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METHODOLOGY

This report builds on the research presented in our previous policy paper and is integral to
ongoing advocacy to transform Hong Kong’s health system into a primary care-led,
integrated, person-centred health system. In this report, OHKF together with Professor Yeoh
Eng-kiong and his team in the Centre for Health Systems and Policy Research of The Jockey
Club School of Public Health and Primary Care, Faculty of Medicine, the Chinese University
of Hong Kong investigates how to strategically organise our health financing system to align
with system goals and meet population demands for enhanced accessibility and affordability
of well-integrated primary care.

Our research began with an extensive study of the literature and institutional reports in latest
health financing trends globally and locally. In this report, we present insights on best
practices and lessons learned from international experience on the application of strategic
purchasing for chronic disease prevention and management. We also identify challenges and
gaps within Hong Kong’s health financing structure and analyse how capacity in the private
sector can be better leveraged for primary care provision through PPPs in Hong Kong. With
these insights, we assessed the feasibility of a Chronic Disease Screening Voucher
and Management Scheme (CDSVMS, also addressed as “Scheme”) for three targeted
chronic conditions, namely hypertension, hyperglycaemia (diabetes), and hyperlipidaemia
(collectively termed “HDH”) designed based on lessons from the implementation of existing
PPPs, as well as the perspectives gained from key stakeholders through interviews, and from
citizens through a population-based telephone survey. We also projected the economic
impact of this Scheme for Diabetes Mellitus (DM) on the health system over the course of 30
years for individuals aged 45 to 54 years of age at the start of the scheme using a Budget
Impact Analysis.

To better inform the application of strategic purchasing, we highlight policy dimensions that
should be accounted for in the formulation and implementation of programmes enhanced
using strategic purchasing. To illustrate, we apply a synthesised framework of strategic
purchasing consisting five key components of consideration to our proposed Scheme (Klasa
et al., 2018). The considerations analysed include population health, citizen
empowerment, strengthening government stewardship and capacity,
developing effective purchaser and provider organisations, and
incorporating cost-effective contracting (Figure A).

Our study received funding support from the Public Policy Research Funding Scheme
offered by the Policy Innovation and Co-ordination Office of the Government of the
Hong Kong Special Administrative Region (Project number: 2020.A4.068.20B).

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