Health Care Reform in Hong Kong - Department of Health

1
Health Care Reform in Hong Kong - Department of
Healths Perspective

• Dr Constance ChanAssistant Director of Health
• May 2001

2
Current Organization of Health Care System
Dual public-private system
Public sector
Private sector

• Health Welfare Bureau
• Department of Health
• Hospital Authority

• GP (solo/group) practice
• Private hospitals and
• nursing homes

3
Provision of Health Services

• Public Health Services
• Ambulatory Care
• Inpatient Care
• Chinese Medicine

4
Public Health Services

• Department of Health is
• Health advisor to the Government and other
  sectors
• Law enforcement agency for all public health
  ordinances
• Responsible for preventive programmes

5
Ambulatory Care

• 85 by private sector physicians
• 15 by public sector
• Inpatient Care
• 92 of total bed days by public sector
• 8 of total bed days by private sector

(Reference Harvards Report P 27-8)
6
Health Care FinancingTrends in Total Domestic
Health Expenditures, 1989/90 96/97
(Ref Harvards Report - Special Report No.1
P. 20)
In 1996/97 - Total domestic health expenditures
HK56,237 millions (US7,210 millions) Per
capita spending HK8,911 (US1,142) Health
spending as a share of GDP 4.6
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Regulation of Health Services

• Regulation of Professional Standards
• Regulation of Hospital Standards
• Regulation of Pharmaceutical Industry
• Regulation of Chinese Medicine

8
Health Care System Strengths

• Relatively equitable
• Improvements in quality of care and technical
  efficiency with setting up of HA
• Cost-effective

9
Health Care System Weaknesses

• Long waiting time in public sector
• Inequitable fee structure
• Variable quality of health care
• Hospital-dominant services
• Inadequate interface and compartmentalization
• Issue of long-term financial sustainability

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11
Consultation Document on Health Care Reform

• Review of the 3 pillars of our health care system
• 11 strategic directions

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Pillars of the Health Care Systems

• Reforms to the Health Care
• Delivery System
• Improvements to the System of
• Quality Assurance
• Options for Financing Health Care Services

13
Health Care Delivery System

• Strengthen preventive care
• Re-organize primary medical care
• Develop community-based integrated services
• Improve public/private interface
• Facilitate dental care
• Promote Chinese Medicine

14
System of Quality Assurance

• Enhance quality assurance
• Improve patient complaint mechanisms

15
Health Care Financing

• Reduce costs and enhance productivity
• Revamp public fees structure
• Establish individual
• Health Protection Account

16
Role of Department of Health

• Strengthen preventive care
• Reorganize primary medical care
• Facilitate dental care
• Promote Chinese medicine
• Enhance quality assurance
• Improve patient complaint mechanism

17
Strengthen Preventive Care (1)

• Health Promotion Disease Prevention
• Enhance health promotion capacity
• Adolescent Health Program
• Cervical Screening Program
• Mens Health Program
• Tobacco Control Office

18
Strengthen Preventive Care (2)

• Disease Surveillance Control
• Cancer Coordinating Committee
• Public Health Information System
• Regular reports on the health status of the
  community

19
Reorganize Primary Medical Care

• Transfer General Out-Patient Clinics
• to the Hospital Authority

20
Facilitate Dental Care

• Continue educational and promotional efforts
• Set oral health goals and standards
• Conduct surveillance programmes
• Encourage Non-governmental Organizations to
  offer affordable care

21
Promote Chinese Medicine

• Introduce Chinese medicine into the public sector
• Establish a regulatory framework and assist to
  enhance standards
• Develop models of collaboration between western
  and Chinese medicine

22
Enhance Quality Assurance

• Take up the role as the coordinator or regulator
  to ensure quality
• Review regulations relating to
• private hospitals
• health care facilities
• health claims
• use of medical devices

23
Improve Patient Complaint Mechanism

• Set up a Complaint Office in DH
• Work with the Legislative Council Special
  Sub-Committee in drawing up the complaint
  mechanism
• Devise improvement measures which are
  user-friendly, transparent and unbiased

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Advantages

• More effective health promotion
  and disease prevention
• Improved oral health
• More choices of health care service available
  with the promotion of Chinese medicine
• Patients safety and quality of service assured
• More transparent and unbiased complaint mechanism

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Conclusion

• People of HK are enabled to

Improve Quality of Life
Maximize Capabilities
Enjoy High Quality Service