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Rationing hospital services in Hong Kong: priority setting by clinicians using the Delphi method
Peter P Yuen1, Derek Gould, M Y Cheng
1Department of Management, Hong Kong Polytechnic University, Hung Hom, Kowloon, China. mspeter@polyu.edu.hk
Health Services Management Research
|February 22, 2002
Summary
Clinicians in Hong Kong identified interventions for potential charges based on effectiveness. However, the limited number of suitable interventions suggests rationing alone won't solve healthcare financing issues.
Area of Science:
- Health Services Research
- Healthcare Management
- Public Health Policy
Background:
- Hong Kong's public hospitals face financial challenges.
- Priority setting is crucial for resource allocation in healthcare.
- Evaluating interventions for cost-effectiveness is essential.
Purpose of the Study:
- To explore clinician-led priority setting for charging interventions in public hospitals.
- To identify interventions with questionable effectiveness suitable for charging.
- To assess the financial impact of rationing specific healthcare services.
Main Methods:
- A three-round Delphi exercise involving 35 chiefs-of-service from Hong Kong public hospitals.
- Identification and consensus-building on interventions to be charged.
- Analysis of intervention characteristics (e.g., preventive, elective, sex-related).
Main Results:
- 246 interventions were initially identified; 126 reached high consensus for potential charging.
- Interventions scoring high included preventive services, elective treatments, and sex-related condition procedures.
- The potential revenue from charging these interventions is unlikely to be substantial.
Conclusions:
- Rationing healthcare services based on effectiveness is a complex process.
- The financial gains from charging a limited set of interventions are minimal.
- Rationing alone is insufficient to address the broader healthcare financing problems in Hong Kong.