Author: Sum, Wing Man Rita
Title: How does healthcare voucher system affect optometric vision care utilization among older people in Hong Kong?
Advisors: Yap, Maurice (SO)
Degree: DHSc
Year: 2019
Subject: Older people -- Medical care -- Economic aspects -- China -- Hong Kong
Eye -- Care and hygiene
Medical care -- China -- Hong Kong
Medical policy -- China -- Hong Kong
Hong Kong Polytechnic University -- Dissertations
Department: Faculty of Health and Social Sciences
Pages: xiii, 178 pages
Language: English
Abstract: Hong Kong has a dual-track health care system providing choices of service. The public health care system is heavily subsidized by the government and most of the services have a long waiting queue. The Elderly Health Care Voucher Scheme is an initiative by the government to provide financial incentive to older people to choose private healthcare services according to their needs and promote preventive care. Vision care delivered by optometrists is one of the 10 healthcare services in the Scheme. Older people have a higher prevalence of eye abnormalities and visual impairment. They need regular eye assessment for early detection and intervention by vision care professionals. Up to now, there is no study in the literature investigating the utilization of optometric vision care services among older people in Hong Kong. This study fills the current knowledge gaps regarding the use of vision care services and also provides information about the change in optometric vision care utilization and visual status with the use of health care vouchers. This study consists of three parts. In the first part, a mixed methods approach was adopted to understand the vision care utilization and voucher use among the older population. One thousand one hundred and fifty-six older people were recruited to respond to an assisted self-administered questionnaire. Twenty participants were recruited by purposive sampling for a semi-structured face-to-face interview. Insufficient access to information of private service and service fragmentation were found as barriers to access of vision care. Hierarchical logistic regressions found usage of voucher was associated with the time of last eye assessment in either public or private service. Those who had not used the voucher on optometric vision care service before did not have eye assessment as regularly as those who did. Older people who need spectacles were more likely to use their voucher on vision care. The second part involves clinical data collection from optometric practices. Older people who used voucher for their first eye assessment were recruited. About 70% of the older people could have their vision corrected by spectacles. Eighteen per cent of those attending was referred to the specialist care. In the third part, 389 optometrists were interviewed to understand their comments to the voucher scheme. Optometrists generally agreed that the voucher scheme was useful to the optometry profession. The optometrists suggest close monitoring by the government to enhance the operation of the voucher scheme. In conclusion, these findings can facilitate understanding to the optometric vision care utilization and aid further enhancement to the voucher scheme.
Rights: All rights reserved
Access: restricted access

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