Population aging worldwide has resulted in increasing demand in primary care settings for screening and management of chronic diseases. The World Health Organization (WHO) carried out a series of national groups to solicit the views of older people themselves and their service providers on barriers to care and their suggestions for change. This initiative resulted in the development of a set of guidelines published in 2004, called Active aging: Towards age-friendly primary health care.  

Hong Kong in particular has the longest life expectancy for men and women among the world. As part of the Cadenza Project in promoting an age-friendly Hong Kong, Jean Woo and co-authors carried out a series of focus group interviews among service providers for elderly people and community groups of older people using the WHO guidelines. Author Jean Woo explains the background and results of their study:

How did you become interested in studying primary care services for older adults in Hong Kong?

The primary care system in Hong Kong is fragmented, with the private sector providing over 80% of consultations. The majority of elderly people have no insurance and cannot afford the fees. Hence the geriatric services of hospitals subvented by the government have evolved to cover acute, non-acute, and community care including the residential care sector. Therefore as a geriatrician, my interest span both secondary and primary care settings

What was previously known about the primary health care systems in Hong Kong?  How has your work in this area advanced understanding of it?

Comparative research has shown that Hong Kong has a high avoidable mortality ratio among the older population compared with other similar cities such as Paris, New York and London, likely related to the structure of primary care system (Chau PH et al European Journal of Public Health 2011; 21(2): 215-220.

Creating elder friendly primary care settings is an important step to facilitate the elderly to seeking primary care in the community.

What do regard as being the most important aspect of the results of your research?

The most important finding is providing information from the users’ perspective regarding both the hardware (design of clinics etc) and the software (changing care providers’ attitudes towards needs of older people) of primary care to meet the changing population patient profile as a result of population ageing.

What was the greatest difficulty you encountered in studying age friendliness of primary care services for older people?

The greatest difficulty encountered is lack of funding support for this type of research. Those providing services do not consider this a priority, while academic grant giving bodies do not regard this as ‘research’. Fortunately this area was recognised as important by a charitable foundation.

To learn more about the S.H. Ho Centre for Gerontology and Geriatrics please visit the website. For more information about CADENZA initiative for seniors please visit the website. Dr Woo’s paper Age-Friendly Primary Health Care: An Assessment of Current service Provision for Older Adults in Hong Kong is available to download, share and comment on here.

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