Zhai Xiaohui, Zhou Zhongliang, Lai Sha, Wang Jieyu, Zhao Yaxin, Liu Guanping, Wang Zhichao, Fan Hongbin, Zhuang Yan, Zhao Dantong, Cao Dan, Coyte Peter C
School of Public Health, Health Science Center, Xi'an Jiaotong University, No. 76 West Yanta Road, Xi'an, Shaanxi, 710061, China.
School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 Xianning West Road, Xi'an, Shaanxi, 710049, China.
Int J Equity Health. 2025 Jan 10;24(1):9. doi: 10.1186/s12939-024-02371-5.
Internal migrants in China have long been at a disadvantage in terms of access to publicly financed services, as well as the utilization of public health services. The aim of the study was to examine inequities in the use of basic public health services between internal migrants and the local population and estimate the factors that contributed to inequity in use.
The data for this study was derived from the 2017 wave of the China Migrants Dynamic Survey. Basic public health services utilization was measured by the establishment of health records, health education and chronic disease management. We performed multivariable logistic regressions to examine inequities in the utilization of basic public health services between locals and internal migrants, and Oaxaca-Blinder decomposition was used to explore possible explanations for such inequities between the two groups.
A total of 27,998 cases were included in the analysis. We found that the utilization rates for establishment of health records, health education and chronic disease management among internal migrants were 71.3%, 49.2% and 65.7% lower than their local counterparts, respectively. The decomposition results indicated that the inequities in the establishment of health records between locals and internal migrants were mainly explained by whether people had heard of the National Basic Public Health Services Program (NBPHSP) (17.67%) and by health insurance (5.99%). The contributors to the inequities in health education between locals and internal migrants were community involvement (14.71%) and whether people had heard of the NBPHSP (13.89%). The main factors contributing to the difference in utilization of chronic disease management between the two groups were whether people had heard of the NBPHSP (14.49%) and community involvement (8.43%).
To reduce inequities in the utilization of basic public health services between locals and internal migrants, measures need to be taken to improve knowledge about the basic public health services and to help migrants integrate into the local community.
长期以来，中国的流动人口在获得公共财政资助服务以及利用公共卫生服务方面一直处于劣势。本研究的目的是调查流动人口与当地人口在基本公共卫生服务使用方面的不公平现象，并估计导致使用不公平的因素。
本研究的数据来自2017年中国流动人口动态监测调查。通过建立健康档案、健康教育和慢性病管理来衡量基本公共卫生服务的利用情况。我们进行了多变量逻辑回归分析，以研究当地人和流动人口在基本公共卫生服务利用方面的不公平现象，并使用Oaxaca-Blinder分解法来探究两组之间这种不公平现象的可能原因。
分析共纳入27998个案例。我们发现，流动人口中健康档案建立、健康教育和慢性病管理的利用率分别比当地人口低71.3%、49.2%和65.7%。分解结果表明，当地人和流动人口在健康档案建立方面的不公平现象主要由人们是否听说过国家基本公共卫生服务项目（17.67%）和医疗保险（5.99%）来解释。当地人和流动人口在健康教育方面不公平现象的促成因素是社区参与（14.71%）和人们是否听说过国家基本公共卫生服务项目（13.89%）。两组在慢性病管理利用差异方面的主要因素是人们是否听说过国家基本公共卫生服务项目（14.49%）和社区参与（8.43%）。
为减少当地人和流动人口在基本公共卫生服务利用方面的不公平现象，需要采取措施提高对基本公共卫生服务的认识，并帮助流动人口融入当地社区。
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