Mental health and socioeconomic outcomes in Hungary

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Date

2022

Authors

Szillery, Mirjam

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Arcidiacono, Peter

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Abstract

This dissertation is comprised of two chapters in the intersection of health and labor economics. In Chapter 1, I describe the patterns between utilization of mental health care and socioeconomic status, as observed in the administrative data-set obtained from Hungary. In line with existing literature, I find that women, older individuals and those in lower wage deciles use more antidepressants, are more likely to go to psychiatric outpatient facilities and are more often hospitalized with psychiatric reasons. Mental health care utilization is also more likely for those with more unemployed months. In addition to the describing the patterns between utilization and individual characteristics, I also examine the geographical variations. Furthermore, I include a description on the effects of the loss of exclusivity of escitalopram, a main ingredient in the antidepressant markets. I find that the loss of exclusivity seems to affect poorer regions more. These regions have higher antidepressant use to begin with, but lower shares of escitalopram use, which increases more after the loss of exclusivity in these regions.

Chapter 2 is based on a collaborative work with Peter Elek. In our research we examine whether increasing access to mental health treatment improves job market outcomes. Specifically, we analyze if having psychiatric outpatient care closer to individuals improves the likelihood of employment of working age adults. We analyze a large administrative dataset from Hungary that links job histories with medical care utilization data between 2009-2017. New outpatient service locations were established in Hungarian micro-regions in 2010-2012, which had lacked such capacities before. This creates quasi-experimental variation in access to treatment that our analysis exploits. In line with existing literature, we find that more access increases healthcare utilization. Psychiatric outpatient visits increase by around 16\% and antidepressant-use increases by 8\% for working age adults compared to the matched control group. We find no evidence that hospitalization rates would fall for working age adults. We also find no evidence of the increased access having a positive effect on employment outcomes.

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Szillery, Mirjam (2022). Mental health and socioeconomic outcomes in Hungary. Dissertation, Duke University. Retrieved from https://hdl.handle.net/10161/25305.

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