Comparing the needs and utilization of health services between urban residents and rural-to-urban migrants in China from 2012 to 2016

Lingling Zheng,Yuantao Hao,Ruwei Hu,Zichuan Dong

doi:10.1186/s12913-018-3522-y

Abstract

BackgroundWith a large population of internal migrants from all over the world, China has the largest number of internal floating migrants, and most of them (up to 169 million in 2016) are rural-to-urban migrants. Those migrants have difficulty accessing essential health care services because of Hukou, leading to disparities in health needs and utilization between rural-to-urban migrants and residents. To compare the needs and utilization of health services between urban residents and rural-to-urban migrants in China from 2012 to 2016.MethodWe used longitudinal data from the Chinese Labor Dynamic Survey (CLDS) with three waves in 2012, 2014 and 2016. Descriptive analysis was employed to show self-reported illnesses and health services utilization among locals and migrants in the most recent 2 weeks in China. Chi-square tests and log binomial regression models were constructed to explore factors influencing health care needs and utilization.ResultA total of 19.97% of respondents were rural-to-urban migrants, with an upward trend from 2012 to 2016. Rural-to-urban migrants (11.99%) had higher needs for health services than urban residents (10.47%) in general, while urban residents and migrants had no differences in needs in 2012. Besides, there was no difference in the utilization of health services between residents and migrants in 2012, 2014 or 2016. In addition, increased age, male sex, poor medical insurance coverage and dissatisfaction with income were found to have negative effects on health care needs.ConclusionThis study has shown that the rural-to-urban migrants had higher health care needs but the same health care utilization compared with urban residents in China. Health policies focusing on equitable health outcomes should pay more attention to rural-to-urban migrants in China’s health care system reform.

Highlights

With a large population of internal migrants from all over the world, China has the largest number of internal floating migrants, and most of them are rural-to-urban migrants
This study has shown that the rural-to-urban migrants had higher health care needs but the same health care utilization compared with urban residents in China
Health policies focusing on equitable health outcomes should pay more attention to rural-to-urban migrants in China’s health care system reform

Summary

Introduction

With a large population of internal migrants from all over the world, China has the largest number of internal floating migrants, and most of them (up to 169 million in 2016) are rural-to-urban migrants. Those migrants have difficulty accessing essential health care services because of Hukou, leading to disparities in health needs and utilization between rural-to-urban migrants and residents. Internal rural-to-urban migration was modeled as a response to the disparities between the urban and rural sectors [4] Due to their comparatively poorer social and economic status, these migrants usually lived in poorer environments [1] and had limited access to a range of public services [5]. The rapid growth of available wealth and labor welfare has not been distributed evenly among the workforce population, leading to increased disparities in health services utilization among the different sectors of the population [6]

Objectives

Methods

Results

Discussion

Conclusion