Mental hospitalisation and its impact on mortality
研究了严重精神问题（精神住院）对男性死亡率的影响，发现忽略住院过程的内生性会高估住院期间的死亡风险，而住院经历对死亡率的影响随时间增加，高学历男性受影响最大。
This paper investigates how severe mental problems (mental hospitalisation) affects mortality for males. We account for the selection into mental hospitalisation (both admittance and discharge) by using a correlated multistate model for the mental hospitalization process and mortality. The empirical analyses, based on data for men from the Swedish Military Conscription Data linked to administrative Swedish registers, reveal that ignoring the endogeneity of the mental hospitalisation process would substantially overestimate the effect of being in a mental hospital on the mortality hazard and (slightly) underestimate the effect of hospital experience on mortality. We also investigate how the effect of mental hospitalisation changes by birth cohort and by education level. The empirical analyses show that the effect of mental hospitalisation increases over time and that high educated men are affected the most by mental hospitalisation. To investigate whether mental hospitalisation affects different causes of death differently we also estimate a timing-of-events model with cause-specific mortality rates, distinguishing five different causes of death. The model is an extension of the timing-of-events model. The empirical results reveal that not only suicide and death due to external causes are affected by mental hospitalisation but also death due to cardiovascular diseases, cancer, and due to death due to other natural causes. • We investigate how severe mental hospitalisation affects mortality. • We account for endogeneity of the hospitalisation. • We use Swedish conscription data comprising 1,700,000 men. • In hospital mortality is 4 times higher, with hospitalization experience mortality is 12 times higher. • Mental hospitalization not only increases suicides but also mortality due to other causes of death.