Socio-economic inequalities in health service utilization among Chinese rural migrant workers with New Cooperative Medical Scheme: a multilevel regression approach



Li, Dan, Zhang, Jian, Yang, Jinjuan, Xu, Yongjian, Lyu, Ruoxi, Zhong, Lichen and Wang, Xiao
(2022) Socio-economic inequalities in health service utilization among Chinese rural migrant workers with New Cooperative Medical Scheme: a multilevel regression approach. BMC PUBLIC HEALTH, 22 (1). 1110-.

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Abstract

<h4>Background</h4>While reducing inequity in health service utilization is an important goal of China's health system, it has been widely acknowledged that a huge number of rural migrant workers cannot be effectually protected against risks with the New Rural Cooperative Medical Insurance (NCMS).<h4>Method</h4>Data of the 2016 China Labor-force Dynamic Survey and the Chinese Urban Statistical Yearbook were used. The multilevel regression approach was implemented with a nationally representative sample of rural migrant workers with NCMS. Our study adopted the concentration index and its decomposition method to quantify the inequality of their health service utilization.<h4>Result</h4>The multilevel model analysis indicated that impact variables for health service utilization were not concentrated, especially the contextual and individual characteristics. The concentration indices of the probability of two weeks outpatient and the probability of inpatient were -0.168 (95%CI:-0.236,-0.092) and -0.072 (95%CI:-1.085,-0.060), respectively. The horizontal inequality indices for the probability of two-week outpatient and the probability of inpatient were -0.012 and 0.053, respectively.<h4>Conclusion</h4>The health service utilization of rural migrant workers with NCMS is insufficient. Our study highlighted that substantial inequalities in their health service utilization did exist. In addition, their need of health service utilization increased the pro-poor inequality. Based on the findings, our study offered notable implications on compensation policies and benefit packages to improve the equality among rural migrant workers with NCMS.

Item Type: Article
Uncontrolled Keywords: Inequality, Health service utilization, Rural migrant workers, New Cooperative Medical Scheme, Multilevel regression approach
Divisions: Faculty of Humanities and Social Sciences > School of Management
Depositing User: Symplectic Admin
Date Deposited: 19 Apr 2023 15:17
Last Modified: 19 Apr 2023 15:17
DOI: 10.1186/s12889-022-13486-1
Open Access URL: https://doi.org/10.1186/s12889-022-13486-1
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3169768