Background: Strengthening primary care is key to Hong Kong's ongoing health system reform. Primary care remains unregulated, private sector dominated and financed mainly out-of-pocket. This study sought to examine the association between patients' socioeconomic status (SES), source of health payments and the quality of primary care they accessed to inform policy discussions. Methods: Data was collected from 1,994 respondents in a stratified random telephone survey with a 68% response rate, using the validated primary care assessment tool (PCAT). Education, household-income and type of housing were selected as indicators of SES. Multivariable ordinal logistic regression models were created to examine associations between indicators of SES and scores of quality. Results: Higher household-income was most significantly associated with better experiences of quality. Respondents with HK$ 15000-39999(USD1934-5158) and HK$ 40000(USD5159) and above were 47%(OR 1.47, 95% CI 1.10-1.96) and 2 times (OR 2.07, 95% CI 1.38-3.09) more likely to experience better quality than the lowest-income group respectively. Income group HK$ 40000(USD5159) and above was 84% more likely to have better utilization (OR 1.84, 95% CI(1.21-2.78), and 2 times more likely to receive better comprehensiveness (OR 1.90, 95% CI 1.26-2.87). Patients who used only private insurance were 80%(OR 1.80, 95% CI 1.20-2.68) more likely to experience better quality than those who paid out-of-pocket. Conclusions: Our results show that the quality of primary care experienced in HK tended to be higher for those who had higher income and private insurance, and were able to pay out-of-pocket for the care. This indicated that the inequality in primary care is likely to be related with the private dominated primary care system in Hong Kong. More public responsibility on primary health care should be sought for in HK and similar contexts to reduce the inequality in primary care.
[Copyright of BMC Health Services Research

This study examines how the language used at home, Putonghua or Cantonese, has influenced the Chinese reading attainment of 4335 primary school students in Hong Kong. Also examined was the influence of the birthplace and home background socioeconomic status (SES) of the reader. Although the indigenous Hong Kong population uses Cantonese, a dialect of Chinese, for everyday communications, the Chinese written in school is Modern Standard Written Chinese (MSWC), the written equivalent of Putonghua, the spoken language of the people of China. Many of the numerous families migrating from China to Hong Kong in recent years have brought with them children educated in Putonghua in China and with extensive experience of MSWC. It was hypothesised that the reading attainment of these students would be superior to that of classmates born in Hong Kong and using Cantonese habitually. This would apply particularly to students from advantaged SES homes. The children born in China indeed had superior reading attainment. But children speaking Cantonese at home and Putonghua 'sometimes' had the highest reading scores, regardless of their birthplace or SES. The writers reflect on assumptions about the influence of the language used at home on language attainment and the implications for educational planning.
[Copyright of Journal of Multilingual and Multicultural Development is the property of Routledge. Full article may be available at the publisher's website:
http://dx.doi.org/10.2167/jmmd529.1 ]