{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T11:29:56Z","timestamp":1789039796577,"version":"build-2803163510"},"reference-count":41,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009625","name":"Beijing Social Science Fund","doi-asserted-by":"publisher","award":["19JSRB006"],"award-info":[{"award-number":["19JSRB006"]}],"id":[{"id":"10.13039\/501100009625","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministry of Education of the People\u2019s Republic of China","award":["16JJD840012"],"award-info":[{"award-number":["16JJD840012"]}]},{"name":"Fulbright Scholarship Program","award":["PS00283464"],"award-info":[{"award-number":["PS00283464"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Since 2009, the Chinese government has launched a basic public health services (BPHS) equalization program to provide the same BPHS to all the citizens. However, utilization of BPHS among older migrants is still low. The purpose of this paper was to explore the determinant individual and contextual factors of older migrants\u2019 utilization of BPHS, and to provide suggestion for the government to improve BPHS utilization. Based on Andersen\u2019s model of health services use, data from the China\u2019s Regional Economic Statistics Yearbook 2014 and National Health and Family Planning Dynamic Monitoring Survey on Migrant Population 2015 were analyzed using a hierarchical random intercept model for binary outcomes. Results showed that the percentage of migrant older adults receiving free physical examinations, which is an important item of BPHS, was 36.2%. Predisposing (education, hukou, living duration in the host city, and scope of migration), enabling (health insurance and social networks), and need (self-rated health and chronic conditions) factors of individuals\u2019 characteristics had significant impact on the use of BPHS. The proportions of both migrant children enrolled in public schools and people with established health records had a positive impact on an individual\u2019s chance of receiving free physical examinations. These findings suggest that economic development and improvement at the level of the city\u2019s health resources cannot effectively improve access to BPHS by older adult migrants. Instead, the driving force appears to be supportive policies for the migrant population.<\/jats:p>","DOI":"10.3390\/ijerph18010270","type":"journal-article","created":{"date-parts":[[2020,12,31]],"date-time":"2020-12-31T20:18:47Z","timestamp":1609445927000},"page":"270","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Basic Public Health Service Utilization by Internal Older Adult Migrants in China"],"prefix":"10.3390","volume":"18","author":[{"given":"Dan","family":"Tang","sequence":"first","affiliation":[{"name":"Center for Population and Development Studies, Renmin University of China, Beijing 100872, China"},{"name":"Institute of Gerontology, Renmin University of China, Beijing 100872, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5764-1971","authenticated-orcid":false,"given":"Jiwen","family":"Wang","sequence":"additional","affiliation":[{"name":"Center for Population and Development Studies, Renmin University of China, Beijing 100872, China"},{"name":"Population Studies and Training Center, Brown University, Providence, RI 02912, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,1]]},"reference":[{"key":"ref_1","unstructured":"National Bureau of Statistics (2019). China Statistical Yearbook 2019, China Statistics Press."},{"key":"ref_2","unstructured":"National Health and Family Planning Commission (2016). China Floating Population Development Report, China Population Press."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Wang, Q. (2017). Health of the Elderly Migration Population in China: Benefit from Individual and Local Socioeconomic Status?. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14040370"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1016\/S0140-6736(08)61360-4","article-title":"Internal migration and health in China","volume":"372","author":"Hu","year":"2008","journal-title":"Lancet"},{"key":"ref_5","first-page":"389","article-title":"Late-Life Immigration, Changes in Living Arrangements, and Headship Status among Older Mexican-Origin Individuals","volume":"81","author":"Angel","year":"2000","journal-title":"Soc. Sci. Q."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.geoforum.2013.04.013","article-title":"Ageing, migration and familial support in rural China","volume":"51","author":"Liu","year":"2014","journal-title":"Geoforum"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1111\/j.1747-7379.2002.tb00091.x","article-title":"Rural Migrants in Shanghai: Living under the Shadow of Socialism","volume":"36","author":"Feng","year":"2002","journal-title":"Int. Migr. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/S2213-8587(15)00438-6","article-title":"Health and lifestyle changes among migrant workers in China: Implications for the healthy migrant effect","volume":"4","author":"Salazar","year":"2016","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1017\/S0047279413000329","article-title":"The Chinese Welfare State in Transition: 1988\u20132007","volume":"42","author":"Gao","year":"2013","journal-title":"J. Soc. Policy"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1002\/app5.294","article-title":"The evolution of health policy in China and internal migrants: Continuity, change, and current implementation challenges","volume":"7","author":"Zheng","year":"2020","journal-title":"Asia Pac. Policy Stud."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Li, T., Lei, T., Xie, Z., and Zhang, T. (2016). Determinants of basic public health services provision by village doctors in China: Using non-communicable diseases management as an example. BMC Health Serv. Res., 16.","DOI":"10.1186\/s12913-016-1276-y"},{"key":"ref_12","first-page":"66","article-title":"Interactive mechanism of the floating population\u2019s health equity and social integration","volume":"9","author":"Yang","year":"2016","journal-title":"Chin. J. Health Policy"},{"key":"ref_13","unstructured":"Government, Chinese National Health and Family Planning Commitment 2011 (2020, March 03). Development of China\u2019s Public Health as an Essential Element of Human Rights, Available online: http:\/\/en.nhc.gov.cn\/2019-04\/29\/c_75161.htm."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12992-019-0486-6","article-title":"The development and reform of public health in China from 1949 to 2019","volume":"15","author":"Wang","year":"2019","journal-title":"Glob. Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12913-018-3271-y","article-title":"Analysis of health service utilization of migrants in Beijing using Anderson health service utilization model","volume":"18","author":"Shao","year":"2018","journal-title":"BMC Health Serv. Res."},{"key":"ref_16","unstructured":"Zheng, Y. Health Policy in China and Rural to Urban Migrants, Unpublished Report."},{"key":"ref_17","first-page":"34","article-title":"A study on the financing mechanism of prompting the equalized supply of basic public health services for China\u2019 migrant population","volume":"4","author":"Duan","year":"2016","journal-title":"Popul. Econ."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1177\/0733464815587966","article-title":"Elderly Migration in China: Types, Patterns, and Determinants","volume":"36","author":"Dou","year":"2015","journal-title":"J. Appl. Gerontol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Li, H., Chung, R.Y.-N., Wei, X., Mou, J., Wong, S.Y.-S., Wong, M.C.S., Zhang, D., Zhang, Y., and Griffiths, S.M. (2014). Comparison of perceived quality amongst migrant and local patients using primary health care delivered by community health centres in Shenzhen, China. BMC Fam. Pract., 15.","DOI":"10.1186\/1471-2296-15-76"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.vhri.2017.04.001","article-title":"Healthy China 2030: A Vision for Health Care","volume":"12","author":"Tan","year":"2017","journal-title":"Value Health Reg. Issues"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Zhang, J., Lin, S., Qian, Y., Qian, Y., Zhang, D., and Hou, Z. (2017). Public Health Services Utilization and Its Determinants among Internal Migrants in China: Evidence from a Nationally Representative Survey. Int. J. Environ. Res. Public Health, 14.","DOI":"10.20944\/preprints201707.0038.v1"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"010807","DOI":"10.7189\/jogh.10.010807","article-title":"Improving the utilization of essential public health services by Chinese elderly migrants: Strategies and policy implication","volume":"10","author":"Tang","year":"2020","journal-title":"J. Glob. Health"},{"key":"ref_23","first-page":"101","article-title":"Analysis on the establishment of health records and health education status of floating population in Shanghai","volume":"14","author":"Nie","year":"2016","journal-title":"Chin. J. Gen. Pract."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Tian, M., Wang, H., Tong, X., Zhu, K., Zhang, X., and Chen, X. (2015). Essential Public Health Services\u2019 Accessibility and its Determinants among Adults with Chronic Diseases in China. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0125262"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.socscimed.2017.08.025","article-title":"Rural-urban disparities in unmet long-term care needs in China: The role of the hukou status","volume":"191","author":"Zhu","year":"2017","journal-title":"Soc. Sci. Med."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Sun, X., Chen, Y., Tong, X., Feng, Z., Wei, L., Zhou, D., Tian, M., Lv, B., and Feng, D. (2014). The use of annual physical examinations among the elderly in rural China: A cross-sectional study. BMC Health Serv. Res., 14.","DOI":"10.1186\/1472-6963-14-16"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s12939-017-0585-z","article-title":"Rural-urban difference in the use of annual physical examination among seniors in Shandong, China: A cross-sectional study","volume":"16","author":"Ge","year":"2017","journal-title":"Int. J. Equity Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1523","DOI":"10.1080\/13607863.2019.1602589","article-title":"Moving beyond living arrangements: The role of family and friendship ties in promoting mental health for urban and rural older adults in China","volume":"24","author":"Tang","year":"2020","journal-title":"Aging Ment. Health"},{"key":"ref_29","unstructured":"Kominski, G.F. (2013). Improving Access to Care in America: Individual and Contextual Indicator. Changing the U.S. Health Care System: Key Issues in Health Service, Policy and Management, Jossey-Bass. [4th ed.]."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2307\/2137284","article-title":"Revisiting the Behavioral Model and Access to Medical Care: Does it Matter?","volume":"36","author":"Andersen","year":"1995","journal-title":"J. Health Soc. Behav."},{"key":"ref_31","first-page":"129","article-title":"Urban inclusiveness and entrepreneurship: Evidence from microdata on migrants","volume":"41","author":"Zhou","year":"2020","journal-title":"Financ. Trade Econ."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.chieco.2005.02.002","article-title":"Spatial inequality in education and health care in China","volume":"16","author":"Zhang","year":"2005","journal-title":"China Econ. Rev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.2105\/AJPH.2005.068007","article-title":"Privatization of Public Services: Organizational Reform Efforts in Public Education and Public Health","volume":"96","author":"Gollust","year":"2006","journal-title":"Am. J. Public Health"},{"key":"ref_34","unstructured":"Government of P.R.C. (2020, March 03). China to Promote Uniform Public Service, Available online: http:\/\/english.www.gov.cn\/policies\/latest_releases\/2017\/03\/01\/content_281475581540604.htm."},{"key":"ref_35","first-page":"91","article-title":"Re-revisiting Andersen\u2019s behavioral model of health services use: A systematic review of studies from 1998\u20132011","volume":"9","author":"Babitsch","year":"2012","journal-title":"GMS Psycho Soc. Med."},{"key":"ref_36","unstructured":"Raudenbush, S.W., and Bryk, A.S. (2002). Hierarchical Linear Models: Applications and Data Analysis Methods, Sage Publications. [2nd ed.]."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12939-017-0523-0","article-title":"What limits the utilization of health services among china labor force? Analysis of inequalities in demographic, socio-economic and health status","volume":"16","author":"Lu","year":"2017","journal-title":"Int. J. Equity Health"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"15","DOI":"10.3389\/fpubh.2013.00015","article-title":"Self-Rated Health and Public Health: A Critical Perspective","volume":"1","author":"Bombak","year":"2013","journal-title":"Front. Public Health"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"535","DOI":"10.5993\/AJHB.31.5.9","article-title":"Do Latino Immigrants Link Self-rated Health with BMI and Health Behaviors?","volume":"31","author":"Kepka","year":"2007","journal-title":"Am. J. Health Behav."},{"key":"ref_40","first-page":"28","article-title":"The Effects of Unemployment Rate on Health Status of Chinese People","volume":"44","author":"Wang","year":"2015","journal-title":"Iran. J. Public Health"},{"key":"ref_41","first-page":"17","article-title":"Influencing factors of basic public health service utilization of the migrant older adults","volume":"11","author":"Tang","year":"2018","journal-title":"Chin. J. Health Policy"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/1\/270\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:06:02Z","timestamp":1760159162000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/1\/270"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,1]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,1]]}},"alternative-id":["ijerph18010270"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18010270","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,1]]}}}