Vouchers and consumer-directed care: Implications for community care services in Hong Kong

Abstract

There has been considerable interest in the concept of consumer-directed care (CDC) for ageing populations. One type of CDC employs vouchers that older people can use to procure a panel of social services that best fits their needs. The voucher-based strategy has been institutionalised in Hong Kong as the Community Care Service Voucher for the Elderly (CCSV). Using a qualitative, semi-structured interview method, researchers probed the experiences of two groups (twenty-six CCSV users and twenty-seven CCSV non-users) with the voucher programme between March 2014 and September 2015 during the first phase of CCSV. The interviews revealed a set of social and institutional supports needed to empower clients to effectively utilise the voucher. These supports (or forms of capital) were consistently present amongst active CCSV users and deficient amongst non-users. The research demonstrates that instituting a voucher does not, by itself, lead to optimised choices but, rather, that a network of institutional and social resources must be assembled in support of the voucher programme. In some instances, a case management approach may be needed, as older people (and family) need to combine different forms of institutional and social support to comprehend the voucher programme and utilise it for their particular needs.