Skip to main content
×
Home
    • Aa
    • Aa

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
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

N. Agabiti , M. Pirani , P. Schifano , G. Cesaroni , M. Davoli , L. Bisanti , N. Caranci , G. Costa , F. Forastiere , C. Marinacci , A. Russo , T. Spadea , C. Perucci (2009), ‘Income level and chronic ambulatory care sensitive conditions in adults: a multicity population-based study in Italy’, BMC Public Health, 9: 457.

J. Banks , M. Marmot , Z. Oldfield J. P. Smith (2006), ‘Disease and disadvantage in the United States and in England’, Journal of the American Medical Association, 295: 20372045.

J. Billings , G. M. Anderson L. S. Newman (1996), ‘Recent findings on preventable hospitalizations’, Health Affairs (Millwood), 15: 239349.

C. Casanova B. Starfield (1995), ‘Hospitalizations of children and access to primary care: a cross-national comparison’, International Journal of Health Services, 25(2): 283294.

P. H. Chau , J. Woo , K. C. Chan , D. Weisz , M. K. Gusmano (2011), ‘Avoidable mortality pattern in a Chinese population – Hong Kong, China’, European Journal of Public Health, 21: 215220.

M. K. Gusmano S. Allin (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.

M. K. Gusmano , V. G. Rodwin D. Weisz (2006), ‘A new way to compare health systems: avoidable hospital conditions in Manhattan and Paris’, Health Affairs (Millwood), 25: 510520.

J. B. Kirby T. Kaneda (2005), ‘Neighborhood socioeconomic disadvantage and access to health care’, Journal of Health and Social Behavior, 46(1): 1531.

G. M. Leung , I. O. L. Wong , W. S. Chan , S. Choi S. V. Lo , on behalf of the Health Care Financing Study Group (2005), ‘The ecology of health care in Hong Kong’, Social Science & Medicine, 61: 577590.

P. Magán , A. Alberquilla , A. Otero J. M. Ribera (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.

G. Pappas , W. C. Hadden , L. J. Kozak G. F. Fisher (1997), ‘Potentially avoidable hospitalizations: inequalities in rates between US socioeconomic groups’, American Journal of Public Health, 87: 811816.

M. L. Parchman S. D. Culler (1999), ‘Preventable hospitalizations in primary care shortage areas. An analysis of vulnerable medicare beneficiaries’, Archives of Family Medicine, 8: 487491.

S. Purdy , T. Griffin , C. Salisbury D. Sharp (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.

T. C. Ricketts , R. Randolph , H. A. Howard , D. Pathman , T. Carey (2001), ‘Hospitalization rates as indicators of access to primary care’, Health Place, 7(1): 2738.

N. P. Roos C. Mustard (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.

S. Saha , R. Solotaroff , A. Oster A. B. Bindman (2007), ‘Are preventable hospitalizations sensitive to changes in access to primary care? The case of the Oregon Health Plan’, Medical Care, 45(8): 712719.

B. Starfield (1994), ‘Is primary care essential?’, Lancet, 344: 11291133.

B. Starfield , L. Shi J. Macinko (2005), ‘Contribution of primary care to health systems and health’, The Milbank Quarterly, 83(3): 457502.

J. S. Weissman , C. Gatsonis A. M. Epstein (1992), ‘Rates of avoidable hospitalization by insurance status in Massachusetts and Maryland’, Journal of the American Medical Association, 268: 23882394.

J. Woo , B. Mak , J. O. Cheng E. Choy (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? *
×