Inequalities on the use of Primary Health Care between Drifting Elderly and the Locals: A Comparison Study on health risks in Dalian, China

Background A growing number of Chinese parents’ generation relocated to the cities where their children live for providing grandchild care or being cared, but the issue of health and well-being among these drifting elderly has become a new challenge for primary health care system. Methods This data used in the study from the China Migration Dynamics Survey and Dalian Residents’ Health-Seeking Behavior Survey. Using ordered Probit regression model to examine the disparities in community care utilization between drifting elderly and the local elders, and using decomposed concentration index to quantify horizontal equity and vertical equity. Results Both the concentration index of primary health care utilization among two elderly groups shows pro-rich inequalities. But the underlying drivers differ markedly. For the drifting elderly, feelings of loneliness, pension status and medical insurance are the main factors affecting inequalities of community care utilization, contributing 73%, 36% and 24%. For the local elders, daily activity duration and access time to the nearest facility are the primary factors, contributing 43% and 77%. Conclusion The analysis results reveal that socio-spatial environmental factors contributed significantly to the inequities of primary health care utilization among the drifting elderly. The quality of neighborhood social integration and the equitable dissemination of health information are fundamental drivers to the equality.