Basic Public Health Service Utilization by Internal Older Adult Migrants in China

Abstract

Since 2009, the Chinese government has launched a basic public health services (BPHS) equalization program to provide the same BPHS to all the citizens. However, utilization of BPHS among older migrants is still low. The purpose of this paper was to explore the determinant individual and contextual factors of older migrants’ utilization of BPHS, and to provide suggestion for the government to improve BPHS utilization. Based on Andersen’s model of health services use, data from the China’s Regional Economic Statistics Yearbook 2014 and National Health and Family Planning Dynamic Monitoring Survey on Migrant Population 2015 were analyzed using a hierarchical random intercept model for binary outcomes. Results showed that the percentage of migrant older adults receiving free physical examinations, which is an important item of BPHS, was 36.2%. Predisposing (education, hukou, living duration in the host city, and scope of migration), enabling (health insurance and social networks), and need (self-rated health and chronic conditions) factors of individuals’ characteristics had significant impact on the use of BPHS. The proportions of both migrant children enrolled in public schools and people with established health records had a positive impact on an individual’s chance of receiving free physical examinations. These findings suggest that economic development and improvement at the level of the city’s health resources cannot effectively improve access to BPHS by older adult migrants. Instead, the driving force appears to be supportive policies for the migrant population.

The Effects of Social Support and Morbidities on Self-Rated Health among Migrant Elderly Following Children to Jinan, China

“…Different from local elderly, migrant elderly generally have low socioeconomic status and cannot enjoy the same social benefits as local residents; they are also less likely to have access to comprehensive health care [4]. Most migrant elderly are less willing to seek medical care, which could be detrimental to their physical and mental health and cause a range of health problems [5]. Compared with the local elderly, the MEFC are far away from their hometown, and their social network and social supports become weaker [6].…”

Correlation between Elderly Migrants’ Needs and Environmental Adaptability: A Discussion Based on Human Urbanization Features

“…Academic research on human urbanization covers many fields, but traditional studies have focused on the household registration (hukou) system and the urban status of migrant people [ 16 ]. In recent years, the issue of human cognitive differences has also gradually gained attention [ 17 ]; for example, public health service utilization [ 18 ], educational assortative mating in marriage [ 19 ], and risk information-seeking behavior [ 20 ]. Through a literature review, this study found that elderly migrants reflect various cognitive characteristics of production and living needs.…”

Do Migration Characteristics Influence the Utilization of Basic Public Health Services in Internal Elderly Migrants in China?

“…The potential participants are informed by issuing leaflets, posting posters, calling through the telephone, and using other methods within the community. Recently, results showed that the percentage of migrant older adults receiving free medical checkups was 36.2% (15). Therefore, our study selected free health checkups as the measurement of basic public health services.…”

“…In contemporary society, an increasing number of families are migrating with their elderly members to look after children, find jobs, or access better healthcare services in China. In addition, most of these elderly members are more than 60 years old (15). Strengthening the utilization of primary healthcare facilities is considered an effective approach to providing affordable, equitable access to quality basic health care for all Chinese citizens by 2020, as was pledged by China (13,16).…”

“…However, many studies have indicated that <40% of elderly migrants have participated in the free community health checkups in the past year. In addition, <40% of internal elderly migrants follow up on chronic diseases, and the level of other behaviors, such as establishing health records and seeking medical attention, is also low (15,18). This suggests that there are deficiencies in the health management of elderly migrants in China.…”