What are the financial barriers to medical care among the poor, the sick and the disabled in the Special Administrative Region of China?

Samuel Yeung-shan WONG, Roger Yat-nork CHUNG, Dicken CHEN, Gary Ka-ki CHUNG, Jerry LI, Dominic MAK, Maggie LAU, Vera TANG, David GORDON, Dicken CHEN, Hung WONG

Research output: Journal PublicationsJournal Article (refereed)

3 Citations (Scopus)


Although Hong Kong is one of the richest cities in the world and has some of the best health outcomes such as long life expectancy, little is known about the people who are unable to access healthcare due to lack of financial means. Cross-sectional data from a sample of 2,233 participants aged 18 or above was collected from the first wave of the “Trends and Implications of Poverty and Social Disadvantages in Hong Kong” survey. Socio-demographic factors, lifestyle factors, and physical and mental health conditions associated with people who were unable to seek medical services due to lack of financial means in the past year were examined using forward stepwise logistic regression analyses. Of the 2,233 participants surveyed, 8.4% did not seek medical care due to lack of financial means during the past year. They were more likely to be income-poor. With respect to physical and mental health, despite having less likelihood to have multimorbidity, they tended to have higher levels of both anxiety and stress, poorer physical and mental health-related quality of life, and suffer from more severe disability and pain symptoms affecting their daily activities, when compared to the rest of the Hong Kong population. People who were denied of medical care due to financial barriers are generally sicker than people in the general Hong Kong population, implying that those with greater healthcare needs may have financial difficulties in receiving timely and appropriate medical care. Our findings suggest that inequity in healthcare utilization remains a critical issue in Hong Kong.
Original languageEnglish
Article numbere0205794
JournalPLoS ONE
Issue number11
Publication statusPublished - 14 Nov 2018


Bibliographical note

The work described in this paper was fully supported by a grant from the Central Policy Unit of the Government of the Hong Kong Special Administrative Region and the Research Grants Council of the Hong Kong Special Administrative Region, China (Project No. 4003-SPPR-11 to HW).

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