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HKDSE Health Management and Social Care Practice Paper: Health Indicators, Care Services and Resource Allocation (12 Questions, 100 Marks, 75 Minutes, with Answers)
HKDSE Health Management and Social Care: Health Indicators, Care Services and Resource Allocation
HKDSE Health Management and Social Care practice paper on birth and death rates, dependency ratios, prevalence, bed occupancy, staffing and resource allocation ethics.
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Paper details Level: S6 | Subject: Health Management and Social Care | Time: 75 minutes | Marks: 100 | Questions: 12 | Answers included
Section A: Health Indicators and Population Structure (32 marks)
Answer all questions in Section A.
| # | Question | Answer and marking notes |
|---|---|---|
| 1 | (Vital statistics) A district has a mid-year population of 7,500,000; 45,000 live births and 37,500 deaths are recorded in a year, including 225 deaths under one year of age. (a) Calculate the crude birth rate per 1,000 (2 marks). (b) Calculate the crude death rate per 1,000 (2 marks). (c) Calculate the rate of natural increase per 1,000 (2 marks). (d) Calculate the infant mortality rate per 1,000 live births (2 marks). | Answer: (a) 45,000 / 7,500,000 x 1,000 = 6.0. (b) 37,500 / 7,500,000 x 1,000 = 5.0. (c) 6.0 – 5.0 = 1.0. (d) 225 / 45,000 x 1,000 = 5.0. Marking: rates are per 1,000; the infant mortality denominator is live births, not total population. |
| 2 | (Population structure) In a population of 7,500,000, 780,000 people are under 15, 5,400,000 are aged 15 to 64 and 1,320,000 are 65 or above; 8% of those aged 65 or above use long-term care services. (a) Calculate the total dependency ratio (3 marks). (b) Calculate the old-age dependency ratio (2 marks). (c) Calculate the number of older people using long-term care services (3 marks). | Answer: (a) (780,000 + 1,320,000) / 5,400,000 x 100 = 38.9%. (b) 1,320,000 / 5,400,000 x 100 = 24.4%. (c) 1,320,000 x 8% = 105,600 people. Marking: the numerator is the dependent population and the denominator is the 15-64 group. |
| 3 | (Disease frequency) A district has 250,000 residents; 3,000 new diabetes cases are diagnosed in a year and 21,250 people are living with diabetes at year end. (a) Calculate the incidence rate per 1,000 (3 marks). (b) Calculate the prevalence rate per 1,000 (3 marks). (c) Explain the difference between incidence and prevalence when planning services (2 marks). | Answer: (a) 3,000 / 250,000 x 1,000 = 12.0. (b) 21,250 / 250,000 x 1,000 = 85.0. (c) Incidence tracks new cases and informs prevention and early detection, while prevalence tracks all existing cases and informs long-term treatment and rehabilitation capacity. Marking: same denominator, different numerator. |
| 4 | (Mortality data) A hospital records 5,000 discharges and 100 hospital deaths in a year; across the whole district, 100,000 admissions produce 800 deaths. (a) Calculate the hospital crude inpatient mortality rate (3 marks). (b) Calculate the district inpatient mortality rate (2 marks). (c) Explain why inpatient mortality alone is a poor basis for comparing hospitals (3 marks). | Answer: (a) 100 / 5,000 x 100 = 2.0%. (b) 800 / 100,000 x 100 = 0.8%. (c) Hospitals differ in case mix, age structure and referral patterns, so a hospital taking more severe cases will show a higher rate; deaths within 48 hours of admission should also be separated. Marking: case-mix difference must be named. |
Section B: Health Services, Staffing and Social Care (36 marks)
Answer all questions in Section B.
| # | Question | Answer and marking notes |
|---|---|---|
| 5 | (Bed utilisation) A hospital has 1,800 beds, operates 365 days a year and records 559,000 occupied bed days; the average length of stay is 6.5 days. (a) Calculate available bed days (2 marks). (b) Calculate the bed occupancy rate (3 marks). (c) Calculate the number of discharges (4 marks). | Answer: (a) 1,800 x 365 = 657,000 bed days. (b) 559,000 / 657,000 x 100 = 85.1%. (c) 559,000 / 6.5 = 86,000 discharges. Marking: bed days equal beds times days; discharges equal occupied bed days divided by average length of stay. |
| 6 | (Manpower) A cluster employs 4,500 nurses for 3,000 beds and loses 540 nurses in a year. (a) Calculate the number of beds per nurse to 2 decimal places (3 marks). (b) Calculate the annual nurse turnover rate (3 marks). (c) Explain two effects of staff turnover on service quality (3 marks). | Answer: (a) 3,000 / 4,500 = 0.67 beds per nurse. (b) 540 / 4,500 x 100 = 12.0%. (c) Loss of experienced staff breaks clinical continuity and increases supervision needs, while overtime and agency cover raise error and infection risks. Marking: the ratio must be beds per nurse. |
| 7 | (Waiting lists) A specialist clinic starts the year with 8,400 pending cases, receives 36,000 new referrals and completes 30,600 cases. (a) Calculate the year-end backlog (3 marks). (b) Calculate completed cases as a percentage of new referrals (3 marks). (c) How many additional cases must be completed to clear the backlog in the same period (3 marks)? | Answer: (a) 8,400 + 36,000 – 30,600 = 13,800 cases. (b) 30,600 / 36,000 x 100 = 85.0%. (c) A further 13,800 cases must be completed. Marking: backlog equals opening balance plus new referrals minus completed cases. |
| 8 | (Care costs) Home care costs 180 dollars per hour and provides 24 hours per household per month; residential care costs 9,600 dollars per household per month. 500 households use home care. (a) Calculate the monthly home care cost per household (3 marks). (b) Calculate the monthly difference between providing home care and residential care for all 500 households (3 marks). (c) State one consideration other than cost (3 marks). | Answer: (a) 180 x 24 = 4,320 dollars. (b) (9,600 – 4,320) x 500 = 2,640,000 dollars. (c) Home care preserves community networks and independence, while residential care provides 24-hour nursing and immediate emergency response; carer support and housing safety also matter. Marking: part (b) must be multiplied by the number of households. |
Section C: Vulnerable Groups, Waiting Lists and Resource Allocation (32 marks)
Answer all questions in Section C.
| # | Question | Answer and marking notes |
|---|---|---|
| 9 | (Poverty and health) The median household income in a district is 18,000 dollars and the poverty line is set at 50% of the median; of 120,000 households, 18,000 fall below the line. (a) Calculate the poverty line (2 marks). (b) Calculate the poverty rate (3 marks). (c) Explain two ways in which poverty and health affect each other (3 marks). | Answer: (a) 18,000 x 50% = 9,000 dollars. (b) 18,000 / 120,000 x 100 = 15.0%. (c) Low income limits nutrition and housing quality, harming health directly, while chronic illness brings medical costs and lost earnings that deepen poverty. Marking: the two-way relationship is required for full marks. |
| 10 | (Rehabilitation services) A district has 2,400 day rehabilitation places and 3,600 people waiting; each year 240 places are added while 300 people join the queue. (a) Calculate the current shortfall in places (3 marks). (b) Calculate the net annual increase in the queue (2 marks). (c) Explain why the queue will not shorten at this rate (3 marks). | Answer: (a) 3,600 – 2,400 = 1,200 places. (b) 300 – 240 = 60 people. (c) New demand of 300 a year exceeds the 240 places added, so the queue grows by 60 each year and will not shorten even with continued expansion. Marking: part (c) must compare new demand with new supply. |
| 11 | (Mental health) A district has 600,000 residents; 30,000 are screened, 2,700 screen positive and 1,620 of those who screen positive receive follow-up care. (a) Calculate the positive screening rate (3 marks). (b) Calculate the proportion of positive cases receiving care (3 marks). (c) Suggest one measure to improve the conversion from screening to treatment (2 marks). | Answer: (a) 2,700 / 30,000 x 100 = 9.0%. (b) 1,620 / 2,700 x 100 = 60.0%. (c) Book the follow-up appointment at the point of screening, or assign a case manager to trace non-attenders and reduce drop-out between a positive result and first treatment. Marking: parts (a) and (b) use different denominators. |
| 12 | (Resource allocation) A fund has 3,000 ten-thousand dollars available. Option A costs 60 ten-thousand dollars per patient and can treat 30 patients; Option B costs 5 ten-thousand dollars per person and can improve quality of life for 400 people. (a) Calculate the cost of each option and state whether each fits the budget (3 marks). (b) Calculate the number of people served per ten-thousand dollars for each option and compare them (3 marks). (c) State two principles other than cost-effectiveness that should guide allocation (2 marks). | Answer: (a) A: 60 x 30 = 1,800 ten-thousand dollars; B: 5 x 400 = 2,000 ten-thousand dollars, and both fit within the 3,000 ten-thousand budget. (b) A: 30 / 1,800 = 0.0167 people per ten-thousand dollars; B: 400 / 2,000 = 0.2 people, so B serves about 12 times as many people per dollar. (c) Equity, severity of condition, patient autonomy and informed consent, and continuity and accessibility of care should also be weighed. Marking: part (b) requires a per-dollar comparison. |
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