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.
Highlights
Over the past and recent decades, China has gained an immense internal migrant community
A health service module for older adults over 60 years old was designed in the 2015 survey only, which provided us with an opportunity to examine the associations between individual and contextual factors and basic public health services (BPHS) utility in the older adult migrants in China
There were huge differences in various facets between the rural and urban population, and the rate of utilization of free physical examinations was significantly higher among migrant older adults who came from urban compared with rural areas, the contextual and individual characteristics had similar effects on the utilization of BPHS
Summary
Over the past and recent decades, China has gained an immense internal migrant community. The socioeconomic status of the older migrants is poorer than that of local residents because they usually arrive in the cities in their later life and encounter more difficulties in adapting to a new life [5,6]. They are not entitled to the same social benefits as the local residents, and are less likely to have comprehensive access to healthcare services, comfortable housing, and fair life conditions [7,8]. Access to health services is important for older adult migrants, which can provide protection for their health
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