Healthcare: Tackling inpatient surge in a rapidly ageing society

March 12, 2019 16:05
Meeting the elderly's needs is becoming a key part of public health planning in Hong Kong. Photo: Bloomberg

Reducing the average length of stay in hospitals (ALOS) is one of the most effective ways to control medical expenditures. However, with the current upward trend of senior population numbers in Hong Kong, there is hardly any room left for reduction of ALOS.

In recent decades, Hong Kong’s population has been aging at an unprecedented pace.

While it takes a century for France’s middle and old aged population to double, Hong Kong experienced that in just 25 years.

Meeting the elderly's needs is becoming a key part of public health planning.

Based on the latest data from United Nations, I recently did an estimation on Hong Kong’s inpatient service needs going forward.

By 2066, for those over 85 years old, ALOS is projected to jump by a drastic 555 percent. ALOS for Hong Kong as a whole is expected to increase by 134 percent.

In 2010, those who were 85 or older only accounted for 15 percent of the ALOS; the share will take a threefold leap by 2066, while 70 percent of ALOS will go to those 75 years old or above.

These estimations are powerful enough to tell how enormous the healthcare burden will become in coming decades.

Hong Kong’s healthcare policy should focus on prevention and the promotion of preventative lifestyle, so as to minimize the frequency of clinic visits and hospitalizations.

We can further explore alternative and innovative approaches, such as community care, to help support our overloaded hospitals. During the past few years, several semi-private hospitals have also been established in light of alleviating the public health strain.

Hong Kong's population growth has been slowing down in recent years; the gross rate is currently less than 0.5 percent and the trend is expected to continue until 2050.

By then, the population composition will become more even, and the medical needs will be different from now.

Before this happens, the government’s expenditure on this area is still expected to go up at a rate of 10–15 percent annually.

In its recent budget, the government has boosted the overall public health/heathcare expenditure to HK$80.6 billion - of which over HK$60 billion will go to Hospital Authority for supporting hospitalization services.

Despite the huge funding, public hospitals are still overloaded with patients. The workload of medical staff has long been a concern, in large part due to the ageing population, which is the leading source of patients. It is incorrect and unfortunate to attribute the overloading of public healthcare to immigrants from the mainland.

To effectively enhance the medical staff’s morale and job satisfaction, and to help maintain their professionalism, funding increment alone is not enough.

The government instead needs to take a hard look at the endless stress and fatigue borne by the overworked medical staff and professionals, and find a way to improve their work environment.

This article appeared in the Hong Kong Economic Journal on March 6

Translation by Connie Li

[Chinese version 中文版]

– Contact us at [email protected]


Professor, Department of Social Work and Social Administration, The University of Hong Kong