Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510030, China.
Int J Environ Res Public Health. 2022 Jun 26;19(13):7849. doi: 10.3390/ijerph19137849.
Depression is one of the most common comorbidities in patients with chronic lung diseases (CLDs). Depressive symptoms have an obvious influence on the health function, treatment, and management of CLD patients. In order to investigate the additional medical expenditure caused by depressive symptoms among middle-aged and elderly patients with CLDs in China, and to estimate urban-rural differences in additional medical expenditure, our study used data from the 2018 China Health and Retirement Longitudinal Study (CHARLS) investigation. A total of 1834 middle-aged and elderly CLD patients were included in this study. A generalized linear regression model was used to analyze the additional medical expenditure on depressive symptoms in CLD patients. The results show that depressive symptoms were associated with an increase in medical costs in patients with CLDs. Nevertheless, the incremental medical costs differed between urban and rural patients. In urban and rural patients with more severe comorbid CLD and depressive symptoms (co-MCDs), the total additional medical costs reached 4704.00 Chinese Yuan (CNY) (USD 711.60) and CNY 2140.20 (USD 323.80), respectively. Likewise, for patients with lower severity co-MCDs, the total additional medical costs of urban patients were higher than those of rural patients (CNY 4908.10 vs. CNY 1169.90) (USD 742.50 vs. USD 176.90). Depressive symptoms were associated with increased medical utilization and expenditure among CLD patients, which varies between urban and rural areas. This study highlights the importance of mental health care for patients with CLDs.
抑郁症是慢性肺部疾病（CLD）患者最常见的合并症之一。抑郁症状对 CLD 患者的健康功能、治疗和管理有明显影响。为了调查中国中老年 CLD 患者抑郁症状引起的额外医疗支出，并估计城乡差异，本研究使用了 2018 年中国健康与退休纵向研究（CHARLS）调查的数据。共有 1834 名中老年 CLD 患者纳入本研究。采用广义线性回归模型分析 CLD 患者抑郁症状的额外医疗支出。结果表明，抑郁症状与 CLD 患者医疗费用的增加有关。然而，城乡患者的增量医疗费用存在差异。在城乡 CLD 合并症更严重和抑郁症状更严重（共合并症 CLD 和抑郁症状，co-MCDs）的患者中，总额外医疗费用达到 4704.00 元人民币（711.60 美元）和 2140.20 元人民币（323.80 美元）。同样，对于合并症较轻的 co-MCDs 患者，城市患者的总额外医疗费用高于农村患者（4908.10 元人民币对 1169.90 元人民币）（742.50 美元对 176.90 美元）。抑郁症状与 CLD 患者的医疗利用和支出增加有关，城乡之间存在差异。本研究强调了对 CLD 患者进行心理健康护理的重要性。
