The concentration indices for 2 weeks outpatient utilisation were -0.2061 for older rural-to-urban migrant workers and -0.2041 for older rural residents.
Health service utilisation shows income-related inequalities between older rural-to-urban migrant workers and older rural residents.
Poor status and socioeconomic status are significant contributors to outpatient utilisation inequalities.
Inpatient utilisation inequality is associated with poor and fair self-assessed health status and sense of happiness among rural elderly.
Horizontal inequality indices indicate disparities in health service utilisation between the two groups, with values of 0.1321 and -0.992 for outpatient and -0.0032 and -0.0396 for inpatient services.
Findings suggest a socioeconomic gradient in health service utilisation, highlighting the need for targeted health policy reforms.
Simplified
OBJECTIVES: This study quantifies income-related inequalities in health service utilisation of older rural-to-urban migrant workers, by comparison with older rural residents, and identify with factors giving rise to the inequalities.
SETTING: Nationally representative survey conducted in 29 provinces, municipalities and autonomous regions of China.
PARTICIPANTS: 952 older rural-to-urban migrant workers and 2676 older rural residents were identified for further analysis.
MAIN OUTCOME MEASURES: The probability of 2 weeks outpatient utilisation and inpatient utilisation.
DESIGN: Coarsened exact matching was used to control the confounding factors between older rural-to-urban migrant workers and their rural counterparts. was used to depict the inequality in health service utilisation, and it can be decomposed proportionally into contributions.
RESULTS: The concentration indices of 2 weeks outpatient utilisation of two groups were -0.2061 (95% CI: 0.0193 to 0.1364) and -0.2041 (95% CI: 0.0594 to 0.1469), respectively. The concentration indices of inpatient of two groups were -0.0024 (95% CI: -0.0047 to 0.0639) and -0.1412 (95% CI: 0.0235 to 0.1125), respectively. The contributors of the inequality of 2 weeks outpatient utilisation of two groups were poor (SAH) status and richest group. The contributors of the inequality of inpatient utilisation of the rural elderly were poor SAH, fair SAH and sense of happiness. The horizontal inequality indices for 2 weeks outpatient of two groups were 0.1321 and -0.0.992, respectively. The horizontal inequality indices for the inpatient of two groups were -0.0032 and -0.0396, respectively.
CONCLUSIONS: The results illustrated the existence of a socioeconomic gradient in health service utilisation between older rural-to-urban migrant workers and older rural residents. Our studies provided evidences to take full account of the health service needs, contributing to more reliable understandings of inequalities in the health service utilisation. The results may be referential to identify policy priorities conducive to the health policy reform in the process of active ageing in China.
Key numbers
5.59%
Outpatient Utilization Probability
Older rural-to-urban migrant workers vs. older rural residents
-0.2061
for Outpatient Utilization
Older rural-to-urban migrant workers
7.57%
Inpatient Utilization Probability
Older rural-to-urban migrant workers vs. older rural residents
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