IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v62y2006i10p2551-2564.html
   My bibliography  Save this article

Non-attendance and effective equity of access at four public specialist outpatient centers in Hong Kong

Author

Listed:
  • Johnston, Janice M.
  • Leung, Gabriel
  • Saing, Hnin
  • Kwok, Kin-On
  • Ho, Lai-Ming
  • Wong, Irene O.L.
  • Tin, Keith Y.K.

Abstract

This study tests whether socio-economic status (SES), at either the individual or ecologic levels, exerts a direct impact on non-attendance or an indirect impact on attendance through longer waiting time for appointments and/or doctor-shopping behavior at four public specialist outpatient centers in Hong Kong. We collected information through three main sources, namely patients' referral letters, telephone interviews with both open- and closed-ended questions (e.g. doctor-shopping data) and hospital administrative databases from a total of 6495 attenders and non-attenders enrolled from July 2000 through October 2001. Individual-level SES was measured by education, occupation and monthly household income. Tertiary planning unit (TPU)-level SES data consisted of proportion unemployed, proportion with tertiary education, median income and Gini coefficient. Direct effects of SES on non-attendance were examined by logistic regression. Indirect contributions mediated through waiting time and doctor-shopping were analyzed by structural equation modeling. We found that SES, at the individual or ecologic level, did not exert a direct effect on non-attendance. Instead, TPU-level SES contributed positively to waiting time ([beta]=0.06±0.03, p=0.048), i.e. worse-off neighborhoods (and those with greater income inequality) had a shorter waiting time. Individual-level SES was also directly associated with the likelihood of doctor-shopping ([beta]=0.16±0.02, p

Suggested Citation

  • Johnston, Janice M. & Leung, Gabriel & Saing, Hnin & Kwok, Kin-On & Ho, Lai-Ming & Wong, Irene O.L. & Tin, Keith Y.K., 2006. "Non-attendance and effective equity of access at four public specialist outpatient centers in Hong Kong," Social Science & Medicine, Elsevier, vol. 62(10), pages 2551-2564, May.
    • Handle: RePEc:eee:socmed:v:62:y:2006:i:10:p:2551-2564
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(05)00560-5
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Dunlop, Sheryl & Coyte, Peter C. & McIsaac, Warren, 2000. "Socio-economic status and the utilisation of physicians' services: results from the Canadian National Population Health Survey," Social Science & Medicine, Elsevier, vol. 51(1), pages 123-133, July.
    2. Campbell, S. M. & Roland, M. O. & Buetow, S. A., 2000. "Defining quality of care," Social Science & Medicine, Elsevier, vol. 51(11), pages 1611-1625, December.
    3. Farmer, P., 1999. "Pathologies of power: Rethinking health and human rights," American Journal of Public Health, American Public Health Association, vol. 89(10), pages 1486-1496.
    4. Arnesen, Kjell E. & Erikssen, Jan & Stavem, Knut, 2002. "Gender and socioeconomic status as determinants of waiting time for inpatient surgery in a system with implicit queue management," Health Policy, Elsevier, vol. 62(3), pages 329-341, December.
    5. Kloos, Helmut & Chama, Tsegaye & Abemo, Dawit & Tsadik, Kefalo Gebre & Belay, Solomon, 1986. "Utilization of pharmacies and pharmaceutical drugs in Addis Ababa, Ethiopia," Social Science & Medicine, Elsevier, vol. 22(6), pages 653-672, January.
    6. King, Gary & Honaker, James & Joseph, Anne & Scheve, Kenneth, 2001. "Analyzing Incomplete Political Science Data: An Alternative Algorithm for Multiple Imputation," American Political Science Review, Cambridge University Press, vol. 95(1), pages 49-69, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Wong, Irene O.L. & Cowling, Benjamin J. & Lo, Su-Vui & Leung, Gabriel M., 2009. "A multilevel analysis of the effects of neighbourhood income inequality on individual self-rated health in Hong Kong," Social Science & Medicine, Elsevier, vol. 68(1), pages 124-132, January.
    2. Chee Hon Chan & Ho Kit Wong & Paul Siu Fai Yip, 2017. "Associations of relative income deprivation with perceived happiness and self-rated health among the Hong Kong Chinese population," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 62(6), pages 697-707, July.
    3. Gabriel M. Leung & Keith Y. K. Tin & Owen O'Donnell, 2009. "Redistribution or horizontal equity in Hong Kong's mixed public–private health system: a policy conundrum," Health Economics, John Wiley & Sons, Ltd., vol. 18(1), pages 37-54, January.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Scott Gehlbach & Konstantin Sonin & Ekaterina Zhuravskaya, 2010. "Businessman Candidates," American Journal of Political Science, John Wiley & Sons, vol. 54(3), pages 718-736, July.
    2. Hoeck, Sarah & François, Guido & Van der Heyden, Johan & Geerts, Joanna & Van Hal, Guido, 2011. "Healthcare utilisation among the Belgian elderly in relation to their socio-economic status," Health Policy, Elsevier, vol. 99(2), pages 174-182, February.
    3. Ihle, R. & Amikuzuno, J. & von Cramon-Taubadel, S. & Zorya, S., 2010. "Grenzeffekte in der Marktintegration bei Mais in Ostafrika: Einsichten aus einem semi-parametrischen Regressionsmodell," Proceedings “Schriften der Gesellschaft für Wirtschafts- und Sozialwissenschaften des Landbaues e.V.”, German Association of Agricultural Economists (GEWISOLA), vol. 45, March.
    4. Matthew Blackwell & James Honaker & Gary King, 2017. "A Unified Approach to Measurement Error and Missing Data: Overview and Applications," Sociological Methods & Research, , vol. 46(3), pages 303-341, August.
    5. Vincent Bauer & Keven Ruby & Robert Pape, 2017. "Solving the Problem of Unattributed Political Violence," Journal of Conflict Resolution, Peace Science Society (International), vol. 61(7), pages 1537-1564, August.
    6. Paul Poast, 2013. "Issue linkage and international cooperation: An empirical investigation," Conflict Management and Peace Science, Peace Science Society (International), vol. 30(3), pages 286-303, July.
    7. Basile, Luigi Jesus & Carbonara, Nunzia & Pellegrino, Roberta & Panniello, Umberto, 2023. "Business intelligence in the healthcare industry: The utilization of a data-driven approach to support clinical decision making," Technovation, Elsevier, vol. 120(C).
    8. Cohen, Joseph N, 2010. "Neoliberalism’s relationship with economic growth in the developing world: Was it the power of the market or the resolution of financial crisis?," MPRA Paper 24527, University Library of Munich, Germany.
    9. You, Jong-Sung & Khagram, Sanjeev, 2004. "Inequality and Corruption," Working Paper Series rwp04-001, Harvard University, John F. Kennedy School of Government.
    10. Sergei Guriev & Daniel Treisman, 2020. "The Popularity of Authoritarian Leaders: A cross-national investigation," SciencePo Working papers Main hal-03878626, HAL.
    11. Senn, Nicolas & Breton, Mylaine & Ebert, Sonja T. & Lamoureux-Lamarche, Catherine & Lévesque, Jean-Frédéric, 2021. "Assessing primary care organization and performance: Literature synthesis and proposition of a consolidated framework," Health Policy, Elsevier, vol. 125(2), pages 160-167.
    12. Magnus Lindelow, 2003. "Understanding spatial variation in the utilization of health services: does quality matter?," Economics Series Working Papers WPS/2004-12, University of Oxford, Department of Economics.
    13. Julia Cage & Yasmine Bekkouche, 2018. "The Price of a Vote: Evidence from France, 1993-2014," Working Papers hal-03393149, HAL.
    14. Bruno Versailles, 2012. "Market Integration and Border Effects in Eastern Africa," Economics Series Working Papers WPS/2012-01, University of Oxford, Department of Economics.
    15. Jan Erik Askildsen & Tor Helge Holmås & Oddvar Kaarboe, 2011. "Monitoring prioritisation in the public health‐care sector by use of medical guidelines. The case of Norway," Health Economics, John Wiley & Sons, Ltd., vol. 20(8), pages 958-970, August.
    16. Askildsen, Jan Erik & Holmås, Tor Helge & Kaarboe, Oddvar, 2010. "Prioritization and patients' rights: Analysing the effect of a reform in the Norwegian hospital sector," Social Science & Medicine, Elsevier, vol. 70(2), pages 199-208, January.
    17. Antonio Filippin & Luca Nunziata, 2019. "Monetary effects of inequality: lessons from the euro experiment," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 17(2), pages 99-124, June.
    18. Chen, Andrew Y. & McCoy, Jack, 2024. "Missing values handling for machine learning portfolios," Journal of Financial Economics, Elsevier, vol. 155(C).
    19. Robert Grafstein, 2009. "Antisocial Security: The Puzzle of Beggar‐Thy‐Children Policies," American Journal of Political Science, John Wiley & Sons, vol. 53(3), pages 710-725, July.
    20. Vanessa Zorrilla-Muñoz & María Silveria Agulló-Tomás & Carmen Rodríguez-Blázquez & Alba Ayala & Gloria Fernandez-Mayoralas & Maria João Forjaz, 2022. "Ageing Perception as a Key Predictor of Self-Rated Health by Rural Older People—A Study with Gender and Inclusive Perspectives," Land, MDPI, vol. 11(3), pages 1-13, February.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:62:y:2006:i:10:p:2551-2564. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.