Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan 24:11:935969.
doi: 10.3389/fpubh.2023.935969. eCollection 2023.

The association between chronic disease and depression in middle-aged and elderly people: The moderating effect of health insurance and health service quality

Dongxu Li  1 , Min Su  1 , Xi Guo  2 , Bin Liu  1 , Tianjiao Zhang  1
Affiliations

The association between chronic disease and depression in middle-aged and elderly people: The moderating effect of health insurance and health service quality

Dongxu Li et al. Front Public Health. .

Abstract

Background: 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.

Methods: 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.

Results: After adjusting for sociodemographic factors, any chronic disease (coefficient 1.471, p < 0.01) and multiple chronic diseases (coefficient 1.733, p < 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.

Conclusions: 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.

Keywords: chronic disease; depression; health insurance; health service quality; multiple chronic diseases.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. The State Council Information Office. The State Council Information Office held a press conference on the “Report on the Nutrition and Chronic Disease Status of Chinese Residents. (2020). Available online at: http://www.gov.cn/xinwen/2020-12/24/content_5572983.htm (accessed December 12, 2020).
    1. Liu SS, Zhang LW, Liu QC, Liu HL. The prevalence of multi-morbidity and related functional limitation among middle-aged and senior population in China: Nationally evidence from CHARLS 2018. J Pract Med. (2021) 4:518–24. 10.3969/j.issn.1006-5725.2021.04.020 - DOI
    1. Birk JL, Kronish IM, Moise N, Falzon L, Yoon S, Davidson KW. Depression and multimorbidity: Considering temporal characteristics of the associations between depression and multiple chronic diseases. Health Psychol. (2019) 38:802–11. 10.1037/hea0000737 - DOI - PMC - PubMed
    1. Liu Q, Cai H, Yang LH, Xiang YB, Yang G, Li H, et al. . Depressive symptoms and their association with social determinants and chronic diseases in middle-aged and elderly Chinese people. Sci Rep. (2018) 8:3841. 10.1038/s41598-018-22175-2 - DOI - PMC - PubMed
    1. Peng ZX, Zhu L. The impacts of health insurance on financial strain for people with chronic diseases. BMC Public Health. (2021) 21:1012. 10.1186/s12889-021-11075-2 - DOI - PMC - PubMed

Publication types