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Medical-social divide

In addition to an underdeveloped PHC system, insufficient support in community settings
and ineffective coordination and collaboration between health and social service providers at
various levels of care further contribute to service fragmentation throughout the system.
Despite initiatives to strengthen post-discharge support for high-risk older populations,
inadequate community support for discharged patients leads to preventable hospital
readmissions and further drains medical resources. The unplanned readmission rate among
older patients in public hospitals is close to 20% (Figure 1.12). This highlights a large gap in
coordinating post-discharge services provided by social service organisations in the
community and discharge planning conducted by hospitals (Wong et al., 2011). Better care
provision and support in community settings, particularly at the primary care level for
discharged patients through strengthened medical-social collaboration, are therefore
necessary to reduce preventable hospitalisations.

Figure 1.12
Observations on hospital admission amongst the older population in
Hong Kong

15% RCHE VS.
[1]
85% Home
HOSPITAL
About 20% avoidable
readmission in 30 days
46.8% due to
ambulatory care sensitive
conditions (ACSC)

4% result in death
in hospital

Note: [1] RCHE = Residential Care Home for the Elderly
Sources: Yeoh, 2018b, 2020

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