A Public Policy Study On Health Care Utilization Of Migrant In China

Background and ObjectivesFor more than twenty years, the number of labor migrants from rural areas to city is increasing year after year in China. According to the 2005 5% sample population census, the number is 14 million. Experts estimate that with the inequalities between rural and city in more recent years this labor migrantion trend of our country would have remained. Migrants often take on the very lowest-paid jobs, which city citizens most often are unwilling to fill. They have experienced poor living and working conditions than inhabitants, which in turn means that the health of migrants is often worse. Previous medical and public health research shows that migrant workers have significantly worse health statistics than city residents. Despite their worse health status and a correlated need for more health and social services, migrant workers face many obstacles to access such services. The majority of migrant workers are excluded from health insurance, birth insurance, and worker's compensation benefits. Migrant laborers are less likely than other groups to obtain preventive care, such as routine physical exam and maternal care service.Previous health researches bring to light significant health disparities related to migrant workers and some influencing factors. However, it is not yet understood which fators are more important and how these factors might influence such health disparities. This study aims to fill these gaps by identifying ways in which how these factors affects their health status, well-being, and medical care, in particular, how to prevent them in public policy perspective.MethodsThe quantitative data comes from literature search, questionnaire survey, and personal interview. The theoretical framework of this study falls within Andersen Mold. Data are analyzed utilizing descriptive analysis, X~2 test, variance analysis, accompanied by theories of structure-process-product, induction, review analysis, Fishbone Diagram, Analytic Hierarchy Process.Conclusions and Policy Recommendation1. Health care service in this research is classified into three types: basic medcial service, public health service, maternal and child health service, which have their own utilization characteristics. Influencing factors are inducted respectively based on Andersen Mold by literature review and survey resluts.2. Top 2 factors in three types of services are counted according to Meta analysis and AHP. Lack of health insurance and high level of medical price are the most important factors in basic medcial service. In public health are inproper way of service providing and wrong health concepte of migrants. In mch service are inproper ways of service providing and lack of government finance support.3. If the problem can not be reasonably solved, it will be very difficult to control the protential harm in the dynamic environment of large-scale population migrant. It will threaten publid health security, urban-rural structure, and social poverty stratification, shock the social value of fairness, righteousness and equality.4. On the basis of distinguishing origin, direct factors and indirect factors, the function mechanism model of three types of services are concluded respectively.5. The paper concludes with strategies toward improving migrant health not only in temporary way but also in fundamental way. Temporary solutions include six strategies: enhancing medical education of migrants, improving health insurance coverage of migrants, standardizing medical market and reducing medical price, definiting government investment paths in public health, maternal and child health service, innovating ways of service supplied in public health and mch.Fundamental solutions also include six strategies: cultivating unified and equal labor market, weakening various kinds of interests attached on household registration system and returning to its function of public order administration, designing a national population management information system, perfecting the legislation of migrant administration and enforcing law strictly, optimizing urban basic level social management system, heightening migrants' consciousness of ensuring their legal rights and constructing a respecting social environment.