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错失机会:探究社会健康保险对老年流动工人获得医疗保健的影响。

Slipping Through the Gap: Exploring the Influence of Social Health Insurance on Access to Healthcare for Older Migrant Workers.

机构信息

Department of Global Health and Social Medicine, King's College London, London, United Kingdom.

School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China.

出版信息

Int J Public Health. 2024 Mar 13;69:1606655. doi: 10.3389/ijph.2024.1606655. eCollection 2024.

Abstract

Older migrant workers (OMWs) frequently confront barriers to accessing care, as their Social Health Insurance (SHI) coverage may not extend beyond their hometown. This study seeks to investigate whether Chinese OMWs can still derive benefits from SHI in accessing healthcare services, even when their SHI is not registered in the same location as their current residence. This study used data from 2015 China Migrants Dynamic Survey and focused on OMWs aged 60 years and older ( = 3,050). Logistic regression models were employed to investigate the factors influencing healthcare use. Having SHI registered in current place of residence and interprovincial migration were significantly associated with increased likelihoods of doctor visits among OMWs. However, inpatient services use did not appear to be associated with the SHI registration place and migration range. Chinese OMWs derive fewer benefits from SHI in accessing healthcare services when their SHI is not registered in current residence. Governments in Low- and Middle-Income Countries should consider implementing targeted policies to provide adequate protection for OMWs and expand the coverage of direct reimbursement for cross-province healthcare services.

摘要

老年流动人口(OMWs)在获得医疗服务方面经常面临障碍,因为他们的社会医疗保险(SHI)覆盖范围可能无法超出其原籍地。本研究旨在探讨即使中国 OMWs 的 SHI 未在当前居住地注册,他们是否仍能从 SHI 中受益,以获得医疗保健服务。本研究使用了 2015 年中国流动人口动态调查的数据,重点关注年龄在 60 岁及以上的 OMWs(=3050)。采用逻辑回归模型来研究影响医疗保健使用的因素。SHI 在当前居住地的注册和省际迁移与 OMWs 就诊的可能性增加显著相关。然而,住院服务的使用似乎与 SHI 注册地和迁移范围无关。当 OMWs 的 SHI 未在当前居住地注册时,他们从 SHI 中获得的医疗服务收益较少。中低收入国家的政府应考虑实施有针对性的政策,为 OMWs 提供充分的保护,并扩大跨省份医疗服务直接报销的覆盖范围。

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