Household Registration System, Migration, and Inequity in Healthcare Access
Abstract
:1. Introduction
2. Methods and Materials
2.1. Study Design: CHARLS-2014 (The Life History Survey)
2.2. Measurement
2.2.1. Dependent Variables
2.2.2. Household Registration and Migration Information
2.2.3. Control Variables
2.3. Grouping Differences and Correlations
2.4. Statistical Analysis
3. Empirical Results
3.1. Descriptive Statistics of the Variables
3.1.1. Dependent Variables
3.1.2. Household Registration and Migration Information
3.1.3. Control Variables
3.2. Results of the Relation between Household Registration Type and Healthcare Access
3.3. Results of the Relations between Household Registration Change, Migration, and Healthcare Access for Rural Residents
3.4. Results of the Relation between Household Registration Type Change and Healthcare Access for Rural Residents that Never Migrated to Other Areas
3.5. Results of the Relation between Migration and Healthcare Access for Rural Residents that Never Changed Household Registration
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Variables | Measurement | Rural Household Registration Type | Non-rural Household Registration Type | Combined | Difference | |
---|---|---|---|---|---|---|
Mean | Mean | Mean | S.D. | t-value | ||
Healthcare Access | ||||||
Healthcare quality | Can you remember the first time you got to see a doctor? What was the type of the doctor? (A doctor in 1 = general hospital, 2 = specialized hospital, 3 = health clinics in towns, 4 = community/village health station, 5 = private clinic, 6 = local doctor without practicing location, 7 = doctor without license, 8 = others, 9 = never seen a doctor) | 4.9256 | 3.2132 | 4.7571 | 2.1302 | 33.9689 ** |
Blood pressure check | Did you have blood pressure checked after you turned 16 years of age? (1 = Yes, 2 = Never) | 1.3010 | 1.1347 | 1.2849 | 0.4514 | 14.9594 ** |
Blood test | Did you have your blood tested after you turned 16 years of age, for example, measurements of cholesterol or blood sugar? (1 = Yes, 2 = Never) | 1.4599 | 1.2585 | 1.4404 | 0.4964 | 16.6747 ** |
Vision exam | Did you have a vision test after you turned 16 years of age? (1 = Yes, 2 = Never) | 1.6864 | 1.3799 | 1.6566 | 0.4748 | 27.2839 ** |
Dental examination | Did you have dental examinations after you turned 16 years of age? (1 = Yes, 2 = Never) | 1.5545 | 1.7644 | 1.7440 | 0.4365 | 20.1783 ** |
Breast exam | Did you have a breast exam after you turned 16 years of age? (1 = Yes, 2 = Never, Female respondents only) | 1.7960 | 1.5267 | 1.7706 | 0.4204 | 19.3437 ** |
Household registration status | ||||||
Household registration (hukou) type | What was your first hukou type? (1 = Rural hukou, 2 = Non-rural hukou (including non-agricultural hukou and unified residence hukou)) | 1.0000 | 2.0000 | 1.0992 | 0.2989 | - |
Registration type change of household | Has the registration type changed for your first hukou change? (1 = Yes, 2 = No) | 1.4887 | 1.7205 | 1.5259 | 0.4994 | −12.8827 ** |
Registered household residence change | Has the registered household residence changed for your first hukou change? (1 = Yes, 2 = No) | 1.3371 | 1.1212 | 1.3024 | 0.4593 | 13.0457 ** |
Residence after migration | After your first migration, were you living in rural or urban areas? (1 = living in a rural area, 2 = mainly living in a rural area, 3 = Time living in rural and urban areas was roughly the same, 4 = mainly living in an urban area, 5 = living in an urban area) | 1.1600 | 4.0490 | 1.5949 | 1.3892 | −92.3630 ** |
Control variables | ||||||
Gender | [1 = Male, 2 = Female] | 1.5275 | 1.5040 | 1.5251 | 0.4994 | 1.9845 * |
Education | [……, 10 = Master program, 11 = Ph.D program] | 3.6094 | 5.2816 | 3.7852 | 2.1770 | −35.4797 ** |
Economic condition | When you were a child before the age of 17, compared to the average family in the same community/village at that time, how was your family’s financial situation? (1 = A lot better, 5 = A lot worse) | 3.5514 | 3.1898 | 3.5157 | 0.9816 | 15.5772 ** |
Ethnic minority | Do you or does your spouse/partner belong to an ethnic minority? (belongs to a certain nationality other than the Han) | 0.0945 | 0.1341 | 0.9847 | 0.2980 | −5.6212 ** |
Religion | Do you or does your spouse/partner believe in religion? | 0.1429 | 0.1302 | 0.1315 | 0.3379 | −1.5783 |
Having insurance or not | Do you have any medical insurance? (1 = Yes, 2 = Never) | 1.0348 | 1.0427 | 1.0356 | 0.1853 | −1.7585 † |
Variables | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Healthcare access | |||||||||||||
1. Healthcare quality | --- | ||||||||||||
2. Blood pressure check | 0.0514 * | --- | |||||||||||
3. Blood test | 0.0776 * | 0.4722 * | --- | ||||||||||
4. Vision exam | 0.0889 * | 0.2384 * | 0.2825 * | --- | |||||||||
5. Dental examination | 0.0705 * | 0.1620 * | 0.2006 * | 0.3196 * | --- | ||||||||
6. Breast exam (female only) | 0.0811 * | 0.1910 * | 0.2318 * | 0.2609 * | 0.1862 * | --- | |||||||
Household registration | |||||||||||||
7. Household registration (hukou) type | −0.2394 * | −0.1091 * | −0.1199 * | −0.1913 * | −0.1425 * | −0.1873 * | --- | ||||||
Demographic variables | |||||||||||||
8. Gender | −0.0179 | 0.0258 * | 0.0241 * | 0.1601 * | 0.0130 * | −0.0015 | −0.0141 | --- | |||||
9. Education | −0.0876 * | −0.1354 * | −0.1375 * | −0.2504 * | −0.1333 * | −0.2507 * | 0.2434 * | −0.2894 * | --- | ||||
10. Economic condition | 0.0394 * | 0.0565 * | 0.0588 * | 0.0740 * | 0.0624 | 0.0740 * | −0.1099 * | −0.0499 * | −0.1552 * | --- | |||
11. Ethnic minority | −0.0422 * | 0.0340 * | 0.0241 * | −0.0080 | −0.0022 | −0.0031 | 0.0397 * | 0.0058 | −0.0067 | −0.0166 | --- | ||
12. Religion | −0.0261 * | −0.0080 | −0.0242 * | 0.0101 | −0.0190 * | 0.0000 | 0.0111 | 0.0351 * | −0.0729 * | −0.0116 | 0.1394 * | --- | |
13. Having insurance or not | 0.0080 | 0.0486 * | 0.0525 * | 0.0362 * | 0.0336 * | 0.0389 * | 0.0128 | 0.0229 * | −0.0514 * | 0.0060 | 0.0060 | −0.0004 | --- |
Variables | Dependent Variable: Healthcare Access | |||||
---|---|---|---|---|---|---|
Healthcare Quality | Blood Pressure Check | Blood Test | Vision Test | Dental Examination | Breast Exam [Female] | |
Independent variable | ||||||
Household registration type | −1.6429 ** [0.0709] | −0.1181 ** [0.0123] | −0.1481 ** [0.0162] | −0.2269 ** [0.0170] | −0.1701 ** [0.0159] | −0.1799 ** [0.0214] |
Control variables | ||||||
Gender | −0.1397 ** [0.0288] | −0.0058 [0.0071] | −0.0077 [0.0077] | 0.1037 ** [0.0077] | −0.0162 * [0.0064] | --- |
Education | −0.0463 ** [0.0097] | −0.0238 ** [0.0020] | −0.0263 ** [0.0023] | −0.0400 ** [0.0022] | −0.0214 ** [0.0019] | −0.0389 ** [0.0024] |
Economic condition | 0.0126 [0.0157] | 0.0127 ** [0.0038] | 0.0157 ** [0.0038] | 0.0176 ** [0.0035] | 0.0125 ** [0.0034] | 0.0117 ** [0.0045] |
Ethnic minority | −0.2080 * [0.0882] | 0.0602 ** [0.0222] | 0.0558 ** [0.0175] | −0.0023 [0.0150] | 0.0110 [0.0133] | 0.0010 [0.0167] |
Religion | −0.1494 * [0.0625] | −0.0272 * [0.0136] | −0.0531 ** [0.0140] | −0.0054 [0.0114] | −0.0333 ** [0.0118] | −0.0186 [0.0135] |
Having insurance or not | 0.1280 [0.0919] | −0.1083 ** [0.0218] | 0.1213 ** [0.0217] | 0.0639 [0.0188] | 0.0697 ** [0.0161] | −0.0564 ** [0.0189] |
Intercept term | 6.8209 ** [0.1647] | 1.3504 ** [0.0370] | 1.5318 ** [0.0381] | 1.7708 ** [0.0357] | 1.9218 ** [0.0316] | 1.9953 ** [0.0349] |
Number of observations | 18028 | 17690 | 18118 | 18550 | 18586 | 9675 |
F statistics [p-value] | 91.32 [0.0000] | 52.52 [0.0000] | 51.18 [0.0000] | 173.52 [0.0000] | 49.33 [0.0000] | 74.67 [0.0000] |
Variables | Dependent Variable: Healthcare Access | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Healthcare Quality | Blood Pressure Check | Blood Test | Vision Test | Dental Examination | Breast Exam [Female] | |||||||
Independent variable | ||||||||||||
Registration type change of household | 0.2192 † [0.1158] | 0.2647 * [0.1196] | 0.1075 ** [0.0193] | 0.1040 ** [0.0193] | 0.1450 ** [0.0231] | 0.1451 ** [0.0236] | 0.2804 ** [0.0252] | 0.2845 ** [0.0252] | 0.1677 ** [0.0231] | 0.1763 ** [0.0244] | 0.1842 ** [0.0291] | 0.1840 ** [0.0295] |
Registered household residence change | 0.2183 [0.1386] | −0.0176 [0.0201] | 0.0002 [0.0280] | 0.0199 [0.0291] | 0.0415 [0.0308] | −0.0011 [0.0357] | ||||||
Residence after migration | 0.0306 [0.0586] | 0.0124 [0.0597] | −0.0066 [0.0086] | −0.0053 [0.0089] | −0.0176 † [0.0098] | −0.0176 † [0.0099] | −0.0144 [0.0108] | −0.0160 [0.0109] | −0.0145 [0.0127] | −0.0178 [0.0126] | −0.0329 * [0.0143] | −0.0328 * [0.0146] |
Control variables | ||||||||||||
Gender | −0.0498 [0.0938] | −0.0441 [0.0938] | 0.0300 [0.0170] | 0.0295 † [0.0170] | 0.0595 ** [0.0207] | 0.0595 ** [0.0208] | 0.1672 ** [0.0238] | 0.1677 ** [0.0239] | 0.0576 ** [0.0201] | 0.0588 ** [0.0201] | --- | --- |
Education | −0.0406 † [0.0208] | −0.0405 † [0.0208] | −0.0159 ** [0.0039] | −0.0159 ** [0.0039] | −0.0206 ** [0.0043] | −0.0206 ** [0.0043] | −0.0302 ** [0.0043] | −0.0302 ** [0.0043] | −0.0178 ** [0.0045] | −0.0178 ** [0.0045] | −0.0403 ** [0.0047] | −0.0403 ** [0.0047] |
Economic condition | −0.0402 [0.0434] | −0.0429 [0.0435] | 0.0103 [0.0075] | 0.0105 [0.0075] | 0.0215 * [0.0084] | 0.0215 * [0.0084] | 0.0041 [0.0085] | 0.0038 [0.0085] | −0.0008 [0.0096] | −0.0013 [0.0097] | −0.0008 [0.0100] | −0.0008 [0.0100] |
Ethnic minority | −0.1961 [0.1679] | −0.2037 [0.1660] | 0.0343 [0.0238] | 0.0349 [0.0238] | 0.0630 * [0.0309] | 0.0630 * [0.0308] | 0.0453 † [0.0257] | 0.0446 † [0.0258] | 0.0121 [0.0325] | 0.0108 [0.0327] | 0.0059 [0.0297] | 0.0060 [0.0297] |
Religion | −0.4745 ** [0.1345] | −0.4704 ** [0.1343] | 0.0043 [0.0225] | 0.0041 [0.0224] | −0.0678 * [0.0271] | −0.0678 * [0.0271] | −0.0118 [0.0244] | −0.0114 [0.0245] | −0.0177 [0.0293] | −0.0170 [0.0294] | −0.0086 [0.0318] | −0.0086 [0.0319] |
Having insurance or not | 0.1040 [0.2278] | 0.1074 [0.2269] | 0.1148 * [0.0462] | 0.1150 * [0.0463] | 0.0986 * [0.0502] | 0.0986 * [0.0502] | 0.1095 * [0.0430] | 0.1096 * [0.0429] | 0.1422 ** [0.0406] | 0.1425 ** [0.0406] | 0.0959 * [0.0401] | 0.0958 * [0.0401] |
Intercept term | 4.7012 ** [0.3988] | 4.3993 ** [0.4439] | 0.9001 ** [0.0759] | 0.9239 ** [0.0781] | 0.9584 ** [0.0855] | 0.9582 ** [0.0954] | 0.8495 ** [0.0793] | 0.8222 ** [0.0886] | 1.2443 ** [0.0789] | 1.1872 ** [0.0925] | 1.5100 ** [0.0825] | 1.5114 ** [0.0944] |
Number of observations | 2833 | 2833 | 2803 | 2803 | 2852 | 2852 | 2914 | 2914 | 2915 | 2915 | 1831 | 1831 |
F statistics [p-value] | 2.70 [0.0066] | 2.71 [0.0044] | 14.72 [0.0000] | 13.05 [0.0000] | 24.88 [0.0000] | 22.35 [0.0000] | 95.12 [0.0000] | 85.64 [0.0000] | 20.38 [0.0000] | 18.28 [0.0000] | 22.15 [0.0000] | 19.40 [0.0000] |
Variables | Dependent Variable: Healthcare Access | |||||
---|---|---|---|---|---|---|
Healthcare Quality | Blood Pressure Check | Blood Test | Vision Test | Dental Examination | Breast Exam [Female] | |
Independent variable | ||||||
Registration type change of household | 0.5400 ** [0.1762] | 0.0877 * [0.0341] | 0.1070 ** [0.0377] | 0.0941 ** [0.0333] | 0.0950 ** [0.0322] | 0.0419 [0.0309] |
Control variables | ||||||
Gender | 0.1170 [0.1201] | −0.0009 [0.0257] | 0.0028 [0.0274] | 0.1271 ** [0.0290] | −0.0381 [0.0268] | --- |
Education | 0.0626 † [0.0323] | −0.0150 * [0.0063] | −0.0223 ** [0.0069] | −0.0465 ** [0.0061] | −0.0084 [0.0065] | −0.0581 ** [0.0068] |
Economic condition | 0.1171 * [0.0581] | 0.0084 [0.0126] | −0.0060 [0.0134] | −0.0019 [0.0118] | 0.0032 [0.0134] | −0.0146 [0.0165] |
Ethnic minority | −0.3476 [0.2832] | 0.0242 [0.0466] | 0.0526 [0.0486] | −0.0535 [0.0462] | −0.0072 [0.0405] | 0.1129 * [0.0534] |
Religion | −0.4065 † [0.2125] | −0.0784 * [0.0343] | −0.0760 * [0.0349] | 0.0289 [0.0365] | −0.0431 [0.0363] | −0.0006 [0.0434] |
Having insurance or not | 0.5627 [0.3824] | −0.0070 [0.0717] | −0.0980 [0.0676] | 0.0318 [0.0784] | 0.0288 [0.0741] | −0.0655 [0.0946] |
Intercept term | 2.6418 ** [0.6245] | 1.1625 ** [0.1090] | 1.4328 ** [0.1125] | 1.4574 ** [0.1171] | 1.6950 ** [0.1172] | 1.9875 ** [0.1251] |
Number of observations | 1400 | 1384 | 1420 | 1448 | 1462 | 827 |
F statistics [p-value] | 2.88 [0.0000] | 3.61 [0.0000] | 4.98 [0.0000] | 25.67 [0.0000] | 2.22 [0.0000] | 15.83 [0.0000] |
Variables | Dependent Variable: Healthcare Access | |||||
---|---|---|---|---|---|---|
Healthcare Quality | Blood Pressure Check | Blood Test | Vision Test | Dental Examination | Breast Exam [Female] | |
Independent variable | ||||||
Residence after migration | 0.0064 [0.0703] | 0.0073 [0.0129] | −0.0040 [0.0137] | 0.0115 [0.0139] | 0.0192 † [0.0106] | 0.0187 [0.0165] |
Control variables | ||||||
Gender | −0.1740 † [0.0916] | 0.0119 [0.0208] | 0.0331 [0.0232] | 0.1753 ** [0.0206] | 0.0227 [0.0180] | --- |
Education | −0.0356 [0.0255] | −0.0206 ** [0.0060] | −0.0198 ** [0.0062] | −0.0297 ** [0.0053] | −0.0070 [0.0050] | −0.0314 ** [0.0058] |
Economic condition | −0.0573 [0.0383] | 0.0025 [0.0092] | −0.0011 [0.0111] | 0.0093 [0.0096] | −0.0005 [0.0088] | 0.0014 [0.0117] |
Ethnic minority | −0.0843 [0.1589] | 0.0947 * [0.0421] | 0.0475 [0.0359] | −0.1031 ** [0.0355] | −0.0210 [0.0315] | −0.0192 [0.0438] |
Religion | 0.0076 [0.1329] | −0.0490 † [0.0294] | −0.0425 [0.0343] | −0.0042 [0.0273] | −0.0169 [0.0118] | −0.0441 [0.0366] |
Having insurance or not | 0.0425 [0.2048] | 0.1410 ** [0.0536] | 0.1174 * [0.0494] | 0.0528 [0.0441] | 0.0927 ** [0.0343] | 0.0699 [0.0426] |
Intercept term | 5.6121 ** [0.3329] | 1.1787 ** [0.0795] | 1.3578 ** [0.0857] | 1.4330 ** [0.0783] | 1.6449 ** [0.0658] | 1.8329 ** [0.0701] |
Number of observations | 2531 | 2479 | 2535 | 2599 | 2600 | 974 |
F statistics [p-value] | 0.89 [0.5174] | 4.99 [0.0000] | 4.17 [0.0002] | 25.62 [0.0000] | 2.69 [0.0098] | 6.36 [0.0000] |
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Yuan, B.; Li, J.; Wang, Z.; Wu, L. Household Registration System, Migration, and Inequity in Healthcare Access. Healthcare 2019, 7, 61. https://doi.org/10.3390/healthcare7020061
Yuan B, Li J, Wang Z, Wu L. Household Registration System, Migration, and Inequity in Healthcare Access. Healthcare. 2019; 7(2):61. https://doi.org/10.3390/healthcare7020061
Chicago/Turabian StyleYuan, Bocong, Jiannan Li, Zhaoguo Wang, and Lily Wu. 2019. "Household Registration System, Migration, and Inequity in Healthcare Access" Healthcare 7, no. 2: 61. https://doi.org/10.3390/healthcare7020061