Research On The Effect Of New Rural Pension Scheme On Depression And Medical Cost Induced By Depression Among Rural Elderly

The latest data from the World Health Organization shows that depression will become the second largest killer of mankind,only trailing cancer by 2020.The number of depressive patients in China has reached 90 million.Research shows that depressive elderly people are on the rise year by year.Among them,elderly people in rural areas may be especially prone to depression.Depression seriously impairs the physical and mental health of rural elderly.Declining health levels due to depression will increase medical expenses for the rural elderly,and then increase the risk of "poorness due to illness" and "returning to poverty due to illness".What factors contribute to the serious mental health problems of the rural elderly?Studies have shown that there is a certain relationship between income and health.New Rural Pension Scheme is an important part of the income among rural elderly in China.In order to improve the New Rural Pension Scheme,reduce the depression of rural elderly and improve their mental health level,this paper uses CFPS 2012 and 2016 panel data to analyze the causal effect of New Rural Pension Scheme on the depressive symptoms and medical cost induced by depression of rural elderly in China.This paper is divided into seven chapters,the core parts are Chapter 3 to Chapter 6,the main research contents include:(1)We introduce data sources,measurement models and methods.We use CES-D scale to measure the depressive symptoms and depression of rural elderly,and then use two-part model,four-part model and counter-factual analysis to measure the medical expenditure caused by depressive symptoms or depression.This paper makes a descriptive analysis of core variables and control variables to understand the participation and degree of the New Rural Pension Scheme,understand the level of depressive symptoms and depression,understand the level of medical expenditure caused by depressive symptoms/depression and other individual characteristics of the rural elderly.(2)Based on the panel data of CFPS 2012 and 2016,this paper examines the impact of the New Rural Pension Scheme enrollment on depressive symptoms/depression and the medical expenses caused by depressive symptoms/depression among rural elderly,and explores the mechanism.First,xtlogit regression was used to examine the influence of New Rural Pension Scheme enrollment on the depressive symptoms and depression of rural elderly.Secondly,xtreg regression was used to test the effect of New Rural Pension Scheme enrollment on medical expenditure caused by depressive symptoms and depression in rural elderly.Thirdly,the instrumental variable is used to solve the possible endogenous problems and can prove the effect.Finally,the mediating effect model is used to analyze the internal mechanism of theNew Rural Pension Scheme enrollment affecting the depressive symptoms/depression and medical cost induced by depressive symptoms/depression.(3)Based on the panel data of CFPS 2012 and 2016,this paper examines the impact of the New Rural Pension Scheme income on depressive symptoms/depression and the medical expenses caused by depressive symptoms/depression among rural elderly,and explores the mechanism.First,xtlogit regression was used to examine the influence of New Rural Pension Scheme income on the depressive symptoms and depression of rural elderly.Secondly,xtreg regression was used to test the effect of New Rural Pension Scheme income on medical expenditure caused by depressive symptoms and depression in rural elderly.Thirdly,the instrumental variable is used to solve the possible endogenous problems and can prove the effect.Finally,the mediating effect model is used to analyze the internal mechanism of the New Rural Pension Scheme income affecting the depressive symptoms/depression and medical cost induced by depressive symptoms/depression.(4)We use the quantile regression and regression discontinuity to test the robustness of the results.And then,we discuss the heterogeneous effects of New Rural Pension Scheme on mental health or medical cost induced by depression of rural elderly by gender,education,chronic disease and children's economic support.This study finds that:(1)The mean CES-D score of the rural elderly was 14.8,among which 17.7% were depressive symptoms and 10.1% suffered from depression.Medical expenses induced by depressive symptoms(depression)for the rural elderly were 481.062CNY(383.977 CNY)per month.In terms of New Rural Pension Scheme,60.1% of rural elderly participated in the pension,of which each person received an average of 118.994 CNY per month.(2)The regression results report that rural elderly who have New Rural Pension Scheme are 5.2% less likely to suffer from depressive symptoms and 14.4% less likely to be depression.The regression results also report that rural elderly who participate New Rural Pension Scheme are spend 4.5%/6.5% less on medical services due to depressive symptoms/depression per year.After solving the possible endogenous problems,this negative impact still exists.The empirical results show that the degree of self-confident about future plays a mediating role.(3)The regression results show that rural elderly who have more pension income per month are 1.6% less likely to suffer from depressive symptoms and 4.9%less likely to be depression.The regression results also show that pension income decreases medical cost of depressive symptoms and depression by 1.3% and 1.9% average,respectively.After solving the possible endogenous problems,this negative impact still exists.The empirical results show that the degree of self-confident about future plays a mediating role.(4)The result is significant for any quantile and regression discontinuity.The research about the effect of pension enrollment or pension income on depression has a strong robustness.Wealso find that the heterogeneous effects of New Rural Pension Scheme on mental health or medical cost induced by depression of rural elderly by gender,education,chronic disease and children's economic support are different.From a policy perspective,our results suggest that the Chinese government needs to perfect New Rural Pension Scheme to eliminate the policy income-caused barriers to mental health,especially for rural elderly.Specifically,the government should pay attention to the depression of the rural elderly,raise the level of pension benefits gradually and reasonably.Secondly,the rural elderly should be guided participate the New Rural Pension Scheme actively.At the same time,considering that the degree of depression caused by the New Rural Pension Scheme varies among the rural elderly with different individual characteristics,the government should consider the impact of different group characteristics on the effectiveness of the policy when formulating the corresponding policies.