Hong Kong domestic health spending: Financial years 1989/90 to 2006/07

This report presents the latest estimates of Hong Kong domestic health spending for fiscal years 1989/90 to 2006/07, cross-stratified and categorised by financing source, provider, and function. Total expenditure on health (TEH) was HK$75 048 million in fiscal year 2006/07, which represents an increase of HK$4405 million or 6.2% over the preceding year. Represented as a percentage of gross domestic product (GDP), TEH increased from 3.6% in 1989/90 to 5.6% in 2003/04 and then decreased to 5.0% by 2006/07. Taking population growth into account, total health spending per capita (at constant 2007 prices) grew at an average annual rate of 5.1%, which was faster than the average annual growth rate of per capita GDP by 2.1 percentage points. In 2006/07, government financing of health expenditure was HK$37 417 million (49.9$37 631 million) in the last decade as a result of the continued growth of private spending (averaging 9.5% per annum in real terms since 2002/03). The second important source of health financing was out-of-pocket payments by households (35.2%), followed by employer-provided medical benefits (7.4%) and private insurance (5.6%). Private insurance has taken on an increasingly important role for financing private spending, whereas household and employer expenditure together has shown a corresponding decrease during the same period. Of the HK$75 048 million total health expenditure in 2006/07, current expenditure comprised HK$71 888 million (95.8%), whereas HK$3161 million (4.2by health care function, services for curative care accounted for the largest share of total health spending (66.2care, private hospitals had increased capital expenditure leading to an observed increase in investment in medical facilities from 2.2Analysed by health care provider, hospitals accounted for the largest share (42.7Not taking into account capital expenses (ie investment in medical facilities), public current expenditure on health amounted to HK$35 437 million (49.3% of total current expenditure) in 2006/07 with the remaining HK$36 451 million made up of private sources of funds. Expenditure on hospital care (HK$32 069 million) was predominately funded by general government revenue (83.8%), whereas that on providers of ambulatory health care (HK$23 201 million) was by private household out-of-pocket payments (67.3%). This reflects the mixed health care economy of Hong Kong, where public hospitals generally account for about 90% of total bed-days and private doctors (including western and Chinese medicine practitioners) provide about 70% of the out-patient care. Although both public and private spending were mostly expended on personal health care services and goods (92.2% of total spending), the distributional patterns among functional categories differed. Public expenditure was targeted at in-patient care (53.3%) and substantially less at out-patient care (24.4%), especially first-contact care. In comparison, private spending was mostly concentrated on out-patient care (48.7%), whereas medical goods outside the patient care setting (22.4%) and in-patient care (18.9%) comprised the majority of the remaining share. Compared to the Organisation for Economic Cooperation and Development countries, Hong Kong has devoted a relatively low percentage of GDP to health care in the last decade. As a share of total spending, public funding (either general government revenue or social security funds) was also lower than in most comparably developed economies, although commensurate with its public revenue collection base.published_or_final_versio

Repeatability of Foveal Measurements Using Spectralis Optical Coherence Tomography Segmentation Software

PURPOSE: To investigate repeatability and reproducibility of thickness of eight individual retinal layers at axial and lateral foveal locations, as well as foveal width, measured from Spectralis spectral domain optical coherence tomography (SD-OCT) scans using newly available retinal layer segmentation software. METHODS: High-resolution SD-OCT scans were acquired for 40 eyes of 40 young healthy volunteers. Two scans were obtained in a single visit for each participant. Using new Spectralis segmentation software, two investigators independently obtained thickness of each of eight individual retinal layers at 0°, 2° and 5° eccentricities nasal and temporal to foveal centre, as well as foveal width measurements. Bland-Altman Coefficient of Repeatability (CoR) was calculated for inter-investigator and inter-scan agreement of all retinal measurements. Spearman's ρ indicated correlation of manually located central retinal thickness (RT0) with automated minimum foveal thickness (MFT) measurements. In addition, we investigated nasal-temporal symmetry of individual retinal layer thickness within the foveal pit. RESULTS: Inter-scan CoR values ranged from 3.1μm for axial retinal nerve fibre layer thickness to 15.0μm for the ganglion cell layer at 5° eccentricity. Mean foveal width was 2550μm ± 322μm with a CoR of 13μm for inter-investigator and 40μm for inter-scan agreement. Correlation of RT0 and MFT was very good (ρ = 0.97, P 0.05); however this symmetry could not be found at 5° eccentricity. CONCLUSIONS: We demonstrate excellent repeatability and reproducibility of each of eight individual retinal layer thickness measurements within the fovea as well as foveal width using Spectralis SD-OCT segmentation software in a young, healthy cohort. Thickness of all individual retinal layers were symmetrical at 2°, but not at 5° eccentricity away from the fovea

Development of a Chinese adult dyslexia screening checklist

Poster Presentation / Interactive pape

Reading-related behavioral characteristics as predictor of reading difficulties of Chinese adults: The use of adult behavior checklist for reading and writing in Hong Kong

Interactive PaperThe present study examined the behavioral characteristics that would predict the reading level of Chinese adults. A confirmatory factor analysis based on the ratings of 3798 adults confirmed the proposed twenty-two reading-related behavioral characteristics of six dimensions (reading, writing, organization, memory, arithmetic and oral language). In a separate sample of 234 adults who did the reading and writing assessment, regression analysis showed that mean scores of the behavioral characteristics significantly predicted the literacy skill of the participants after controlling for age, education level and intelligence. Each item score and the mean score of the behavioral checklist were also able to differentiate adults with reading difficulties from those with average reading-level. Results indicated a sensitivity and a specificity of 75.7% and 75.6% respectively, at a cutoff score of 2.4 out of the total score of 5

Early language and phonological difficulties of Chinese preschool children at familial risk for dyslexia

Paper PresentationThe present study examined whether Chinese preschool children at familial risk for dyslexia had early language and cognitive difficulties. 99 high-risk and 44 low-risk Chinese 4-year-old children (Kindergarten first year, K1) were recruited at the beginning of a 4-year longitudinal study. Results of the first two years of this study showed that high-risk children performed significantly less well than low-risk children in language and phonological measures. Language, phonological, paired-associate learning (PAL), and rapid naming skills were found to have significant unique contribution to Chinese character reading in K2 even when the autoregressive effect of Chinese reading in K1 was controlled. However, only Chinese phonological skills and PAL had significant unique contribution to English word reading in K2. These results suggest that Chinese preschool children at familial risk for dyslexia have early difficulties in spoken language and phonological processing like their alphabetic counterparts. Phonological skills and PAL may be common to learning both Chinese and English at their early stage, but oral language and rapid naming skills in Chinese are relevant mainly for learning Chinese. (This study was funded by the Research Grants Council in Hong Kong, #HKU 7212/04H

Reading-related cognitive deficits in developmental dyslexia, attention-deficit/hyperactivity disorder, and developmental coordination disorder among Chinese children

MOST PAST research findings suggest that phonological deficit is unique to developmental dyslexia insofar as alphabetic languages are concerned. The present study investigated the existence of any similar unique reading-related cognitive deficits associated with developmental dyslexia in a nonalphabetic script, Chinese. The pattern of comorbidity among various developmental disorders was also examined. One hundred six Chinese children with different types of developmental disorders or learning difficulties, including developmental dyslexia (DYS), attention-deficit/hyperactivity disorder (ADHD), developmental coordination disorder (DCD), and borderline intelligence (BI) were tested on literacy, rapid-naming, phonological, orthographic, and visual processing skills. It was found that (a) the comorbidiry rates among these developmental disorders were high; (b) the DYS-only group was most impaired in rapid naming and orthographic processing and performed significantly worse than other "pure" groups; (c) the ADHD-only and DCD-only groups performed very closely to the average normal range in literacy and cognitive domains; and (d) the cognitive profile of the DYS+ADHD group resembled that of the DYS-only group, while that of the DYS+DCD group resembled some characteristics of both the "pure" groups. The authors conclude that rapid-naming deficit and orthographic deficit are unique marker deficits of developmental dyslexia in Chinese, while children with ADHD or DCD are less impaired in literacy and reading-related cognitive areas. Implications for educational and clinical practices are also discussed. © 2005 International Reading Association.link_to_subscribed_fulltex

Reading-related cognitive deficits in developmental dyslexia, attention-deficit/hyperactivity discorder, and developmental coordination disorder among Chinese children

Conference Theme: Enhancing the Visibility and Credibility of Educational Researc