|
Domestic health expenditure in Hong Kong: 1989/90 to 2001/02
GM Leung, KYK Tin, RYT Yeung, R Rannan-Eliya, ESK Leung, DWS Lam, SV Lo
Department of Community Medicine and School of Public Health, The University of Hong Kong, Pokfulam Road, Hong Kong
OBJECTIVE. To estimate the total domestic health
expenditure in Hong Kong between fiscal years 1989/90 and 2001/02,
with breakdown by financing source, provider, and function over
time.
METHODS. The standard health accounting methods
as per the Organisation for Economic Co-operation and Development
System of Health Accounts guidelines of 2000 were adopted.
RESULTS. Total domestic health expenditure was $68
620 million in the fiscal year 2001/02. In real terms, expenditure
grew at an average rate of 7% while gross domestic product increased
by 4% during the same period. This indicates a growing share of
health spending relative to gross domestic product, from 3.8% in
1989/90 to 5.5% in 2001/02. This upward trend was largely driven
by increased public spending that rose 208% in real terms over the
period, compared with 76% for private spending. Out-of-pocket payments
by households accounted for about 70% of private spending while
employers and insurance accounted for 28%. Private insurance plays
an increasingly important role in financing private spending whereas
household expenditure has shown a corresponding decrease during
the period. Expenditure incurred at providers of ambulatory services
and hospitals accounted for more than 70% of total health expenditure
during the observed period. Hospitals’ share of total spending
increased by 18%, reaching 45% of total expenditure in 2001/02,
whilst the share of providers of ambulatory services reduced to
30% in 2001/02. The two largest functional components of total health
expenditure were ambulatory care (35-41%) and in-patient curative
care (20-27%). Public spending generally financed in-patient curative
care and ambulatory services; private spending was concentrated
on ambulatory services and medical goods outside the patient care
setting.
CONCLUSION. These data provide important information
for the public, policymakers, and researchers to assess the performance
of the health care system longitudinally, and to evaluate health
expenditure-related policies.
Hong Kong Med J 2006;12:47-55
Key words: Delivery of health care; Health expenditures; Hong Kong
|
