What are the financial barriers to medical care among the poor, the sick and the disabled in the Special Administrative Region of China?

PLoS One. 2018 Nov 14;13(11):e0205794. doi: 10.1371/journal.pone.0205794. eCollection 2018.

Abstract

Although Hong Kong is one of the richest cities in the world and has some of the best health outcomes such as long life expectancy, little is known about the people who are unable to access healthcare due to lack of financial means. Cross-sectional data from a sample of 2,233 participants aged 18 or above was collected from the first wave of the "Trends and Implications of Poverty and Social Disadvantages in Hong Kong" survey. Socio-demographic factors, lifestyle factors, and physical and mental health conditions associated with people who were unable to seek medical services due to lack of financial means in the past year were examined using forward stepwise logistic regression analyses. Of the 2,233 participants surveyed, 8.4% did not seek medical care due to lack of financial means during the past year. They were more likely to be income-poor. With respect to physical and mental health, despite having less likelihood to have multimorbidity, they tended to have higher levels of both anxiety and stress, poorer physical and mental health-related quality of life, and suffer from more severe disability and pain symptoms affecting their daily activities, when compared to the rest of the Hong Kong population. People who were denied of medical care due to financial barriers are generally sicker than people in the general Hong Kong population, implying that those with greater healthcare needs may have financial difficulties in receiving timely and appropriate medical care. Our findings suggest that inequity in healthcare utilization remains a critical issue in Hong Kong.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety Disorders / economics*
  • Anxiety Disorders / epidemiology
  • Cross-Sectional Studies
  • Female
  • Health Care Costs*
  • Hong Kong / epidemiology
  • Humans
  • Income
  • Male
  • Mental Health / economics*
  • Middle Aged
  • Patient Acceptance of Health Care*
  • Persons with Disabilities
  • Quality of Life
  • Surveys and Questionnaires
  • Young Adult

Grants and funding

The work described in this paper was fully supported by a grant from the Central Policy Unit of the Government of the Hong Kong Special Administrative Region and the Research Grants Council of the Hong Kong Special Administrative Region, China (Project No. 4003-SPPR-11 to HW). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.