The Association between Daily Care, and Social Support, and Health Care Services Utilization and Depressive Symptoms Among Chinese Older Adults with Chronic Diseases

Background: Chinese older adults with chronic diseases are subject to suffering from depressive symptoms. Home and community-based services (HCBSs) can facilitate health management for older adults with chronic diseases. However, few studies have shown a relationship between different types of HCBSs utilization and depressive symptoms. Therefore, this study, with a focus on Chinese older adults with chronic diseases, is designed to explore whether daily care, social support, and health care services utilization are associated with depressive symptoms respectively. Methods: Data used in the study were from the 2018 China Longitudinal Aging Social Survey (CLASS). Concentrating on older adults with chronic diseases, 7025 participants (≥60 years old) were included. Depressive symptoms scores were evaluated by applying 9-item Center for Epidemiological Studies depressive symptoms Scale (CES -D) with a range from 0 to 18. Results: Daily care (β=-0.044,p<0.001) and social support (β=-0.094,p<0.001) services utilization are negatively associated with depressive symptoms in Chinese older adults with chronic diseases, but not health care services utilization.Stratified by marital status, the results showed that health care services utilization (β=-0.047,p<0.05) was correlated with depressive symptoms in those who were widowed/divorced/unmarried, but not in those with a spouse.Conclusion: Daily care and social support services have a likelihood of alleviating depressive symptoms in older adults with chronic diseases.Moreover, health care services utilization was related to depressive symptoms in those without a spouse, but not in those with a spouse.HCBSs should be provided specifically by multiple subjects in terms of the needs for older adults with chronic diseases in order to alleviate depressive symptoms.