参加新农合对农村老年人抑郁状况的影响:身体健康变化的中介效应

Impact of participating in the“New Rural Cooperative Medical Insurance”on the depression of the elderly in rural areas:The mediating effect of health change

目的:探究农村老年人的抑郁状况与参加新农合的关系,并分析身体健康的中介作用。方法:文章基于中国家庭追踪调查(CFPS)2012、2016年完成流调中心抑郁量表(CES-D20)拟评估的农村老人各1618例,构建二期平衡面板数据,选用固定效应模型分析参加新农合对农村老年人抑郁状况的影响,运用改进的中介效应分析法(Bootstrap)测量健康状况的中介效应。结果:相关分析结果表明,参与新农合与总体抑郁水平(r=-0.14,P<0.05)、健康变化(r=-0.12,P<0.05)均呈显著负相关。回归结果显示,参加新农合与总体抑郁水平显著负相关(β=-0.47,P<0.05),身体健康变化在新农合对抑郁状况影响中存在部分中介效应,中介效应值为0.27,占总效应的39.3%。结论:参加新农合能够促进农村老年人抑郁状况的缓解,身体健康变化起部分中介作用。

Objective:To explore the relationship between participating in the New Rural Cooperative Medical System(NCMS)and depression of the elderly in rural areas,and the mediating effect of physical health in thisprocess.Methods:Based on the data of China’s Family Panel Survey(CFPS)in 2012 and 2016,1618 samples(879 males and 739 females)who completed the CES-D20 complete scale evaluation were selected to construct balance panel data.The fixed effect model was used to analyze the impact of participating in the NCMS on depression of the elderly in rural areas,and the improved Bootstrap method was used to measure the mediating effect of physical health.Results:Correlation analysis showed that participating in NCMS was significantly negative correlated with depression status(r=-0.14,P<0.05)and health changes(r=-0.12,P<0.05).The regression results showed that participating in NCMS significantly alleviated the depression status(β=-0.47,P<0.05),and health changes had a partial mediating effect on the NCMS effect on depression,with a median effect value of 0.27,accounting for 39.3%of the total effect.Conclusion:Participating in NCMS has a direct impact on the depression status of the elderly,and physical health plays a mediating role in the effect of NCMS on the depression status.