Study: insurance usage surge of minor operations; warns premium hikes

A new study on the employee health insurance index shows a surge in insurance usage rates of inpatient services.

Researchers say that could drive up insurance premiums and eventually add burdens on the public healthcare system.

Conducted by the College of Professional and Continuing Education of the Hong Kong Polytechnic University, and a corporate employee benefits and MPF consultancy firm, the research looked into data from the past ten years, covering some 26,000 employees from 135 companies.

It was found that inpatient utilisation rate surged 16.5 percent year-on-year. Analysis indicated that minor day procedures are the key driver of the surge, accounting for 87 percent of inpatient cases in 2025.

Among them, around two-thirds were non-urgent minor operations, including viral wart-, endoscopy- and earwax-related procedures. Ingrown nails, localised superficial swellings or lumps and cellulitis also entered the top ten inpatient diagnosis for the first time.

Notably, ingrown nail cases averaged around 17,000 dollars per claim -- even higher than endoscopy-related cases by around 4,000 dollars.

Outpatient expenses now averaged 610 dollars per visit -- nearly doubled over the past ten years. Among them, sharp rises in visits to physiotherapies.

Prof. PETER YUEN, Dean, PolyU College of Professional & Continuing Education: "The rate of increase seems to be so high that it cannot just be accountable for natural ageing. So, I guess it's more patient's awareness, they think that this would help them. And also, I guess, there are also more providers who are willing to provide."

They said potentially abusive insurance claims could lead to backlash on the public healthcare system and taxpayers.

Dr. BEN FONG, Director, Centre for Ageing & Healthcare Management Research: "Maybe partly due to the distorted insurance, eventually, patients will seek treatment in the public sector and that will gradually increase the utilisation and the expenses in the public hospitals. And of course that through the taxation."

Researchers remind that as all invasive procedures carry risks, including endoscopy, patients should weigh the benefits and risks carefully even when insurance coverage is available.

Apart from improving pre-authorisation mechanisms, researchers suggest enhancing patient education to avoid over treatment.