Survey study reveals distinct healthcare access models shape settlement horizons in older Chinese migrants, highlighting the need to reform medical portability for urban integration.
Key Points
To examine how public healthcare service utilization—contrasting local insurance enrollment against cross-regional portability—affects the settlement intentions of older retired migrants in China.
Analyzed nationally representative survey data from 5,002 older migrants who reached the statutory retirement age in China.
Assessed four public healthcare utilization indicators: destination-based insurance, origin-based insurance with direct settlement, local health record creation, and health education participation.
Applied multinomial probit models to assess categorical settlement choices (no intention, short-term, or long-term) and examined the moderating role of origin–destination disparities in medical provision.
Older migrants enrolled in destination-based medical insurance were significantly more likely to report long-term settlement intentions.
Older migrants relying on origin-based insurance with cross-regional portability exhibited a greater tendency toward short-term rather than long-term settlement intentions.
Establishing a local resident health record increased long-term settlement intentions, with origin–destination healthcare supply disparities significantly moderating these relationships.