Regional variation in mental healthcare utilization and suicide: Evidence from movers in Australia
利用澳大利亚人口迁移数据，分离患者因素与地区因素对精神卫生服务利用地区差异的影响，发现地区因素解释了约72%的服务利用差异和19%的处方差异，且地区效应越大，自杀相关事件越少。
Poor mental health is a major global health issue, with many countries documenting high levels of unmet need and regional disparities in mental healthcare utilization. To determine how best to address these disparities, it is important to understand what drives regional variation. Using Census-linked microdata from Australia, we exploit cross-region migration to identify the extent to which patient and place factors drive regional variation in utilization of mental healthcare services and mental health prescriptions (antidepressants, anxiolytics, antipsychotics). We find that place factors account for approximately 72 % and 19 % of the regional variation in utilization of mental healthcare services and mental health prescriptions, respectively, with the rest reflecting patient-related demand. We also find suggestive evidence that larger place effects predict fewer mental health related Emergency Department presentations, self-harm hospitalizations, and suicides. Altogether, our findings suggest there is inadequate and inequitable supply in regions with low utilization, rather than inefficiently high utilization in high utilization regions.