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We recommend that the purchaser also consider purchasing follow-up
consultations with family doctors on lifestyle modification for users
who are not diagnosed with HDH and referrals to re-screening. Our cost
projections assume that patients without diagnosed HDH may benefit from a HKD 350
subsidy, to match the approximate cost of one GOPC-PPP consultation, towards obtaining
a follow-up consultation with their chosen private sector family doctor.
• For whom to purchase? HDH screening services in the proposed Scheme should initially
be targeted at adults in the 45–54 age group at the beginning of the
Scheme to promote earlier detection and necessary intervention for prevalent chronic
conditions.

• From whom to purchase? The screening and management services to be purchased are
proposed to be administered by primary care service providers in the private
sector, including family physicians and allied health professionals, in conjunction with the
District Health Centres.
• Who to purchase? The Government should identify a central purchaser for
primary care services and clearly define its role as a purchaser.

• How to purchase? The Scheme will deploy a hybrid-model comprised of a fully
subsidised voucher as a demand-side instrument, with financial flexibility for
co-payment determined by the purchaser as well as performance-based payment
to providers for management services as a supply-side instrument.

Economic analysis suggests that the health system

will prevent a total of 47,138 mortalities over the
course of 30 years if it implements a screening
voucher scheme and management for diabetes.

RECOMMENDATION 3. The Government must consider
key policy dimensions to ensure effective application of
strategic purchasing

Key stakeholders of Hong Kong’s health system in our interviews unequivocally welcome the
launch of the Scheme but stressed the need for comprehensive policy, planning, and
regulation of participating providers, and of addressing implementation barriers that exist in
the health system. The importance of a well-designed management scheme for desirable
results was also emphasised. With these insights, we recommend that the Government take
into consideration the five key components of a synthesised framework of strategic
purchasing as elaborated below when designing and implementing the Scheme.

3.1 Population health

Identifying population health needs and incorporating them into the purchasing process is a
core element in strategic purchasing decisions. To ensure that policy decisions related to the
Scheme are based on the latest population health data, the Government should
better information-sharing systems and systematise the tracking of PHC
expenditure using international standards.

The Government should better leverage and strengthen existing infrastructure, such as the
Electronic Health Record Sharing System (eHRSS) to better track population health needs.
To integrate data into purchasing decisions, we suggest that the Government systematise
and regularise tracking of Hong Kong’s PHC expenditure using international measurement
standards, specifically by fully adopting the System of Health Accounts (SHA) (for more
details, please refer to Chapter 3).
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