Study On The Effect Of Social Integration On The Establishment Of Health Records Among The Migrant Seniors In China

BackgroundSince the reform and opening,China's economy and society have developed rapidly.At the same time,the gap between urban and rural areas has gradually widened,which led to the emergence of large number of the migrant population,and the elderly migrant population size is also on rapid rise.Under the existing household registration system in China,migrants are not entitled to the same social welfare and healthcare benefits as local residents with registered Hukou.In order to ensure that every resident has equal access to essential public health services,the government proposes to implement equalization of basic public health services and aim to cover all migrants.Establishment of health records for migrants is the key item of the basic public health services.The primary beneficiaries of health records are elderly.Migrant seniors,as a special group,have the dual nature of the elderly and migrant,their social integration is limited by many factors such as individual factors,family factors,social support factors and policy support factors.It is hard for the migrant seniors to integrate into inflow areas.Previous studies have already explored basic public health services use among the seniors,but few studies have connected social integration with the establishment of the health records among the elderly migrantsObjectiveOur study aims to investigate the status of the establishment of health records,to analyze the effect of social integration on the establishment of health records among the migrants seniors,and provide evidence for.policy development to improve the fairness of the use of essential public health services for migrant seniors.MethodsThe data used for this study were from the 2015 National Internal Migrants Dynamic Monitoring Survey(NIMDMS),the age of the respondent should be 60 years old and above.The questionnaire was answered entirely by the respondents and there were 3,389 migrants seniors who eventually met the inclusion criteria.Social integration was measured through three dimensions:economic status,social engagement,self-identify.IBM SPSS version 22.0 was used to conduct the statistical analysis.First,descriptive analyses were used to describe the elderly migrants'demographic characteristics,migration characteristics,health behavior characteristics,health status characteristics and social integration.Univariate logistic regression and multivariate logistic regression were employed to explore the effect of social integration on the establishment of health records among the migrants seniors.ResultsThere were 3389 elderly migrants in this study.Of which,about 59.4%of the elderly migrants have not yet established the health records in their inflow community,and only 40.6%of the elderly migrants established health records.Univariate analyses showed that the type of household registration,age,type of health insurance,duration in inflow area,migration reason,daily exercise time,utilization of free medical examination services,and social integration dimension which include economic integration dimensions(monthly household income,occupation,local medical insurance),self-identity dimension(the willingness to settle),and social engagement dimension(the number of local friends),were found to be related to the use of health records.The multivariate logistic-regression analysis showed that those elderly migrants who were from richest group were less likely to establish health records,those elderly migrants who had health insurance in current residence,who decided to settle in current residence in the future five years,who had more than 10 local friends were more likely to establish health records.ConclusionsEstablishment rate of health records among the migrant seniors was low.This study found a relationship between social integration and establishing the health records among elderly migrants.Those elderly migrants who were from richest groups were less likely to establish health records,those elderly migrants who decided to settle in current residence in the future five years,who had health insurance in current residence,and who had more than 10 local friends were more likely to establish health records.Therefore,the governmentneed to accelerate the establishment of health records system among the migrant seniors,implement the funding guarantee mechanism;strengthen the promotion of health records services,raise awareness of the establishment of health records among the migrant seniors;strengthen the information construction of health records of the migrant population;and pay attention to the psychological construction of the migrant seniors.