The determinants affecting the utilization of elderly primary health care in Hong Kong

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The determinants affecting the utilization of elderly primary health care in Hong Kong


Author: Chiu, Pui-yin
Title: The determinants affecting the utilization of elderly primary health care in Hong Kong
Degree: M.Sc.
Year: 1999
Subject: Older people -- Medical care -- China -- Hong Kong
Community health services -- Utilization -- China -- Hong Kong
Medical care -- Utilization -- China -- Hong Kong
Primary health care -- China -- Hong Kong
Hong Kong Polytechnic University -- Dissertations
Department: Multi-disciplinary Studies
Dept. of Management
Pages: vi, 96 leaves : ill. ; 30 cm
Language: English
Abstract: Hong Kong has undergone rapid socio-economic growth and demographic changes in past few decades. Together with medical advance, we are now facing the same problem, aging population, as in other developed countries. Thus the government has to develop a wide range of services to meet the health care needs of the elderly population. Amongst others, primary health care has become an important area in developing health services for the elderly. With the setting up of the Elderly Health Services by the Department of Health in 1998, an integrated and multi-disciplinary approach in providing primary health care services for the elderly was introduced. This study aims to identify the predictors affecting the use of elderly primary health care services to direct service planning and implementation strategy of the elderly health centres. The Andersen's (1968) behavioral model was adopted to study the use of health services by the elderly. The model developed consisted of predisposing characteristics, enabling resources and need as the independent variables. Attendance for curative treatment and health promotional activities for a 3-month period were the dependent variables used to represent utilization of health services. A correlational study using multivariate analysis was conducted to determine the relationship between the independent and dependent variables. A study sample consisted of 300 subjects were selected by simple random sampling from 537 enrollments of seven elderly health centres in June 1998. Multiple regression analysis showed that the model of this study could predict total attendance of clients of elderly health centres with F-ratio of 2.71 (p <.001) and an overall explained variance of 13%. It was found that male clients had more attendance, clients with less money to spend used the services more, clients with no regular contact with people and those with nutritional problem were more frequent users. All three components, namely predisposing characteristics, enabling resources and need, were proven to have significant contributions in predicting use of health services. Enabling resources as a group had the greatest effect on total attendance. With the identification of significant predictors in use of elderly primary health services, the elderly health centres should enhance services for elderly with low income, less social support, nutritional problems and poor self-rated health as well as encourage elderly living in the community and those with medical problems to attend health promotional activities. For future studies, independent variables at the macro level (e.g. health policy, health care system, access and barriers to health care) and outcome measurements (e.g. health status and customer satisfaction) may be added to increase the explanatory power of the existing model.

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