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Article: Redistribution or horizontal equity in Hong Kong's mixed public-private health system: A policy conundrum

TitleRedistribution or horizontal equity in Hong Kong's mixed public-private health system: A policy conundrum
Authors
Issue Date2009
PublisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/5749
Citation
Health Economics, 2009, v. 18 n. 1, p. 37-54 How to Cite?
AbstractWe examine the distributional characteristics of Hong Kong's mixed public-private health system to identify the net redistribution achieved through public spending on health care, compare the income-related inequality and inequity of public and private care and measure horizontal inequity in health-care delivery overall. Payments for public care are highly concentrated on the better-off whereas benefits are pro-poor. As a consequence, public health care effects significant net redistribution from the rich to the poor. Public care is skewed towards the poor in part not only because of allocation according to need but also because the rich opt out of the public sector and consume most of the private care. Overall, there is horizontal inequity favouring the rich in general outpatient care and (very marginally) inpatient care. Pro-rich bias in the distribution of private care outweighs the pro-poor bias of public care. A lesser role for private finance may improve horizontal equity of utilisation but would also reduce the degree of net redistribution through the public sector. Copyright © 2008 John Wiley & Sons, Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/151669
ISSN
2015 Impact Factor: 2.151
2015 SCImago Journal Rankings: 1.364
ISI Accession Number ID
Funding AgencyGrant Number
Central Policy Unit of the Government of the Hong Kong Special Administrative Region
the Research Grants Council Of the Hong Kong Special Administrative Region, ChinaHKU 7011-PPR20051
European Commission INCO-DEV programmeICA4-CT-2001-10015
Funding Information:

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. HKU 7011-PPR20051) and the European Commission INCO-DEV programme (ICA4-CT-2001-10015). GML is grateful to the Takemi Program of the Harvard School of Public Health for hosting his sabbatical leave during which part of this work was completed.

References
Grants

 

DC FieldValueLanguage
dc.contributor.authorLeung, GMen_US
dc.contributor.authorTin, KYKen_US
dc.contributor.authorO'donnell, Oen_US
dc.date.accessioned2012-06-26T06:26:20Z-
dc.date.available2012-06-26T06:26:20Z-
dc.date.issued2009en_US
dc.identifier.citationHealth Economics, 2009, v. 18 n. 1, p. 37-54en_US
dc.identifier.issn1057-9230en_US
dc.identifier.urihttp://hdl.handle.net/10722/151669-
dc.description.abstractWe examine the distributional characteristics of Hong Kong's mixed public-private health system to identify the net redistribution achieved through public spending on health care, compare the income-related inequality and inequity of public and private care and measure horizontal inequity in health-care delivery overall. Payments for public care are highly concentrated on the better-off whereas benefits are pro-poor. As a consequence, public health care effects significant net redistribution from the rich to the poor. Public care is skewed towards the poor in part not only because of allocation according to need but also because the rich opt out of the public sector and consume most of the private care. Overall, there is horizontal inequity favouring the rich in general outpatient care and (very marginally) inpatient care. Pro-rich bias in the distribution of private care outweighs the pro-poor bias of public care. A lesser role for private finance may improve horizontal equity of utilisation but would also reduce the degree of net redistribution through the public sector. Copyright © 2008 John Wiley & Sons, Ltd.en_US
dc.languageengen_US
dc.publisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/5749en_US
dc.relation.ispartofHealth Economicsen_US
dc.subject.meshDelivery Of Health Care - Economics - Organization & Administrationen_US
dc.subject.meshFinancing, Government - Economicsen_US
dc.subject.meshFinancing, Personal - Economicsen_US
dc.subject.meshHealth Care Reform - Economicsen_US
dc.subject.meshHealth Policy - Economicsen_US
dc.subject.meshHealthcare Disparities - Economicsen_US
dc.subject.meshHong Kongen_US
dc.subject.meshHumansen_US
dc.subject.meshPrivate Sector - Economicsen_US
dc.subject.meshPublic Sector - Economicsen_US
dc.subject.meshSocioeconomic Factorsen_US
dc.titleRedistribution or horizontal equity in Hong Kong's mixed public-private health system: A policy conundrumen_US
dc.typeArticleen_US
dc.identifier.emailLeung, GM:gmleung@hku.hken_US
dc.identifier.emailTin, KYK:tinyiuke@hku.hken_US
dc.identifier.authorityLeung, GM=rp00460en_US
dc.identifier.authorityTin, KYK=rp00494en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1002/hec.1342en_US
dc.identifier.pmid18264997-
dc.identifier.scopuseid_2-s2.0-61449514279en_US
dc.identifier.hkuros155231-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-61449514279&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume18en_US
dc.identifier.issue1en_US
dc.identifier.spage37en_US
dc.identifier.epage54en_US
dc.identifier.isiWOS:000262275300004-
dc.publisher.placeUnited Kingdomen_US
dc.relation.projectHorizontal equity in health care utilization in Hong Kong-
dc.identifier.scopusauthoridLeung, GM=7007159841en_US
dc.identifier.scopusauthoridTin, KYK=7003796897en_US
dc.identifier.scopusauthoridO'Donnell, O=6601988937en_US

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