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. 2017 Aug 12;14(8):910.
doi: 10.3390/ijerph14080910.

Study on the Status of Health Service Utilization among Caregivers of Left-Behind Children in Poor Rural Areas of Hunan Province: A Baseline Survey

Meimei Ji  1 , Yefu Zhang  2 , Jiaojiao Zou  3 , Tong Yuan  4 , Amber Tang  5 , Jing Deng  6 , Lina Yang  7 , Mingzhi Li  8 , Jihua Chen  9 , Hong Qin  10 , Qian Lin  11
Affiliations

Study on the Status of Health Service Utilization among Caregivers of Left-Behind Children in Poor Rural Areas of Hunan Province: A Baseline Survey

Meimei Ji et al. Int J Environ Res Public Health. .

Abstract

Background: The caregivers of left-behind children (CLBC) in China's poor, rural areas are mostly elderly and women. Their health status and access to health services have not been previously characterized. This study aims to explore the status of CLBC in terms of their health service utilization and to provide a scientific basis for guiding effective implementation of health policy in rural Hunan.

Methods: Random cluster sampling was used to survey CLBC in two rural counties. Face-to-face interviews and questionnaires were used to collect data, including socioeconomic status and health service utilization. The two-week prevalence rate was used to reflect health service needs, while the two-week visiting rate, annual hospitalization rate and participation in basic public health services were used to evaluate health service utilization.

Results: Of the 518 respondents in the study, 95.9% were farmers and 88.4% were over 40 years old. The two-week prevalence rate was 36.1%. Furthermore, 40.1% of ill caregivers' activities were partly restricted by illness and 3.7% needed to be on bed rest. The two-week visiting rate was 21.0%. The main reasons for not seeing a doctor were "self-medication" (39.1%) or "financial difficulties" (32.6%). The annual hospitalization rate of the CLBC was 22.6% and the non-hospitalization rate of those who needed hospitalization was 41.5%. "Lack of time" (22.3%) and "financial difficulties" (50.5%) were the major factors affecting the utilization of hospitalization services. In terms of participation in basic public health services, only 35.1% CLBC clearly knew that township hospitals have established health records for them. Only 50.6% of caregivers received free health examinations in village clinics or township hospitals and 81.3% of the caregivers did not participate in health education or lectures organized by local health institutions in 2014.

Conclusions: The utilization rate of health services was extremely low, which may affect the quality of care for left-behind children. Better public health education through multi-sector cooperation is urgently needed to improve health cognition among CLBC in rural China.

Keywords: China; caregiver; health service utilization; left-behind children; rural area.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Reasons for not seeing a doctor after developing diseases among caregivers in the past two weeks.
Figure 2
Figure 2
Reasons for those who should be hospitalized without hospitalization among caregivers in 2014.
See this image and copyright information in PMC

References

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    1. Niu T.H., Meng Q.Y., Wang G.D. The study on the status of the utilization of the Health services of the Shandong province rural elders and its influencing factors. Chin. Prim. Health Care. 2010;24:7–8. (In Chinese)
    1. Zhang M.Y. The Study about Left-Behind Children Guardinas’s Social Capitals’ Influence towards Health Service Utilization in Yanbian Area. Yanbian University; Jilin, China: 2013. (In Chinese)
    1. Tu D. Investigation and Analysis to the Basic Medical and Health Service Needs of the Rural Elderly with Migrant Children in Chongqing. Chongqing Medical University; Chongqing, China: 2015. (In Chinese)
    1. Xiao Y.Z. Research on Life Quality and Health Service Utilization among the Elder Left-Behind Population in Henyang County of Hunan Province. Central South Univerty; Hunan, China: 2010. (In Chinese)

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