Research On Health Service Demand And Utilization Of Floating Population In Hangzhou

Objective:The study is aimed to understand the health service demand and utilization status of floating population in Hangzhou and find out the influencing factors between them.On the basis of this,this study put forward proposals and suggestions on improving health service demand and utilization of floating population so as to propose reasonable measures and suggestion based on the research results.Moreover,the study intends to provide reference for Hangzhou which can improve relevant health policies of floating population and improve the health status of floating population as well as enhance the utilization level of health services of floating population.Methods:Firstly,according to the method of simple random sampling,this research selected the floating population aged over 16 who has lived in Hangzhou for more than half a year as the sample population.Secondly,we used self-designed questionnaire on health service demand and utilization of floating population in Hangzhou to carry out field investigation in six major urban areas of Hangzhou by unified trained investigators.Moreover,in terms of research methods,the research combined sociology,demography,statistics and other relevant disciplines.Meanwhile,it connected theoretical research with empirical analysis,which helped to design the theoretical framework of Anderson health service utilization model that is suitable for this research.In addition,in terms of mathematical statistics,descriptive analysis,Chi-square test and Logistic regression analysis were used to verify factors which affected the demand and utilization for health services of floating population.Results:(1)General information Firstly,a total of 752 floating population were surveyed,including 428 males and324 females,most of whom were unmarried.Secondly,as for the mobile characteristics,the floating population of rural household registration outside theprovince is relatively large.Besides,82.8% of the floating population of the floating population expressed their willingness to proactively acquire health knowledge.Moreover,92.4% of floating population have medical insurance,and some floating population have more than one medical insurance.Only 7.6 percent of the floating population do not have any insurance,which means that medical insurance coverage is relatively high.(2)Demands for health services As for self-assessment of health,43% of the floating population thought that they were in good physical condition and none of them thought their physical quality was very poor.The two-week prevalence was 16.2%,with 7.6% of that in males and 8.6%of that in females.Apparently,the two-week prevalence in women was higher than that in men.According to the statistics of disease types,acute illness occurs most frequently within two weeks,accounting for 11%.Among them,6% were female and5% were male.And women were more likely to have acute disease than men.Meantime,the prevalence of chronic diseases was 16%.Hypertension was the most common type of chronic diseases,followed by gastritis and gastric ulcer.Logistic regression analysis found that gender,age and working hours were the main factors influencing whether the floating population in Hangzhou had two-week disease(P < 0.05).Firstly,the two-week prevalence is higher in women than that in men.Secondly,migrants aged 56 and above are more likely to be ill than younger people aged 16-25.Thirdly,migrants who work more than eight hours a day are more likely to get sick in two weeks than those who work less than eight hours.As for chronic diseases,the influence of age on the prevalence of chronic diseases is statistically significant(P < 0.05).Compared with the young floating population aged between 16 and 25,higher age level is having greater the risks of chronic diseases.(3)Utilization of health services The rate of two-week visits of the floating population in Hangzhou was10.2%,while the unattended rate for two-week was 36.9% respectively.The main reason for not seeing a doctor was that the disease is not so serious so that visits were unnecessary.Secondly,the study found that many people didn't go to hospital due tothe choice of self-medication,time limitation and financial difficulties.Moreover,the rate of hospitalization was 8.4 per cent and the rate of people who are supposed to be hospitalized but not in hospital was 4.3 per cent.The main reason for not being hospitalized was that it was not necessary to be hospitalized due to mild illness,followed by unaccompanied hospitalization and that ineffective treatment for this condition.In addition,about 50% of the floating population will have a regular physical examination every year.The reason why 50% of them cannot have a physical examination every year is that 38.9% of the floating population think it is unnecessary to have a regular physical examination every year.21.6% of the floating population do not have a regular physical examination because they do not have convenient services.And 77.8% of the floating population obtain health knowledge mainly from the mobile Internet.Logistic regression analysis found that age had an impact on the two-week medical visits of floating population in Hangzhou(P < 0.05).Migrants aged between26 and 35 are more likely to be diagnosed with the disease within two weeks than those aged between 16 and 25.Variables with statistical significance for the annual hospitalization rate include: age,marital status,education level,household status,housing source,distance from home to medical institution,understanding of the use of smart medicine,two-week incidence of diseases,and chronic diseases(P <0.05)Variables with statistical significance for the utilization of preventive health care included: age?education level?working hours?monthly income?source of housing distance from home to medical institution,and knowledge of intelligent medical use(P < 0.05).Conclusions:(1)Above all,the health awareness of floating population in Hangzhou is generally good.And the medical insurance coverage rate is high,but the medical insurance utilization rate needs to be further improved.Secondly.the variables in different dimensions have different influencing ways and degrees on the demand and utilization of health services of the floating population.Chronic diseases such as hypertension are the main factors that harm the health of the floating population.Mostof the floating population choose to go to regular hospitals,which are mainly municipal hospitals and provincial hospitals.However,medical service institutions such as district-level hospitals and community health service centers are less used.(2)First and foremost,it is necessary to further improve the reimbursement process of medical insurance and to enhance the utilization rate of medical insurance as well as to improve the existing basic health construction.And we also need to reasonably guide the diversion of medical treatment and to establish and improve the public service platform for the floating population,which uses the advantages of big data to provide accurate health services for the floating population.Meantime,the study also suggests to strengthen health education for the floating population and to pay great attention to the prevention and control of chronic diseases.In the end.we also need to strengthen the care for the floating population by building a multi-level social care system.