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16. Health and Care Utilization Patterns of the Community-dwelling Elderly Persons in Hong Kong
- Hong Kong University Press, HKU
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16 Health and Care Utilization Patterns of the Community-dwelling Elderl y Persons in Hong Kong Ben C.P. Liu, Y.H. Cheng and S.M . McGhee DIntroduction Hong Kon g i s n o exceptio n t o th e globa l tren d o f populatio n ageing . I t i s predicted tha t peopl e age d 6 5 o r ove r wil l increas e fro m 10 % i n 199 1 t o 13.3% ove r th e nex t tw o decade s i n Hon g Kon g (Hon g Kon g Censu s an d Statistics Departmen t 1997) . Concernin g thos e age d 6 0 or over , in 5 0 years' time, they will make up about two-fifth s o f the population i n Hong Kong. By 2025, the proportion o f elderly population in Hong Kong will be higher tha n that i n Japan an d Chin a (Min g Pao Daily News 1999) . Th e growin g agein g population will bring along social repercussions. Although many elderly people remain fit and active until very late in their lives, chronic illness and disabilit y are not uncommo n experience s i n old people (Fiel d 1997) . In fact , statistic s gathered b y Bury (1997 ) suggeste d tha t i n Grea t Britain , fo r thos e sufferin g from a t least one form o f disability, almost 70 % of disabled adults were 60 or over. Apparently, thos e sufferin g fro m a high leve l of disability , livin g alon e or wit h a n inadequat e suppor t networ k ma y hav e t o rel y o n forma l car e (Tennstedt, Harrow and Crawford 1996) . Since the health status of individuals has cost implications for formal services (McNamee, Gregson and Buck 1999) , the increas e i n frai l elderl y peopl e create s a great challeng e t o th e provider s of health an d socia l car e (Youn g e t al. 1999 ; Walker an d Warren 1996) . In additio n t o forma l services , informal car e is a fundamenta l sourc e o f 242BEN C.P.LIU, Y.H. CHENG ANDS.MMCGHEE support t o elderly persons, especially those with functional declin e (Unge r e t al. 1999) . Informa l car e — a kin d o f socia l suppor t — i s a continuu m o f helping behaviour s o r assistanc e tha t i s not derive d fro m lega l mandate s o r public financing mechanisms , but from normativ e or voluntary interpersona l association (Litwi n an d Auslande r 1990) . I t is an unpai d care , which i s no t organized vi a a statutory o r voluntary organization , bu t i s offered mainl y b y family members , relatives , friend s o r neighbour s (Victo r 1997) . I n term s o f financial cost , informa l car e appear s t o b e les s costl y tha n forma l car e (Tennstedt, Harro w an d Crawfor d 1996) . Unde r th e curren t economi c conditions, policy-makers ten d t o promote informal car e as a complement t o formal services . A s ther e ar e factor s affectin g famil y car e o f th e elderly , i t becomes a new strain on family members (Cooney and Di 1999; Walker 1993 ) no matte r ho w th e cos t o f car e ma y diffe r i n term s o f financia l expenses , time, duration , intensity , complexit y an d prognosi s o f car e require d (Rime r 1999; Parker 1981) . Many studies (Melzer et al. 1999; Tennstedt, Harrow and Crawford 1996 ; Chappell 1995 ) sugges t tha t elderl y persons livin g in th e communit y utiliz e both forma l an d informa l care . However, ther e are still some elderly person s who rel y solely o n eithe r forma l o r informa l care . Efforts hav e alread y bee n made t o investigat e th e utilizatio n pattern s o f car e s o a s t o provid e mor e...
