College of Economics and Management, Shenyang Agricultural University, Shenyang, 110866, Liaoning, China.
College of Liberal Arts, Shanxi Agricultural University, Jinzhong, 030801, Shanxi, China.
Public Health. 2020 Apr;181:141-150. doi: 10.1016/j.puhe.2019.12.011. Epub 2020 Feb 28.
To provide an evaluation of medical expenditures induced by depression and depressive symptoms among rural elderly in China.
The panel dataset used for this study is taken from the China Family Panel Studies (CFPS) data for the years 2012 and 2016. We examined the case of rural elderly who were 60 years old or older at the time of the 2012 survey and 64 years old or older at the time of the 2016 survey and then created a panel dataset that includes 2938 rural elderly for both years to estimate the influence of depressive symptoms/depression on medical cost.
Both two part model and four part model were used to estimate the influence of depressive symptoms and depression on medical expenditure. Then a counter-factual method was used to calculate the cost of depressive symptoms and depression among rural elderly in China.
Mental health status has significant effects on individual medical expenses, and they aggregately contribute to 47.26% of total personal expected medical expenditures. Specifically, the rural group, the female group, the widowed group, and the poorly educated group have higher medical expenditures because of depressive status than the other groups.
Mental health status significantly increased both the chance of undergoing medical care and the degree of medical expenditure among rural elderly in China. This situation is more serious in some vulnerable groups. Therefore, the Chinese government needs to reform its mental health of rural elderly and insurance institutions to eliminate the policy-caused barriers to mental health resources, especially for vulnerable groups.
评估中国农村老年人抑郁和抑郁症状导致的医疗支出。
本研究使用的面板数据集来自中国家庭追踪调查（CFPS）2012 年和 2016 年的数据。我们考察了 2012 年调查时年龄在 60 岁及以上、2016 年调查时年龄在 64 岁及以上的农村老年人的情况，然后创建了一个包含这两年的 2938 名农村老年人的面板数据集，以估计抑郁症状/抑郁对医疗费用的影响。
采用两部分模型和四部分模型来估计抑郁症状和抑郁对医疗支出的影响。然后采用反事实方法计算中国农村老年人抑郁症状和抑郁的成本。
心理健康状况对个人医疗费用有显著影响，它们共同占个人预期医疗总支出的 47.26%。具体来说，农村群体、女性群体、丧偶群体和受教育程度较低的群体由于抑郁状态而导致的医疗支出高于其他群体。
心理健康状况显著增加了中国农村老年人接受医疗服务的机会和医疗支出的程度。这种情况在一些弱势群体中更为严重。因此，中国政府需要改革农村老年人的心理健康和保险制度，消除政策导致的心理健康资源障碍，特别是对弱势群体。
