Background: As in the rest of the world, cancer has been a leading killer in Hong Kong. Though technology has been growing rapidly, expensive cancer treatments have continuously been problematic to patients and their families. There are some known risk factors that make some people have a higher risk for cancer than others, but the reason why some develop cancer and some do not is mostly still unknown. In addition, the expensive cancer treatments can distress patients and their families psychologically during the painful and long chemotherapy process which is a common cancer treatment. While it is important for experts to research on effective cancer treatment, it is also important for the government and health care experts to solve associated financial problems. In response to help patients to ease their financial burden of expensive medical treatment, the Hong Kong government has proposed a new health protection scheme (HPS), “My Health, My Choice.” Objective: In this paper, a systematic review on different published literatures is conducted to analyze the prospective outcome of HPS and if it can help patients to ease their financial burden. Results and Discussion: The Health scheme provides a financial aid option for patients who suffer from chemotherapy through monthly premium. However, the implementation of this HPS seems to be difficult both on the patients’ and the providers’ sides. Case study of health care systems in US and Canada is included in this paper to find out what Hong Kong can learn from other countries with completely different payment systems would manage to deal with this problem. Australia which with a universal coverage health care system has also proposed a similar HPS plan aiming to help lower health care cost by increasing individual responsibility on medical expenses. However, it failed by lack of support from the general public. The Australian example would be used to criticize some essential elements that would contribute to the failure of the HPS, and how Hong Kong would use this example to yield a better proposal. Conclusion: As HPS might not be able to ease the burden on cancer patients in Hong Kong, it is suggested for government to allocate more effective and direct resources on helping cancer patients, especially those who are receiving chemotherapy or improve services through better primary care. However, the final outcome remains unknown, and the final option still depends on the ultimate need from the general public. / published_or_final_version / Public Health / Master / Master of Public Health

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

by Lo Pak Chuen. / Thesis (M.B.A.)--Chinese University of Hong Kong, 1998. / Includes bibliographical references (leaves 141-145). / Questionnaires in Chinese and English. / ABSTRACT --- p.iii / TABLE OF CONTENTS --- p.iv / LIST OF TABLES --- p.vii / LIST OF APPENDICES --- p.viii / ACKNOWLEDGEMENT --- p.ix / Chapter / Chapter I. --- INTRODUCTION --- p.1 / Rise of Consumerism --- p.1 / Consumerism and Health Care Reform --- p.2 / Recreation of Consumer --- p.2 / Consumer Rights - Patient Rights --- p.3 / Global Public Sector Reform --- p.3 / Redefining Citizens --- p.4 / Separation of Providers and Consumers --- p.4 / Participation - Public Participation --- p.5 / Hong Kong Health Care Reform --- p.5 / Establishment of Hospital Authority --- p.5 / Point of Contact: Hospital Authority and Patients --- p.6 / Rise of Patient Oriented Services and Total Quality Management Philosophy --- p.7 / Patients' Charter --- p.8 / Patient Satisfaction Measurement --- p.9 / Hospital Authority Complaint Channels --- p.9 / Public Participation --- p.10 / Purpose of the Study --- p.10 / Local Studies --- p.10 / Business Objectives --- p.11 / Research Objectives --- p.12 / Chapter II. --- METHODOLOGY --- p.13 / Definition of Concepts --- p.13 / Patient Participation --- p.13 / Background --- p.13 / Different Meanings in Different Contexts --- p.14 / Active Process --- p.14 / Attributes of Patient Participation --- p.14 / Relationship --- p.15 / Information Gap --- p.15 / Surrendering of Degree of Power and Control --- p.15 / Intellectual and Physical Attributes --- p.16 / Patient Satisfaction --- p.17 / Background --- p.17 / Theoretical Models of Patient Satisfaction --- p.18 / "Stimuli, Value Judgements, and Reactions" --- p.18 / Perceptual Realities --- p.18 / Intervention in the Patient Satisfaction Process --- p.18 / Individual Differences --- p.19 / Survey Design --- p.20 / Design --- p.20 / Sampling Site --- p.21 / Time --- p.22 / Respondents --- p.22 / Field Work --- p.22 / Questionnaire - Operationalization of Concepts --- p.23 / Patient Participation --- p.23 / Patient Satisfaction --- p.24 / Demographic Data and Hospital Experience --- p.25 / Hypotheses --- p.25 / Chapter III. --- DATA ANALYSIS --- p.26 / Survey Summary --- p.26 / Overview of Patient Satisfaction --- p.26 / Accessibility --- p.27 / Process --- p.27 / Outcomes --- p.28 / Overview of Patient Participation --- p.30 / Relationship --- p.30 / "Narrowing of Information, Knowledge and Competence Gap" --- p.30 / Spend Time to Search for Information --- p.30 / Patient - Health Care Professional Relationship --- p.31 / Knowledge about Patient Resources --- p.33 / Patients' Charter --- p.33 / Familiarity with Complaint Channels --- p.36 / Engagement of Physical and Intellectual Activities --- p.37 / Use Patient Resources --- p.37 / Use Complaint Channels --- p.37 / Public Participation --- p.38 / Revisit Same Hospital and Doctor --- p.39 / Demographic Data --- p.39 / Hospital Experience --- p.42 / Hypothesis - Data Reduction --- p.43 / Factor Analysis --- p.43 / Patient Participation --- p.44 / Patient Satisfaction --- p.48 / Patient Satisfaction Equation --- p.49 / Hypothesis Testing --- p.51 / Patient Participation and Satisfaction --- p.51 / Patient Participation Knowledge --- p.51 / Patient Participation Use --- p.52 / Correlation Studies --- p.53 / Demographic Variables and Participation --- p.53 / Chapter IV. --- IMPLICATIONS --- p.58 / Patient Participation --- p.58 / Relationship --- p.58 / "Narrowing of Information, Knowledge and Competence Gap" --- p.58 / Information Sharing and Decision Making --- p.58 / Opening Channels of Communication --- p.60 / Role of Nurse --- p.60 / Engage in Physical and Intellectual Activities --- p.61 / Promotion of Patients' Charter and Patient Resources --- p.61 / Complaint Channels --- p.61 / Patient Satisfaction --- p.62 / Comparison and Benchmarking --- p.62 / Theoretical Framework Revisited --- p.63 / Participation: Modify Patients' Expectations --- p.65 / Patients as High-Involvement Customers --- p.65 / Modify the Stimuli --- p.66 / Quality --- p.66 / Customer Chain --- p.67 / Chapter V. --- CONCLUSION --- p.68 / Limitations of the Study --- p.69 / Hypothesis Testing --- p.65 / Reliability and Validity --- p.70 / Quantitative Methodology --- p.71 / Scope of Study --- p.71 / APPENDICES --- p.73 / BIBLIOGRAPHY --- p.141

Wong, King Moses. / "August 2010." / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 158-172). / Abstracts in English and Chinese. / Chapter Chapter One: --- Introduction --- p.1 / Chapter 1.1 --- Background --- p.1 / Chapter 1.2 --- Research objectives --- p.5 / Chapter 1.3 --- Research hypothesis --- p.7 / Chapter 1.4 --- Research questions --- p.7 / Chapter 1.5 --- Research structure --- p.9 / Chapter Chapter Two: --- Literature Review --- p.10 / Chapter 2.1 --- "Health geography: knowledge of population, people, places and health" --- p.10 / Chapter 2.2 --- Understanding geographies of diseases: mapping and modeling diseases and health --- p.17 / Chapter 2.3 --- Healthcare services provision and utilization --- p.22 / Chapter 2.4 --- Hong Kong: facts and context --- p.31 / Chapter 2.4.1 --- Demographics --- p.32 / Chapter 2.4.2 --- Key challenges arising from population ageing --- p.37 / Chapter 2.4.2.1 --- Implications to medico-social agenda --- p.38 / Chapter 2.4.2.2 --- Implications to health status --- p.38 / Chapter 2.4.2.3 --- Implications to disease pattern --- p.39 / Chapter 2.4.3 --- Healthcare service delivery system in Hong Kong --- p.41 / Chapter 2.4.3.1 --- Financing and expenditure --- p.42 / Chapter 2.4.3.2 --- Organizational framework and healthcare policy --- p.44 / Chapter 2.4.3.3 --- Healthcare resources --- p.49 / Chapter 2.4.3.4 --- Utilization and provision of public healthcare services --- p.50 / Chapter Chapter Three: --- Material & Methods --- p.55 / Chapter 3.1 --- Background of main source of data --- p.55 / Chapter 3.2 --- Sources of data --- p.57 / Chapter 3.2.1 --- Hospital services utilization data --- p.57 / Chapter 3.2.2 --- Healthcare resources data --- p.61 / Chapter 3.2.3 --- Population data --- p.62 / Chapter 3.3 --- Spatial scale of analysis --- p.62 / Chapter 3.4 --- Statistical analyses --- p.63 / Chapter 3.4.1 --- Service utilization ratios --- p.63 / Chapter 3.4.2 --- Provision of healthcare resources to population --- p.65 / Chapter 3.4.3 --- Adequacy of healthcare services provision --- p.65 / Chapter 3.4.4 --- Mortality analysis --- p.67 / Chapter 3.4.5 --- Multi-level analysis --- p.69 / Chapter 3.4.6 --- Mapping of health services utilization ratio and mortality ratio --- p.70 / Chapter 3.5 --- Statistical packages used --- p.73 / Chapter 3.6 --- Cautions on interpretation --- p.74 / Chapter 3.6.1 --- Confounding and ecological fallacy --- p.74 / Chapter 3.6.2 --- Problem with the use of Standardized Mortality Ratio --- p.75 / Chapter 3.6.3 --- Problem with mapping and visualization --- p.76 / Chapter Chapter Four: --- Results --- p.78 / Chapter 4.1 --- Socio-spatial variation in mortality --- p.78 / Chapter 4.2 --- Statistical analysis and mapping of health services utilization ratio --- p.80 / Chapter 4.3 --- Statistical and cartographic analysis in Standardized Mortality Ratio --- p.88 / Chapter 4.4 --- Provision of healthcare resources to population --- p.91 / Chapter 4.5 --- "Multi-level analysis of hospital services utilization, provision and mortality" --- p.92 / Chapter 4.6 --- Further analysis --- p.95 / Chapter Chapter Five: --- Discussion --- p.100 / Chapter 5.1 --- Geographic variations in health services utilization ratios --- p.101 / Chapter 5.2 --- Geographic variation in Standardized Mortality Ratio --- p.107 / Chapter 5.3 --- "Multi-level models on health services utilization, provision and mortality" --- p.121 / Chapter 5.3.1 --- Socio-demographic characteristics of health services utilization --- p.121 / Chapter 5.3.1.1 --- Age --- p.121 / Chapter 5.3.1.2 --- Gender --- p.124 / Chapter 5.3.2 --- Health services utilization in relation to services provision --- p.129 / Chapter 5.3.3 --- Health services utilization in relation to mortality --- p.132 / Chapter 5.3.4 --- Adequacy of healthcare services provision --- p.134 / Chapter 5.3.4.1 --- Adequacy of hospital care provision --- p.134 / Chapter 5.3.4.2 --- Adequacy of primary care provision --- p.139 / Chapter 5.4 --- Implications --- p.143 / Chapter 5.5 --- Strengths of study --- p.146 / Chapter 5.6 --- Limitations of study --- p.148 / Chapter 5.7 --- Recommendations for future research --- p.151 / Chapter Chapter Six: --- Conclusion --- p.154 / References --- p.158

Taking into account of the colonial nature of modern Hong Kong, this author is to examine how the TWGHs as a medical space gradually developed from one that used only Chinese medicine into one in which Chinese medicine and western medicine coexisted. However, it finally became a western style hospital using only western medicine in the inpatient services in the 1940s, along with the growing hegemony of western medicine that was underpinned by colonial power. The multidimensional relationships among different agents in the process of transformation of medical services in the TWGHs constitutes another important theme of this thesis. These relationships touched upon a series of significant interactions between colonial government and Chinese community, colonial authorities and the Tung Wah Board of Directors, Chinese and western medical practitioners, Chinese community and the Tung Wah authorities, and so on. / The implantation, dissemination and expansion of modern western medicine, as an important part of western learning that infiltrated into the Orient, exerted profound impacts on Chinese traditional medical patterns and Chinese medical ideas and practices. As the center for exchange between Chinese and Western Culture, Hong Kong became a significant space for the spread and practice of western medicine. A wide range of western medical services and activities were delivered and developed by the colonial government, western missionaries, benevolent societies, and private practitioners in order to promote the development and popularization of western medicine among the Chinese community, including the establishment of hospitals, dispensaries and clinics, the opening of medical schools and training of western doctors, and the promotion of public health education. / This thesis also points out that the early intense prejudice and resistance against western medicine is not necessarily and cannot be entirely attributed to the underlying difference in the concept and practice of healing and sickness in the two different medical systems. Instead, I argue that a number of technical and practical factors in the delivery of western medical services provided by different agencies greatly affected and determined the choices and uses of the Chinese population. At the same time, the gradual recognition and reception of western medicine among the Chinese was not only the passive result of the compulsory western medical system developed by the colonial government, but also an active realization of the real efficiency and value of western medicine among the indigenous population and their consent and acceptance of its ideology and cultural value, to a great extent. / This thesis examines the confrontation and interaction between Chinese medicine and Western medicine, and the diverse and complicated Chinese attitudes towards western medicine by studying the history of the introduction of western medicine into Hong Kong and the case of transformation of Chinese and western medical services in the Tung Wah Group of Hospitals (TWGHs) during the period between 1894 and 1941. The history of the TWGHs dates back to the opening of the Tung Wah Hospital in 1870. Originally intended for the accommodation and treatment of those Chinese who had strong fears and prejudices against western medicine, the Tung Wah Hospital was founded to provide treatment only by Chinese doctors using Chinese medicine. The bubonic plague of 1894 in Hong Kong marked an important turning point in the history of medical services of the Tung Wah Hospital. Since then, western medicine was formally introduced into the Tung Wah Hospital in 1897. / 楊祥銀. / Adviser: Hon-ming Yip. / Source: Dissertation Abstracts International, Volume: 69-02, Section: A, page: 0715. / Thesis (doctoral)--Chinese University of Hong Kong, 2007. / Includes bibliographical references (p. 279-306). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in Chinese and English. / School code: 1307. / Yang Xiangyin.