Geographic Variation in Mental Health Treatment Utilization: Evidence from Migration
研究了美国老年医保参保者中，心理健康服务（如心理治疗）和药物（如抗抑郁药）使用率的地理差异，发现服务利用差异的45.8%由地区因素造成，而药物利用仅为15.1%，并探讨了医疗服务可及性的作用。
The older population bears a heavy burden of mental illness. Despite the availability of effective treatments, including services (e.g., psychotherapy) and drugs (e.g., antidepressants, antipsychotics), this paper documents substantial geographic variation in treatment utilization rates among Medicare enrollees. Exploiting patient migration, I show that 45.8 percent of service utilization variation is attributable to place-specific factors, compared to 15.1 percent for drug utilization. Further analyses suggest the role of provider accessibility in explaining the different place effects between service and drug use. Regarding health outcomes, I find that higher treatment utilization is associated with lower risks of self-harm-related emergency department visits.