The growing demand for home rehabilitation and care services in Hong Kong, driven by the ageing population, has led to individuals awaiting relevant subvented services or with urgent needs to consider employing short-term private or self-financed home rehabilitation and care services, including physiotherapy, private nursing or home care services, etc. Amongst the many companies/organisations (“service providers”) in the market providing such services, the Consumer Council surveyed 15 of them, and collected the charges and service details of therapists, nurses and health workers. The findings revealed significant variations in the basic charges across providers, of which the service charges of speech therapists could vary by up to 1.8 times (based on 50 minutes per session), while hourly charges of physiotherapists and occupational therapists could differ by more than onefold. Additionally, some organisations required a minimum service fee per visit, equivalent to at least 2 hours of service. 3 service providers offered packages for multiple home visits with lower hourly rates compared to one-off services, but it must be borne in mind that the duration of the packages would expire in 4 months at the most. Furthermore, some service providers would have additional surcharges under certain situations, such as express services, change or cancellation of appointment time, going to remote areas in Hong Kong, working in inclement weather or on public holidays, etc. The Council recommends consumers to carefully study the conditions of service and the calculation of service charges before engaging any service providers, to avoid unexpected additional costs. Service providers should consider providing detailed quotations that clearly list all service items and associated charges, enabling consumers to make informed comparisons and select the most suitable care or rehabilitation services for their needs or those of their families, to alleviate the pressure faced by patients and caregivers.
Between September and October 2024, the Council collected information on service charges and terms of service from the official websites of 15 non-government-funded service organisations that provided home rehabilitation and care services, including 8 private agencies and 7 self-financed organisations or service units. Council staff, posing as regular consumers, also made enquiries via telephone or on social media platforms with the 15 service providers on the details of service charges and terms of services. They later solicited more relevant information through correspondence for verification. As of the publishing deadline, replies had been received from 13 service providers. The survey covered 3 categories of home services, including professional rehabilitation services provided by physiotherapists, occupational therapists or speech therapists; nursing services provided by registered nurses or enrolled nurses; and personal care services provided by health workers or personal care workers. Notably, 9 of the service providers stipulated that physiotherapy, occupational therapy or rehabilitation services must be referred by a doctor.
Disparate Charges for 3 Types of Home Services
The Longer the Service Hours, the Lower the Average Charges for Some Services
The majority of the surveyed service providers offered one-time services at hourly rates, with vastly disparate charges. For physiotherapists and occupational therapists, the hourly rates ranged from $900 to $2,000, a difference of more than onefold. Of the 9 service providers offering speech therapy services on home visits, 5 of them charged $900 to $2,000 per hour; whilst the other 4 charged $500 to $1,400 per 50-minute session, a difference of up to 1.8 times. As 4 service providers stipulated a minimum of 2 hours of service per visit, consumers should be aware of any such requirements. Furthermore, some service providers would arrange a professional therapist to conduct an assessment and devise a rehabilitation plan for service recipients prior to the actual sessions. If the case is then followed up by physiotherapy assistants or occupational therapy assistants, the charges would be cheaper than those for services provided by therapists. Of these, 3 service providers stipulated a minimum of 1 hour of service, charging from $250 to $800, while another 7 service providers stipulated a minimum of 2 hours of service per visit, charging from $310 to $610.
For home nursing or home care services, the hourly rates generally decreased as the service duration increased. Using registered nurse as an example, the 1-hour rate ranged from $830 to $1,500, while the 4-hour rate ranged from $1,320 to $1,470 for the 8 service providers with different hourly rates, whereas for the other 4 service providers with a uniform hourly rate, the charges for 4 hours would range from $3,520 to $6,000, indicating that for longer service hours, those with different hourly rates might be more economical. Health workers or personal care workers would adopt a similar service charge model. Using one service provider as an example, the hourly rate of a health worker would cost $300, but if the service is extended to 8 hours, the average hourly rate would be $134.
Apart from charges as per a single occasion, 3 service providers offered service packages for multiple home visits, with 1 company offering a 20-hour package of home care services at $3,040 to $3,800, averaging $152 to $190 per hour. This package was inclusive of medical appointment escorting service, food reheating, changing of diapers, bathing service or simple wound-dressing, etc. by personal care worker and health worker respectively. As for the other 2 service providers that provided home physiotherapy or occupational therapy, their rehabilitation packages cost from $3,840 to $14,000, but it should be noted that the range of services and the number of sessions varied. Even though the hourly rate would be lower, such packages have a validity period, from the longest being 4 months to the shortest being 30 days. Consumers should pay more attention.
Express or Late Hours Service Might Incur Surcharges
Service Provision During Holidays Even Entail Double the Charges
Apart from the basic fees, most of the surveyed service providers would collect surcharges for consumers that have special requests. For example, for changing appointment hours or cancellation of services after making a reservation, all 15 service providers required prior notification within certain time limits. 2 of them were more lax, allowing for change of appointment time or cancellation of appointment just 4 hours before the scheduled appointment time at the latest; 1 even required notification to be made 7 working days beforehand. For failing to make notification within the time limit, most service providers would collect a surcharge from consumers, ranging from $200 to $1,000, whereas some would collect transportation fees for the service agents, the minimum service charge for the booked service, the service charge for the day, or double the service charge. Only 2 service providers indicated that if the consumer could provide a sick leave certificate or a hospital admission letter, then the appointment date could be changed without a surcharge, however this might not be applicable if the service agent had already arrived at the place of work.
12 of the service providers requested consumers to make appointments 1 day to 2 weeks in advance. For urgent express service, 7 of them indicated that there would be no extra surcharge, subject to availability of staff; while another 7 indicated that they would collect a surcharge depending on the appointment time or the type of service agent. Taking 3 of the service providers for instance, if a physiotherapist could successfully be arranged within 12 hours or for a same-day appointment, there would be a surcharge of $300 to $500; another service provider indicated that for same- or next-day appointment for a health worker, personal care worker or home care services, the same-day or next-day services would charge an additional $75; another indicated that if there is a need for a registered nurse for 5 consecutive days, with such arrangements being made within 24 hours before service commencement, then the fees for the first day of service would be doubled.
For request of service outside of working hours, 10 service providers would apply surcharges. For example, the therapists of 1 service provider would charge double, whereas health workers would charge at the rate of $250 per hour; 2 service providers indicated that they would charge an extra 20% on top of their daytime service fees or hourly rate; another 3 indicated that for work during night hours or the early hours after midnight, there would be a surcharge of $100 to $200, or reimbursement of taxi fees. Furthermore, if consumers request service on special days such as New Year’s Day, Chinese New Year holidays, Christmas or Winter Solstice, 11 service providers would charge double the service fees, and 2 did not even provide any service on these special days.
Surcharges Apply for Services in Remote Areas or During Inclement Weather
Definitions Should be Clarified
Consumers residing in remote areas should be aware of possible surcharges. 7 surveyed service providers would charge an additional $20 to $200 on each occasion for consumers residing in areas that are not along the MTR lines or in the outlying islands; 1 service provider would charge an extra hour or 1.5 hour in service fees, depending on the area; another 4 did not give any actual monetary amount, indicating that it would depend on the location and traffic situation, to be mutually agreed upon. In fact, different service providers may have different definitions of what constitutes “remote areas”, and clarifications should be made before engaging the services. Furthermore, if inclement weather arises at the scheduled appointment time or during the service provision (such as tropical cyclone signal No.8 or above or black rainstorm warning), only 1 service provider indicated that there would be no surcharge, whilst 2 would cease their services and 9 would charge 1.5 times to double the normal service fees, and depending on the actual situation, an additional $100 to the full taxi fees incurred.
Home rehabilitation and care services come in a vast variety of service types, basic charge and surcharge schemes. The Council urges service providers to actively offer clear and detailed quotations to facilitate price comparison based on individual needs, as well as to budget for the final costs. Consumers may refer to the following tips when choosing home rehabilitation and care services:
- Determine the type of care or rehabilitation services required according to actual needs, and seek professional advice on the patient’s health conditions;
- Be aware that the therapists or caregivers referred by some agencies may not be their direct employees. Consumers should try to communicate with them directly beforehand to understand their qualifications, training and relevant work experience etc., or check the registration status of the therapists or related staff on the websites of relevant institutions such as the Supplementary Medical Professions Council and the Nursing Council of Hong Kong;
- Clearly explain to the caregiver the condition of the individual being cared for, such as the physical condition and mobility, the level of involvement and support from family members, and a list of items to be cared for, so as to enable the caregiver to assess whether he/she is capable to handle the task;
- Clearly state the required service timing, find out how fees are charged and the terms and conditions, make any special requests as soon as possible, and obtain a detailed price list from the service provider. For service packages, pay attention to the included services and the validity period, etc.;
- Family members should maintain regular contact with the caregiver(s) and the service provider, and if there is any dissatisfaction with the service, they should communicate with the other party first to address any workflow issues, and request a change of staff if necessary.
Download the article (Chinese only): https://ccchoice.org/577-rehab
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