Cross-border healthcare seeking behavior: a study of Myanmar patients in Ruili, China

Abstract

With globalization and regionalization, traditional borders often present fewer barriers to the sharing of resources, particularly in the context of cross-border healthcare. This trend is driven by cost, medical technology, healthcare quality, and other factors. The study aimed to examine the overall pattern of cross-border healthcare seeking behavior among Myanmar patients in Ruili, China, evaluate the accessibility of healthcare services in China, and identify determinants of healthcare seeking behavior during the decision-making process. Data were collected using a structured questionnaire from three healthcare providers in Ruili, China, supplemented by secondary data from the Health Commission of Dehong, as well as in-depth interviews with nine Myanmar cross-border patients and were analyzed using content analysis. Results from our study indicate that in 2020 there were an estimated 30,032 Myanmar cross-border patients who sought healthcare in Ruili, China (14% in-patients and 86% out-patients): 90% used services at county-level and equivalent hospitals in Ruili, while 10% used services at primary healthcare institutions. Most of the patients were fluent speakers of the Mandarin. The in-depth interviews revealed that Myanmar cross-border patients were willing to seek healthcare services in Ruili. Analysis using Kroeger's model shows that patients primarily from the Han and Kachin/Jingpo ethnic groups (aged 20-60) seek advanced medical equipment and modern facilities in Ruili, despite the higher costs there compared to Myanmar. While staff experiences vary, accessibility of technology drives their decision, suggesting a shift in cross-border healthcare priorities. This study provides insights for improving border region healthcare systems and informs future research on cultural influences, language barriers, and broader system impacts.