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Access to primary care in Hong Kong, Greater London and New York City

Published online by Cambridge University Press:  01 May 2012

Pui Hing Chau ,
Jean Woo ,
Michael K. Gusmano ,
Daniel Weisz ,
Victor G. Rodwin  and
Kam Che Chan
Pui Hing Chau*
Affiliation:
Research Assistant Professor, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China
Jean Woo
Affiliation:
Professor, Faculty of Medicine, Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
Michael K. Gusmano
Affiliation:
Associate Professor, New York Medical College, USA Research Scholar, Hastings Center, USA
Daniel Weisz
Affiliation:
Associate Research Scientist, World Cities Project, International Longevity Center, Mailman School of Public Health, Columbia University, New York, USA
Victor G. Rodwin
Affiliation:
Professor, Robert F. Wagner Graduate School of Public Service, New York University, New York, USA
Kam Che Chan
Affiliation:
Senior Research Assistant, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China
*
*Correspondence to: Pui Hing Chau, Research Assistant Professor, Faculty of Social Sciences, The University of Hong Kong, Room 104, Meng Wah Complex, The University of Hong Kong, Pokfulam, Hong Kong, China. Email: phchau@graduate.hku.hk
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Abstract

We investigate avoidable hospital conditions (AHC) in three world cities as a way to assess access to primary care. Residents of Hong Kong are healthier than their counterparts in Greater London or New York City. In contrast to their counterparts in New York City, residents of both Greater London and Hong Kong face no financial barriers to an extensive public hospital system. We compare residence-based hospital discharge rates for AHC, by age cohorts, in these cities and find that New York City has higher rates than Hong Kong and Greater London. Hong Kong has the lowest hospital discharge rates for AHC among the population 15–64, but its rates are nearly as high as those in New York City among the population 65 and over. Our findings suggest that in contrast to Greater London, older residents in Hong Kong and New York face significant barriers in accessing primary care. In all three cities, people living in lower socioeconomic status neighborhoods are more likely to be hospitalized for an AHC, but neighborhood inequalities are greater in Hong Kong and New York than in Greater London.

Type
Articles
Information
Health Economics, Policy and Law , Volume 8 , Issue 1 , January 2013 , pp. 95 - 109
Copyright
Copyright © Cambridge University Press 2012

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