79 Patient cost-sharing, mental health care and inequalities contrast to the baseline results for the overall population, this subgroup analysis finds equivalent reductions for females and males. We attribute this fact to the different trends (and composition) of mental health care service use by gender in youth (Figure 1). On the one hand, male service use peaks in the early teens and decreases later in adolescence [2]. Hence, cost-sharing will mostly reflect additional treatment cessation of male patients. On the other hand, use of mental health care by females peaks later in adolescence, and thus cost-sharing might act more as a barrier to those that would start treatment at this time. Table 4. Differences in mental health care cessation between low and high deductible periods (panel A) by subgroups defined according to previous treatment intensity (panel B), number (panel C) and type (panel D) of psychotropic drug classes used High deductible (pp) Baseline use Relative change Observations Panel A: Overall cessation Female -5.6 (-8.1 , -3.2)*** 28.3% -19.9% (-28.5%, -11.3%)** 24,972 Male -7.1 (-9.6 , -4.6)*** 26.7% -26.5% (-35.9%, -17.1%)*** 21,996 Panel B: Treatment intensity (quartile of expenditure) a Female 1st -5.0 (-9.3 , -0.7)** 18.9% -26.5% (-49.1%, -3.8%)** 6,296 2nd -6.3 (-11.0 , -1.7)*** 24.7% -25.7% (-44.6%, -6.8%)*** 6,281 3rd -5.0 (-9.9 , -0.1)** 28.8% -17.5% (-34.4%, -0.5%)** 6,239 4th -5.4 (-10.6 , -0.2)** 41.8% -12.9% (-25.4%, -0.4%)** 6,156 Male 1st -5.3 (-9.7 , -1.0)** 16.8% -31.8% (-57.9%, -5.7%)** 5,553 2nd -9.1 (-13.8 , -4.4)*** 22.7% -40.1% (-60.6%, -19.5%)*** 5,519 3rd -6.1 (-11.1 , -1.0)** 28.0% -21.7% (-39.7%, -3.7%)** 5,503 4th -9.3 (-14.9 , -3.7)*** 40.2% -23.1% (-37.0%, -9.2%)*** 5,421 Panel C: Number of drug classes Female 0 -5.2 (-7.9 , -2.6)*** 24.8% -21.1% (-31.6%, -10.6%)*** 19,549 1 -8.7 (-15.1 , -2.4)*** 41.0% -21.3% (-36.8%, -5.8%)*** 4,569 2 or more -10.8 (-25.0 , 3.4) 52.5% -20.6% (-47.7%, 6.4%) 854 Male 0 -5.1 (-8.0 , -2.3)*** 22.2% -23.0% (-35.8%, -10.2%)*** 14,038 1 -14.7 (-19.8 , -9.6)*** 31.6% -46.4% (-62.5%, -30.3%)*** 6,838 2 or more -11.9 (-24.8 , 0.9)* 49.5% -24.1% (-50.1%, 1.9%)* 1,120 Panel D: Type of drug classes (adolescents using 1 drug class only) Female Antipsychotics -5.9 (-22.3 , 10.5) 62.0% -9.5% (-35.9%, 16.9%) 527 Anxiolytics 7.4 (-19.7 , 34.5) .. .. .. 194 3
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