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“Fostering Medical-Social Collaboration in Achieving Quality End-of-life Care”

Executive Summary

People are living longer, but not necessarily better

With a laudable life expectancy that ranks top in the world, Hong Kong’s population is ageing rapidly.
Greater longevity and the steep increase in co-morbidity in the elderly population has called for
increased territory-wide attention on not just the quality of life, but also of death.

In 2018, Our Hong Kong Foundation (“OHKF”) published the research report “Fit for Purpose: A
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Health System for the 21 Century” that advocated for the urgent need to reorient our currently hospital-
centric, treatment-focused health system towards an integrated, primary care-led system (OHKF, 2018).
In stressing the importance of care and not just cure, we emphasise the need to take a holistic approach
in health service provision that should address the multidimensional needs of individuals throughout the
entire life course; including the final stages of life.

Whilst palliative care, a concept that embraces end-of-life care (EoLC), is affirmed by the World
Health Organization (WHO) as a core component of health systems (WHO, 2016), Hong Kong is clearly
under-performing. In the “Quality of Death Index” launched by The Economist in 2015 that measures
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the quality of palliative care, Hong Kong was ranked 22 of 80 selected countries, the lowest amongst
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its Asian counterparts including Taiwan (8 ), Singapore (12 ), Japan (14 ) and South Korea (18 ) (The
Economist Intelligence Unit, 2015a). In particular, Hong Kong’s score in the sub-category “community
engagement” that assesses the level of discussion and awareness of end-of-life choices in communities,
was below the global average of 80 countries (The Economist Intelligence Unit, 2015b).
OHKF recognises the continuous efforts of local institutions in both the public and private healthcare
sectors in advancing palliative and end-of-life care services in Hong Kong. OHKF also acknowledges
the Government’s latest public consultation on EoLC (Food and Health Bureau, 2019) as a good effort
to push end-of-life care development forward in Hong Kong.

Building on an expansive local literature in the past decade that has already revealed the palpable need
to reinforce EoLC development, OHKF takes a progressive approach to explore views held towards
EoLC in the community, specifically through the lens of potential EoLC service end-users reached in a
telephone polling exercise. The polling, commissioned by OHKF and conducted by the Hong Kong
Institute of Asia-Pacific Studies at The Chinese University of Hong Kong, was executed through
telephone interviews with 1,001 Hong Kong residents between 26 November and 6 December 2019.
Through understanding public perception and practice related to end-of-life care services in local
communities, this study concludes that focusing on EoLC at a community level is vital not just for

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