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

PH. Chau, J. Woo, MK. Gusmano, D. Weisz, VG. Rodwin, KC. Chan
Health Economics, Policy and Law, 8(1): 95-109.

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.

Wagner Faculty