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      Comparison of access to health services among urban-to-urban and rural-to-urban older migrants, and urban and rural older permanent residents in Zhejiang Province, China: a cross-sectional survey

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          Abstract

          Background

          While much literature reported the access of Chinese older migrants to health services, little was known about the differences among sub-groups of older adults, including urban-to-urban and rural-to-urban migrants, and urban and rural permanent residents. This study aimed to examine the access of these four groups to health services in Zhejiang Province, China and provide an evidence for the development of health services policies.

          Methods

          A cross-sectional survey was conducted in community-dwelling older adults (aged 60 years or above) in 2013. Participants were recruited by random sampling. Demographic information and access to health services for the elderly populations were obtained via interviews using a self-designed structured questionnaire. Pearson’s chi-square tests and Cochran-Mantel-Haenszel (CMH) tests were performed to examine the differences in access to health services among the four groups. Binary logistic regression was conducted to explore the associations of participants’ visits to doctors with their group status after controlling confounding factors.

          Results

          The two-week hospital visiting rates were significantly lower in migrants (55.56% in rural-to-urban and 62.50% in urban-to-urban) than that in urban and rural permanent residents (67.40 and 82.25%, respectively; p < 0.01). The majority of older adults who received a diagnosis indicating need for hospital treatment accepted the treatment, with no significant difference among the four groups after controlling for health service need ( χ 2  = 7.08, p = 0.07). On the other hand, 30.05% of the older adults did not visit a doctor when they got ailments in the past 2 weeks prior to the survey, and 16.42% (33/201) did not receive hospital treatment after receiving a diagnosis indicating need for hospital treatment. Factors including age, marital status, educational attainment, major financial source, and living with family members did not influence health services use.

          Conclusions

          Targeted social and health policies integrating the strengths of government, society and families should be implemented to further improve health services use for different groups of older adults.

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          Most cited references24

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          Health and access to care for undocumented migrants living in the European Union: a scoping review

          Background Literature on health and access to care of undocumented migrants in the European Union (EU) is limited and heterogeneous in focus and quality. Authors conducted a scoping review to identify the extent, nature and distribution of existing primary research (1990–2012), thus clarifying what is known, key gaps, and potential next steps. Methods Authors used Arksey and O’Malley’s six-stage scoping framework, with Levac, Colquhoun and O’Brien’s revisions, to review identified sources. Findings were summarized thematically: (i) physical, mental and social health issues, (ii) access and barriers to care, (iii) vulnerable groups and (iv) policy and rights. Results Fifty-four sources were included of 598 identified, with 93% (50/54) published during 2005–2012. EU member states from Eastern Europe were under-represented, particularly in single-country studies. Most study designs (52%) were qualitative. Sampling descriptions were generally poor, and sampling purposeful, with only four studies using any randomization. Demographic descriptions were far from uniform and only two studies focused on undocumented children and youth. Most (80%) included findings on health-care access, with obstacles reported at primary, secondary and tertiary levels. Major access barriers included fear, lack of awareness of rights, socioeconomics. Mental disorders appeared widespread, while obstetric needs and injuries were key reasons for seeking care. Pregnant women, children and detainees appeared most vulnerable. While EU policy supports health-care access for undocumented migrants, practices remain haphazard, with studies reporting differing interpretation and implementation of rights at regional, institutional and individual levels. Conclusions This scoping review is an initial attempt to describe available primary evidence on health and access to care for undocumented migrants in the European Union. It underlines the need for more and better-quality research, increased co-operation between gatekeepers, providers, researchers and policy makers, and reduced ambiguities in health-care rights and obligations for undocumented migrants.
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            Utilization of health care services by migrants in Europe-a systematic literature review.

            Our study reviewed the empirical evidence on the utilization of health care services by migrants in Europe, and on differences in health service utilization between migrants and non-migrants across European countries.
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              Left Out: Immigrants' Access To Health Care And Insurance

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                Author and article information

                Contributors
                masha.1987@163.com
                zhouxudong@zju.edu.cn
                0015695@zju.edu.cn
                lqjwish@163.com
                chaog@zju.edu.cn
                cwm@zju.edu.cn
                prof_lilu@zju.edu.cn
                Journal
                BMC Geriatr
                BMC Geriatr
                BMC Geriatrics
                BioMed Central (London )
                1471-2318
                6 August 2018
                6 August 2018
                2018
                : 18
                : 174
                Affiliations
                [1 ]ISNI 0000 0004 1759 700X, GRID grid.13402.34, The Institute of Social and Family Medicine, , School of Medicine, Zhejiang University, ; 866 Yuhangtang Road, Xihu District, Hangzhou, Zhejiang Province 310058 People’s Republic of China
                [2 ]ISNI 0000 0000 8744 8924, GRID grid.268505.c, School of Humanities and Social Sciences, Zhejiang Chinese Medical University, ; Gaoke Road, Fuyang District, Zhejiang Province 311402 People’s Republic of China
                Article
                866
                10.1186/s12877-018-0866-4
                6091183
                30081826
                5af53e4d-6db9-4824-b8b1-ab5fa0a6d740
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. 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.

                History
                : 11 June 2017
                : 27 July 2018
                Funding
                Funded by: the National Natural Science Foundation of China
                Award ID: 71273229
                Award Recipient :
                Funded by: the program of Zhejiang Natural Science Foundation
                Award ID: LQ12G03015
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Geriatric medicine
                health needs,health services,health equity,migrant older adults
                Geriatric medicine
                health needs, health services, health equity, migrant older adults

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