OBJECTIVES : There has been an increase in migrants both within countries and internationally in terms of urbanization and globalization. Although these older migrants have worse health status and higher health needs, older migrants motivated by escape from economic hardship are more likely to be from lower socioeconomic groups and vulnerable to healthcare access. Thus, this study aims to examine the differences in the use of health services among older migrants with different migrating reasons and explore the factors and paths regarding why they use insufficient healthcare.

METHODS : The data were derived from a national cross-sectional dataset of the 2015 Chinese Migrant Dynamic Monitoring Survey. The population of interest was older Chinese migrants – migrating for employment (N=2303), caring offspring (N=3756), and retirement (N=3902). Path Analysis was conducted to explore the paths in the use of health services among older migrants with different migrating reasons.

RESULTS : The use of visiting doctors in all the populations was no more than one-half. Older migrants migrating for employment were less likely to visit doctors, while they were more likely to be healthy, had less monthly household expenditure, longer migrating duration, and local health insurance. An association among physical health status, visiting doctors, and household expenditure was observed in older migrants migrating for employment and enjoyment, while it was not observed in older migrants migrating for retirement, so was the association among migrating duration, health insurance, migrating range.

CONCLUSIONS : With the effects of health expenditure and local health insurance, older migrants with worse health status are more likely to have less health expenditure, migrate more extensively, and not have local health insurance, which incurred a decreased use of health services. Health policies that may be worthy of consideration include further enhancing the delivery capacity of primary health institutions, and launching the target policies to improve the accessibility of healthcare.