社会融入对流动人口健康档案建立的影响

Effect of social integration on establishment of health records among internal migrants in China

目的了解流动人口健康档案建立现状,探索社会融入对流动人口健康档案建立的影响。方法数据来自2014年全国流动人口动态监测调查。社会融入通过经济融入、行为适应、文化融入和身份认同四个维度进行衡量。考虑到区域发展水平的异质性,采用多水平Logistic回归模型,分析社会融入对流动人口健康档案建立的影响。结果在13865名流动人口中,仅有24%的流动人口建立健康档案。多水平Logistic回归分析结果显示,每周工作天数≥5 d(OR=0.84,95%CI:0.76~0.94)会降低流动人口建立健康档案的可能性;家庭月均收入5000~7000元(OR=1.26,95%CI:1.10~1.45)、家庭月均收入7000元以上(OR=1.30,95%CI:1.13~1.50)、签订劳动合同(OR=1.38,95%CI:1.21~1.57)、参与社会组织(OR=1.35,95%CI:1.21~1.50)、参与社区活动(OR=1.75,95%CI:1.58~1.94)、打算在本地长期居住(OR=1.22,95%CI:1.11~1.36)、认为自己是本地人(OR=1.36,95%CI:1.22~1.51)均会增加流动人口建立健康档案的可能性。结论良好的社会融入程度与较高的健康档案建立率有关。提高流动人口在迁入地社会融入水平的干预措施可能会改善流动人口对健康档案的建立。同时,应该加强健康档案服务的宣传,提高流动人口建档意识。

Objective To explore the association between social integration and the establishment of health records among the internal migrants.Methods This study used cross-sectional data from the National Internal Migrant Dynamic Monitoring Survey in 2014.Social integration was measured through four dimensions:economic integration,behavioral adaptation,acculturation,and self-identity.Multilevel Logistic regression models were used to explore the association between social integration and the establishment of health records for considering heterogeneity in the level of regional development.Results Among a total of 13865 internal migrants,only 24%of the internal migrants established health records.Multilevel Logistic regression model showed that working days over 5 days per week(OR=0.84,95%CI:0.76-0.94)could reduce the possibility of establishing health records;the average monthly household income 5000-7000 yuan(OR=1.26,95%CI:1.10-1.45)and over 7000 yuan(OR=1.30,95%CI:1.13-1.50),signing of labour contracts(OR=1.38,95%CI:1.21-1.57),participation in social organizations(OR=1.35,95%CI:1.21-1.50)and community activities(OR=1.75,95%CI:1.58-1.94),intending to live locally(OR=1.22,95%CI:1.11-1.36),thinking of themselves as a local(OR=1.36,95%CI:1.22-1.51)increased the possibility of migrant population establishing health records.Conclusions A higher degree of social integration might associate with higher establishment of health records.Intervention aimed at improving social integration could effectively increase the probability of the establishment of health records for internal migrants.The government should strengthen the publicity of health records services,and increase the awareness of the establishment of health records for the internal migrants.