title: Comparing knowledge and use of health services of migrants from rural and urban areas in Kunming City, China.
abstract: This paper compares the knowledge and utilization of health services among rural residents, urban residents, rural migrants and urban migrants in a large Chinese city. Data were obtained from a questionnaire survey of 2765 individuals (1951 heads of households and 814 spouses) in Guandu district, Kunming, in 2005. The determinants of their knowledge and utilization of health services were analysed using multivariate logistic regression. First, the migrant population was less likely to know of, or utilize, high-level hospitals and township hospitals than residents. Migrants were more likely to utilize private rather than public services for general health care and delivery care. Second, there was a difference between rural migrants and urban migrants in terms of knowledge and utilization of health services. Rural migrants utilized more low-cost private clinics, but had less knowledge about sources of condoms than urban migrants. Finally, rural residents had more knowledge and utilization of township hospitals than urban residents. This latter group were more likely to utilize high-level hospitals. Migrants' access to health care in urban China is understood better using a dual rural-urban and migrant-resident analytical framework. Rural migrants are the most disadvantaged in their access to urban health care. Further reform of the registered residence system and urban public financing system is recommended. Better information on services and their utilization should be provided to migrants and residents.
authors.affiliation: Nuffield Centre for International Health & Development, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
authors.forename: Xiaolin
authors.initials: X
authors.lastname: Wei
authors.forename: Stephen
authors.initials: S
authors.lastname: Pearson
authors.forename: Zhanxin
authors.initials: Z
authors.lastname: Zhang
authors.forename: Jiangmei
authors.initials: J
authors.lastname: Qin
authors.forename: Nancy
authors.initials: N
authors.lastname: Gerein
authors.forename: John
authors.initials: J
authors.lastname: Walley
mesh_terms: D000704:Analysis of Variance; D002681:China; D003430:Cross-Sectional Studies; D003625:Data Collection; D007722:Health Knowledge, Attitudes, Practice; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D012424:Rural Population / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014171:Transients and Migrants / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*