Utilization of elderly health care vouchers on dental services in Hong Kong

Abstract

The Elderly Health Care Voucher (EHCV) Scheme was launched by the Hong Kong government in 2009 to ease the financial burden of the elderly and to supplement their expenses at private healthcare services, hence alleviating the burden of the public sector which was overstrained. The objectives of this study were to describe the utilization pattern of the EHCV among the elderly in Hong Kong, to assess the effectiveness of EHCV in promoting their use of dental care services, to compare their perceived and the nominative dental treatment needs and to provide primary preventive dental treatments for the elderly in an outreach setting. Elderly from two district community centers in Wong Tai Sin were invited to participate in the project. The field work of this study comprised three major sessions in sequence: (1) oral health talk, (2) questionnaire survey and oral examination, and (3) primary dental care services. A structured questionnaire was used in a face-to-face interview to collect information regarding the elderly’s knowledge and utilization of EHCV, perceived oral health status, and willingness to use EHCV on their assessed dental treatment needs. A total of 101 elderly participated in this study. It was found that most (>85%) of them had good knowledge about the EHCV scheme and 87% of them had used the scheme in the past year with services from private medical practitioners being the most common usage (used by 70% of the elderly). Only 14% of the elderly had used EHCV on dental services in the past year and the amount used was used. There were marked differences between the elderly’s perceived oral conditions and the actual clinical status. Most of them were not aware of their actual conditions, e.g. dental caries and periodontal disease. No perceived needs was the main reason (39%) given by the participants who had not visited a dentist in the past year. After being informed of their dental treatment needs as found in the clinical examination, 74% of the elderly expressed willingness to spend their EHCV on dental services. The outreach dental service in this project was able to raise the elderly’s oral health awareness and tackle some of their problems such as small carious cavity, mild periodontal disease and denture problems. The Hong Kong government and the dental profession should collaborate to educate the elderly, to increase their awareness of their own oral health status and treatment needs, and to promote the use of their EHCV on necessary dental services instead of saving it annually. The government should also review the scheme and revise the EHCV amount regularly.