Evaluating quality and utilisation of primary care among older adults in Hong Kong: a mixed-methods study protocol
Fong, Ben Y.F., Ng, Tommy K.C., Chiu, Wang Kin, Chan, Karly O.W., Law, Vincent T.S., Wong, William C.W., Liang, Zhanming, Lau, Mei Mei, and Ho, Sammantha S.P. (2025) Evaluating quality and utilisation of primary care among older adults in Hong Kong: a mixed-methods study protocol. BMC Primary Care, 26 (1). p. 339.
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Abstract
Background Hong Kong’s rapidly ageing population poses significant challenges to the sustainability of its healthcare system. With over 75% of adults aged 65 and above experiencing at least one chronic condition, enhancing the accessibility and quality of primary care is critical. Despite policy efforts such as the Primary Healthcare Blueprint and District Health Centres (DHCs), significant structural and operational challenges persist, including low service engagement, fragmented multidisciplinary care coordination, and socioeconomic inequities in access, perceived service quality, and satisfaction. Building on evidence that socioeconomic factors would influence care access, this study examines how these disparities shape older adults’ primary care experiences.
Methods This mixed-methods study investigates the quality and utilisation of primary care among older adults in Hong Kong. Phase 1 involves a quantitative survey using the Chinese version of the Primary Care Assessment Tool (PCAT-C), combined with validated measures of service quality, satisfaction, trust, and revisit intention. A geographically and socioeconomically stratified cluster sampling strategy will be used to collect 510 responses. Phase 2 consists of qualitative focus group discussions with at least 25 older adults and their caregivers to explore in-depth experiences and expectations regarding primary care.
Discussion Findings will provide a multidimensional understanding of primary care delivery and its impact on older adults’ satisfaction and behavioural intentions. Early data suggest that while technical care remains difficult for patients to evaluate, non-clinical service quality, such as staff communication and system efficiency greatly influences perceived value. Socioeconomic disparities also affect care continuity and trust. This study will identify gaps in meeting the needs and expectations of older adults for primary care service and propose targeted interventions to enhance primary care accessibility and quality for older adults. Insights will inform policy adjustments to better support healthy ageing and reduce dependence on overstretched hospital services.
| Item ID: | 89924 |
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| Item Type: | Article (Scholarly Work) |
| ISSN: | 2731-4553 |
| Keywords: | Health policy, Hong kong older adults, Perceived service quality, Primary care assessment tool, Satisfaction, trust, revisit intention |
| Copyright Information: | © The Author(s) 2025. This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. |
| Date Deposited: | 29 Jul 2026 04:59 |
| FoR Codes: | 42 HEALTH SCIENCES > 4203 Health services and systems > 420319 Primary health care @ 100% |
| SEO Codes: | 20 HEALTH > 2003 Provision of health and support services > 200310 Primary care @ 100% |
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