Comparison of access to health services among urban-to-urban and rural-to-urban older migrants, and urban and rural older permanent residents in Zhejiang Province, China: a cross-sectional survey

Abstract

BackgroundWhile much literature reported the access of Chinese older migrants to health services, little was known about the differences among sub-groups of older adults, including urban-to-urban and rural-to-urban migrants, and urban and rural permanent residents. This study aimed to examine the access of these four groups to health services in Zhejiang Province, China and provide an evidence for the development of health services policies.MethodsA cross-sectional survey was conducted in community-dwelling older adults (aged 60 years or above) in 2013. Participants were recruited by random sampling. Demographic information and access to health services for the elderly populations were obtained via interviews using a self-designed structured questionnaire. Pearson’s chi-square tests and Cochran-Mantel-Haenszel (CMH) tests were performed to examine the differences in access to health services among the four groups. Binary logistic regression was conducted to explore the associations of participants’ visits to doctors with their group status after controlling confounding factors.ResultsThe two-week hospital visiting rates were significantly lower in migrants (55.56% in rural-to-urban and 62.50% in urban-to-urban) than that in urban and rural permanent residents (67.40 and 82.25%, respectively; p < 0.01). The majority of older adults who received a diagnosis indicating need for hospital treatment accepted the treatment, with no significant difference among the four groups after controlling for health service need (χ2 = 7.08, p = 0.07). On the other hand, 30.05% of the older adults did not visit a doctor when they got ailments in the past 2 weeks prior to the survey, and 16.42% (33/201) did not receive hospital treatment after receiving a diagnosis indicating need for hospital treatment. Factors including age, marital status, educational attainment, major financial source, and living with family members did not influence health services use.ConclusionsTargeted social and health policies integrating the strengths of government, society and families should be implemented to further improve health services use for different groups of older adults.

Barriers of effective health insurance coverage for rural-to-urban migrant workers in China: a systematic review and policy gap analysis

“…Therefore, most RUMWs have high work mobility and low job stability, placing them in a disadvantaged and marginalized socioeconomic position [33]. The inherent characteristics of RUMWs inevitably shape their health needs, as follows: (1) They exhibit better physical health [17,19,40,59,60], but worse mental health than local residents [17,19,34,59,2) Except for industrial injury, they are less likely to suffer from serious diseases, but are more likely affected by common ailments, infectious diseases [15,[60][61][62] or sexually transmitted diseases [3,63] Their needs for healthcare and medical services are often delayed and the origins of their illness are often far from where they end up [14,34], as they devote their young and healthy bodies to the flow-in cities, and bring their older and ailing bodies back to the flow-out place [40]. The question is: What factors contribute to the suffering of RUMWs in China within the current healthcare system?…”

Barriers of effective health insurance coverage for rural-to-urban migrant workers in China: A systematic review and policy gap analysis

“…The inherent characteristics of RUMWs have inevitably shaped their health needs featured by: (1) They exhibit better physical health [17,19,40,59,60], but worse mental health than local residents [17,19,34,59]; (2) Except for industrial injury, they are less likely to suffer from serious diseases, but are more likely affected by common ailments, infectious diseases [15,[60][61][62] or sexually transmitted diseases [63]; (3) Their needs for healthcare and medical services are often delayed in their life time and the origins of their illness are often hundreds miles away from where they end up [14,34], as they devote their young and healthy bodies to the flow-in cities, and bring their older and ailing bodies back to the flow-out place [40]. The question is: What makes RUMWs in China suffer from the current healthcare system?…”

Investigating China's inter-prefecture migration from a place attractivity perspective, its spatial patterns, and demographic characteristics

“…We explore the spatial patterns of different cities' RIA among three age groups (Carbonaro et al 2018;Ma et al 2018), namely, the younger working age group (16-29 years old), the older working age group (30-59 years old) and the retiree group (60 years and older). The RIA scores for the three age groups are mapped in Figure 2.…”