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Int. J. Environ. Res. Public Health 2017, 14(10), 1256; https://doi.org/10.3390/ijerph14101256

Does Migration Limit the Effect of Health Insurance on Hypertension Management in China?

1
China Center for Health Development Studies, Peking University, Beijing 100000, China
2
Department of Health Policy and Administration, School of Public Health, Peking University, Beijing 100191, China
3
Department of Economics, State University of New York at Stony Brook, Stony Brook, NY 11794, USA
4
Department of Preventive Medicine, State University of New York at Stony Brook, Stony Brook, NY 11794, USA
5
Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA 30602, USA
6
Department of Social Medicine, School of Public Health, National Key Laboratory of Health Technology Assessment (National Health and Family Planning Commission), Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, China
*
Author to whom correspondence should be addressed.
Received: 25 August 2017 / Revised: 21 September 2017 / Accepted: 29 September 2017 / Published: 20 October 2017
(This article belongs to the Section Health Services and Health Economics Research)
View Full-Text   |   Download PDF [304 KB, uploaded 20 October 2017]

Abstract

Background: In China, rapid urbanization has caused migration from rural to urban areas, and raised the prevalence of hypertension. However, public health insurance is not portable from one place to another, and migration may limit the effectiveness of this non-portable health insurance on healthcare. Our study aims to investigate whether migration limits the effectiveness of health insurance on hypertension management in China. Methods: Data were obtained from the national baseline survey of the China Health and Retirement Longitudinal Study in 2011, including 4926 hypertensive respondents with public health insurance. Outcome measures included use of primary care, hypertension awareness, medication use, blood pressure monitoring, physician advice, and blood pressure control. Multivariate logistic regressions were estimated to examine whether the effects of rural health insurance on hypertension management differed between those who migrated to urban areas and those who did not migrate and lived in rural areas. Results: Among hypertensive respondents, 60.7% were aware of their hypertensive status. Compared to rural residents, the non-portable feature of rural health insurance significantly reduced rural-to-urban migrants’ probabilities of using primary care by 7.8 percentage points, hypertension awareness by 8.8 percentage points, and receiving physician advice by 18.3 percentage points. Conclusions: In China, migration to urban areas limited the effectiveness of rural health insurance on hypertension management due to its non-portable nature. It is critical to improve the portability of rural health insurance, and to extend urban health insurance and primary care coverage to rural-to-urban migrants to achieve better chronic disease management. View Full-Text
Keywords: migration; health insurance; hypertension; awareness; disease control; China migration; health insurance; hypertension; awareness; disease control; China
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Fang, H.; Jin, Y.; Zhao, M.; Zhang, H.; A. Rizzo, J.; Zhang, D.; Hou, Z. Does Migration Limit the Effect of Health Insurance on Hypertension Management in China? Int. J. Environ. Res. Public Health 2017, 14, 1256.

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