上海市外来务工人员体检的健康自评研究

Health self-assessment of the migrant workers received physical examination in Shanghai

【目的】了解上海市参加体检的外来务工人员的健康自评及相关影响因素,为制定相应的外来务工人员健康服务政策提供参考依据。【方法】以上海市“智慧蓝领”健康科普服务站为调查点,对8100名城镇劳动者进行问卷调查。问卷包括基本信息、健康自评、基本医保参保率及满意度、主观幸福感等情况。【结果】外来务工人员的健康自评、2周患病率和慢性病患病率与本地劳动者比较差异有统计学意义(χ^(2)=32.981,P<0.05;χ^(2)=4.554,P<0.05;χ^(2)=86.695,P<0.05)。基本医保参保率、保障水平满意度与本地劳动者比较,差异有统计学意义(χ^(2)=221.592,P<0.05;χ^(2)=30.950,P<0.05)。主观幸福感与本地劳动者比较,差异无统计学意义(χ^(2)=8.787,P>0.05)。年龄较大的外来务工人员健康自评显著优于新生代外来务工人员(β=0.062,P<0.05)。女性外来务工人员健康自评显著差于男性(β=−0.120,P<0.05)。农业户口外来务工人员健康自评显著优于非农业户口(β=0.060,P<0.05)。基本医保保障水平满意度越高,主观幸福感越强,健康自评越好(β=0.148,P<0.05;β=0.422,P<0.05)。【结论】上海市参加体检的外来务工人员健康状况优于本地劳动者,基本医保参保率低于本地劳动者,年龄、性别和户籍是影响健康自评的重要因素,基本医保保障水平满意度和主观幸福感可以显著正向预测健康自评。需进一步提高外来务工人员医保受益公平性,提升主观幸福感,切实维护该群体的健康公平性。

[Objective]To understand the health self-assessment and related influencing factors in the migrant workers who received of physical examination in Shanghai,so as to provide reference for formulating health service policies for migrant workers.[Methods]Taking Shanghai"Intelligent Blue Collar"Health Science Popularization Service Station as the investigation site,8,100 urban workers were surveyed by questionnaire.The questionnaire includes basic information,health self-assessment,basic medical insurance coverage and satisfaction,subjective well-being and so on.[Results]There were significant differences between migrant workers and local workers in health self-assessment,two-week disease prevalence rate,and chronic disease prevalence rate(χ^(2)=32.981,P<0.05;χ^(2)=4.554,P<0.05;χ^(2)=86.695,P<0.05).The differences between migrant workers and local workers were also significant in the basic medical insurance coverage rate and the level of satisfaction(χ^(2)=221.592,P<0.05;χ^(2)=30.950,P<0.05).There was no significant difference in subjective well-being between these two groups(χ^(2)=8.787,P>0.05).The health self-assessment of older migrant workers was significantly better than that of new generation migrant workers(β=0.062,P<0.05),and was significantly worse in female migrant workers than that in male migrant workers(β=−0.120,P<0.05).The health self-assessment was significantly better in migrant workers with agricultural household registration than that in non-agricultural household registration(β=0.060,P<0.05).The higher the satisfaction of basic medical insurance,the higher the subjective well-being and the better the health self-assessment(β=0.148,P<0.05;β=0.422,P<0.05).[Conclusion]The health status of migrant workers in Shanghai who received physical examination is better than that of local workers,and the participation rate of basic medical insurance is lower than that of local workers.Age,gender and household registration are the important factors influencing the health selfassessment.Satisfaction with basic medical insurance level and subjective well-being is a significant factor to predict health self-assessment positively.We should further improve the fairness of medical insurance benefits for migrant workers,improve subjective well-being,and ensure the health fairness of the group.