Health Insurance and Basic Public Health Service Coverage Among the Floating Population in Hubei Province, 2014-2017

China's floating population has grown significantly due to rapid economic development and urbanisation. However, this population faces substantial barriers to accessing and utilising health services. Identifying factors affecting health service coverage and access among the floating population is essential for guiding targeted interventions to improve overall population health.

This study aims to explore the trends and socio-demographic factors influencing health insurance and public health service coverage among the floating population in Hubei Province from 2014 to 2017.

We performed a trend and regression analysis on data collected from 2014, 2015, 2016 and 2017 in Hubei Province from the China Migrant Population Dynamics Monitoring Survey. The data included socio-demographic and economic characteristics and health insurance coverage. Local health care record establishments and health education access were measured as indicators of basic public health service coverage.

From 2014 to 2017, 89.01%, 93.45%, 88.49% and 93.37% of respondents, respectively, were covered by at least one type of basic health insurance. During the same period, the establishment of local health records increased from 45.36% in 2014 to 64.52% in 2016, before declining to 36.90% in 2017. Additionally, 83.24%, 90.95%, 89.11%, and 64.11% of respondents, respectively, received health education. While progress was made in improving health service infrastructure, its growth was inconsistent and lacked sustainability. Factors associated with higher local health record coverage included long floating time, individual household employment status, willingness for long-term residence, and medical insurance coverage. Factors influencing access to health education varied annually.

Efforts should be directed towards optimising health insurance policies, adjusting the allocation of medical resources, and strengthening community health services to enhance health care capacity in areas with a high concentration of floating populations. These measures can help improve local public health service coverage and health information access among the floating population.