The Effect of Migration Duration on Treatment Delay Among Rural-to-Urban Migrants After the Integration of Urban and Rural Health Insurance in China: A Cross-Sectional Study

Inquiry. 2020 Jan-Dec:57:46958020919288. doi: 10.1177/0046958020919288.

Abstract

Few researches have been focused on the treatment delay of rural-to-urban migrants in China. Our study aimed to investigate the effect of migration duration on treatment delay among rural-to-urban migrants in tertiary hospitals. A cross-sectional study was conducted based on a sample of 727 patients and surveyed factors including sociodemographics, medical costs, migration, treatment delay, and health cost-coping strategies. Totally, 727 patients were included, of which 61 delayed their treatment and 666 had no treatment delay. Statistically significant differences were found between different migration duration groups in marital status, education, insurance, family annual income, residency, payment before treatment, reported disease, and migration duration (P < .05). The results from multiple logistic regression showed that migration between 1 and 5 years (adjusted odds ratio [OR] = 7.24; 95% confidence interval [CI] = 1.59-32.87; P < .05) was considered the significant contributing risk factor for treatment delay after adjusting for age, sex, and other variables. To cope with their health expenditure, patients with treatment delay tended to use less savings and borrow more money than those without. Rural-to-urban migrants with 1 to 5 years of migration were the most vulnerable group of having treatment delay. Migrants were more likely to borrow money to cope with the health expenditure. Targeted services should be provided to meet different needs of migrants according to migration duration.

Keywords: cost-coping strategy; health insurance; migrants; migration duration; treatment delay.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • China
  • Cross-Sectional Studies
  • Female
  • Health Services Accessibility*
  • Humans
  • Insurance, Health / economics*
  • Male
  • Middle Aged
  • Rural Population / statistics & numerical data*
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Time-to-Treatment / statistics & numerical data*
  • Transients and Migrants / statistics & numerical data*
  • Urban Population / statistics & numerical data*