Yt Wun

How do patients choose their doctors for primary care in a free market

AIMS A recent trend in health care system is to provide more choices to the patients. This study surveyed the general publics choices for primary care in Hong Kong which has the setting of free choices for private or public service and also direct access to specialists. METHODS We used a combined qualitative and quantitative approach. We held five focus group interviews with participants of different socio-economic categories. Information from the focus groups helped to design a questionnaire for random telephone interviews with members of the public aged 18 or above. RESULTS There were 37 participants in the focus groups and 1647 respondents in the telephone survey. The most important factor for choosing a doctor was proximity to home or workplace, followed by quick relief from the illness. Once continuity of care had been established, distance was of less importance but comprehensive care was valued. Nearly 70% of the public had regular doctors. About 93% of the public would consult specialists directly when they thought they needed a specialists opinion. Nearly 30% chose specialists for any medical care and 38% preferred specialists to also look after their primary care problems. CONCLUSION Convenient accessibility was the most important factor for the initial choice of primary care doctors by the general public. The perceived clinical proficiency of the doctor determined future continuity of care. Patients liked to have direct access to specialists. Though some chose to see the specialists even for primary care problems, most people had regular doctors who were likely to have the attributes of family doctors.

The public's perspectives on antibiotic resistance and abuse among Chinese in Hong Kong

Antibiotic abuse and resistance impose a continuing threat to the world. The awareness of antibiotic resistance is said to be inversely associated with the prevalence of abuse. We examined the publics perspectives on antibiotic resistance in our study of the publics knowledge, attitude and practice with antibiotics.

Antibiotic use: do parents act differently for their children?

Background:  Many children in the community take antibiotics inappropriately. Previous studies comparing parents with other adults suggest that parents are more judicious with antibiotics for their children. This study aims to explore the difference between parents’ use of antibiotics for themselves and for their children.

A Curvilinear Nomogram of Peak Expiratory Flow Rate for the Young

Objective. Peak expiratory flow rates (PEFRs) differ among populations and between times. The new EU scale of the mini-Wright flow-meter has been introduced since 2004. This study updated the PEFR nomograms with the new scale for Chinese children and adolescents (aged 6–19 years) in Hong Kong. Methods. A convenience sample was recruited from 34 primary care practices (patients’ companions/children) and four schools. Standardization workshops were run for the physicians, and the proper use of the flow-meter was demonstrated to students prior to the data collection. Brand new meters were used. For each sex, the linear regression model was used to determine the relationship between PEFR and the variables of age and body height. The open-source software PyNomo was used to generate the nomograms. Results. After excluding 66 participants with past/current history of respiratory tract diseases, heart disease, incomplete data, and poor effort, PEFRs were collected from 798 males and 794 females. The PEFR had a linear relationship with age but a curvilinear relationship with height. The regression equations for predicted PEFR were ln(PEFR) = 1.810256*ln(height) + 0.038297*age – 3.734139 for males and ln(PEFR) = 1.525509*ln(height) + 0.033275*age – 2.368592 for females. The corresponding nomograms were constructed. They were tested with 230 patients in primary care; 9.6% (12 males and 10 females) had PEFR less than the predicted value by ≥20%. Conclusion. The body height was a stronger determinant than age for PEFR. The predicted PEFR with these determinants bear a curvilinear relationship.

Are There Differences in Antibiotic Use Between the Recent-Immigrants from Mainland China and the Local-Born in Hong Kong?

Abstract Immigrants, especially the first-generation, were thought to have different knowledge, attitudes and practice (KAP) with antibiotics. Doctors often perceived extra pressure from them to prescribe antibiotics. To test these perceptions, we studied the difference in KAP with antibiotics between the recent-immigrants from mainland China and the local-born of Hong Kong—places with significantly different healthcare and socio-economic systems. Focus groups (including one specific group of recent-immigrants) with 56 participants and territory-wide telephone questionnaire survey with 2,471 randomly selected respondents. Recent-immigrants shared similar KAP with the local-born. After adjustment for age, sex and education, the main significant difference was the new-immigrants’ behaviour of acquiring antibiotics without prescription and keeping the leftover. They, like the local-born, preferred doctors who prescribed antibiotics cautiously. Immigration status could be the surrogate for age, sex and education in the KAP with antibiotics. For antibiotic use, health education and patient care could be similar between the recent-immigrants and the local-born.