Access to primary care in Hong Kong, Greater London and New York City

We investigate avoidable hospital conditions (AHC) in three

world cities as a way to assess access to primary care. Residents of Hong Kong

are healthier than their counterparts in Greater London or New York City.

In contrast to their counterparts in New York City, residents of both Greater

London and Hong Kong face no financial barriers to an extensive public hospital

system. We compare residence-based hospital discharge rates for AHC, by age

cohorts, in these cities and find that New York City has higher rates than Hong

Kong and Greater London. Hong Kong has the lowest hospital discharge rates

for AHC among the population 15–64, but its rates are nearly as high as those in

New York City among the population 65 and over. Our findings suggest that in

contrast to Greater London, older residents in Hong Kong and New York face

significant barriers in accessing primary care. In all three cities, people living in

lower socioeconomic status neighborhoods are more likely to be hospitalized for

an AHC, but neighborhood inequalities are greater in Hong Kong and New York

than in Greater London.