Economics Seminar - Safety-net Primary Care Clinics and Psychiatric Emergency Department Visits

In this paper, I examine whether expanding access to safety-net primary care clinics (SNPCCs) has an impact on psychiatric emergency department (ED) utilization defined as mental illness and substance use disorders, in California. Primary care physicians have assumed an increasingly important role in outpatient
behavioral healthcare through screening, diagnosing, and prescribing medications. I leverage variation in travel distance to the nearest clinic in a zipcode area over the period 2005 to 2015 in a two-way fixed-effects regression. I find that one additional mile increase in travel distance leads to an increase of 0.13% in the number of psychiatric ED visits and the effects are primarily driven by female patients. My findings imply that delivering behavioral healthcare in SNPCCs can be a strategy to reduce unmet needs for behavioral healthcare among low-income groups. Policies designed to increase investments in safety-net primary care settings may have unintended benefits in reducing psychiatric ED utilization.