Yang Xi, Ke Hailing, Song Yuting, Han Honggu, Zhao Yuxiang, Shi Saibo
School of Politics and Public Administration, Zhengzhou University, 100 Science Avenue, Zhengzhou, Henan, 450001, China.
School of Nursing, Qingdao University, Qingdao, China.
BMC Health Serv Res. 2025 Jul 1;25(1):877. doi: 10.1186/s12913-025-13022-y.
Population aging is the predominant global demographic trend of the contemporary era. However, the mental health of many older adults is not as good as it could be. Ensuring the rights and well-being of older adults is crucial for achieving sustainable and healthy aging. Numerous countries have implemented healthcare integration services tailored to their unique contexts. In 2016, China initiated community health care services for older adults.
We used panel data derived from the China Health and Retirement Longitudinal Study from 2015 to 2018 and analyses were performed using STATA, version 17. Our study employed a difference-in-differences model to assess the association of community health care services with mental health of older adults and conducted a placebo test to assess the reliability of the difference-in-differences model estimations. Additionally, subgroup regression analyses were conducted to investigate whether community health care services exert differing effects on the mental well-being of older adults across subgroups by sex, age groups, and education level.
Community health care services significantly improved depression levels and cognitive function in older adults. Notably, these services exerted a more pronounced effect on alleviating depression symptoms among male older adults and more positively affected cognitive function among female older adults. Additionally, the services demonstrated greater effectiveness in improving both depression levels and cognitive function among older adults with lower educational attainment, while maintaining positive impacts on younger older adults.
Community health care services played a crucial role in enhancing the mental health of older adults, with varying degrees of impact across demographic groups. Our study underscores the importance of such services in promoting healthy aging and provides a foundation for the further development of hierarchical community health care services. This development is conducive to advancing community health care services, enhancing the mental well-being, and fostering healthy aging for Chinese older adults.
人口老龄化是当代全球主要的人口趋势。然而，许多老年人的心理健康状况并不理想。保障老年人的权利和福祉对于实现可持续和健康老龄化至关重要。许多国家已根据其独特国情实施了医疗保健整合服务。2016年，中国启动了针对老年人的社区卫生保健服务。
我们使用了来自2015年至2018年中国健康与养老追踪调查的面板数据，并使用STATA 17版进行分析。我们的研究采用双重差分模型来评估社区卫生保健服务与老年人心理健康之间的关联，并进行了安慰剂检验以评估双重差分模型估计的可靠性。此外，还进行了亚组回归分析，以研究社区卫生保健服务是否对不同性别、年龄组和教育水平的老年亚组人群的心理健康产生不同影响。
社区卫生保健服务显著改善了老年人的抑郁水平和认知功能。值得注意的是，这些服务对缓解男性老年人的抑郁症状有更显著的效果，而对女性老年人的认知功能有更积极的影响。此外，这些服务在改善低学历老年人的抑郁水平和认知功能方面显示出更大的效果，同时对年轻老年人也保持着积极影响。
社区卫生保健服务在增强老年人心理健康方面发挥了关键作用，对不同人口群体的影响程度各异。我们的研究强调了此类服务在促进健康老龄化方面的重要性，并为进一步发展分层社区卫生保健服务奠定了基础。这一发展有利于推进社区卫生保健服务，提高中国老年人的心理健康水平，促进健康老龄化。
