scholarly journals Decomposing Differences of Health Service Utilization among Chinese Rural Migrant Workers with New Cooperative Medical Scheme: A Comparative Study

2021 ◽  
Vol 18 (17) ◽  
pp. 9291
Author(s):  
Dan Li ◽  
Liang Zhu ◽  
Jian Zhang ◽  
Jinjuan Yang
Keyword(s):  
Health Service ◽  
Service Utilization ◽  
Migrant Workers ◽  
Health Service Utilization ◽  
Individual Characteristics ◽  
Service Needs ◽  
Mutual Aid ◽  
Exact Matching ◽  
Rural Migrant ◽  
Rural Migrant Workers

The New Rural Cooperative Medical Insurance (NCMS) in China has provided benefits for rural migrant workers’ health service utilization, but the financial coordination and mutual aid of NCMS is mainly based on the county or district as a unit, leading NCMS with the characteristics of regional segmentation. Our study aims to explore their health service utilization, as well as to decompose differences of the health service utilization into contributors.Data from the China Labor-Force Dynamic Survey in 2016 and Urban Statistical Yearbook in 2016 were used. We used coarsened exact matching to control the confounding factors in order to enhance the comparison of two groups. The Fairlie decomposition method was used to analyze the differences and the sources of health service utilization.Influencing factors of health service utilization for rural migrant workers with NCMS were diversified, especially contextual characteristic and individual characteristics. The proportion of ethnic minorities, the number of medical institutions for 10,000 people in the community, the number of beds for 10,000 people in the city, and the urban service quality index were the major contributors of the differences. The proportion of difference in the health service utilization of rural migrant workers with NCMS caused by health service need were −54.73% and 6.92%, respectively. The inequities of the probability of two weeks outpatient, and the probability of inpatients, were −0.006 and −0.007, respectively. There were substantial differences in the health service utilization between rural migrant workers with NCMS in the county/district and rural migrant workers with NCMS across the county/district. Our results illustrated the inequity from the differences on basis of characteristic effect and the discrimination effect. Our studies clarified that health service needs of should be fully considered, contributing to a more reliable understanding of the health service utilization of rural migrant workers.

scholarly journals Assessing Income-Related Inequality on Health Service Utilization among Chinese Rural Migrant Workers with New Co-Operative Medical Scheme: A Multilevel Approach

2021 ◽  
Vol 18 (20) ◽  
pp. 10851
Author(s):  
Dan Li ◽  
Shaoguo Zhai ◽  
Jian Zhang ◽  
Jinjuan Yang ◽  
Xiao Wang
Keyword(s):  
Health Service ◽  
Service Utilization ◽  
Migrant Workers ◽  
Health Service Utilization ◽  
Medical Insurance ◽  
Total Cost ◽  
Rural Migrant ◽  
Related Inequality ◽  
Income Related Inequality ◽  
Rural Migrant Workers

Background: Eliminating inequality in health service utilization is an explicit goal of China’s health system. Rural migrant workers with New Rural Cooperative Medical Insurance (NCMS) still face the dilemma of limited health service; however, there is a lack of analysis or measurement on the income-related inequality of health service utilization. Method: The nationally representative data of the China Labor-Force Dynamic Survey in 2016 were used for analysis. Multilevel regressions were used to obtain robust estimates and to account for various covariates associated with health service utilization of rural migrant workers with NCMS. The concentration index and its decomposition method were applied to quantify the income-related inequality of health service utilization of rural migrant workers. Result: The multilevel model analysis indicated that influencing factors of health service utilization were diversified, including gender, city service quality index, type of industry, the per capita annual income, marital status, health self-assessment, the community health index and the number of friends. The concentration indices of the total cost of inpatient and OOP cost of inpatient were 0.102 (95%CI: 0.031, 0.149), and the CI of OOP cost of inpatient was 0.094 (95%CI: 0.007, 0.119), respectively. The horizontal inequality indices of the total cost of inpatient and OOP cost of inpatient were 0.051 and 0.009, respectively. Conclusion: Our study presented a unique opportunity to examine the potential influence factors of health service utilization of rural migrant workers with NCMS, and highlighted that unequal health service utilization is evident among rural migrant workers with NCMS. This study provides important corroborative evidence to take full account of the contribution of each determinant to the inequality and health service needs among rural migrant workers with NCMS, in order to improve the basic medical insurance and social security systems—particularly for some marginal groups in China.

scholarly journals Decomposing Differences in Health Service Utilization between Older Rurul-to-Urban Migrant Workers and Older Rural Residents：What is Driving the Differences?

2021 ◽  
Author(s):  
Dan Li ◽  
Jian Zhang
Keyword(s):  
Health Service ◽  
Service Utilization ◽  
Migrant Workers ◽  
Health Service Utilization ◽  
Influence Factors ◽  
Andersen Model ◽  
Inpatient Utilization ◽  
Urban Migrant ◽  
Total Difference ◽  
Rural Dwellers

Abstract Background: In recent years, the widening gap of health service utilization between different groups in mainland China has become an important issue that cannot be avoided. Yet the related study on the health services utilization for older rural-to-urban migrant workers and comparative study on older rural-to-urban migrants in China is still in its infancy. Our study explored the health service utilization of the older rural-to-urban migrant workers based on a sinicization of the latest Andersen model, by comparison with the older rural dwellers. Further, our study revealed the facets and causes by decomposing the differences in the health service utilization into determinants.Methods: The data of China Labor-Force Dynamic Survey in 2016, the data of Urban Statistical Yearbook in 2016, and Statistical Bulletin were used. Our study applied the lasted Andersen Model according to China's currency situation. Before we studied the health service utilization, we used Coarsened Exact Matching to control the confounding factors to enhance the comparability of the two groups. The matched data were used to analyze the influencing factors. Fairlie decomposition method was used to analyze the differences and the sources of health service utilization between older rural-to-urban migrant workers and their rural counterparts.Results: After matching, the probability of two weeks outpatient of older rural-to-urban migrant workers (5.59%) was significantly lower than older rural dwellers (7.57%). The probability of inpatient of older rural migrant workers (5.59%) was significantly lower than older rural dwellers (9.07%). 17.98% of the total difference of two weeks outpatient utilization was due to the observed influence factors. 71.88% of the total difference of inpatient utilization was due to the observed influence factors. Income quantiles (49.57%), self-assessed health (80.91%), and sex ratio in the community (-102.29%) were significant in the differences of inpatient utilization.Conclusions: The findings have important implications for the difference in the health services utilization between older rural-to-urban migrant workers and older rural residents in China, urging the government to take full account of the heterogeneity. The results provide references for the healthcare policy reform in the process of active ageing in China.

scholarly journals Wage Differential between Rural Migrant and Urban Workers in the People's Republic of China

2020 ◽  
Vol 37 (1) ◽  
pp. 43-60 ◽  
Author(s):  
Hong Cheng ◽  
Dezhuang Hu ◽  
Hongbin Li
Keyword(s):  
Migrant Workers ◽  
Fixed Effects ◽  
Individual Characteristics ◽  
People’S Republic Of China ◽  
People's Republic Of China ◽  
Republic Of China ◽  
Urban Workers ◽  
Rural Migrant ◽  
Earnings Gap ◽  
Rural Migrant Workers

Using a recently constructed dataset that draws on the China Employer–Employee Survey, this paper provides new evidence on the earnings gap between rural migrant and urban manufacturing workers in the People's Republic of China. When we only control for province fixed effects, we find that rural migrant workers are paid 22.3% less per month and 32.2% less per hour than urban workers. We find that the gap in hourly earnings is larger than the gap in monthly earnings because rural migrant workers tend to work an average of 5.6% more hours per month than urban workers. Using these data, we also find that 87.4% of the monthly earnings gap and 73.9% of the hourly earnings gap can be attributed to differences in the individual characteristics and human capital levels of rural migrant and urban workers. Furthermore, we find that this unexplained earnings gap varies among different groups of workers. The earnings gap is much larger (i) for workers in state-owned enterprises than in nonstate-owned enterprises, (ii) for college-educated workers than workers with lower levels of educational attainment, and (iii) in Guangdong province than in Hubei province.

The Plight of Rural Migrant Workers in Urban China

2016 ◽  
Author(s):  
Rongwei Chu ◽  
James W. Gentry ◽  
Jie Fowler Gao ◽  
Xin Zhao
Keyword(s):  
Migrant Workers ◽  
Urban China ◽  
Rural Migrant ◽  
Rural Migrant Workers
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