Shenzhen Centre for Disease Control and Prevention, Shenzhen, 518020, Guangdong, China.
BMC Health Serv Res. 2009 Nov 21;9:214. doi: 10.1186/1472-6963-9-214.
As one of the most populous metropolitan areas in the Pearl River Delta of South China, Shenzhen attracts millions of migrant workers annually. The objectives of this study were to compare health needs, self-reported health and healthcare utilisation of insured and uninsured migrant workers in Shenzhen, China, where a new health insurance scheme targeting at migrant workers was initiated.
A cross-sectional survey using multi-staged sampling was conducted to collect data from migrant factory workers. Statistical tests included logistic regression analysis were used.
Among 4634 subjects (96.54%) who responded to the survey, 55.11% were uninsured. Disease patterns were similar irrespective of insurance status. The uninsured were more likely to be female, single, younger and less educated unskilled labourers with a lower monthly income compared with the insured. Out of 1136 who reported illness in the previous two weeks, 62.15% did not visit a doctor. Of the 296 who were referred for inpatient care, 48.65% did not attend because of inability to pay. Amongst those who reported sickness, 548 were insured and 588 were uninsured. Those that were insured, and had easier access to care were more likely to make doctor visits than those who were uninsured.
Health care utilisation patterns differ between insured and uninsured workers and insurance status appears to be a significant factor. The health insurance system is inequitably distributed amongst migrant workers. Younger less educated women who are paid less are more likely to be uninsured and therefore to pay out of pocket for their care. For greater equity this group need to be included in the insurance schemes as they develop.
作为中国华南珠江三角洲人口最多的大都市区之一，深圳每年吸引数以百万计的外来务工人员。本研究的目的是比较中国深圳参保和未参保农民工的健康需求、自我报告健康状况和医疗保健利用情况，深圳推出了一项针对农民工的新医疗保险计划。
采用多阶段抽样的横断面调查收集了来自农民工工厂工人的数据。采用了逻辑回归分析等统计检验方法。
在 4634 名（96.54%）回答调查的受试者中，有 55.11%未参保。无论参保情况如何，疾病模式相似。与参保者相比，未参保者更可能是女性、单身、年龄较小、教育程度较低、月收入较低的非熟练劳动力。在 1136 名报告两周内患病的人中，有 62.15%的人未去看医生。在 296 名被转诊住院的人中，有 48.65%的人因无力支付费用而未就诊。在报告患病的 548 名参保者和 588 名未参保者中，参保者更容易获得医疗服务，更有可能去看医生。
参保和未参保工人的医疗保健利用模式不同，参保状况似乎是一个重要因素。医疗保险制度在农民工中分配不均。收入较低、受教育程度较低、年龄较小的年轻女性更有可能未参保，因此更有可能自费支付医疗费用。为了实现更大的公平，在制定保险计划时，应将这一群体纳入其中。
