22 October 2016
Hospital Advisor app aims to help people make better and more-informed decisions on healthcare services and providers in Hong Kong.
Hospital Advisor app aims to help people make better and more-informed decisions on healthcare services and providers in Hong Kong.

Hospital care: How we can help people make better decisions

Hong Kong is facing a growing problem in terms of healthcare capacity. Population growth, the aging of the population and rising expectations among the public are all adding to demand. At times – such as winter flu season – some public hospitals reach full capacity.

The government has announced a 10-year, HK$200 billion expansion plan for the public hospital network. This will increase the number of public hospital beds by some 20 percent. The administration is also conducting a strategic review of healthcare manpower planning and training.

Public hospitals provide around 80 percent of in-patient care, which leaves our private hospital network relatively underutilized. Even so, the number of private beds is also expanding.

There is also the question of how healthcare should be funded in the long term. Over the years we have seen various proposals to reform healthcare funding. Those with long memories will recall the 1985 “Scott Report”. Then there was the “Harvard Report” in 1999, and several others.

The most recent proposal involves a voluntary system of health insurance. As with previous ideas, officials wanted to encourage the middle class to pay more into the system and make more use of private hospitals.

Although this approach looks like a good idea, there are major problems to making it work in practice.

One key challenge is costs. Public hospitals charge very low fees for any sort of treatment, while private hospitals have a reputation for very high charges.

I used the phrase “have a reputation” deliberately. That is because it can be very difficult to find out exactly what treatment in a private facility will cost. There is a serious lack of pricing transparency.

Hence it is difficult to make an accurate cost comparison between different hospitals.

At the same time, there is no objective information about the quality of care offered in different hospitals.

Given this, it is hardly surprising that people are reluctant to commit themselves to making more use of private hospitals. This goes not only for patients, but for the insurance industry (which my company has interests in) and indeed for policymakers in government.

A charitable foundation called the Zubin Foundation is showing a way forward. Run by Shalini Mahtani, the social policy foundation has launched a website and app called “Hospital Advisor”.

In some ways the site has the same approach as apps that allow consumers to rate restaurants or hotels. However, this is not about impressions; the aim is to ensure that the ratings are based on objective and measurable data.

Working with academics from Harvard and Hong Kong University, the Zubin Foundation has created a user-friendly but specific method of compiling feedback from hospital patients.

The site is still at an early stage, but already several dozen private and public hospitals have been rated. As more people learn about it and use it, the app will give a fuller picture of patients’ experiences in different hospitals.

This is just one example of how we can empower patients to make better decisions about where to seek treatment. Needless to say, it should also give hospitals an incentive to see how they can improve their services.

Hospital ranking systems of this sort are standard in many other places, such as the US and Europe.

Past experience suggests that Hong Kong people are reluctant to consider private hospitals because they cannot be sure what it will cost, or what they will get for their money.

Officials should welcome and encourage initiatives like Hospital Advisor to bring more transparency in this area.

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Executive Council member and former legislator; Hong Kong delegate to the National People’s Congress

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