Effect of social integration on family doctor contracting services among migrant populations in China: a national cross-sectional survey

Abstract

Abstract Background The family doctor (FD) contracting system is a key reform in the development of the Chinese health system, and is considered an effective way to ensure equitable access to healthcare services. This study investigates the effects of social integration on FD contracting services among migrant populations. Methods In total, 120,106 respondents from the 2018 China Migrants Dynamic Survey were included in this study. Two multivariate regression models were used to estimate the effect of social integration and other factors on FD contracting services among migrant populations. Results This study found that only 14.0% of the migrant populations had a FD. Multiple dimensions of social integration and some covariates were shown to be positively associated with FD contracting services, including average monthly household income, local medical insurance (odds ratio [OR] = 1.34, 95% confidence interval [CI] = 1.29–1.39), employment status (OR = 0.86, 95% CI = 0.82–0.91), settlement intention (OR = 1.15, 95% CI = 1.09–1.22), received health education (OR = 4.88, 95% CI = 4.51–5.27), sex (OR = 1.16, 95% CI = 1.12–1.20), age (OR = 1.66, 95% CI = 1.51–1.82), marital status (OR = 1.38, 95% CI = 1.31–1.46), sickness within a year (OR = 0.84, 95% CI = 0.79–0.89), and flow range (OR = 1.12, 95% CI = 1.07–1.16). Conclusions All dimensions of social integration, including economic integration, social identity, and social involvement, are associated with FD contracting services among migrant populations. Policymakers should focus on improving the signing rates of migrant populations and implement more effective measures to enhance their social integration, such as settlement incentives and encouraging social participation.