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政策素养、障碍以及强制性移民医疗保险下性别对泰国缅甸移民工人获得医疗保健服务的影响。

Policy Literacy, Barriers, and Gender Impact on Accessibility to Healthcare Services under Compulsory Migrant Health Insurance among Myanmar Migrant Workers in Thailand.

机构信息

Health Impact Assessment Research Center, Health System Management Institute, Prince of Songkla University, Songkhla 90110, Thailand.

Faculty of Nursing, Prince of Songkla University, Songkhla 90110, Thailand.

出版信息

J Environ Public Health. 2020 Dec 29;2020:8165492. doi: 10.1155/2020/8165492. eCollection 2020.

Abstract

Accessibility to health service and experience of healthcare are important factors for public health policymaking. The current study aimed to describe the status of accessibility and barriers to getting care as well as policy literacy among Myanmar migrant workers and ultimately to identify the predictors of accessibility to healthcare services among this population through Thailand's Compulsory Migrant Health Insurance (CMHI). A cross-sectional survey was used to collect data from 240 Myanmar migrant workers who were 18 years or older, resided in Songkhla Province, and had Compulsory Migrant Health Insurance. The instrument was a set of questionnaires consisting of a Personal Data Form, Policy Literacy Questionnaire, Barriers to Get Care Questionnaire, and Accessibility to Healthcare Services Questionnaire. Descriptive statistics, correlation analysis, and multiple regression analysis were used to analyze data. The majority of participants had a high level of policy literacy (36.3%), barriers to get care (34.2%), and accessibility to health care services (35.8%). Policy literacy ( = 0.35, < 0.001), barriers to get care ( = -0.32, < 0.001), and gender ( < 0.001) were significant predictors of accessibility to healthcare services and could explain 43.2% of the total variance. To increase the accessibility to healthcare services among migrant workers with Compulsory Migrant Health Insurance, public health policymakers are recommended to cooperate more with healthcare staff and the workers' employers to enhance the distribution of information about the health insurance to decrease barriers to get care.

摘要

卫生服务的可及性和医疗保健体验是公共卫生政策制定的重要因素。本研究旨在描述缅甸移民工人的可及性和获得医疗保健服务的障碍状况以及政策知识水平,并最终通过泰国强制性移民健康保险(CMHI)确定该人群获得医疗保健服务的可及性的预测因素。本研究采用横断面调查方法,从居住在宋卡府且参加强制性移民健康保险的 240 名 18 岁及以上的缅甸移民工人中收集数据。研究工具是一套由个人资料表、政策知识问卷、获得医疗保健服务障碍问卷和卫生服务可及性问卷组成的问卷。采用描述性统计、相关分析和多元回归分析对数据进行分析。大多数参与者具有较高的政策知识水平(36.3%)、获得医疗保健服务的障碍(34.2%)和卫生服务可及性(35.8%)。政策知识( = 0.35, < 0.001)、获得医疗保健服务的障碍( = -0.32, < 0.001)和性别( < 0.001)是卫生服务可及性的显著预测因素,可解释总方差的 43.2%。为了提高参加强制性移民健康保险的移民工人的卫生服务可及性,公共卫生政策制定者建议与医疗保健人员和工人的雇主更多地合作,以加强医疗保险信息的传播,减少获得医疗保健服务的障碍。

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