Skip to main content
×
Home

Access to primary care in Hong Kong, Greater London and New York City

  • Pui Hing Chau (a1), Jean Woo (a2), Michael K. Gusmano (a3) (a4), Daniel Weisz (a5), Victor G. Rodwin (a6) and Kam Che Chan (a7)...
Abstract
Abstract

We investigate avoidable hospital conditions (AHC) in three world cities as a way to assess access to primary care. Residents of Hong Kong are healthier than their counterparts in Greater London or New York City. In contrast to their counterparts in New York City, residents of both Greater London and Hong Kong face no financial barriers to an extensive public hospital system. We compare residence-based hospital discharge rates for AHC, by age cohorts, in these cities and find that New York City has higher rates than Hong Kong and Greater London. Hong Kong has the lowest hospital discharge rates for AHC among the population 15–64, but its rates are nearly as high as those in New York City among the population 65 and over. Our findings suggest that in contrast to Greater London, older residents in Hong Kong and New York face significant barriers in accessing primary care. In all three cities, people living in lower socioeconomic status neighborhoods are more likely to be hospitalized for an AHC, but neighborhood inequalities are greater in Hong Kong and New York than in Greater London.

Copyright
Corresponding author
*Correspondence to: Pui Hing Chau, Research Assistant Professor, Faculty of Social Sciences, The University of Hong Kong, Room 104, Meng Wah Complex, The University of Hong Kong, Pokfulam, Hong Kong, China. Email: phchau@graduate.hku.hk
References
Hide All
Agabiti N., Pirani M., Schifano P., Cesaroni G., Davoli M., Bisanti L., Caranci N., Costa G., Forastiere F., Marinacci C., Russo A., Spadea T., Perucci C. (2009), ‘Income level and chronic ambulatory care sensitive conditions in adults: a multicity population-based study in Italy’, BMC Public Health, 9: 457.
Ahmad O., Boschi-Pinto C., Lopez A. D., Murray C. J. L., Lozano R., Inoue M. (2001), Age Standardization of Rates: A New WHO World Standard. GPE Discussion Paper Series, No. 31, Geneva: World Health Organization.
Banks J., Marmot M., Oldfield Z.Smith J. P. (2006), ‘Disease and disadvantage in the United States and in England’, Journal of the American Medical Association, 295: 20372045.
Billings J.Weinick R. M. (2003), Monitoring the Health Care Safety Net, Book I: A Data Book for Metropolitan Areas, Washington, DC: Agency for Healthcare Quality and Research.
Billings J., Anderson G. M.Newman L. S. (1996), ‘Recent findings on preventable hospitalizations’, Health Affairs (Millwood), 15: 239349.
Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene (2010), Summary of Vital Statistics 2009 – the City of New York, Electronic: Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene.
Casanova C.Starfield B. (1995), ‘Hospitalizations of children and access to primary care: a cross-national comparison’, International Journal of Health Services, 25(2): 283294.
Census and Statistics Department, Hong Kong SAR Government (2009), Thematic Household Survey Report No. 41, Electronic: Census and Statistics Department, Hong Kong SAR Government.
Census and Statistics Department, Hong Kong SAR Government (2010), Hong Kong Life Tables, 1971–2010, Electronic: Census and Statistics Department, Hong Kong SAR Government.
Chau P. H.Woo J. (2008), How Well are Seniors in Hong Kong Doing? An International Comparison, Hong Kong: The Hong Kong Jockey Club.
Chau P. H., Woo J., Chan K. C., Weisz D., Gusmano M. K. (2011), ‘Avoidable mortality pattern in a Chinese population – Hong Kong, China’, European Journal of Public Health, 21: 215220.
Coyle N.Fitzpatrick J. (2009), Health and Lifestyle in London – Initial Findings from the London Boost of the Health Survey for England, Electronic: London Health Observatory.
Department of Health, Hong Kong SAR Government and Department of Community Medicine, The University of Hong Kong (2005), Population Health Survey 2003/2004, Electronic: Centre for Health Protection, Hong Kong SAR Government.
Evandrou M. (2006), ‘Inequalities Amongst Older People in London: The Challenge of Diversity’, in V. G. Rodwin and M. K. Gusmano (eds), Growing Older in World Cities, Nashville: Vanderbilt University Press.
Food and Health Bureau, Hong Kong SAR Government (2010), My Health My Choice: Healthcare Reform Second Stage Public Consultation – Consultation Document, Electronic: Food and Health Bureau, Hong Kong SAR Government.
Gusmano M. K.Allin S. (2011), ‘Health care for older persons in England and the United States: a contrast of systems and values’, Journal of Health Politics, Policy and Law, 36(1): 89118.
Gusmano M. K., Rodwin V. G.Weisz D. (2006), ‘A new way to compare health systems: avoidable hospital conditions in Manhattan and Paris’, Health Affairs (Millwood), 25: 510520.
Gusmano M. K., Rodwin V. G.Weisz D. (2010), Health Care in World Cities: London, New York and Paris, Baltimore, MD: Johns Hopkins University Press.
Kirby J. B.Kaneda T. (2005), ‘Neighborhood socioeconomic disadvantage and access to health care’, Journal of Health and Social Behavior, 46(1): 1531.
Leung G. M., Wong I. O. L., Chan W. S., Choi S.Lo S. V., on behalf of the Health Care Financing Study Group (2005), ‘The ecology of health care in Hong Kong’, Social Science & Medicine, 61: 577590.
Magán P., Alberquilla A., Otero A.Ribera J. M. (2011), ‘Hospitalizations for ambulatory care sensitive conditions and quality of primary care: their relation with socioeconomic and health care variables in the Madrid regional health service (Spain)’, Medical Care, 49(1): 1723.
Millman M. L. (1993), Access to Health Care in America, Washington, DC: National Academy Press.
National Health Service (2011), Help with Health Costs, Electronic: NHS.
New York City Department of Health and Mental Hygiene (2009), Community Health Survey, Electronic: New York City Department of Health and Mental Hygiene.
Office for National Statistics, United Kingdom (2010), Life Expectancy at Birth and at Age 65 by Local Areas in the United Kingdom, 2007–2009, Electronic: Office for National Statistics, United Kingdom.
Pappas G., Hadden W. C., Kozak L. J.Fisher G. F. (1997), ‘Potentially avoidable hospitalizations: inequalities in rates between US socioeconomic groups’, American Journal of Public Health, 87: 811816.
Parchman M. L.Culler S. D. (1999), ‘Preventable hospitalizations in primary care shortage areas. An analysis of vulnerable medicare beneficiaries’, Archives of Family Medicine, 8: 487491.
Parchman M. L.Culler S. (1994), ‘Primary care physicians and avoidable hospitalizations’, Journal of Family Practice, 39: 123128.
Purdy S., Griffin T., Salisbury C.Sharp D. (2009), ‘Ambulatory care sensitive conditions: terminology and disease coding need to be more specific to aid policy makers and clinicians’, Public Health, 123(2): 169173.
Ricketts T. C., Randolph R., Howard H. A., Pathman D., Carey T. (2001), ‘Hospitalization rates as indicators of access to primary care’, Health Place, 7(1): 2738.
Rodwin V. G., Brecher C., Jully D.Baxter R. (eds) (1992), Public Hospital Systems in New York and Paris, New York: New York University Press.
Roos N. P.Mustard C. (1997), ‘Variation in health and health care use by socioeconomic status in Winnipeg, Canada: does the system work well? Yes and No’, The Milbank Quarterly, 75(1): 89111.
Saha S., Solotaroff R., Oster A.Bindman A. B. (2007), ‘Are preventable hospitalizations sensitive to changes in access to primary care? The case of the Oregon Health Plan’, Medical Care, 45(8): 712719.
Starfield B. (1994), ‘Is primary care essential?’, Lancet, 344: 11291133.
Starfield B., Shi L.Macinko J. (2005), ‘Contribution of primary care to health systems and health’, The Milbank Quarterly, 83(3): 457502.
Weissman J. S., Gatsonis C.Epstein A. M. (1992), ‘Rates of avoidable hospitalization by insurance status in Massachusetts and Maryland’, Journal of the American Medical Association, 268: 23882394.
Woo J., Mak B., Cheng J. O.Choy E. (2011), ‘Identifying service needs from the users and service providers’ perspective: a focus group study of Chinese elders, health and social care professionals’, Journal of Clinical Nursing, 20: 34633471.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Health Economics, Policy and Law
  • ISSN: 1744-1331
  • EISSN: 1744-134X
  • URL: /core/journals/health-economics-policy-and-law
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 3
Total number of PDF views: 33 *
Loading metrics...

Abstract views

Total abstract views: 275 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 19th November 2017. This data will be updated every 24 hours.