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

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 healthcar...

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Detalles Bibliográficos
Autores principales: Fang, Hai, Jin, Yinzi, Zhao, Miaomiao, Zhang, Huyang, A. Rizzo, John, Zhang, Donglan, Hou, Zhiyuan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5664757/
https://www.ncbi.nlm.nih.gov/pubmed/29053607
http://dx.doi.org/10.3390/ijerph14101256
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author Fang, Hai
Jin, Yinzi
Zhao, Miaomiao
Zhang, Huyang
A. Rizzo, John
Zhang, Donglan
Hou, Zhiyuan
author_facet Fang, Hai
Jin, Yinzi
Zhao, Miaomiao
Zhang, Huyang
A. Rizzo, John
Zhang, Donglan
Hou, Zhiyuan
author_sort Fang, Hai
collection PubMed
description 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.
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spelling pubmed-56647572017-11-06 Does Migration Limit the Effect of Health Insurance on Hypertension Management in China? Fang, Hai Jin, Yinzi Zhao, Miaomiao Zhang, Huyang A. Rizzo, John Zhang, Donglan Hou, Zhiyuan Int J Environ Res Public Health Article 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. MDPI 2017-10-20 2017-10 /pmc/articles/PMC5664757/ /pubmed/29053607 http://dx.doi.org/10.3390/ijerph14101256 Text en © 2017 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/).
spellingShingle Article
Fang, Hai
Jin, Yinzi
Zhao, Miaomiao
Zhang, Huyang
A. Rizzo, John
Zhang, Donglan
Hou, Zhiyuan
Does Migration Limit the Effect of Health Insurance on Hypertension Management in China?
title Does Migration Limit the Effect of Health Insurance on Hypertension Management in China?
title_full Does Migration Limit the Effect of Health Insurance on Hypertension Management in China?
title_fullStr Does Migration Limit the Effect of Health Insurance on Hypertension Management in China?
title_full_unstemmed Does Migration Limit the Effect of Health Insurance on Hypertension Management in China?
title_short Does Migration Limit the Effect of Health Insurance on Hypertension Management in China?
title_sort does migration limit the effect of health insurance on hypertension management in china?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5664757/
https://www.ncbi.nlm.nih.gov/pubmed/29053607
http://dx.doi.org/10.3390/ijerph14101256
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