How internal migrants’ socioeconomic status affect their unmet inpatient service need? Evidence from a national study in China

Abstract

Background: China has experienced the largest migration during the past three decades. Compared with the permanent residents, migrants faced more obstacles in accessing essential health care services. This study aimed to explore the association between socioeconomic status and unmet inpatient service need among internal migrants in China. Methods: The data used in this study were from the 2014 nationally representative cross-sectional sample of internal migrants in China. All respondents were aged 15-59 years who had been living in local residence without the ‘Hukou’ for more than one month, and a total of 7592 migrants with inpatient service need were included in this analysis. Results: The migrants with unmet inpatient service need were 1667(21.96%). We found that internal migrants with higher socioeconomic defined by economic status(OR=1.74, 95 CI% 1.55-1.96) and educational attainment (OR=1.77, 95% CI 1.56-2.00) were more inclined to use inpatient services when needed, while the unemployed internal migrants (OR=0.36, 95% CI 0.32-0.41) were more likely to use inpatient service than the employed migrants. After adjustment for other demographic variables such as gender, age, marital status etc., these figures did not substantially change in model 2, the OR were 1.28(95% CI 1.12-1.46), 1.31(95% CI 1.13-1.52), and 0.59(95% CI 0.51-0.68), respectively. Conclusion: Internal migrants with higher socioeconomic defined by economic status and education attainment were more inclined to use inpatient services when needed, while the unemployed internal migrants were more likely to use inpatient service than the employed. This suggests that future policies should make the reimbursement more pro-poor among migrants and more effective policies targeting the migrants with low educational attainment and employed.