultations of Practitioners of Western medicine in Western medicine clinics/
centres under HA/ DH, and A&E under HA, and practitioners of Chinese medicine in Chinese medicine clinics/
centres under HA; private services are the sum of consultations of private practitioners of Western medicine and
private practitioners of Chinese medicine
Source: C&SD, 2019

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