Depressive symptoms and health service utilization among Chinese middle aged and older adults: A national population-based longitudinal survey
Abstract Background: The prevalence of depressive symptoms has been steadily increasing in recent years, however middle aged and older adults was less likely to use mental health services. The aims of this study were to 1) examine the cross-sectional and longitudinal relationships between depressive symptoms and health services utilization among Chinese middle-aged and older adults; and 2) evaluate whether there exists a rural-urban difference in such relationships. Methods: Data was obtained from China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2015, a nationally representative survey of 13,551 adults aged 45 years and above in China. Multivariate logistic regression analyses were conducted to assess the cross-sectional and longitudinal relationship between depressive symptoms and health services utilization in the whole sample, and urban and rural subsamples respectively. Results: Depressive symptoms were positively associated with a greater likelihood of outpatient and inpatient health services utilization. In addition, the relationships between depressive symptoms and health service use were consistent across rural and urban settings, indicating the robustness of such findings across geographic areas. Conclusions: Findings indicate that depressive symptoms are significantly associated with both in-patient and out-patient health service utilization among Chinese adults. Screening for depressive symptoms needs to be incorporated in these care settings in China.