2014 年至 2017 年中国 500 万移民健康记录建立的社会人口统计学差异：一项全国性横断面研究。
Sociodemographic disparities in the establishment of health records among 0.5 million migrants from 2014 to 2017 in China: a nationwide cross-sectional study.
机构信息
Center for Health Policy Research and Evaluation, Renmin University of China, Beijing, 100872, China.
Department of Economics, University of Birmingham, B15 2TT, Birmingham, UK.
出版信息
Int J Equity Health. 2021 Dec 2;20(1):250. doi: 10.1186/s12939-021-01584-2.
BACKGROUND
Migrants account for a large part of China's population. Many policies and inventions have been taken to improve access to public health services and the health of migrants. China's Basic Public Health Services(BPHS) are a series of public health services in this policy domain, which aims at promoting the access of public health sevices and improve health equity of residents. The establishment of health records is the fundamental service of BPHS. However, there is little known about the establishment of health records among migrants in China, which hinders the more efficient provision of health services for migrants, and health equity is difficult to achieve. Based on the research gap, this study aims at showing the sociodemographic disparities in the establishment rate of health records, and identifying priorities and recommendations for promoting health equity of migrants in China.
METHODS
This study used national data from China Migrants Dynamic Survey (CMDS) from 2014 to 2017 to evaluate the sociodemographic disparities in the establishment rate of health records and utilization of relevant public health services. The study included 539,926 respondents. Following the descriptive statistics of migrants, we showed the establishment rate of health records by sociodemographic characteristics and migrating related characteristics. Multivariate analysis was conducted to explore the associations between sociodemographic charicteristics, migrating related charicteristics and the establishment of health records.
RESULTS
The establishment rate of health records among migrants in the sampled years were 22.99, 38.44, 27.29% respectively, and 29.18% in general, and there existed heterogeneity in the establishment rate of health records by sociodemographic charicteristics and migrating related charicteristics. Female migrants who were older, from middle age, married or living with partner, with higher educational attainment, with urban household registration, migrated for longer time, migrated for the reason of studying or family issues, migrated in province were more likely to establish health records.
CONCLUSION
There existed sociodemographic disparities in the establishment rate of health records and inequalities in the utilization of health records services among migrants in China. Migrating related characteristics also had impact on the establishment status. Policies should take both supply side and demand side of health services to improve the health equity of migrants, which means that relative departments should continue to invest in primary healthcare centers to improve their ability to provide services as well as migrants' health literacy.
背景
移民在中国人口中占很大比例。为了改善移民获得公共卫生服务和健康的机会，已经采取了许多政策和发明。中国的基本公共卫生服务（BPHS）是这一政策领域的一系列公共卫生服务，旨在促进公共卫生服务的获取，提高居民的健康公平性。建立健康档案是 BPHS 的基本服务。然而，目前对中国移民建立健康档案的情况知之甚少，这阻碍了为移民提供更高效的卫生服务，也难以实现健康公平。基于这一研究差距，本研究旨在展示健康档案建立率方面的社会人口学差异，并确定促进中国移民健康公平的优先事项和建议。
方法
本研究使用了 2014 年至 2017 年中国流动人口动态监测调查（CMDS）的全国数据，评估了社会人口学差异对健康档案建立率和相关公共卫生服务利用的影响。该研究共纳入了 539926 名受访者。在描述流动人口特征的基础上，我们展示了社会人口学特征和迁移相关特征与健康档案建立率的关系。采用多变量分析方法探讨了社会人口学特征、迁移相关特征与健康档案建立的关系。
结果
在所研究的年份中，移民的健康档案建立率分别为 22.99%、38.44%、27.29%和 29.18%，存在社会人口学特征和迁移相关特征的差异。年龄较大、处于中年、已婚或与伴侣生活、受教育程度较高、拥有城市户籍、迁移时间较长、出于学习或家庭原因迁移、在省内迁移的女性移民更有可能建立健康档案。
结论
中国移民的健康档案建立率存在社会人口学差异，移民健康档案服务的利用不平等。迁移相关特征也对建立状况有影响。政策应从卫生服务的供给侧和需求侧入手，提高移民的健康公平性，这意味着相关部门应继续投资于基层医疗中心，提高其提供服务的能力，以及移民的健康素养。
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