Abstract
The second stage consultation of healthcare reform in Hong Kong was launched in late 2010. One of the key features in the healthcare reform is the use of packaged charging based on Diagnosis-Related Group (DRG) structure, for reimbursement of medical fees in order to enhance cost certainty and transparency in private healthcare services. The objective of the study was to investigate the comments, concerns and suggestions of medical practitioners and private hospitals about medical pricing based on DRG. A survey completed by 1100 medical practitioners, seven focus groups with 42 medical practitioners and six hospital administrators participated was conducted. Generally, the participants believed that DRG was more applicable to straight-forward and one-off treatment procedures. Those working in the private sector and non-Family Medicine specialists were more concerned about the desirability and feasibility of DRG, and the potential of control of pricing in private market. The practice of DRG-based pricing method in certain specialties and cases which required multiple examinations and procedures for diagnosis were discussed. Concerns about doctors’ selection of cases, upcoding and gaming on the charging system, as well as the high administration cost were also raised.
Highlights
The Hong Kong healthcare system is a dual system
A total of 1100 surveys were completed. 72.5% of the respondents were male and 27.8% aged 41 - 50 years (Table 1). 88.1% were working full-time, 46.3% were working in public sector, followed by 44.4% working in private clinics
Among those working in the private sector, the majority (69.3%) were solo practitioners. 65.4% of the participants identified themselves as specialists, including 5.8% in family medicine
Summary
The Hong Kong healthcare system is a dual system. It has a public sector and a private sector. The current healthcare reform in Hong Kong was first launched in 2008 of which improvements and resources had been invested in public healthcare services, healthcare infrastructure and safety net [3]. The HPS is a voluntary and supplementary healthcare financing scheme regulated by the government. It aims to ease the pressure on the public healthcare system by encouraging more people to use private healthcare on a sustained basis. The government believed that the packaged charging system would enhance cost certainty and transparency to consumers in using private healthcare services. The perspectives of general practitioners and specialists, especially those working in
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