A Geographical Study of Health Services Utilization among the Elderly in Hong Kong: From Spatial Variations to Health Care Implications

Health Services Insights

Volumn 2, Issue , 2009, Pages

  Wong, M ^a   Chau, P H ^b   Goggins, W ^c   Woo, J ^a  

^a Prince of Wales Hospital   (Hong Kong)

^b UNIVERSITY OF HONG KONG   (Hong Kong)

^c CHINESE UNIVERSITY OF HONG KONG   (Hong Kong)

Author keywords

elderly; geographic variations; healthcare delivery; services utilization

Indexed keywords

EID: 84868557216     PISSN: None     EISSN: 11786329     Source Type: Journal    
DOI: 10.4137/HSI.S3087     Document Type: Article

References (42)

1. Birdsall S.S., Planning urban service locations for the elderly. In: Golant S.M., editor. Location and environment of elderly population. New York: Wiley Halsted Press; 1979.
2. Anderson O.W., Anderson R., Patterns of use of health services. In: Freeman H., Levine S., Reeder L., editors. Handbook of medical sociology, 2nd ed. Englewood Cliff, New Jersey: Prentice-Hall; 1972.
3. Hospital Authority. Statistical Report 2001/2002 [Online] 2003 [cited 2009 Jun 10]; Available from: URL: http://www.ha.org.hk/haho/ho/hesd/123229e.pdf
4. Rennemark M., Holst G., Fagerstrom C., Halling A., Factors related to frequent usage of the primary healthcare services in old age: findings from The Swedish National Study on Ageing and Care. Health Soc Care Comm. 2009; 17(3): 304–11.
5. Joseph A.E., Phillips D.R., Accessibility and Utilization: Geographical Perspectives on Health care Delivery. London: Harper and Row Ltd: 1984.
6. Virnig B.A., Toward a better understanding of the role of geography in intensity of end-of-life care. Must we first come to an understanding of end-of-life care? Med Care. 2007: 45(5): 374–6.
7. Maheswaran R., Supply of inpatient services for elderly people and geographical variation in medical admissions in a health district in England. Public Health. 1997; 111: 411–5.
8. Wennberg J.E., Fisher E.S., Stukel T.A., Skinner J.S., Sharp S.M., Bronner K.K., Use of hospitals, physician visit, and hospice care during the last six months of life among cohorts loyal to highly respected hospitals in the United States. BMJ. 2004; 328: 607–11.
9. Busato A., Kunzi B., Primary care supply and other key determinants of health care utilization: the case of Switzerland. BMC Health Serv Res. 2008; 8: 8.
10. Westert G.P., Groenewegen P.P., Boshuizen H.C., Spreeuwenberg P.M.M., Steultjens M.P.M., Medical practice variations in hospital care; time trends of a spatial phenomenon. Health Place. 2004; 10: 215–20.
11. Thomas C., Kelman H.R., Health services use among the elderly under alternative health service delivery systems. J Community Health. 1990; 15: 77–92.
12. Kelman H.R., Thomas C., Hospital and ambulatory service use by the urban elderly under different health care delivery systems. Med Care. 1988; 26: 739–47.
13. Mutran E., Ferraro K.F., Medical need and use of services among elder men and women. J Gerontol. 1988; 43: S162–71.
14. Evashwick C., et al. Factors explaining the use of health care services by the elderly. Health Serv Res. 1984; 19: 357–82.
15. Wong C.M., Hedley A.J., Lam T.H., Bacon-Shone J., Ma S., Fung H., et al. Estimation and variations in health care needs between small areas in Hong Kong using routine statistics on morbidity, mortality and socioeconomic and demographic characteristics of the population HSRC Report # 621009 Dec 1999.
16. Lloyd O.L., Wong T.W., Wong S.L., Yu T.S.I., Atlas of disease mortalities in Hong Kong for the three five-year periods in 1979–93. Hong Kong: The Chinese University Press; 1996.
17. Fein R., On achieving access and equity in health care. Milbank Q. 1972; 50: 157–90.
18. Galvin M.E., Fan M., The utilization of physicians’ services in Los Angeles County. J Health Soc Behav. 1975; 16: 74–94.
19. Haynes R.M., Bentham C.G., The effect of accessibility on general practitioner consultations, out-patient attendances and in-patient admissions in Norfolk, England. Soc Sci Med. 1982; 16: 561–9.
20. Himsworth R.L., Goldacre M.J., Does time spent in hospital in the final 15 years of life increase with age at death? A population based study. BMJ. 1999; 319: 1338–9.
21. Busse R., Krauth C., Schwartz F.W., Use of acute hospital beds does not increase as the population ages: results from a seven year cohort study in Germany. J Epidemiol Community Health. 2002; 56: 289–93.
22. Dixon T., Shaw M., Frankel S., Ebrahim S., Hospital admissions, age, and death; retrospective cohort study. BMJ. 2004; 328: 1288–90.
23. Temkin-Greener H., Meiners M.R., Pretty E., et al. Spending-down to Medicaid in the nursing home and in the community. A longitudinal study from Monroe County, New York. Med Care. 1993; 31: 663–79.
24. Mukamel D.B., Chou C., Zimmer J.G., et al. The effect of accurate patient screening on the cost effectiveness of case management programme. Gerontologist. 1997; 37: 777–84.
25. Scitovsky A.A., The high cost of dying: What do the data show? Milbank Q. 1984; 62: 591–607.
26. Scitovsky A.A., “The high cost of dying” revisited. Milbank Q. 1994; 72: 561–91.
27. Home Affairs Department. Hong Kong the facts: District Administration. [Online] 2008 Jan [cited 2009 Jun 10]; Available from: URL: http://www.had.gov.hk
28. Census and Statistics Department. 2006 Population By-census: Basic tables for district council districts. [Online] 2007 May 31 [cited 2009 Jun 10]; Available from: URL: http://www.bycensus2006.gov.hk/FileManager/EN/Content_962/06bc_dcd.pdf
29. Beyene J., Moineddin R., Methods for confidence interval estimation of a ratio parameter with application to location quotients. BMC Med Res Methodol. 2005; 5: 32.
30. Goldstein H., Multilevel Statistical Models. 3rd ed. London: Edward Arnold; 2003.
31. Giggs J.A., Human health problems in urban areas. In: Herbert D.T., Smith D.M., editors. Social problems and the city. Oxford: Oxford University Press; 1979.
32. Phillips D.R., Contemporary issues in the geography of health care. Norwich: Geo Books; 1981.
33. Bailey W., Phillips D.R., Spatial patterns of use of health services in the Kingston Metropolitan Area, Jamaica. Soc Sci Med. 1990; 30: 1–12.
34. Powell M., On the outside looking in: Medical geography, medical geographers and access to health care. Health Place. 1995; 1: 41–50.
35. Lieu T.A., Newacheck P.W., McManus M.A., Race, ethnicity, and access to ambulatory care among US adolescents. Am J Public Health. 1993; 83(7): 960–5.
36. Gellet G.A., Maxwell R.M., Higgins K.V., Mai K.K., Lowery R., Barriers to health care access and utilization among Vietnamese Americans in southern California. Health Place. 1995; 1: 91–9.
37. Feinson M.C., Popper M., Does affordability affect mental health utilization? A United States-Israel comparison of older adults. Soc Sci Med. 1995; 40: 669–78.
38. Hospital Authority. HA Statistical Report. [Online] 2007 [cited 2009 Jun 10]; Available from: URL: http://www.ha.org.hk/
39. Harvard University Consultancy Team. Improving Hong Kong's health care system: Why and for whom?[Online] 1999 Apr 12 [cited 2009 Jun 10]; Available from: URL: http://www.fhb.gov.hk/en/press_and_publications/consultation/HCS.HTM#MAIN%20REPORT
40. Starfield B., Lemke K.W., Herbert R., Pavlovich W.D., Anderson G., Comorbidity and the use of primary care and specialist care in the elderly. Ann Fam Med. 2005; 3: 215–22.
41. Clearly P.D., Mechanic D., Greenley J.R., Sex differences in medical care utilization: an empirical investigation. J Health Soc Behav. 1982; 23: 106–19.
42. Gibson A., Asthama S., Brigham P., Moon G., Dicker J., Geographies of need and the new NHS: methodological issues in the definition and measurement of the health needs of local populations. Health Place. 2002; 8; 47–60.