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南京医科大学学报（社会科学版）京医科大学学报（社会科学版） 第6期 总第107期
南
· 566 · Journal of Nanjing Medical University（Social Sciences）of Nanjing Medical University（Social Sciences） 2021年12月
Journal

A study on the influence of depression on medical service utilization in

middle⁃aged and elderly people with chronic diseases

WEI Yue，LUO Enli
Department of Public Policy，School of Social and Public Administration，East China University of Science and Technology，
Shanghai 200237，China
Abstract：Understanding the depression status of middle⁃aged and elderly patients with chronic diseases
and its relationship with the utilization of medical services is of great practical significance to optimize the
allocation of medical resources. Based on CHARLS 2015，using Logistic regression，we explored the influence
of depression on the utilization of medical services of chronically ill people from two dimensions of outpatient
and inpatient services，and tried to explain the influence mechanism by taking self ⁃ reported health as the
mediating variable. The conclusions include：① Depression significantly increased the probability of medical
service utilization in middle-aged and elderly people with chronic diseases. The probability of outpatient and
inpatient service utilization increased by 8.4 percentage points and 4.8 percentage points，respectively. ②Self⁃
rated health played a partial mediating role，and the mediating effect affecting outpatient and inpatient service
utilization accounted for 46.02% and 63.92% of the total effect，respectively. Depression can directly predict
the medical service utilization in middle⁃aged and elderly people with chronic diseases or indirectly predict the
medical service utilization via self ⁃ rated health as the mediating variable. It is suggested to increase the
intervention for depression of patients with chronic diseases，pay attention to the cognitive ability of self⁃rated
health status of middle⁃aged and elderly people，and improve the level of health cognition，so as to promote the
rational and effective allocation of medical service resources.
Key words：depression；chronic diseases；middle⁃aged and elderly people；utilization of medical services；
self⁃rated health