Priority setting of hospital services: a demonstration project involving clinicians and citizens in Hong Kong

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Journal Article

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Public hospitals, Community health services, Health care rationing, Hospitals--Administration, Cost of medical care, History


Objective: To present the findings of a demonstration project on working within a framework of empirically-measured community values to establish a more rational and transparent method of fee-charging and priority setting for public hospital services in Hong Kong.

Approach: The study was undertaken by the authors. Using the Delphi method, the study sought to identify medical interventions which a panel of clinical experts considered to be relatively ineffective and a panel of lay persons regarded as non-essential from a public subsidy point of view.

Results: Consensus existed among and between doctors and lay persons on a small number of interventions for which a fee should be charged, generally (1) elective procedures; (2) interventions where cheaper substitutes were available; and (3) preventive and early detection services.

Conclusions: The current policy of providing most public hospital services free or at a nominal charge should continue, as the bulk of these services do not fall within the three categories identified for exclusion by this study. Hence, adopting a policy of excluding non-core list items must not be seen as the sole solution to health care financing problems in Hong Kong, as the amount of money that can be recovered from excluded services is not likely to be significant.

Source Publication

Asia Pacific Journal of Health Management

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