Regular Source of Care for the Elderly: A Cross-National Comparative Study of Hong Kong With 11 Developed Countries

Wong, Samuel Yeung Shan; Zou, Dan; Chung, Roger Yat‐Nork; Sit, Regina Wing-Shan; Zhang, Dexing; Chan, Daniel; Yeoh, Eng Kiong; Woo, Jean

doi:10.1016/j.jamda.2017.05.009

Cited by 12 publications

(17 citation statements)

References 20 publications

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“…The age–gender‐weighted sample (94.1%) had regular source of primary care, but this percentage became 67.3% when Chinese medical practitioners were not included in the analyses, making it comparable with the previous studies (Fung, Wong, Fong, Lee, & Lam, ; Wun, Lam, & Sun, ; Lam et al, ; Wong et al, ). Our path analyses showed that those who have more health needs would be more likely to have regular source of primary care, but poverty would reduce that likelihood.…”

Section: Discussionsupporting

confidence: 80%

“…Further, whereas the public sector assigns a doctor from the team on duty at each of the patient's visits (Wong et al, ; Wong et al, ), in the private sector, patients can pick and choose their own service providers on the basis of specific health needs, availability of services when in need, and cost. Residents are used to using a combination of services from both sectors to meet a wide range of health needs; however, such set‐up does not facilitate quality regular source of care, and it contributes to the findings of a cross‐national comparative study, which showed that Hong Kong had the lowest rate of regular source of care for older persons and the highest rate of cost‐related accessibility problems in the past year when compared with Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States (Wong et al, ). Taken together, poorer people in Hong Kong are discouraged from seeking regular primary care from the private sector due to financial constraints and also face difficulty in receiving regular primary care in the public sector due to logistical and systemic reasons.…”

Section: Discussionmentioning

confidence: 99%

“…however, such set-up does not facilitate quality regular source of care, and it contributes to the findings of a crossnational comparative study, which showed that Hong Kong had the lowest rate of regular source of care for older persons and the highest rate of cost-related accessibility problems in the past year when compared with Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States (Wong et al, 2017). Taken together, poorer people in Hong Kong are discouraged from seeking regular primary care from the private sector due to financial constraints and also face difficulty in receiving regular primary care in the public sector due to logistical and systemic reasons.…”

Section: A Structural Determinant Of Health-care Inequity In a Mixementioning

confidence: 97%

“…Private providers are also available at many more convenient locations than the public ones. Further, whereas the public sector assigns a doctor from the team on duty at each of the patient's visits (Wong et al, 2010;Wong et al, 2017), in the private sector, patients can pick and choose their own service providers on the basis of specific health needs, availability of services when in need, and cost. Residents are used to using a combination of services from both sectors to meet a wide range of health needs;…”

Section: A Structural Determinant Of Health-care Inequity In a Mixementioning

confidence: 99%

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Poverty affects access to regular source of primary care among the general population in Hong Kong

et al. 2019

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A territory‐wide two‐stage stratified random sample of 2,282 community‐dwelling Hong Kong adults were surveyed between 2014 and 2015 to investigate the association between poverty and regular source of primary care utilization. Poverty was operationalized by income‐poverty and deprivation. About 94% of our sample reported having regular source of primary care (Western and/or Chinese medical practitioner) and about 69% among them were in private sector. Multivariable logistic regression showed that people who were income‐poor and deprived were less likely to have regular source of primary care (income‐poor: OR = 0.523, p = .027; deprived: OR = 0.488, p = .007) and visit private primary care doctors (income‐poor: OR = 0.445, deprived: OR = 0.222, both p < .0001). Those who had chronic diseases were more likely to have regular source of primary care (multimorbid: OR = 10.709, p < .0001), but less likely to access care in the private sector (one chronic disease: OR = 0.690, p = .019; multimorbid: OR = 0.374, p < .0001) than those without. Further, being older and less skilled were significantly associated with less likelihood of visiting a private doctor. Path analysis showed that the number of chronic diseases had significant indirect effect on having regular source of primary care with being income‐poor and deprived as the mediators (β = −.0183, p = .0016). Therefore, despite a public health‐care system that aims to deny no one from adequate health care for lack of means, regular source of primary care in Hong Kong is found to be pro‐rich. Future policies should tackle the problem of health‐care inequalities to meet the needs of the underprivileged.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: A Structural Determinant Of Health-care Inequity In a Mixementioning

confidence: 97%

Section: A Structural Determinant Of Health-care Inequity In a Mixementioning

confidence: 99%

See 2 more Smart Citations

Poverty affects access to regular source of primary care among the general population in Hong Kong

et al. 2019

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“…JAMDA has been an increasingly valuable outlet for such information, with at least nine other papers reporting data from multiple countries in the recent past. [9][10][11][12][13][14][15][16][17] That said, it is necessary that such research be mindful of important differences in culture and the organization of health care delivery if the results and interpretations are to be valid and optimally informative. In addition, certain methodological considerations are especially relevant for research comparing international data.…”

mentioning

confidence: 99%

It's Not a Small World After All

Zimmerman

Steen

2018

Journal of the American Medical Directors Association

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The article by Morris and colleagues in this issue of JAMDA, entitled "Hearing the Voice of the Resident in Long-Term Care Facilities-an Internationally Based Approach to Assessing Quality of Life," 1 underscores the importance of including residents' perspectives regarding the care they receive. InterRAI, an international research collaborative, developed a Self-Report Quality of Life Survey for Long-Term Care Facilities (SQOL-LTCF) which assesses resident perspectives on subscales reflecting social life, personal control, food, caring staff, and staff responsiveness. The results are based on reports of more than 16,000 residents who resided in 355 LTCFs; 44% of the respondents are from Belgium (residing in 70% of the LTCFs in the study), 32% are from Canada, 21% are from the United States, and fewer than 1% are from each of Poland, Estonia, South Africa, the Czech Republic, and Australia. Based on the distributions of the data, the researchers collapsed the scores (i.e., never/rarely; sometimes; most of the time; always); established benchmark standards for subscales; and compared scores to a single item (home-likeness) that was considered to represent an overall measure of "personal quality of life." This study is valuable in its findings as well as in the issues it raises inherent to cross-cultural research: with long-term care a reality around the world, to what extent is research on care systems broadly generalizable? Obtaining perspectives directly from residents is important, and since 2010 has been a standard part of screening in the U.S. Minimum Data Set 3.0 Resident Assessment Instrument (MDS 3.0 RAI) for nursing homes. 2,3 However, not all residents are able to self-report, and in the interRAI effort, those with more severe cognitive impairment were excluded from participation. Although it may be challenging to "hear the voice" of these

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How does chronic multimorbidity affect daily routines? An experience sampling study of community‐dwelling adults in Hong Kong

Lai

Hou

2020

Journal Community Psychology

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Limited by conventional data collection methods, it is unclear how community‐dwelling multimorbid people's daily routines are affected by their co‐occurring illnesses. This study investigated the differences in everyday life schedules between multimorbid and nonmultimorbid people. Three hundred community‐dwelling adults, representative of the Hong Kong Chinese population, provided real‐time self‐reports of daily routines over a 7‐day study period. Stratified by baseline multimorbidity status, we implemented generalized linear mixed models (binomial) for each of the four outcomes: meal, chores, conversation, and work/school, with time intervals as independent variable and potential confounders adjusted. The odds of engaging in these activities were compared between multimorbid and nonmultimorbid participants by time intervals. Significant differences were identified. Unlike nonmultimorbid participants, late evening (22:00–24:00) was estimated to be the most frequently observed meal time among multimorbid participants (adjusted odds ratio [AOR] = 8.21, 95% confidence interval [CI] = 2.59–26.01 vs. 14:00–16:00), who also did chores significantly earlier in the morning (AOR = 1.97, 95% CI = 1.09–3.58 in 8:00–10:00 vs. 14:00–16:00). Conversations were significantly less likely among multimorbid participants throughout the day. Last, multimorbid participants seemed to have less typical working/schooling hours. Further studies are warranted to investigate how these disruptions may lead to lower levels of quality of life and poorer mental health.

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Regular Source of Care for the Elderly: A Cross-National Comparative Study of Hong Kong With 11 Developed Countries

Cited by 12 publications

References 20 publications

Poverty affects access to regular source of primary care among the general population in Hong Kong

Poverty affects access to regular source of primary care among the general population in Hong Kong

It's Not a Small World After All

How does chronic multimorbidity affect daily routines? An experience sampling study of community‐dwelling adults in Hong Kong

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