School of Public Administration, Inner Mongolia University, Hohhot, China.
Inner Mongolia University of Technology, Hohhot, China.
Front Public Health. 2023 Jan 24;11:935969. doi: 10.3389/fpubh.2023.935969. eCollection 2023.
Depression in chronic disease patients was an important public health problem. However, limited work has been done on how to alleviate the depression of chronic disease patients. This paper attempted to explore the alleviating effect of health insurance and health service quality.
A total of 11,500 middle-aged and elderly people were drawn from four waves (2011, 2013, 2015, and 2018) of the China Health and Retirement Longitudinal Study (CHARLS). We analyzed the effect of chronic disease on depression in middle-aged and elderly people in China, and explored the mechanism of action from health insurance and health service quality.
After adjusting for sociodemographic factors, any chronic disease (coefficient 1.471, < 0.01) and multiple chronic diseases (coefficient 1.733, < 0.01) could significantly increase the depression score. Any chronic disease increased the depression score (165.3 and 147.4% in non-health insurance group and health insurance group, respectively), the multiple chronic diseases increased the depression score (190.6 and 173.5% in non-health insurance group and health insurance group, respectively). Any chronic disease increased the depression score (161.3 and 139.5% in lower health service quality group and higher health service quality group, respectively), the multiple chronic diseases increased the depression score (228.4 and 162.9% in lower health service quality group and higher health service quality group, respectively). And similar results were obtained after using depression status instead of depression score.
Chronic disease and multiple chronic diseases were important determinants of depression in middle-aged and elderly people. Health insurance and health service quality were the key factors in relieving the depression of chronic disease patients. Several strategies were urgently needed: paying attention to the mental health of chronic disease patients, increasing the participation rate of health insurance, further improving the quality of health service, and alleviating the psychological harm caused by chronic disease.
慢性病患者的抑郁是一个重要的公共卫生问题。然而，关于如何缓解慢性病患者的抑郁，相关工作还很有限。本文试图探讨医疗保险和卫生服务质量的缓解作用。
本研究共纳入了来自中国健康与养老追踪调查（CHARLS）的 11500 名中年和老年人，他们分别来自四个波次（2011、2013、2015 和 2018 年）。我们分析了慢性病对中国中老年人群抑郁的影响，并从医疗保险和卫生服务质量两个方面探讨了其作用机制。
在调整了社会人口学因素后，任何一种慢性病（系数 1.471，<0.01）和多种慢性病（系数 1.733，<0.01）都会显著增加抑郁评分。任何一种慢性病都会增加抑郁评分（非医疗保险组和医疗保险组分别增加 165.3%和 147.4%），多种慢性病也会增加抑郁评分（非医疗保险组和医疗保险组分别增加 190.6%和 173.5%）。任何一种慢性病都会增加抑郁评分（卫生服务质量较低组和较高组分别增加 161.3%和 139.5%），多种慢性病也会增加抑郁评分（卫生服务质量较低组和较高组分别增加 228.4%和 162.9%）。使用抑郁状态而不是抑郁评分也得到了类似的结果。
慢性病和多种慢性病是中老年人抑郁的重要决定因素。医疗保险和卫生服务质量是缓解慢性病患者抑郁的关键因素。迫切需要采取几种策略：关注慢性病患者的心理健康，提高医疗保险的参与率，进一步提高卫生服务质量，减轻慢性病带来的心理伤害。
