Inequalities in the Access to Health Services Among Older Migrants: Evidence From the China Migrant Dynamic Monitoring Survey

Chengxu Long; Fangfei Chen; Yisheng Ye; Lu Ji; Xinyin Xu; Shangfeng Tang

doi:10.3389/ijph.2023.1605325

Inequalities in the Access to Health Services Among Older Migrants: Evidence From the China Migrant Dynamic Monitoring Survey

Int J Public Health. 2023 Apr 7:68:1605325. doi: 10.3389/ijph.2023.1605325. eCollection 2023.

Authors

Chengxu Long^{1

2}, Fangfei Chen¹, Yisheng Ye³, Lu Ji¹, Xinyin Xu⁴, Shangfeng Tang¹

Affiliations

¹ School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Department of Global Health and Social Medicine, School of Global Affairs, Faculty of Social Science and Public Policy, King's College London, London, United Kingdom.
³ Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
⁴ Department of Chronic Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China.

Abstract

Objectives: To identify differences in healthcare use between older migrant workers (OMWs) and older migrants (OMs) and explore associated factors and paths of healthcare use. Methods: The data came from the 2015 China Migrant Dynamic Monitoring Survey (CMDMS). CMDMS used a multi-stage stratified probability proportionate to size method as the sampling technique and conducted a desk review. The samples include OMWs, OMs for caring offspring (N = 4,439), and OMs for receiving care from family (N = 4,184). We built logistic regression and path analysis models to analyze the data. Results: Social health insurance (SHI) in current place of residence is associated with less expenditure among all subgroups. OMWs and OMs for receiving care from family with SHI in current place of residence are more likely to use healthcare. Conclusion: OMWs are particularly vulnerable in healthcare use and socioeconomic status. Having SHI registered in current place of residence helps decrease expenditure among OMs. We urge policymakers to consider a united health financing scheme across OMWs and other urban employees and streamline policies for migrants to enroll in SHI in current place of residence.

Keywords: access to health services; health equity; older migrant workers; rural-to-urban migrants; social health insurance.

MeSH terms

China
Health Services
Health Services Accessibility
Humans
Social Class
Surveys and Questionnaires
Transients and Migrants*

Grants and funding

This study was supported by the National Key R&D Program of China from the Ministry of Science and Technology of China (grant number 2022YFE0133000), the National Science Foundation of China (grant number 72004073), and the Chinese Ministry of Education of Humanities and Social Science project (grant No. 20YJC630134). This study also is supported by King’s-China Scholarship Council Program.