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Article: Contract medicine arrangements in Hong Kong: An example of risk-bearing provider networks in an unregulated environment

TitleContract medicine arrangements in Hong Kong: An example of risk-bearing provider networks in an unregulated environment
Authors
Issue Date2000
PublisherPergamon. The Journal's web site is located at http://www.elsevier.com/locate/socscimed
Citation
Social Science And Medicine, 2000, v. 51 n. 8, p. 1221-1229 How to Cite?
AbstractIt is increasingly common in Hong Kong and elsewhere for employers to contract directly with physician networks to provide medical services to employees. These contracts are known in Hong Kong as contract medicine arrangements. In other countries and areas, managed care organizations are generally required by regulation or legislation to ensure that services of adequate quality are provided to patients who are locked in to network providers. There are no such requirements in Hong Kong and concerns have been raised about potential quality and cost trade-offs in contract medicine arrangements. Satisfaction surveys were sent to contract medicine enrollees in one large company in Hong Kong. The response rate was 30% and analysis of non-respondent data shows that respondents were representative of their group. Comparison of satisfaction using logistic regression showed that risk-bearing networks paid by capitation had consistently lower satisfaction ratings across all major dimensions including access, interpersonal care, communication with the doctor, choice of doctor, and outcomes. These findings suggest that quality, at least as perceived by the patient, may be lower in these networks. The issue is of concern in Asia where infrastructures and data systems are not well developed to adequately monitor quality of care or protect patient interests. This study highlights the need to structure pre-paid provider networks and managed care organizations so that quality of care is not compromised. At a time when managed care concepts are being applied throughout Asia, we believe attention needs to be drawn to this problem. Copyright (C) 2000 Elsevier Science Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/86704
ISSN
2015 Impact Factor: 2.814
2015 SCImago Journal Rankings: 1.894
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorBrudevold, Cen_HK
dc.contributor.authorMcGhee, SMen_HK
dc.contributor.authorHo, LMen_HK
dc.date.accessioned2010-09-06T09:20:18Z-
dc.date.available2010-09-06T09:20:18Z-
dc.date.issued2000en_HK
dc.identifier.citationSocial Science And Medicine, 2000, v. 51 n. 8, p. 1221-1229en_HK
dc.identifier.issn0277-9536en_HK
dc.identifier.urihttp://hdl.handle.net/10722/86704-
dc.description.abstractIt is increasingly common in Hong Kong and elsewhere for employers to contract directly with physician networks to provide medical services to employees. These contracts are known in Hong Kong as contract medicine arrangements. In other countries and areas, managed care organizations are generally required by regulation or legislation to ensure that services of adequate quality are provided to patients who are locked in to network providers. There are no such requirements in Hong Kong and concerns have been raised about potential quality and cost trade-offs in contract medicine arrangements. Satisfaction surveys were sent to contract medicine enrollees in one large company in Hong Kong. The response rate was 30% and analysis of non-respondent data shows that respondents were representative of their group. Comparison of satisfaction using logistic regression showed that risk-bearing networks paid by capitation had consistently lower satisfaction ratings across all major dimensions including access, interpersonal care, communication with the doctor, choice of doctor, and outcomes. These findings suggest that quality, at least as perceived by the patient, may be lower in these networks. The issue is of concern in Asia where infrastructures and data systems are not well developed to adequately monitor quality of care or protect patient interests. This study highlights the need to structure pre-paid provider networks and managed care organizations so that quality of care is not compromised. At a time when managed care concepts are being applied throughout Asia, we believe attention needs to be drawn to this problem. Copyright (C) 2000 Elsevier Science Ltd.en_HK
dc.languageengen_HK
dc.publisherPergamon. The Journal's web site is located at http://www.elsevier.com/locate/socscimeden_HK
dc.relation.ispartofSocial Science and Medicineen_HK
dc.subject.meshCommunity Networks - organization & administrationen_HK
dc.subject.meshContract Services - organization & administrationen_HK
dc.subject.meshCost-Benefit Analysisen_HK
dc.subject.meshDelivery of Health Care - organization & administrationen_HK
dc.subject.meshHong Kongen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLogistic Modelsen_HK
dc.subject.meshManaged Care Programs - organization & administrationen_HK
dc.subject.meshPatient Satisfactionen_HK
dc.subject.meshQuality of Health Careen_HK
dc.titleContract medicine arrangements in Hong Kong: An example of risk-bearing provider networks in an unregulated environmenten_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0277-9536&volume=51&spage=1221&epage=1229&date=2000&atitle=Contract+medicine+arrangements+in+Hong+Kong:+an+example+of+risk-bearing+provider+networks+in+an+unregulated+environmenten_HK
dc.identifier.emailMcGhee, SM:smmcghee@hkucc.hku.hken_HK
dc.identifier.emailHo, LM:lmho@hkucc.hku.hken_HK
dc.identifier.authorityMcGhee, SM=rp00393en_HK
dc.identifier.authorityHo, LM=rp00360en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S0277-9536(00)00055-1en_HK
dc.identifier.pmid11037212-
dc.identifier.scopuseid_2-s2.0-0034676260en_HK
dc.identifier.hkuros55971en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0034676260&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume51en_HK
dc.identifier.issue8en_HK
dc.identifier.spage1221en_HK
dc.identifier.epage1229en_HK
dc.identifier.isiWOS:000089217700008-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridBrudevold, C=6506132254en_HK
dc.identifier.scopusauthoridMcGhee, SM=7003288588en_HK
dc.identifier.scopusauthoridHo, LM=7402955625en_HK

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