Suicide and Primary Health Care in Swedish Regions - Do Increasing Number of Healthcare Centres Prevent Suicides?

Abstract

Suicide is a public health concern in Sweden and suicide preventive work is being made in many areas. This study aims to examine the relationship between suicide rates and primary health care. The study exploits a set of reforms implemented in Swedish regions between 2007-2010, that aimed to increase patients’ choice of health care provider and the competition in the primary health care market. In order to estimate a causal relationship between primary healthcare centres and suicide rates, we examine the effect of the reforms on suicide rates using panel data over Sweden’s regions between 2006-2018. We also examine first stage effects of the reforms on health care personnel and health care visits, to further study the relationship between suicide and primary health care. The study finds no causal effect of healthcare centres on suicide rates but finds a significant negative effect of the reforms on suicide rates. The study also finds that the reforms increased visits to general practitioners but not to other professions, and the number of health care personnel did not increase after the reform. The study concludes that a negative effect of primary health care on suicide rates should be expected, but due to a limited data set, the effect is not significant in this study. The increase in access to general practitioners support this conclusion, but the lack of increase in access to other professions suggests that the effect of primary health care on suicide rates should be of low magnitude.