Zhongguo quanke yixue (Oct 2022)
Migrant Population's Experience of Using Essential Medical Services
Abstract
Background The number of migrant population in China remains high, primarily driven by the developments in industrialisation and urbanisation. The health status and healthcare-seeking experience of this group has become a hot social issue, and promoting their access to equitable essential healthcare services is an important part of China's healthcare system reform. Objective To compare the experience of using essential medical services between migrant and permanent populations in Guangzhou, to provide evidence for improving the level of using essential medical services in migrant population and for promoting the healthcare equity. Methods From September to November 2019, we used a multistage random sampling method to select 1 568 cases (including migrant and permanent residents) treated by six general practitioner teams from six community health centers in Guangzhou. Their demographics and experiences of using essential medical services were collected by a questionnaire survey using a self-developed General Data Questionnaire and the simplified Primary Care Assessment Tool-Adult Edition (PCAT-AE) . We compared the total score of the PCAT-AE and its domains scores between the two groups. We used the generalized linear model to analyze the association between the residency status and the experience of using essential medical services. Results Altogether, 1 568 cases who handed in responsive questionnaires were included for final analysis, among whom 186 (11.86%) were migrant residents. The average total score of the PCAT-AE of all participants, permanent and migrant cases was 3.19 (1.22) , 3.24 (1.23) , and 2.93 (0.75) , respectively. Compared with the permanent residents, the migrants showed lower total score and dimension scores of the PCAT-AE (P<0.05) . The results of the generalized linear model demonstrated that compared with the permanent residents, migrants had worse experience in using services〔b (95%CI) =-0.128 (-0.218, -0.037) , P=0.006〕, such as the use of first-contact care〔b (95%CI) =-0.245 (-0.341, -0.148) , P<0.001〕, continuing care〔b (95%CI) =-0.175 (-0.292, -0.059) , P=0.003〕, family-centered care〔b (95%CI) =-0.112 (-0.225, 0.001) , P=0.050〕, community-oriented care〔b (95%CI) =-0.176 (-0.286, -0.066) , P=0.002〕, and culturally competent care〔b (95%CI) =-0.270 (-0.383, -0.156) , P<0.001〕. Conclusion The migrants had worse experience of using essential medical services than the permanent residents. In view of this, it is recommended for primary healthcare institutions to provide continuous, accessible, and comprehensive life-cycle essential healthcare services for migrants according to their characteristics, so as to promote the quality development of community health services.
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