Different health utilization

In Mou et al, 2009, the authors try to elucidate the different health utilization and states of health reported in an undeserved region of China, overpopulated with factory workers that are either insured or not insured. The importance of their study lies in the contexts of primary research in the fields of health disparities. It is important to research communities that are suffering from conditions such as poverty and overpopulation, not only to finds ways to alleviate their suffering but because these communities provide with original research findings in the fields of health disparities research. Communities in the midst of developed countries are overwhelmed with existing problems, but disparities research often seems to reach a dead end due to the overlapping of socioeconomic and various other factors that obscure the research process of identifying true causes. On a primary research context however, communities emerged in deep poverty and disadvantage present with more homogeneity and larger study samples for the study of effects and causes in health disparities, as does the present study by Mou et al,2009.

What was the hypothesis?

A new insurance scheme was recently initiated for migrant workers at the region Shenzhen, China. The hypothesis of the present study was that socio-demographic factors, self-rated and reported health (SRH) and health service utilisation among insured and uninsured migrant workers are different and thus quality of health depends on the presence or not of an insurance policy.

What study design was implemented (cohort, case control, cross-sectional etc.)?

A cross-sectional survey using multiple-factors random sampling was used to collect information from migrant factory workers in region Shenzhen, China. Later, logistic regression analysis was used to analyze the results of the survey.

What are the types/classification of the variables?

The main variables were socio-demographic variables such as "age, sex, education, marital status, occupation, monthly income, living expenses, medical expenditure, and current health insurance status of the recent year". Also, the survey measured the self-reported health (SRH), outpatient and inpatient healthcare usage, and characteristics of the used health units. As for the classification of these variables; these are in the social-demographic range and in the health utilization range.

How were the variables operationalized?

Questionnaires were used and were administered by registered physicians. Ethical consent was required prior to their administration. As the authors state...: "The questionnaire was derived from an original questionnaire designed for use amongst general Chinese populations by the Ministry of Health of China".

Were the instruments validated (i.e. against measures obtained using a different instrument)?

No. The survey instruments were not validated by comparison to other widely accepted instruments in this field of study. However, the authors use a governmental instrument that conveys a significant amount of status quo and certainty as to its applicability in the study setting.


  • Centre for Health Statistic and Information, Minister of Health, China: Abstract of the report on the 3rd National Health Service Survey and analysis. Chinese Hospital 2005, 9(1):4-11.
  • Mou J, Cheng J, Zhang D, Jiang H, Lin L & Griffiths SM. Health care utilisation amongst Shenzhen migrant workers: does being insured make a difference? BMC Health Serv Res. 2009 ; 9:214

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