Skip to main content
Top
Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Research article

Comparison of primary care experiences among adults in general outpatient clinics and private general practice clinics in Hong Kong

Authors: Samuel YS Wong, Kenny Kung, Sian M Griffiths, Tanya Carthy, Martin CS Wong, Su V Lo, Vincent CH Chung, William B Goggins, Barbara Starfield

Published in: BMC Public Health | Issue 1/2010

Login to get access

Abstract

Background

The main goal of Hong Kong's publicly-funded general outpatient clinics (GOPCs) is to provide primary medical services for the financially vulnerable. The objective of the current study was to compare the primary care experiences of GOPC users and the users of care provided by private general practitioners (GPs) in Hong Kong via a territory-wide telephone survey.

Methods

One thousand adults in Hong Kong aged 18 and above were interviewed by a telephone survey. The modified Chinese translated Primary Care Assessment Tool was used to collect data on respondents' primary care experience.

Results

Our results indicated that services provided by GOPC were more often used by female, older, poorer, chronically-ill and less educated population. GOPC participants were also more likely to have visited a specialist or used specialist services (69.7% vs. 52.0%; p < 0.001), although this difference in utilization of specialist services disappeared after adjusting for age (55.7% vs. 52.0%, p = 0.198). Analyses were also performed to asses the relationship between healthcare settings (GOPCs versus private GPs) and primary care quality. Private GP patients achieved higher overall PCAT scores largely due to better accessibility (Mean: 6.88 vs. 8.41, p < 0.001) and person-focused care (Mean: 8.37 vs. 11.69, p < 0.001).

Conclusions

Our results showed that patients primarily receiving care from private GPs in Hong Kong reported better primary care experiences than those primarily receiving care from GOPCs. This was largely due to the greater accessibility and better interpersonal relationships offered by the private GPs. As most patients use both GOPCs and private GPs, their overall primary care experiences may not be as different as the findings of this study imply.
Appendix
Available only for authorised users
Literature
2.
go back to reference Starfield B, Shi L, Macinko J: Contribution of primary care to health systems and health. Milbank Q. 2005, 83: 457-502. 10.1111/j.1468-0009.2005.00409.x.CrossRefPubMedPubMedCentral Starfield B, Shi L, Macinko J: Contribution of primary care to health systems and health. Milbank Q. 2005, 83: 457-502. 10.1111/j.1468-0009.2005.00409.x.CrossRefPubMedPubMedCentral
3.
go back to reference Shi L, Starfied B: Primary care, income inequality, and self-rated health in the United States: A mixed level analysis. Int J Health Serv. 2000, 30: 541-555. 10.2190/N4M8-303M-72UA-P1K1.CrossRefPubMed Shi L, Starfied B: Primary care, income inequality, and self-rated health in the United States: A mixed level analysis. Int J Health Serv. 2000, 30: 541-555. 10.2190/N4M8-303M-72UA-P1K1.CrossRefPubMed
4.
go back to reference Starfield B: Primary care: Balancing Health Needs, Services, and Technology. 1994, New York: Oxford University Press Starfield B: Primary care: Balancing Health Needs, Services, and Technology. 1994, New York: Oxford University Press
5.
go back to reference Bindman AB, Grumbach K, Osmond D, Varanizan K, Stewart AL: Primary care and receipt of preventive services. J Gen Intern Med. 1996, 11: 269-276. 10.1007/BF02598266.CrossRefPubMed Bindman AB, Grumbach K, Osmond D, Varanizan K, Stewart AL: Primary care and receipt of preventive services. J Gen Intern Med. 1996, 11: 269-276. 10.1007/BF02598266.CrossRefPubMed
6.
go back to reference Greenfield S, Rogers W, Mangotich M, Carney MF, Tarlov AR: Outcomes of patients with hypertension and non-insulin-dependent diabetes melltisu tereated by different systems and specialities: results from the medical outcomes study. JAMA. 1995, 274: 1436-1444. 10.1001/jama.274.18.1436.CrossRefPubMed Greenfield S, Rogers W, Mangotich M, Carney MF, Tarlov AR: Outcomes of patients with hypertension and non-insulin-dependent diabetes melltisu tereated by different systems and specialities: results from the medical outcomes study. JAMA. 1995, 274: 1436-1444. 10.1001/jama.274.18.1436.CrossRefPubMed
7.
go back to reference World Health Organization: From Alma-Ata to the year 2000. Reflections at the midpoint. Geneva. 1988 World Health Organization: From Alma-Ata to the year 2000. Reflections at the midpoint. Geneva. 1988
8.
go back to reference Donaldson M, Yordy K, Lohr K, Vanselow N: Primary care: America's health in a new era. 1996, Washington, DC: National Academy Press Donaldson M, Yordy K, Lohr K, Vanselow N: Primary care: America's health in a new era. 1996, Washington, DC: National Academy Press
9.
go back to reference Saltman RB, Rico A, Boerma W: European Observatory on Health Systems and Policies Series - Primary care in the driver's seat? Organizational reform in European primary care. 2006, London: Open University Press Saltman RB, Rico A, Boerma W: European Observatory on Health Systems and Policies Series - Primary care in the driver's seat? Organizational reform in European primary care. 2006, London: Open University Press
10.
13.
go back to reference World Health Organization Commission on Social Determinants of Change: Closing the gap in a generation: health equity through action on the social determinants of health. Geneva. 2008 World Health Organization Commission on Social Determinants of Change: Closing the gap in a generation: health equity through action on the social determinants of health. Geneva. 2008
15.
go back to reference Shi L: Type of health insurance and the quality of primary care experience. Am J of Public Health. 2000, 90: 1848-1855. 10.2105/AJPH.90.12.1848.CrossRef Shi L: Type of health insurance and the quality of primary care experience. Am J of Public Health. 2000, 90: 1848-1855. 10.2105/AJPH.90.12.1848.CrossRef
16.
go back to reference Shi L, Macinko J, Starfield B, Xu J, Politzer R: Primary care, income inequality, and stroke mortality in the United States: A longitudinal analysis: 1985-1995. Stroke. 2003, 34: 1958-1964. 10.1161/01.STR.0000082380.80444.A9.CrossRefPubMed Shi L, Macinko J, Starfield B, Xu J, Politzer R: Primary care, income inequality, and stroke mortality in the United States: A longitudinal analysis: 1985-1995. Stroke. 2003, 34: 1958-1964. 10.1161/01.STR.0000082380.80444.A9.CrossRefPubMed
17.
go back to reference Shi L, Stevens GD: The role of community health centres in delivering primary care to the underserved. Experiences of the uninsured and Medicaid insured. J Ambul Care Manage. 2007, 30: 159-170.CrossRefPubMed Shi L, Stevens GD: The role of community health centres in delivering primary care to the underserved. Experiences of the uninsured and Medicaid insured. J Ambul Care Manage. 2007, 30: 159-170.CrossRefPubMed
18.
go back to reference Food and Health Bureau, HKSAR: 2008, Your health, your life. Healthcare reform consultation document. Hong Kong Food and Health Bureau, HKSAR: 2008, Your health, your life. Healthcare reform consultation document. Hong Kong
19.
go back to reference Medical Services Development Committee: 2005, Alternative Models for General Outpatient Service. Hong Kong Medical Services Development Committee: 2005, Alternative Models for General Outpatient Service. Hong Kong
22.
go back to reference Shi L, Starfield B, Xu J, Politzer RM, Regan J: Primary care quality: community health center and health maintenance organization. Southern Med J. 2003, 96: 787-795. 10.1097/01.SMJ.0000066811.53167.2E.CrossRefPubMed Shi L, Starfield B, Xu J, Politzer RM, Regan J: Primary care quality: community health center and health maintenance organization. Southern Med J. 2003, 96: 787-795. 10.1097/01.SMJ.0000066811.53167.2E.CrossRefPubMed
23.
go back to reference Shi L, Starfield B, Xu J: Validating the Adult Primary Care Assessment Tool. J Fam Pract. 2001, 50: E1- Shi L, Starfield B, Xu J: Validating the Adult Primary Care Assessment Tool. J Fam Pract. 2001, 50: E1-
25.
go back to reference Lu JR, Leung GM, Kwon S, Tin KYK, van Doorslaer E, O'Donnell O: Horizontal equity in health care utilization evidence from three high income Asian economies. Soc Sci Med. 2007, 64: 199-212. 10.1016/j.socscimed.2006.08.033.CrossRefPubMed Lu JR, Leung GM, Kwon S, Tin KYK, van Doorslaer E, O'Donnell O: Horizontal equity in health care utilization evidence from three high income Asian economies. Soc Sci Med. 2007, 64: 199-212. 10.1016/j.socscimed.2006.08.033.CrossRefPubMed
26.
go back to reference Chung V, Wong E, Woo J, Lo SV, Griffiths S: Use of traditional Chinese medicine in Hong Kong special administrative region of China. J Altern Complement Med. 2007, 13: 361-367. 10.1089/acm.2006.6152.CrossRefPubMed Chung V, Wong E, Woo J, Lo SV, Griffiths S: Use of traditional Chinese medicine in Hong Kong special administrative region of China. J Altern Complement Med. 2007, 13: 361-367. 10.1089/acm.2006.6152.CrossRefPubMed
27.
go back to reference Chung V, Lau CH, Yeoh EK, Griffiths S: Age, chronic non-communicable disease and choice of traditional Chinese and western medicine outpatient services in a Chinese population. BMC Health Serv Res. 2009, 9: 207-10.1186/1472-6963-9-207.CrossRefPubMedPubMedCentral Chung V, Lau CH, Yeoh EK, Griffiths S: Age, chronic non-communicable disease and choice of traditional Chinese and western medicine outpatient services in a Chinese population. BMC Health Serv Res. 2009, 9: 207-10.1186/1472-6963-9-207.CrossRefPubMedPubMedCentral
28.
go back to reference Chung V, Hong LC, Wong E, Yeoh EK, Griffiths S: Perceived quality of communication amongst outpatients in western and traditional Chinese medicine clinics in a Chinese population. Health Policy. 2009, 90: 66-72. 10.1016/j.healthpol.2008.09.005.CrossRefPubMed Chung V, Hong LC, Wong E, Yeoh EK, Griffiths S: Perceived quality of communication amongst outpatients in western and traditional Chinese medicine clinics in a Chinese population. Health Policy. 2009, 90: 66-72. 10.1016/j.healthpol.2008.09.005.CrossRefPubMed
29.
go back to reference Griffiths S, Chung V: Development and regulation of traditional Chinese medicine practitioners in Hong Kong. Perspect Public Health. 2009, 129: 64-10.1177/1757913908101611.CrossRefPubMed Griffiths S, Chung V: Development and regulation of traditional Chinese medicine practitioners in Hong Kong. Perspect Public Health. 2009, 129: 64-10.1177/1757913908101611.CrossRefPubMed
30.
go back to reference Shi L, Stevens GD, Wulu JT, Politzer RM, Xu L: America's health centers: reducing racial and ethnic disparities in perinatal care and birth outcomes. Health Serv Res. 2004, 39: 1881-1901. 10.1111/j.1475-6773.2004.00323.x.CrossRefPubMedPubMedCentral Shi L, Stevens GD, Wulu JT, Politzer RM, Xu L: America's health centers: reducing racial and ethnic disparities in perinatal care and birth outcomes. Health Serv Res. 2004, 39: 1881-1901. 10.1111/j.1475-6773.2004.00323.x.CrossRefPubMedPubMedCentral
31.
go back to reference Gregory PM, de Jesus ML: Racial differences in birth outcomes and costs in relation to prenatal WIC participation. New J Med. 2003, 100: 29-36. Gregory PM, de Jesus ML: Racial differences in birth outcomes and costs in relation to prenatal WIC participation. New J Med. 2003, 100: 29-36.
32.
go back to reference Kowaleski-Jones L, Duncan GL: Effects of participation in the WIC program on birthweight: evidence from the National Longitudinal Survey of Youth. Special Supplemental Nutrition Program for Women, Infants, and Children. Am J Public Health. 2002, 92: 799-804. 10.2105/AJPH.92.5.799.CrossRefPubMedPubMedCentral Kowaleski-Jones L, Duncan GL: Effects of participation in the WIC program on birthweight: evidence from the National Longitudinal Survey of Youth. Special Supplemental Nutrition Program for Women, Infants, and Children. Am J Public Health. 2002, 92: 799-804. 10.2105/AJPH.92.5.799.CrossRefPubMedPubMedCentral
33.
go back to reference Leung GM, Yue R, Yeung T, Wong IO, Castan-Cameoa S, Johnston JM: Time costs of waiting, doctor-shopping and private-public sector imbalance: Microdata evidence from Hong Kong. Health Policy. 2006, 76: 1-12. 10.1016/j.healthpol.2005.04.004.CrossRefPubMed Leung GM, Yue R, Yeung T, Wong IO, Castan-Cameoa S, Johnston JM: Time costs of waiting, doctor-shopping and private-public sector imbalance: Microdata evidence from Hong Kong. Health Policy. 2006, 76: 1-12. 10.1016/j.healthpol.2005.04.004.CrossRefPubMed
Metadata
Title
Comparison of primary care experiences among adults in general outpatient clinics and private general practice clinics in Hong Kong
Authors
Samuel YS Wong
Kenny Kung
Sian M Griffiths
Tanya Carthy
Martin CS Wong
Su V Lo
Vincent CH Chung
William B Goggins
Barbara Starfield
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-397

Other articles of this Issue 1/2010

BMC Public Health 1/2010 Go to the issue