Authors (including presenting author) :
Wong SH, Fung Hong
Affiliation :
The Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong
Keyword 1: :
Willingness-To-Pay
Keyword 2: :
Healthcare Financing
Keyword 3: :
Fee and Charge Reform
Keyword 4: :
Physiotherapy Services
Keyword 5: :
Patient Satisfaction
Introduction :
Public healthcare fee and charges reforms (F&C) in Hong Kong aim to optimize resource allocation but may impact service accessibility and equity. However, there is a lack of local, patient-centered data on financial sensitivity and perceived value to manage this transition. Understanding pre-reform patient demographics, perceived barriers, and predictors of willingness-to-pay (WTP) is essential to anticipate post-reform utilization trends and safeguard vulnerable groups.
Objectives :
To establish a pre-reform patient-centered baseline of (1) key service metrics (referrals, no-show/ default rate, waitlists), (2) patient socioeconomic and clinical profiles, (3) perceived affordability and service satisfaction, and (4) factors predicting WTP for standard physiotherapy sessions.
Methodology :
A mixed-methods study was conducted. Pre-reform administrative data (including referrals, no-show/default rate, waitlists metrics) were systematically extracted from the OPAS system to establish a baseline for future comparison. Concurrently, a structured telephone questionnaire was administered to a random sample of patients (n=50) attending the UCH PT Department between Aug and Dec 2025. Data included demographics, socioeconomic status, clinical perception, service satisfaction, and WTP. Multiple linear regression identified significant predictors of WTP.
Result & Outcome :
Surveyed patients (mean age: 56 ± 14.93 years, 70% female) reported high service satisfaction (mean score: 80.3 ± 14.5). Affordability was not a pre-reform concern for 94% of respondents. Multiple linear regression analysis identified several significant predictors of WTP associated with 1)Had private health insurance (β= 199.72, P< 0.001) 2)Reported higher service satisfaction (β= 5.13, P=0.001) 3)Greater pain severity (β= 28.96, P=0.002) 4)Younger age (β= -4.57, P=0.007) 5)Receiving individual (vs. group) therapy sessions (β=25.81, P=0.034). Other predictors, including sex, waiver status, perceived need, condition chronicity, household income, education level, employment status, and geographical barriers, etc., were not statistically significant predictors of WTP in pre-reform data. 6)Half (56%) of patients reported their maximum WTP would not exceed HKD 250 per session under the pre-reform service model. Conclusion: This pre-reform baseline provides critical data for service planning by identifying key predictors of willingness-to-pay. These findings enable targeted strategies to optimize patient satisfaction, resource allocation, and direct proactive service redesign. Furthermore, the data establishes an essential baseline for our ongoing longitudinal study, which will evaluate the reform’s impact at 3 and 12 months post-implementation.
