政府数字化转型与中国流动人口对基本公共卫生服务的利用。

IF 3.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH BMC Public Health Pub Date : 2024-11-22 DOI:10.1186/s12889-024-20730-3
Haowen Jia
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引用次数: 0

摘要

研究背景本研究探讨了政府数字化转型(GDT)对中国流动人口使用基本公共卫生服务(BPHS)的影响。在数字化融入公共服务不断升级的框架下,当务之急是评估政府数字化转型举措如何能够改善流动人口的医疗服务使用情况。这种审查对于制定以证据为基础的政策,利用数字创新来减少医疗差距至关重要:分析采用了 2018 年中国移民动态调查的数据,并与地市级国家信息惠民政策试点城市的详细情况进行了比对,得出了一个包含 113905 个观测值的数据集。为衡量流动人口的基本医疗卫生服务使用情况,我们制定了两个指标:建立健康档案和家庭医生登记。在初步分析中,利用普通最小二乘法回归估算了GDT对BPHS使用情况的影响,同时纳入了一系列全面的个人和家庭属性以及省份固定效应,以确保评估的全面性:基线回归分析表明,GDT 与移民建立健康档案和向家庭医生登记的概率显著相关,分别增加了 7.53% 和 2.75%。随后进行的稳健性检查,包括使用替代因变量、倾向得分匹配法、双重/偏差机器学习法和安慰剂测试进行的敏感性分析,进一步证实了这些发现。此外,分析还探讨了 GDT 促进 BPHS 获取的机制,发现健康信息的可获取性是促进移民参与医疗保健的重要中介因素。值得注意的是,在 GDT 的影响中观察到了个体和地区的异质性:女性移民、教育水平较低者、年龄较大者和农村户口持有者的受益更明显,而在 GDP 较低和人口较少的城市,GDT 的影响也更强。这些研究结果表明,在经济或人口条件受限的地区,全球分级诊疗在缩小医疗服务差距方面尤为有效:研究结果表明,全球数据传输大大提高了移民对基本保健服务的利用率,将数字治理定位为缩小医疗服务差距的一种有效机制。观察到的对不同亚群和地区的不同影响强调了定制数字医疗战略的重要性,以满足移民社区的不同需求。例如,在国内生产总值较低或较小的城市采取有针对性的干预措施,可以最大限度地提高全球数据传输在资源不足地区的效益。这项研究为有关数字治理和公共卫生的实证研究做出了贡献,倡导扩大部署全球数据传输倡议,以促进为移民人口提供更公平的卫生服务,在快速城市化的社会中促进包容性。
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Government Digital Transformation and the utilization of Basic Public Health Services by China's migrant population.

Background: This research delves into the ramifications of Government Digital Transformation (GDT) on Basic Public Health Services (BPHS) utilization among China's migrant populace. Within the framework of escalating digital incorporation into public services, it becomes imperative to assess how GDT initiatives could ameliorate healthcare access for migrants, a group habitually confronted with systemic obstacles. Such scrutiny is crucial for the formulation of evidence-based policies that harness digital innovations to mitigate healthcare disparities.

Methods: The analysis employs data from the 2018 China Migrants Dynamic Survey, matched with details on the National Pilot Cities for Information Benefit to the Public policy at the prefecture city level, yielding a dataset comprising 113,905 observations. To gauge BPHS utilization among migrants, two indicators were developed: the establishment of health records and registration with family doctors. The influence of GDT on BPHS access was estimated utilizing Ordinary Least Squares regression for the initial analysis, incorporating a comprehensive array of individual and household attributes, alongside province fixed effects, to ensure a thorough evaluation.

Results: Baseline regression analyses revealed that GDT is significantly correlated with an enhanced probability of migrants establishing health records and registering with family doctors, with increases of 7.53% and 2.75%, respectively. Subsequent robustness checks, including sensitivity analyses with alternate dependent variables, the Propensity Score Matching method, Double/Debiased Machine Learning method, and placebo tests, further substantiated these findings. Additionally, the analysis explored mechanisms through which GDT facilitates BPHS access, identifying health information accessibility as a significant mediator in promoting healthcare engagement among migrants. Notably, both individual and regional heterogeneity were observed in GDT's impact: female migrants, those with lower educational levels, older individuals, and rural hukou holders experienced more pronounced benefits, while the effects of GDT were also stronger in cities with lower GDP and smaller populations. These findings suggest that GDT is particularly effective in bridging healthcare access gaps in economically or demographically constrained areas.

Conclusions: The outcomes underscore that GDT significantly enhances BPHS utilization among migrants, positioning digital governance as an instrumental mechanism in bridging healthcare access gaps. The observed differential impacts across various subgroups and regions emphasize the importance of customized digital health strategies that cater to the diverse needs of migrant communities. For instance, targeted interventions in lower-GDP or smaller cities could maximize the benefits of GDT in under-resourced areas. Contributing to the body of empirical evidence on digital governance and public health, this research advocates for the expanded deployment of GDT initiatives to foster more equitable health service provision for migrant demographics, promoting inclusivity within a rapidly urbanizing society.

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来源期刊
BMC Public Health
BMC Public Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.50
自引率
4.40%
发文量
2108
审稿时长
1 months
期刊介绍: BMC Public Health is an open access, peer-reviewed journal that considers articles on the epidemiology of disease and the understanding of all aspects of public health. The journal has a special focus on the social determinants of health, the environmental, behavioral, and occupational correlates of health and disease, and the impact of health policies, practices and interventions on the community.
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