Primary Care Quality and Revisit Intention Among Hong Kong Older Adults: A Cross-Sectional Study

Abstract

Background: The healthcare system of Hong Kong is facing a growing burden arising from chronic diseases and patient demands because of the rapid ageing and healthcare workforce shortage. Primary care is widely recognised as the most cost-effective way in improving health of the people. This study aimed to understand how older adults’ experiences of primary care in Hong Kong may impact the service utilisation and revisit intention of primary care services. Methods: This correlational study used a combination of cluster, purposive, and snowball sampling methods and collected 573 valid responses from Hong Kong residents aged 60 years or above. A modified version of the Primary Care Assessment Tool Chinese Version (PCAT-C), requiring an estimated 15 min to complete, was used to measure the perceived service quality, satisfaction, trust, and revisit intention. Data collections were performed between March 2025 and November 2025. A partial least squares structural equation modelling (PLS-SEM) was performed in the statistical software SmartPLS 4.0 to test the relationships of various variables. Results: By analysing the 573 valid samples (Mage: 74.2, SD: 7.3; female: 80.5%) from the 607 total collected responses, ongoing care was revealed as the most influential PCAT factor in both older adults’ perceived service quality (β = 0.368; p < 0.0001) and satisfaction (β = 0.189; p < 0.0001), while trust (β = 0.265; p < 0.0001) and perceived service quality (β = 0.195, p = 0.001) were found to have positively contributed to older adults’ intention to revisit primary care services among the respective relationships among perceived service quality, satisfaction, and trust towards revisit intention. Conclusions: To enhance the utilisation of primary care among older adults, it is vital to improve their trust, perceived service quality, and satisfaction with primary care providers. One promising way to achieve this goal is to improve ongoing quality of care and people-centred care at the primary care level.