Vouchers for primary healthcare services in an ageing world? The perspectives of elderly voucher recipients in Hong Kong

Hor Yan Angel Lai, Zoey MS Kuang, Carrie Ho Kwan Yam, Shereen Ayub, Eng kiong Yeoh

Research output: Journal article publicationJournal articleAcademic researchpeer-review

Abstract

Considering the ageing population in economically advanced regions across the world, measures are necessary to enhance the health of the older population as well as contain public healthcare spending. Hong Kong implements the Elderly Health Care Voucher Scheme (EHCVS), providing older people aged 65 or above an annual subsidy of visiting private healthcare service providers for chronic disease prevention and management. The services also aim at reallocating demand from the public to private sector as well as improve quality of services. This qualitative study explored the experiences of EHCVS recipients (n = 55, aged 61–94) with eight focus group interviews in Hong Kong in the year 2016. Convenience sampling was used. Research questions were: (1) Why do older people choose not to use EHCVS for preventive as well as disease management services among older people in Hong Kong? (2) What are the barriers to reallocating demand from the public to private sector? (3) In what ways did EHCVS improve the quality of primary care services for older people? Using a deductive and inductive approach, eight qualitative themes were identified. Findings suggested that the non- targeted services and inadequate knowledge on EHCVS deterred older people from using the vouchers for disease management and prevention. The relatively expensive private services, lack of trust in the private sector, low public clinic fees and good services quality of the public sector, together with inadequate private practitioners in the healthcare market were barriers that hinder demand reallocation. Nevertheless, the quality of primary care services had been improved after the implementation of EHCVS with shortened wait times and opportunities to discuss health- related issues with private practitioners. Findings were discussed with practice, policy and research implications.
Original languageEnglish
Pages (from-to)374
Number of pages382
JournalHealth and Social Care in the Community
Volume26
Issue number3
DOIs
Publication statusPublished - May 2018
Externally publishedYes

Keywords

  • ageing
  • chronic disease management
  • healthcare vouchers
  • older people
  • preventive care

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