HMSC 健康管理與社會關懷 Health Management and Social Care

Primary care
Primary health care health promotion, illness prevention, care of the sick, advocacy and community development	Primary medical care a component of primary health care which is the health services provided by qualified health professionals such as family doctors

Three levels of medical care

Primary medical care	Secondary medical care	Tertiary medical care
first point of contact that patients make with their doctors	specialist medical care	highly complex and costly hospital care
such as general practitioners	hospital care - in‐patient care, day surgery, specialist out‐patient, and Accident and Emergency services	such as organ transplants and radio-surgery of the brain

Healthcare System in Hong Kong

Policy Objective： to ensure no one is deprived of medical care because of lack of means
Health Bureau - Policy Making	Hospital Authority management of public hospitals, specialist clinics and related outreaching services	Department of Health promotive, preventive, curative and rehabilitative services

Public and Private Sectors and their Roles in Healthcare Services

Public Sector	Private Sector
predominant provider of secondary and tertiary healthcare services provides Hong Kong citizens with equitable access to healthcare service at highly subsidized rates a safety net for all with four areas of services: Acute and emergency care lower-income and under-privileged groups Illnesses that entail cost, advanced technology and multi-disciplinary professional team work Training of healthcare professionals	main provider of primary care complements public healthcare by offering choice for those who can afford and are willing to use private healthcare services offers personalised choices, enhanced privacy and more accessible services

Burden of Public Sector: Adjusting the balance between Public and Private Sectors

Reasons	Ways to adjust
Ageing population leads to an increasing need on secondary / tertiary medical care , i.e. expanding healthcare expenditure in public secto Public sector cannot meet the needs by an increased deployment of human resources in short term Workload of medical and health professionals in the public sector is heavy Waiting lists and waiting time on the treatment for chronic illnesses in public sector becomes longer and longer	Strengthen Public Safety Net - deploy more manpower and resources in public sector Review Healthcare Manpower Planning - Increase the training Enhance Primary Care Promote Public-Private Partnership Voluntary Health Insurance Scheme Review Regulation of Private Healthcare Facilities Develop Electronic Health Record Sharing

Public-private collaboration

Forms of public-private collaboration	Benefits
subsidy of the services provided by private sector makes it affordable to those patients willing to pay Shared care	control of the expanding cost: from being the major service provider to subsidizing the services with cost controlled participation of private medical and health professionals instantly provide more human resources for the treatment of patients extends patients' choice - private medical practitioners may be located in areas convenient and may be available during more convenient time for the service users some patients may choose services provided by private sector to reduce the waiting time encourages higher income segments of the population to use the services provided by the private sector the waiting list for the treatment in public sector will be shortened as some of the patients my choose services provided by private sector

Tension and crisis

Tension	Crisis
Competing resources Different visions, expectations and perspectives	Quality of services decline/ malpractice Ineffective use of resources Obstruct the coordinated service delivery that best fit the clients health services become fragmented, poorly planned and badly coordinated If services are confined to the same standard, hamper the development of the private sector

Different Health Care Systems

	Market-oriented countries	Welfare states
Rationale	Individual needs should be satisfied by the private market and family Allocation of resources according to consumers’ willingness to pay	Everyone is entitled to reasonable access to health care, regardless of the ability to pay
Policy objectives	To minimize government intervention. Government only provides assistance through Medicaid and Medicare to the low-income individuals and families	To provide universal services for all people To provide access to a comprehensive range of health services
Feature of service provision	Private Insurance, supplemented by government aid (Medicaid and Medicare in USA)	Public hospital services- free of charge for all citizens/ Fully subsidized primary health care services/ Medicine to be paid at a flat rate for each prescription

Latest Update: August 2022

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