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Poverty affects access to regular source of primary care among the general population in Hong Kong
Author(s) -
Chung Roger YatNork,
Chan Dicken,
Chau Nancy NamSze,
Huang Suki,
Wong Hung,
Wong Samuel YeungShan
Publication year - 2019
Publication title -
social policy and administration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.972
H-Index - 63
eISSN - 1467-9515
pISSN - 0144-5596
DOI - 10.1111/spol.12538
Subject(s) - poverty , medicine , operationalization , primary care , population , logistic regression , public health , household income , environmental health , gerontology , demography , family medicine , nursing , geography , economic growth , sociology , philosophy , epistemology , economics , archaeology
A territory‐wide two‐stage stratified random sample of 2,282 community‐dwelling Hong Kong adults were surveyed between 2014 and 2015 to investigate the association between poverty and regular source of primary care utilization. Poverty was operationalized by income‐poverty and deprivation. About 94% of our sample reported having regular source of primary care (Western and/or Chinese medical practitioner) and about 69% among them were in private sector. Multivariable logistic regression showed that people who were income‐poor and deprived were less likely to have regular source of primary care (income‐poor: OR = 0.523, p = .027; deprived: OR = 0.488, p = .007) and visit private primary care doctors (income‐poor: OR = 0.445, deprived: OR = 0.222, both p < .0001). Those who had chronic diseases were more likely to have regular source of primary care (multimorbid: OR = 10.709, p < .0001), but less likely to access care in the private sector (one chronic disease: OR = 0.690, p = .019; multimorbid: OR = 0.374, p < .0001) than those without. Further, being older and less skilled were significantly associated with less likelihood of visiting a private doctor. Path analysis showed that the number of chronic diseases had significant indirect effect on having regular source of primary care with being income‐poor and deprived as the mediators ( β = −.0183, p = .0016). Therefore, despite a public health‐care system that aims to deny no one from adequate health care for lack of means, regular source of primary care in Hong Kong is found to be pro‐rich. Future policies should tackle the problem of health‐care inequalities to meet the needs of the underprivileged.