{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T02:40:37Z","timestamp":1784169637029,"version":"3.55.0"},"reference-count":51,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T00:00:00Z","timestamp":1568937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["71373146"],"award-info":[{"award-number":["71373146"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["71702131"],"award-info":[{"award-number":["71702131"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Depression, one of the most frequent mental disorders, affects more than 350 million people of all ages worldwide, with China facing an increased prevalence of depression. Childhood depression is on the rise; globally, and in China. This study estimates the hospitalization costs and the financial burden on families with children suffering from depression and recommends strategies both to improve the health care of children with depression and to reduce their families\u2019 financial burden. Methods: The data were obtained from the hospitalization information system of 297 general hospitals in six regions of Shandong Province, China. We identified 488 children with depression. The information on demographics, comorbidities, medical insurance, hospitalization costs and insurance reimbursements were extracted from the hospital\u2019s information systems. Descriptive statistics were presented, and regression analyses were conducted to explore the factors associated with hospitalization costs. STATA14 software was used for analysis. Results: The mean age of children with depression was 13.46 \u00b1 0.13 years old. The availability of medical insurance directly affected the hospitalization costs of children with depression. The children with medical insurance had average total hospitalization expenses of RMB14528.05RMB (US$2111.91) and length of stay in hospital of 38.87 days compared with the children without medical insurance of hospital with expenses of RMB10825.55 (US$1573.69) and hospital stays of 26.54 days. Insured children\u2019s mean out-of-pocket expenses (6517.38RMB) was lower than the those of uninsured children (RMB10825.55 or US$1573.69), significant at 0.01 level. Insured children incurred higher treatment costs, drug costs, bed fees, check-up fees, test costs and nursing fees than uninsured patients (p &lt; 0.01). Conclusions: Children suffering from depression with medical insurance had higher hospitalization costs and longer hospitalization stays than children without medical insurance. While uninsured inpatients experienced larger out-of-pocket costs than insured patients, out-of-pocket hospital expenses strained all family budgets, pushing many, especially low-income, families into poverty\u2014insured or uninsured. The different hospital cost structures for drugs, treatment, bed fees, nursing and other costs, between insured and uninsured children with depression, suggest the need for further investigations of treatment regimes, including over-demand by parents for treatment of their children, over-supply of treatment by medical staff and under-treatment of uninsured patients. We recommend more careful attention paid to diagnosing depression in girls and further reform to China\u2019s health insurance schemes\u2014especially to allow migrant families to gain basic medical insurance.<\/jats:p>","DOI":"10.3390\/ijerph16193526","type":"journal-article","created":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T10:48:14Z","timestamp":1568976494000},"page":"3526","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Hospitalization Costs and Financial Burden on Families with Children with Depression: A Cross-Section Study in Shandong Province, China"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2033-9349","authenticated-orcid":false,"given":"Yawei","family":"Guo","sequence":"first","affiliation":[{"name":"Center for Health Economics Experiment and Public Policy, School of Public Health, Shandong University; Key Laboratory of Health Economics and Policy Research, NHFPC (Shandong University), Jinan 250012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjie","family":"Sun","sequence":"additional","affiliation":[{"name":"Shandong Health Commission Medical Management Service Center, Jian 250014, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simeng","family":"Hu","sequence":"additional","affiliation":[{"name":"Center for Health Economics Experiment and Public Policy, School of Public Health, Shandong University; Key Laboratory of Health Economics and Policy Research, NHFPC (Shandong University), Jinan 250012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6770-7105","authenticated-orcid":false,"given":"Stephen","family":"Nicholas","sequence":"additional","affiliation":[{"name":"School of Management and School of Economics, Tianjin Normal University, West Bin Shui Avenue, Tianjin 300074, China"},{"name":"Newcastle Business School, University of Newcastle, University Drive, Newcastle, NSW 2038, Australia"},{"name":"Guangdong Institute for International Strategies, Guangdong University of Foreign Studies, Baiyun, Guangzhou, Guangdong 510420, China"},{"name":"Top Education Institute, 1 Central Avenue, Australian Technology Park, Eveleigh, Sydney, NSW 2015, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8769-7928","authenticated-orcid":false,"given":"Jian","family":"Wang","sequence":"additional","affiliation":[{"name":"Dong Fureng Institute of Economic and Social Development, Wuhan University, No.54 Dongsi Lishi Hutong, Dongcheng District, Beijing 100010, China"},{"name":"Center for Health Economics and Management at School of Economics and Management, Wuhan University, 299 Bayi Road, Wuchang District, Wuhan, Hubei Province 430072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,9,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0140-6736(06)67964-6","article-title":"Recent developments and current controveries in depression","volume":"367","author":"Ebmeier","year":"2006","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1517\/14656566.6.3.369","article-title":"The economic burden of depression in the US: Societal and patient perspectives","volume":"6","author":"Greenberg","year":"2005","journal-title":"Expert Opin. 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