Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

Health insurance and healthcare utilisation for Shenzhen residents: a tale of registrants and migrants?

Authors: Kelvin KF Lam, Janice M Johnston

Published in: BMC Public Health | Issue 1/2012

Login to get access

Abstract

Background

Shenzhen’s rapid growth and urbanisation has attracted a large, mobile, migrant working population. This article explores health protection through the means of social health insurance between migrants and registrants and their point of access to healthcare.

Methods

A cross-sectional questionnaire survey was conducted in Shenzhen, with a random sample of 793 registered and 750 non-registered residents. Chi-square test and multivariate logistic regression were applied to analyse the association between health insurance coverage with Hukou registration status and healthcare utilisation.

Results

Amongst 1543 respondents, 43.1% of non-registered residents were uninsured. Being non-registered strongly predicted for no insurance (OR = 5.00; CI 3.53,7.07) and have purchased additional/ private insurance (OR = 2.99; CI 1.66,5.37). Migrants who self-reported chronic health conditions were also more likely to utilise health services in general (OR = 2.77; CI 1.18,6.52).

Conclusions

Inadequate health insurance coverage for migrants as observed in Shenzhen remains a challenge for the Chinese health reform. Our results suggest that the current insurance system must seek to include migrants in order to achieve universal coverage and improved health protection for its population.
Appendix
Available only for authorised users
Literature
1.
National Population and Family Planning Commission of China: National population statistics. Annual statistical report of National Population and Family Planning Commission of China. 2011
2.
China Renji Medical Group Limited: Business Review and Projections. Annual business report of the China Renji Medical Group. 2008
3.
Mou J, Fellmeth G, Griffiths S, Dawes M, Cheng J: Tobacco Smoking Among Migrant Factory Workers in Shenzhen. 2012, China, Nicotine Tob Res
4.
Yuen P: Reforming health care financing in urban China. International Journal of Public Administration. 1996, 19 (2): 211-232. 10.1080/01900699608525092.CrossRef
5.
Yip WC, Hsiao WC: Medical savings accounts: Lessons from China. Health Affair. 1997, 16 (6): 244-251. 10.1377/hlthaff.16.6.244.CrossRef
6.
Liu GG, Zhao ZY, Cai RH, Yamada T, Yamada T: Equity in health care access to: assessing the urban health insurance reform in China. Social Science & Medicine. 2002, 55 (10): 1779-1794. 10.1016/S0277-9536(01)00306-9.CrossRef
7.
National Development and Reform Commission of China: Opinions of the CPC Central Committee and the State Council on Deepening the Health Care System Reform. 2009, National Development and Reform Commission of China
8.
Blomqvist Å: Health system reform in China: What role for private insurance?. China Econ Rev. 2009, 20 (4): 605-612. 10.1016/j.chieco.2009.07.001.CrossRef
9.
McLeod CB, Lavis JN, Mustard CA, Stoddart GL: Income inequality, household income, and health status in Canada: A prospective cohort study. Am J Public Health. 2003, 93 (8): 1287-1293. 10.2105/AJPH.93.8.1287.CrossRefPubMedPubMedCentral
10.
Mou J, Cheng JQ, Zhang D, Jiang HP, Lin LQ, Griffiths SM: Health care utilisation amongst Shenzhen migrant workers: does being insured make a difference?. Bmc Health Serv Res. 2009, 9: 214-10.1186/1472-6963-9-214.CrossRefPubMedPubMedCentral
11.
Van Doorslaer E, O’Donnell O, Rannan-Eliya RP, Somanathan A, Adhikari SR, Garg CC, Harbianto D, Herrin AN, Huq MN, Ibragimova S, et al: Catastrophic payments for health care in Asia. Health Econ. 2007, 16 (11): 1159-1184. 10.1002/hec.1209.CrossRefPubMed
12.
Merler E, Bizzotto R, Calisti R, Cavone D, De Marzo N, Gioffre F, Mabilia T, Marcolina D, Musti M, Munafo MG, et al: Mesotheliomas among Italians, returned to the home country, who worked when migrant at a cement-asbestos factory in Switzerland. Soz Praventiv Med. 2003, 48 (1): 65-69. 10.1007/s000380300007.CrossRef
13.
Hesketh T, Jun YX, Lu L, Mei WH: Health status and access to health care of migrant workers in China. Public Health Rep. 2008, 123 (2): 189-197.PubMedPubMedCentral
14.
Hu S, Tang S, Liu Y, Zhao Y, Escobar ML, de Ferranti D, Wagstaff A, Lindelow M: Reform of how health care is paid for in China: challenges and opportunities. Lancet. 2008, 372 (9652): 1846-1853. 10.1016/S0140-6736(08)61368-9.CrossRefPubMed
15.
Liu M: Change in access to healthcare in Guangzhou 1999–2009. MPH dissertation thesis. 2010, University of Hong Kong
16.
World Bank: Financing health care: issues and options for China. World Bank Report. 1998
17.
Centre for Health Statistics and Information China: Report on the results of the 1998 National Health Services Survey. 1999, Centre for Health Statistics and Information, Ministry of Health, China
18.
Leung GM, Wong IOL, Chan WS, Choi S, Lo SV, Grp HCFS: The ecology of health care in Hong Kong. Social Science & Medicine. 2005, 61 (3): 577-590. 10.1016/j.socscimed.2004.12.029.CrossRef
19.
Census and Statistics Department of Hong Kong: Thematic Household Survey Report - Report No. 48. 2011, Census and Statistics Department of Hong Kong
20.
Chinese National Health Services Survey: Guangdong Province– general health statistics by cities. 2008, Chinese National Health Services Survey Report
21.
Cleary PD, Edgmanlevitan S, Roberts M, Moloney TW, Mcmullen W, Walker JD, Delbanco TL: Patients Evaluate Their Hospital-Care - a National Survey. Health Affair. 1991, 10 (4): 254-267. 10.1377/hlthaff.10.4.254.CrossRef
22.
Honaker J, King G: What to Do about Missing Values in Time-Series Cross-Section Data. Am J Polit Sci. 2010, 54 (2): 561-581. 10.1111/j.1540-5907.2010.00447.x.CrossRef
23.
Royston P: Multiple imputation of missing values: further update of ice, with an emphasis on interval censoring. Stata J. 2007, 7 (4): 445-464.
24.
Royston P: Multiple imputation of missing values: Further update of ice, with an emphasis an categorical variables. Stata J. 2009, 9 (3): 466-477.
25.
Zhao DH, Rao KQ, Zhang ZR: Coverage and utilization of the health insurance among migrant workers in Shanghai, China. Chinese Med J-Peking. 2011, 124 (15): 2328-2334.
26.
Chinese National Health Services Survey: Guangdong Province– Insurance coverage by cities. 2008, Chinese National Health Services Survey Report
27.
Xiamen Municipal Bureau of Human Resources and Social Security: Xiamen Health insurance statistics. 2008, Annual report of Xiamen Municipal Bureau of Human Resources and Social Security
28.
Peng YC, Chang WH, Zhou HQ, Hu HP, Liang WN: Factors associated with health-seeking behavior among migrant workers in Beijing. China. Bmc Health Serv Res. 2010, 10: 69-10.1186/1472-6963-10-69.CrossRefPubMed
29.
Tuohy CH: Parting at the crossroads: The emergence of health insurance in the United States and Canada. J Health Polit Polic. 2000, 25 (5): 1005-1008. 10.1215/03616878-25-5-1005.CrossRef
30.
Joshi S, Simkhada P, Prescott GJ: Health problems of Nepalese migrants working in three Gulf countries. Bmc Int Health Hum R. 2011, 11: 3-10.1186/1472-698X-11-3.CrossRef
31.
Gravel S, Vissandjee B, Lippel K, Brodeur JM, Patry L, Champagne F: Ethics and the compensation of immigrant workers for work-related injuries and illnesses. J Immigr Minor Health. 2010, 12 (5): 707-714. 10.1007/s10903-008-9208-5.CrossRefPubMed
32.
Xu L, Wang Y, Collins CD, Tang SL: Urban health insurance reform and coverage in China using data from National Health Services Surveys in 1998 and 2003. Bmc Health Serv Res. 2007, 7: 37-10.1186/1472-6963-7-37.CrossRefPubMedPubMedCentral
33.
Dumoulin-Smith A: Social Health Insurance in China: An Example of Nascent Social Security in China. 2005, Center for the Study of Inequality, Cornell University
34.
Yu B, Meng Q, Collins C, Tolhurst R, Tang S, Yan F, Bogg L, Liu X: How does the New Cooperative Medical Scheme influence health service utilization? A study in two provinces in rural China. Bmc Health Serv Res. 2010, 10 (1): 116-10.1186/1472-6963-10-116.CrossRefPubMedPubMedCentral
Metadata
Title
Health insurance and healthcare utilisation for Shenzhen residents: a tale of registrants and migrants?
Authors
Kelvin KF Lam
Janice M Johnston
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-868

Other articles of this Issue 1/2012

BMC Public Health 1/2012 Go to the issue

Research article

The changes in female physical and childbearing characteristics in china and potential association with risk of breast cancer

Research article

Alcohol and cannabis use among adolescents in Flemish secondary school in Brussels: effects of type of education

Research article

Ideal and actual involvement of community pharmacists in health promotion and prevention: a cross-sectional study in Quebec, Canada

Research article

How countries cope with competing demands and expectations: perspectives of different stakeholders on priority setting and resource allocation for health in the era of HIV and AIDS

Research article

Fluid intake patterns: an epidemiological study among children and adolescents in Brazil

Research article

Health policymakers’ knowledge and opinions of physicians smoking and tobacco policy control in Lao PDR