L24: Healthcare Organisation In HK

Question 1

Components of health system

Answer 1

1. Deliver health care
2. Money
   - general revenue
   - social and private insurance
   - out-of-pocket
   - medical savings accounts
3. Regulators, financial intermediaries
   - Regulatory bodies
   - governement
   - insurance companies
4. Specialised inputs
   - drug and device manufacturers
   - schools
5. Preventative services
   - family planning
   - immunisation
   - health promotion

Question 2

Well-functioning health system

Answer 2

1. Improving health status
2. Defending against health threats
3. Protect against financial consequences of ill-health
4. Equitable access
5. Possible to participate in decisions

Question 3

Resilient health system

Answer 3

1. Capacity to effectively respond to crises
2. Good health outcome during and after crises
3. Everyday benefits and positive health outcomes

Question 4

Central knobs for health system reform by government

Answer 4

FPORB

1. Financing: raise money
2. Payment: pay providers
3. Organisation: assign roles and functions
4. Regulation: force to alter behaviour
5. Behaviour: Influence how providers and patients behave

Question 5

Macroorganisation of Hong Kong health system

Answer 5

Public
Food and Health Bureau
—> Hospital Authority
—> DoH / Centre for Health Protection (surveillance, health promotion, regulatory, clinical services)
—> Food and Environmental Hygiene Department
—> Agriculture, Fisheries and Conservation Department

Private
Private insurers / Managed care organisation
—> Western
—> Chinese
—> Dental
—> Laboratories
—> Ambulatory care
—> Residential care

Question 6

Hong Kong health system

Answer 6

Expenditure:

• 6% GDP (efficient)
• Rising faster than GDP
• 50% public, 50% private
• mainly out-of-pocket
• rising private health insurance
• public HE mainly at hospitals

Comparison with other economies
- Comparable quality

Question 7

Health system reform in Hong Kong

Answer 7

1. The Harvard Proposal
   - compulsory social insurance scheme + health savings account
2. Health Protection Scheme
3. Voluntary Health Insurance Scheme (自願醫保)