| BackgroundsIt is an inevitable phenomenon that floating population appears in urban areas with the course of industrialization and urbanization. The large-scale flow of population in China began in mid-1980s and expanded with the incessant deepening of reform and opening-up as well as the rapid development of market economy. At present, this group has accounted for more than 10 percents of total population in the country, and is considered becoming larger in the future.Despite of its great contributions to the growth of the city, this group is still excluded from urban social welfare systems. One problem of the marginality is that the group lacks necessary health care, which threatens its health condition and then influence the public health, economic development and even social security of the city. Thus, it is supposed to pay more attention to the health of this group and to improve its healthcare condition through researches.ObjectivesThis study was designed to probe into the status quo of the health service utilization of floating population in cities, to analyze the differences between floating and household population, to explore the influence factors of the health service utilization of floating population and accordingly to put forward the relevant suggestions which provide policy recommendations.MethodsThe research data were derived from field survey, literature search and general statistical data collection. Baoshan District in Shanghai was selected as the investigation field, while 14055 objects in this district were investigated through multistage sampling, including 4839 from floating population and 9216 from household population. The data were then put into database through Epidata 3.1, and processed and analyzed using descriptive statistics, single and multiple factor analysis through statistical softwares of SPSS 11.5 and Microsoft Excel 2003. Results1. Among the investigated objects in the floating population group, 90.5 percents of two-week outpatients and 94.3 percents of inpatients were public hospital users; 50.0 percents of the former preferred community health organizations when seeking medical advice. The level of medical service utilization was comparable to that of the household population group, while the rate of utilization was significantly lower. The analysis of logistic regression showed that age and medical insurance level were the two major factors affecting medical utilization of floating population.2. Compared with those of women's and children's health services, the utilization rates of maternal care were much higher on the whole, which indicated that an imbalance of utilization existed in woman-child health care (WCHC). The difference of WCHC utilization level and quality between the floating and household population group was rather big. It was also found that floating population was lack of systematic and whole-course health care. The analysis of logistic regression showed that education, income and medical insurance level were the major factors affecting the group's WCHC utilization.3. For the investigated floating group, planned vaccination rates of children under age 7 were all above 90%, close to the household group.4. The health education service (HES) utilization of floating population was not satisfactory, considering the single approach to HES utilization as well as the low-level popularization.Conclusions and Policy Recommendations1. To establish and perfect the basic medical insurance system for floating population.2. To reform the present mode of community administration and strengthen the community-based management of floating population.3. To set up a community-based integrated healthcare delivery system and provide medical, preventive and health care services for floating population.4. To strengthen, promote, and enhance the practice of health education in the floating population group.
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