Economic Burden of Depressive Symptoms Conditions among Middle-Aged and Elderly People with Hypertension in China

Abstract

People with hypertension are more prone to incur depressive symptoms, while depressive symptoms have an obvious influence on the healthy functioning, treatment, and management of hypertensive patients. However, there have been limited studies on the association between depression and the economic burden of hypertension. We used data from the 2018 China Health and Retirement Longitudinal Study (CHARLS) to estimate the additional annual direct and indirect economic burden of depressive symptoms among middle-aged and elderly hypertensive patients with a multivariable regression model. The depressive symptoms were associated with substantial additional direct and indirect economic burden. Compared with non-co-MHDS (non-co-morbid hypertension and depressive symptoms) patients, the direct economic burden of lower co-MHDS (co-morbid hypertension and depressive symptoms) patients and higher co-MHDS patients increased 1887.4 CNY and 5508.4 CNY, respectively. For indirect economic burden, the lower co-MHDS patients increased 331.2 CNY and the higher co-MHDS patients increased 636.8 CNY. Both direct and indirect economic burden were incremental with the aggravation of depressive symptoms. The results showed depressive symptoms increased total healthcare costs by increasing the utilization and expenditure of primary healthcare services. Depressive symptoms also led to economic loss of productivity, especially for agricultural workers. This study highlights the importance of mental healthcare for hypertensive patients.

Mental Health Among Hypertensive People and its Associated Factors: Findings From RISKESDAS 2018 Data

“…The investigation revealed a significant link between employment status and depression among individuals with hypertension, with a higher prevalence observed among the unemployed respondents. It is well established that health issues related to hypertension can hinder an individual's ability to work, subsequently increasing healthcare costs (Wu et al, 2021). This situation can lead to emotional distress, as supported by established associations between employment status and psychological distress (Norström et al, 2019;Zuelke et al, 2018).…”

The Economic Burden Associated with Depressive Symptoms among Middle-Aged and Elderly People with Chronic Diseases in China

“…Thus, the economic agricultural and employed losses were calculated by multiplying the average daily wage (CNY 104.8 for urban residents/CNY 59.3 for rural residents) with the number of missed days in a year. Unemployment cost was calculated by multiplying the average monthly wage (CNY 2183.8 for urban residents/CNY 1234.3 for rural residents) with the number of unemployment months in a year [29]. The average monthly/daily wage incomes were based on the per capital wage income of (urban/rural) residents published by the China National Bureau of Statistics in 2012, adjusted to 2018 levels by the Gross Domestic Product index [30].…”

Outpatient depression current care expenditure changes in Liaoning Province from 2015 to 2020: a study based on the “system of health accounts 2011”

“…One study used econometric modeling to examine healthcare costs associated with depression and depressive symptoms, estimating projected healthcare costs for depression and depressive disorders based on a two-step approach with a two-part model and four-part model coefficients ( Hsieh and Qin, 2018 ) and analyzing antidepressant use and expenditures based on evidence from urban claims data in China ( Ding et al, 2022 ). Patient and self-medication visits ( Jin et al, 2022 ), as well as the economic burden of hypertension and depression ( Wu et al, 2021 ). Were assessed based on data from the China Health and Retirement Longitudinal Study (CHARLS) database and using a zero-inflated Poisson regression model, including a Logit model predicting multiple zeros and a Poisson count model.…”