Page 217 - Hospital Authority Convention 2017

Service Enhancement Presentations

F6.2 Enhancing Partnership with Patients and Community 10:45 Room 421

Patient Engagement: Strategies to Improve Chronic Disease Control among Ethnical Minority Patients in the
Primary Care
Chen CXR, Hui LC, Man FY, Chan KKH HOSPITAL AUTHORITY CONVENTION 2017
Department of Family Medicine and General Outpatient Clinics, Kowloon Central Cluster, Hospital Authority, Hong Kong

Introduction
Hong Kong is the “Asia’s World City” with multi-culture and diversity. According to the Census in 2011, about 95% of the local
inhabitants are ethnic Chinese; the remainders are mainly from South Asia (India, Philippines, Nepal, Pakistan, and Indonesia).

Objectives
Previous studies have shown that chronic disease, i.e. diabetes and hypertension, affect certain ethnical minority groups
(EMGs) in various ways. Our mission is to provide comprehensive programmes that facilitate access for all, including EMGs,
to the public healthcare system, and to promote that all individuals enjoy equality of health and guard against discrimination.
Methodology
A clinical audit on chronic disease control (DM and HT) among EMG patients was carried out in Yau Ma Tei Jockey Club
General Outpatient Clinic. The first cycle was carried out from 1 January 2013 to 31 December 2013 with deficiencies of
chronic disease control identified. A series of improvement strategies were taken since 2014, including internet resources
for health information in multi-languages; standardisation and alignment of interpretation services across all primary care
clinics in Kowloon Central Cluster; training and coordination with traditional healers and NGOs; diet counselling tailor-made
specifically to different ethnical groups; culturally competent health promotion, including family/community members; set
up of chronic disease evening clinic to cater for patients who could not attend regular daytime followup due to work, etc.
Service improvement was reviewed between 1 January 2015 to 31 December 2015 (second cycle). Patients’ demographics,
blood pressure (BP) and biochemical parameters were retrieved from the Clinical Management System (CMS) and the clinical
outcomes between the first and second cycle were compared. Student’s t-test was used for analysing continuous variables
and Chi-square test for categorical data. All statistical tests were two-sided, and a p-value of < 0.05 was considered
significant.
Results
Compared with Chinese DM and HT patients, EMG patients were much younger and more obese. Deficiencies existed in the
comprehensive management of chronic diseases, particularly with respect to glycaemic and BP control. During the first cycle,
it was found that compared with Chinese hypertensive patients, EMG hypertensive patients have higher systolic and diastolic
BP (both P<0.001), and had a much lower proportion with BP adequately controlled (68% vs. 80%, P<0.001). Average fasting
blood sugar level was also higher in EMGs (6.6 ± 2.3mmol/L vs 5.9 ± 1.5mmol/L, P<0.001). Similarly, the glycaemic control
was poorer in EMG diabetes patients than their Chinese counterparts (HbA1c 7.8 ± 1.7% vs 7.5 ± 1.4%; P=0.006), who had a
much lower proportion of patients being adequately controlled metabolically (Hba1c <7%, 48% versus 60%, P<0.001). After
three years of implementations of the above improvement strategies, the key performance indexes of chronic disease control
were significantly improved among EMG patients. Wednesday, 17 May

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