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Health Services Insights

Synopsis: An open access, peer reviewed electronic journal that covers quality and effectiveness of health care services.


Indexing: Indexed by OAIster.  Pubmed indexing for NIH-funded research.

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About this journal

ISSN: 1178-6329



Aims and scope:

Health Services Insights aims to improve healthcare services through analysis of their quality and effectiveness, as well as looking at the wider picture. This encompasses investigation into all areas of health care and the provision of services. Demographic issues, access to services, quality of services, implementation problems, systems, economics and organisations involved as well as health policy and effects of change are included but articles are by no means limited to these areas.

The process of developing, researching, implementing and assessing health services is complex and involves many factors, and this is recognised by the integration of these different aspects within the journal.

Indexing:

This journal is indexed by:

  • OAIster

Editorial standards and procedures:

Submissions, excluding editorials, letters to the editor and dedications, will be peer reviewed by two reviewers.  Reviewers are required to provide fair, balanced and constructive reports.  

Under our Fairness in Peer Review Policy authors may appeal against reviewers' recommendations which are ill-founded, unobjective or unfair.  Appeals are considered by the Editor in Chief or Associate Editor.

Papers are not sent to peer reviewers following submission of a revised manuscript. Editorial decisions on re-submitted papers are based on the author's response to the initial peer review report.

National Institutes of Health Public Access Policy compliant:

As of April 7 2008, the US NIH Public Access Policy requires that all peer reviewed articles resulting from research carried out with NIH funding be deposited in the Pubmed Central archive.

If you are an NIH employee or grantee Libertas Academica will ensure that you comply with the policy by depositing your paper at Pubmed Central on your behalf. 



 
 
 


A Geographical Study of Health Services Utilization Among the Elderly in Hong Kong: From Spatial Variations to Health Care Implications

Authors: M. Wong, P.H. Chau, W. Goggins and J. Woo
Publication Date: 09 Sep 2009
Health Services Insights 2009:2 1-13

M. Wong1, P.H. Chau2, W. Goggins3 and J. Woo1

1Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR. 2Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR. 3Division of Biostatistics, School of Public Health, The Chinese University of Hong Kong, Hong Kong SAR.

Abstract

Introduction: Levels of utilization of health services vary socially and geographically. Differences in the rates of usage are also associated with geographical aspects of health care systems. The purpose of this study was to capture spatial variations in hospital health services utilization in the elderly population in Hong Kong, a Special Administrative Region of China.

Materials and Methods: We carried out a secondary analysis of a database from the Hospital Authority (HA) which covers 98% (N = 243,245) of the total registered deaths in Hong Kong during 1999 to 2005. Deaths at age 65y and above (N = 184,671) were included in the analysis. Age-sex weighted mean utilization ratio of hospital services was calculated by dividing the age-sex weighted mean usage of a particular service for each district by that for the whole territory. The variation in utilization by the seniors was analyzed in terms of four types of services: length of stay (LOS) in HA hospitals, number of inpatient admissions, number of visits to specialist outpatient department (SOPD), and attendances at accident and emergency department (AED).

Results: Deaths at age 65y and above contributed to 76% of the total registered deaths. Each district contributed 1.0% to 9.1% of the total number of deaths in Hong Kong. Spatial analysis of the age-sex weighted mean utilization ratio showed significant geographic variation in the use of hospital services: the range of difference in the LOS between the lowest and highest district was 44%, while some differences as high as 33%, 35% and 39% in utilization ratios were observed in relation to number of inpatient admissions, visits to SOPD, and attendances at AED respectively. However, the patterns of these variations were not consistent for the four types of service being analyzed.

Conclusions: Geographic variation in the utilization of hospital health services across the 18 districts in Hong Kong among the elderly population during the last three years before death was demonstrated. However, the patterns of variation were different for the types of services being examined. Further studies using primary data at an individual level are needed to explain the variations. Detailed analysis examining the relationship between service provision, accessibility and health outcomes are also indicated in order to inform the planning of health service delivery.

Categories: Health services


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