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Ma Y, Shi X, Sznajder KK, Zhao Y, Wan Q, Chai P, Yang X. Outpatient depression current care expenditure changes in Liaoning Province from 2015 to 2020: a study based on the "system of health accounts 2011". Front Pharmacol 2024; 15:1092580. [PMID: 38318143 PMCID: PMC10839069 DOI: 10.3389/fphar.2024.1092580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/08/2024] [Indexed: 02/07/2024] Open
Abstract
Introduction: Depression is the leading cause of disability worldwide and has become a health issue of global concern. Based on the "System of Health Accounts 2011" (SHA 2011) for patients with depression, this paper studies the changes in the current curative expenditure (CCE) of outpatient depression in Liaoning Province, China, and provides policy recommendations. Method: A stratified multistage random sample of 56,994 patients with depression included from 1,227 healthcare facilities in Liaoning Province were included. The significance of differences in variables within groups was analyzed by univariate analysis (including descriptive statistics analysis, Mann-Whitney U test and Kruskal-Wallis H test), and factors influencing depression outpatient CCE were analyzed by multiple linear regression analysis and constructing structural equation models (SEM). Results: The CCE of outpatient depression was ranging from CNY 75.57 million to CNY 100.53 million in 2015-2020, with the highest of CNY 100.53 million in 2018, CNY 103.28 million in 2019. Medical expenditures are mainly concentrated in general hospitals and provincial healthcare institutions, accounting for about 90% of all provincial scope expenditures. The multiple regression results show that provincial healthcare institutions, purchase of drug, select medical treatment for depression, general hospitals and urban employees' health insurance are the main influencing factors for depression outpatient CCE. The results of SEM show that insurance status negative impact outpatient expenditure. Conclusion: Health insurance is an important factor in equitable access to healthcare resources for patients, and medication expenditure is the influential factor affecting the high expenditure of outpatient clinics. It is of great importance to reduce the medical burden of patients by increasing the coverage of medical insurance, increasing the proportion of bills that are eligible for reimbursement, and improving the system by guaranteeing the supply of psychotropic medication.
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Affiliation(s)
- Yuedan Ma
- Department of Traditional Chinese Medicine, School of Graduate Students, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Xiaoxia Shi
- Department of Traditional Chinese Medicine, School of Graduate Students, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Kristin K. Sznajder
- Department of Public Health, School of Medicine, Pennsylvania State University, Hershey, PA, United States
| | - Yue Zhao
- Department of Traditional Chinese Medicine, School of Graduate Students, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Quan Wan
- China National Health Development Research Center, Beijing, China
| | - Peipei Chai
- China National Health Development Research Center, Beijing, China
| | - Xiaoshi Yang
- Department of Social Medicine, School of Health Management, China Medical University, Shenyang, China
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Ren X, Wang S, Lian J, Pan C, Li B, He Y, Zhao J, Wang D, Luo Z, Shen J, Sun Z, Hou Y, Qi L, Lu Q, Lv P, Wang Y, Yong Q. Interrelation of Chronic Lung Disease and Cardiovascular Disease Based on Two National Prospective Cohort Studies. Heart Lung Circ 2023; 32:1167-1177. [PMID: 37574417 DOI: 10.1016/j.hlc.2023.06.862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 05/27/2023] [Accepted: 06/09/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Chronic lung diseases (CLDs) and cardiovascular diseases (CVDs) are the main chronic diseases responsible for a considerable burden of disease. This study aimed to estimate the interrelation of CLDs and CVDs using two Chinese national longitudinal cohort studies. METHODS The China Health and Retirement Longitudinal Study (CHARLS) and Chinese Longitudinal Healthy Longevity Survey (CLHLS) were used in this study with 15,052 and 9,765 participants, respectively. The Cox proportional risk model was used to estimate the interrelation between CLDs and CVDs. Mediating effects were performed to detect possible influencing pathways between CLDs and CVDs. RESULTS The association of CLDs with CVDs was identified in 1,647 participants (10.9%) with newly diagnosed CVDs in CHARLS and 332 participants (11.6%) in CLHLS. The Cox proportional risk model showed that CLDs were a significant predictor of CVDs (HR 1.49, 95% CI 1.27-1.76) after adjusting for covariates, and the hazard ratios of stroke and CVDs excluding stroke were (HR 1.02, 95% CI 0.79-1.31) and (HR 1.76, 95% CI 1.46-2.13), respectively. These association were mediated by body mass index (BMI) and Center for Epidemiological Studies Depression Scale (CES-D-10) scores. No significant association was found in CHARLS and CLHLS regarding CVDs with CLDs. In CHARLS, CVDs was a significant predictor of CLDs (HR 1.40, 95% CI 1.09-1.79). CONCLUSIONS Chronic lung disease was associated with increased incidence of CVDs in middle-aged and older people in the community population and vice versa. Body mass index and depressive symptoms might be mediated by the effect of CLD on CVD.
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Affiliation(s)
- Xueling Ren
- Department of Respiratory, National Clinical Research Center for Geriatrics Diseases, The Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shengshu Wang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, The Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Junsong Lian
- Ninth Department of Healthcare, The Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Chunjiang Pan
- PLA Strategic Support Force Characteristic Medical Center, Beijing, China
| | - Baobao Li
- State Key Laboratory of Highly Toxic Substances for Anti-Drug Research, Institute of Pharmacology and Toxicology, Academy of Military Medical Sciences, Academy of Military Sciences, Beijing, China
| | - Yan He
- Department of Occupational Disease Treatment, Medical Center of The Second Artillery, Beijing, China
| | - Jing Zhao
- Department of Respiratory, National Clinical Research Center for Geriatrics Diseases, The Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Dan Wang
- Department of Respiratory, National Clinical Research Center for Geriatrics Diseases, The Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zheng Luo
- Department of Respiratory, National Clinical Research Center for Geriatrics Diseases, The Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jiangqiong Shen
- Department of Nursing, National Clinical Research Center for Geriatrics Diseases, The Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhifeng Sun
- Department of Respiratory, National Clinical Research Center for Geriatrics Diseases, The Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yanka Hou
- Department of Respiratory, National Clinical Research Center for Geriatrics Diseases, The Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Lin Qi
- Department of Respiratory, National Clinical Research Center for Geriatrics Diseases, The Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Qian Lu
- Department of Respiratory, National Clinical Research Center for Geriatrics Diseases, The Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ping Lv
- Department of Respiratory, National Clinical Research Center for Geriatrics Diseases, The Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yuling Wang
- Department of Nursing, Chinese PLA General Hospital, Beijing, China.
| | - Qinge Yong
- Department of Nursing, National Clinical Research Center for Geriatrics Diseases, The Second Medical Center of Chinese PLA General Hospital, Beijing, China.
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Liu H, Zhou Z, Fan X, Shen C, Ma Y, Sun H, Xu Z. Association Between Multiple Chronic Conditions and Depressive Symptoms Among Older Adults in China: Evidence From the China Health and Retirement Longitudinal Study (CHARLS). Int J Public Health 2023; 68:1605572. [PMID: 36938299 PMCID: PMC10020227 DOI: 10.3389/ijph.2023.1605572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/15/2023] [Indexed: 03/06/2023] Open
Abstract
Objectives: The purpose of this study was to explore the association between multiple chronic conditions (MCCs) and depressive symptoms among older adults in China. Methods: We used the fourth round of data from the China Health and Retirement Longitudinal Study, and included 9789 older adults aged 60 years old and above. Results: Compared with the older adults without chronic disease, older adults with MCCs and those with one chronic disease had a high risk of depression (MCCs: OR-adjusted: 1.55, 95% CI: 1.37 to 1.75; one chronic disease: OR-adjusted: 1.20, 95% CI: 1.05-1.37). In urban areas, the prevalence among older adults with MCCs was 2.01 times higher than that among older adults without chronic disease (OR-adjusted: 2.01, 95% CI: 1.56-2.60), while it was 1.44 times higher in rural areas (OR-adjusted:1.44, 95% CI: 1.25-1.65). Self-reported health, duration of sleep, social activities, and type of medical insurance were the influencing factors of depressive symptoms in older adults. Conclusion: This study contributed to enriching the research on the relationship between MCCs and depressive symptoms in older adults in China.
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Affiliation(s)
- Haixia Liu
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
- *Correspondence: Haixia Liu,
| | - Zhongliang Zhou
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Xiaojing Fan
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Chi Shen
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Yang Ma
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
| | - Hongwei Sun
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
| | - Zhaoyang Xu
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
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