中老年糖尿病患者共病抑郁的生命质量与疾病经济负担分析——基于CHARLS数据的实证研究

Empirical Research of the Quality of Life and Disease Economic Burden of Comorbid Depression in Middle-Aged and Elderly Patients with Diabetes Based on CHARLS Data

目的:分析中老年糖尿病患者共病抑郁的健康相关生命质量和疾病经济负担情况,为政府合理配置卫生资源以及完善糖尿病综合防治方案提供依据。方法:使用2018年度中国健康与养老追踪调查(CHARLS)数据,采用流行病调查中心抑郁量表(CES-D)10条目简易量表和EQ-5D-3L量表,测量45岁及以上中老年糖尿病患者抑郁状况和健康状态。使用Logit模型计算倾向得分,匹配糖尿病共病抑郁患者和糖尿病患者,分析两组患者的健康相关生命质量和疾病经济负担情况。结果:中老年糖尿病患者共病抑郁的患病率为41.8%;糖尿病共病抑郁组生命质量五个维度得分的平均值均高于糖尿病组,且健康效用值低于糖尿病组,差异具有统计学意义(P<0.05);糖尿病共病抑郁患者每年人均疾病经济负担为14940.8元,是无抑郁糖尿病患者的1.7倍。结论:抑郁会影响中老年糖尿病患者的健康相关生命质量,加重患者的疾病经济负担,建议重视糖尿病患者的心理健康,开展针对中老年糖尿病患者的抑郁筛查,完善糖尿病综合管理方案,提高医疗诊治和保障水平,减轻患者的负担。

Objective To analyze the health-related quality of life and disease economic burden of comorbid depression in middle-aged and elderly patients with diabetes,so as to provide basis and reference for the government to rationally allocate health resources and improve the comprehensive management plan for diabetes.Methods Data of the 2018 China Health and Retirement Follow up Survey(CHARLS)were used to measure the depression and health status of middle-aged and elderly patients with diabetes aged 45 years and older by using the CES-D 10 item simple scale and EQ-5D-3L scale.Logit model was used to calculate propensity score,matching diabetes comorbid depression patients and diabetes only,to analyze health-related quality of life and disease economic burden of these two groups of patients.Results The prevalence of depression in middle-aged and elderly patients with diabetes was 41.8%.The average scores of five dimensions of quality of life in the diabetes comorbidity depression group were higher than those in the diabetes group,and the health utility value was lower than that in the diabetes group,with a statistically significant difference(P<0.05).The average annual economic burden of diabetes comorbid depression patients was 14940.8 yuan,1.7 times that of diabetes patients without depression.Conclusion Depression will affect the health-related quality of life of middle-aged and elderly patients with diabetes,and increase the economic burden of patients with disease.It is suggested to pay attention to the mental health of diabetes patients,carry out depression screening for middle-aged and elderly diabetes patients,improve the comprehensive management plan for diabetes,improve medical treatment and security level,and reduce the burden of patients.