A systematic review to assess the impact of the Elderly Health Care Voucher Scheme (EHCVS) and the feasibility to fully adopt in Hong Kong elder care services

Abstract

Background: Finding a solution to tackle the overcrowding and over-reliance on public health care services has been a policy agenda of the Hong Kong Government throughout the past decade. The purpose of this review is to provide valuable insight for policymakers to understand whether the Elderly Health Care Voucher Scheme (EHCVS) is a realistic policy tool to shift service demand from the public to the private sector and its possibility to apply in other similar publicly funded settings.Methods: Included records in this review were selected through CINAHL, PubMed, and Google Scholar peer-reviewed articles databases and nine targeted government websites. All potential records were assessed based on the prespecified inclusion and exclusion criteria. Thematic synthesis was used to combine the extracted data and to construct key themes of the impact of the EHCVS.Results: The findings highlight some of the successes of the policy that focus on strengthening the connection between government, elders and private health care providers, and improving the quality of acute care. However, less than successful elements that require revision include designing the purpose of voucher for preventive care and disease management and shifting elders from the public to private health sector through financial incentives. Overall, the analysis suggested the financial subsidies have not motivated elders to utilise private health care services, but rather it demonstrates an effort by the Hong Kong Government to begin addressing public health care waiting lists while prioritising quality care for senior citizens throughout the last 10 years.Conclusion: Better consideration of the subsidy amount to remove the financial burden of the older population, along with greater information disclosure and promotion may increase elders’ willingness to utilise private elder care services, potentially improve the quality of life for seniors, and ultimately reduce the burden on public elder care sector in the future.