07.01.08. Do people with dementia experience out-of-pocket expense to access diagnosis or care? | Hong Kong SAR

07.01.08. Do people with dementia experience out-of-pocket expense to access diagnosis or care? | Hong Kong SAR

22 Aug 2022

Yes. For public healthcare services, 5% of the cost has to be covered by users and the remaining 95% is subsidised by the Government (Food and Health Bureau, 2010). Individuals with more financial difficulties may apply for medical fee waiver such that there will be no out-of-pocket payments when using public healthcare services (Hospital Authority, 2019d). The service fees of public services offered by the Hospital Authority and commonly used by people with dementia are specialist outpatient (HK$135 for the 1st attendance, $80 per subsequent attendance, $15 per drug item), general outpatient ($50 per attendance), geriatric day hospital ($60 per attendance) and rehabilitation day hospital services ($55 per attendance) (Hospital Authority, 2020d).

For private healthcare services, the Hong Kong Medical Association has been conducting surveys on doctors’ fees every four years since 1991, with the aim to gather information on the prevailing charges of medical services in the private sector. According to the latest survey conducted in 2018 (Hong Kong Medical Association, 2019), the median service charge (medication inclusive) of specialists for regular clinic consultation and psychiatry consultation (half-hour) are $800 and $900 respectively. Under the Health Care Voucher Scheme implemented by the Government, older adults age over 65 may make use of the annual voucher amount of $2000 to cover their medical expenses in the private sector.

For public social care services, under the Dementia Community Support Scheme, people with dementia can receive care and support services, training and carer support services provided by District Elderly Community Centres (operated by NGOs). Recipients of Comprehensive Social Security Assistance or Old Age Living Allowance, and holders of medical fee waiver can receive free-of-charge service. Other users have to pay $150 per month to receive support under this scheme (Food and Health Bureau, 2019a). For other care services provided by NGOs under governmental subvention, most of the services are free-of-charge or they charge a very small amount.

For care services provided by dementia-specific service centres operated by self-financing NGOs, people with dementia will experience a higher amount of out-of-pocket payments. For instance, according to the Hong Kong Alzheimer’s Disease Association, the service fee of day care services is $340 – 420 per day (meals included) (Hong Kong Alzheimer’s Disease Association, 2020b); while according to the Jockey Club Centre for Positive Ageing, the service fee of day care services is $435 – 565 per day (meals included) (Jockey Club Centre for Positive Ageing, 2020b).

References:

Food and Health Bureau. (2010). My Health My Choice – Healthcare Reform Second Stage Consultation Document. Retrieved from https://www.myhealthmychoice.gov.hk/pdf/consultation_full_eng.pdf

Food and Health Bureau. (2019a, 4 June, 2019). Dementia Community Support Scheme. Retrieved from https://www.fhb.gov.hk/en/press_and_publications/otherinfo/180500_dcss/dcss_index.html

Hong Kong Alzheimer’s Disease Association. (2020b). Services – Day Centres. Retrieved from https://www.eng.hkada.org.hk/day-centres

Hong Kong Medical Association. (2019). Hong Kong Medical Association Doctors’ Fees Survey 2018. Retrieved from Hong Kong: https://www.thkma.org/pressrelease/details/20190125_a1.pdf

Hospital Authority. (2019d). Waiting Time for New Case Booking at Psychiatry Specialist Out-patient Clinics. Retrieved from https://www.ha.org.hk/visitor/ha_visitor_index.asp?Content_ID=214197&Lang=ENG&Dimension=100&Parent_ID=10053

Hospital Authority. (2020d). Service Guides – Fee and Charges. Retrieved from https://www.ha.org.hk/visitor/ha_visitor_index.asp?Parent_ID=10044&Content_ID=10045&Ver=HTML

Jockey Club Centre for Positive Ageing. (2020b). Service – Day Care Service. Retrieved from https://www.jccpa.org.hk/en/service/day_care_service/index.html