Rationing hospital services in Hong Kong: priority setting by clinicians using the Delphi method

Abstract

This article presents the results of a demonstration project of priority setting by clinicians in Hong Kong's public hospitals. Thirty-five chiefs-of-service of public hospitals in Hong Kong participated in a three-round Delphi exercise on identifying interventions that should be charged in public hospitals on the basis of questionable effectiveness and other reasons. A total of 246 interventions were identified in the first round, 126 of which received a positive score (indicating a high degree of consensus amongst the participants) at the end of the final round. The interventions that received higher scores tend to be preventive services, treatment of an elective nature, and procedures for sex-related conditions. As the number of interventions with positive scores in the final round are relatively small, the amount of money to be recovered from charging these interventions is not likely to be substantial. Such results suggest that rationing by itself cannot be a solution to the problems of healthcare financing in Hong Kong.