Socio-Economic Variation in Health Care Utilization among Middle Aged and Older Migrants in India

Amar Bharti, International Institute for Population Sciences (IIPS)
Suraj Maiti, Virginia Tech
Reshmi R.S., International Institute for Population Sciences

Multiple complex factors shape healthcare utilization among middle-aged and elderly migrants, with socioeconomic disparities being critical. This study is the first to leverage data from the nationally representative Longitudinal Ageing Study of India (LASI) 2017-18 to examine migrant healthcare utilization and socioeconomic variation in Indian context. Using a stepwise logistic regression model, a modified version of Andersen's Health Behaviour Model was utilised to identify healthcare use determinants. Socioeconomic inequality in inpatient and outpatient healthcare utilisation was examined using erreyger’s concentration indices and concentration curves. The study found that Females (0.75, 95% CI 0.57, 0.98) have lower odds of using outpatient care among middle-aged and older migrants. Schedule tribes are less likely than scheduled castes to seek outpatient care (0.72 95% CI 0.60,0.84). These indicate that vulnerable migrants utilise healthcare less. Socio-economic factors like consumption quintiles, health insurance coverage, and working status, and need factors like self-reported health state and presence of morbidities, influence migrant healthcare utilisation. Concentration indices indicate pro-rich (outpatient: 0.049, 95% CI 0.02, 0.7); inpatient: 0.19, 95% CI 0.13, 0.21) inequality in healthcare utilization, with variations across regions of India. For egalitarian healthcare and universal health coverage in India, disadvantaged elderly migrants must have access to affordable healthcare.

Keywords: Internal Migration and Urbanization, Health and Morbidity, Older Adults and Intergenerational Relations, Migrant Populations and Refugees

See extended abstract.