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      Association between social integration and medical returns among the migrant elderly following children to Jinan City China

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          Abstract

          Background

          Studies had shown that social integration was related to the utilization of medical services. Few studies investigated the relationship between social integration and medical returns among the elderly. None research had ever clarified the effect of social integration on medical returns among the migrant elderly following children (MEFC) to new cities. This study aimed to explore the association between social integration and medical returns among the MEFC in Jinan, China.

          Method

          This cross-sectional study included 627 MEFC in Jinan China. Social integration was evaluated by economic integration, acculturation, and identification. Medical return was assessed by asking the subjects whether go back to hometown to use the medical services when ill. Chi-squared test and multivariable logistic regression were applied to analyze the association between social integration and medical returns of the MEFC.

          Results and discussion

          It was found that 20.3% of the MEFC had a medical return. As for social integration, those who had not joined local medical insurance (OR = 3.561, 95% CI 1.577–8.039, p = 0.002) and were unwilling to stay for a long time (OR = 2.600, 95% CI 1.620–4.174, p = 0.001) were more likely to have a medical return. Furthermore, our findings showed that the MEFC who were accompanied by one or more (OR = 1.568, 95% CI 1.027–2.392, p = 0.037) were more likely to have a medical return than those who migrated alone.

          Conclusion

          Negative relationship between social integration and medical returns was found among the MEFC, which means the better social integration of the MEFC would generally have fewer medical return, as well as the better refunding connections of the medical insurance between the current residence and hometown.

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          Most cited references46

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          Rethinking Assimilation Theory for a New Era of Immigration

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            Analysis of health service utilization of migrants in Beijing using Anderson health service utilization model

            Background Migrants are the unique production of China’s urbanization process. They are often excluded from social welfare and security systems of cities, and often exposed to high health risk related closely to their health problems. This research sought to unveil and explore the influencing factors on health services utilization of migrants in Beijing. Methods A sample of 2014 inter-provincial migrants and 4578 residents with Beijing “Hukou” who were 15 years old and above was chosen by three-stage stratified cluster sampling method. A structured questionnaire survey was conducted via face-to-face interviews. Anderson health service utilization model was used to demonstrate the effects of the explanatory variables on health seeking behavior from predisposing, enabling and need variables. Results The study reveals that the rate of ‘having symptoms’ of migrants was lower than that of residents with “Hukou” only in the group of 25 to 34 years old in the past month. 503 migrants (25.0%) and 1441 (31.5%) residents with “Hukou” reported at least one episode of discomfort in the past month, and the rate of health service seeking behavior among migrants (46.8%) was lower than residents with “Hukou” (62.6%) (P < 0.0001). Chi-square independence test shows that age, ethnicity, employment status, having chronic disease and the degree of symptom were the major determinants affecting migrants to receive health services. The binary logistic regression indicates that the degree of symptom as the need variable and ethnicity as the predisposing variable were the strong and consistent determinants of health services seeking behavior. The migrants with moderate degree and severe degree of symptom in the past month were at 1.623-times (OR = 1.623) and 5.035-times (OR = 5.035) higher chances of seeking health services respectively, comparing to mild degree of symptom. Minority migrants were less likely to seek health services than Han migrants (OR = 0.282). Conclusions The results indicate that the current health delivery system is not conducive for migrants to seek appropriate health services. Relevant policies and feasible measures, including increasing the coverage of health insurance and improving the health perception of migrants should be vigorously implemented to provide affordable health services and change health service utilization behaviors for migrants.
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              Health service utilisation of rural-to-urban migrants in Guangzhou, China: does employment status matter?

              To describe the self-reported health status and service utilisation of employed, retired and unemployed migrants in Guangzhou, a megacity in southern China.
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                Author and article information

                Contributors
                kongfanlei@sdu.edu.cn
                shixueli@sdu.edu.cn
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                9 October 2021
                9 October 2021
                2021
                : 21
                : 1822
                Affiliations
                [1 ]GRID grid.27255.37, ISNI 0000 0004 1761 1174, Centre for Health Management and Policy Research, School of Public Health, , Cheeloo College of Medicine, Shandong University, ; Jinan, 250012 China
                [2 ]GRID grid.27255.37, ISNI 0000 0004 1761 1174, NHC Key Lab of Health Economics and Policy Research (Shandong University), ; Jinan, 250012 China
                Article
                11901
                10.1186/s12889-021-11901-7
                8501928
                34627226
                29e4ef24-0262-49b8-b1e1-313436b9d527
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 19 March 2021
                : 27 September 2021
                Categories
                Research
                Custom metadata
                © The Author(s) 2021

                Public health
                migrant elderly following children,medical return,social integration,medical insurance

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