Does Geographic Access to a Psychiatry Clinic Influence Mental Health Care Utilization?

Abstract

Although South Koreas suicide rate is highest among the OECD countries, its mental health care utilization remains low. Using the unique administrative data–the National Health Information Database, I explore the impacts of change in geographic access to psychiatry clinics on mental health care utilization. I employ the Difference-in-Differences estimation combining the event-study approach that compares Eup/Myeon/Dong-level (region-level) monthly outcomes. The region-level geographic accessibility is measured by the straight-line distance to the nearest psychiatry clinic from the population centroid of each region, and its change means that the distance becomes shorter or longer due to the opening or closing of a psychiatry clinic. The results show that the number of outpatients visiting psychiatry clinics per 100,000 people increases by 3.1% after psychiatry clinic openings, and decreases by 8.6% after closings. In the regions where the distance increases by more than 8km, the number of outpatients sharply declines by 45.4%. Patients with dementia, alcohol use disorders, and neurotic disorders are more likely to visit a psychiatry clinic when the accessibility expands. Patients who have milder depressive symptoms are more susceptible to the expanding accessibility. Finally, evidence suggests that as distance from the nearest psychiatric clinic increases, hospital utilization increases.