Authors (including presenting author) :
Xinliang Cai(1), Ruofan Shi(2), Yung Na (2)
Affiliation :
(1) Division of Urology, Department of Surgery, The University of Hong Kong-Shenzhen Hospital (2) Department of Surgery, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong
Introduction :
The Pilot Scheme for Supporting Patients of Hospital Authority in the Guangdong-Hong Kong-Macao Greater Bay Area (Pilot Scheme) represents a strategic initiative aimed at enhancing healthcare accessibility for Hong Kong (HK) residents. By enabling eligible patients to receive subsidized outpatient services at the University of Hong Kong-Shenzhen Hospital (HKU-SZH), the program seeks to mitigate the challenges of cross-border healthcare and facilitate greater regional healthcare integration within the Greater Bay Area.
Objectives :
This study aims to evaluate the Pilot Scheme using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Specifically, the study objectives are to: (a) assess the baseline health conditions of participating patients; (b) analyse the costs associated with accessing services at HKU-SZH; (c) compare patient satisfaction with healthcare services in HK and HKU-SZH; and (d) evaluate the long-term sustainability of the Pilot Scheme.
Methodology :
A standardized questionnaire was administered to gather comprehensive data on patients' background information, EQ-5D health-related quality of life, consultation satisfaction, expenditures, differences in healthcare services between HK and HKU-SZH, and the perceived sustainability of the Pilot Scheme. Inclusion criteria required participants to be adult HK residents seeking care at HKU-SZH, with informed consent obtained prior to participation. All data were anonymized, and ethical approval was secured for the study.
Result & Outcome :
A total of 22 participants, with a median age of 67 years (interquartile range, IQR: 61-71.5), were included in this preliminary study. All of the study subjects were referred via Hospital Authority in the Guangdong-Hong Kong-Macao Greater Bay Area, while the remaining seek for the service at HKU-SZH spontaneously. The mean EQ-5D utility index was 0.969, and the mean EQ-VAS score was 79.2, which indicated good health conditions of the patients. The average travel time to HKU-SZH was 1.73 hours (95% confidence interval, CI: 0.43-3.03), with a mean satisfaction score of 3.95 out of 5. The average waiting time for consultations was 0.6 hours, with a corresponding satisfaction score of 4.45/5. The median self-funded medical expenditure was $8,000 (IQR: $2,398-$13,895), with transportation costs averaging $100 (IQR: $90-$160). Participants expressed high satisfaction with communication (4.64/5), professional skills (4.59/5), service quality (4.68/5), and the overall assessment of HKU-SZH (4.73/5). In comparing healthcare services between HK and HKU-SZH, 77.3% of respondents reported shorter waiting times in HKU-SZH. Over half indicated better professional skills (55.0%), service quality (60.0%), and more reasonable medical expenses (57.1%) in HKU-SZH. Healthcare facilities (95.2%), environments (81.0%), and language competence (71.4%) in HKU-SZH were non-inferior to those in HK. Additionally, all participants acknowledged a better understanding and recognition of treatment plans at HKU-SZH. Regarding the Pilot Scheme, participants rated its implementation with an average score of 4.14/5. A majority (90.5%) of patients believed the program would alleviate the healthcare burden in Hong Kong, and 85.7% anticipated increasing participation from HK residents in the future. Survey with larger sample sizes will be conducted in the future.
Conclusions
The Pilot Scheme demonstrates promise in improving healthcare access for HK residents and reducing the healthcare burden in HK. High patient satisfaction with services at HKU-SZH and favorable comparisons of healthcare services between HK and Shenzhen suggest potential for long-term sustainability and wider adoption. Further studies are needed to optimize the program’s implementation and engagement.
