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Erschienen in: Journal of General Internal Medicine 6/2014

01.06.2014 | Original Research

Health Care Contacts in the Year Before Suicide Death

verfasst von: Brian K. Ahmedani, PhD, Gregory E. Simon, MD, Christine Stewart, PhD, Arne Beck, PhD, Beth E. Waitzfelder, PhD, Rebecca Rossom, MD, Frances Lynch, PhD, Ashli Owen-Smith, PhD, Enid M. Hunkeler, MA, Ursula Whiteside, PhD, Belinda H. Operskalski, MPH, M. Justin Coffey, MD, Leif I. Solberg, MD

Erschienen in: Journal of General Internal Medicine | Ausgabe 6/2014

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ABSTRACT

BACKGROUND

Suicide prevention is a public health priority, but no data on the health care individuals receive prior to death are available from large representative United States population samples.

OBJECTIVE

To investigate variation in the types and timing of health services received in the year prior to suicide, and determine whether a mental health condition was diagnosed.

DESIGN

Longitudinal study from 2000 to 2010 within eight Mental Health Research Network health care systems serving eight states.

PARTICIPANTS

In all, 5,894 individuals who died by suicide, and were health plan members in the year before death.

MAIN MEASURES

Health system contacts in the year before death. Medical record, insurance claim, and mortality records were linked via the Virtual Data Warehouse, a federated data system at each site.

KEY RESULTS

Nearly all individuals received health care in the year prior to death (83 %), but half did not have a mental health diagnosis. Only 24 % had a mental health diagnosis in the 4-week period prior to death. Medical specialty and primary care visits without a mental health diagnosis were the most common visit types. The individuals more likely to make a visit in the year prior to death (p < 0.05) tended to be women, individuals of older age (65+ years), those where the neighborhood income was over $40,000 and 25 % were college graduates, and those who died by non-violent means.

CONCLUSIONS

This study indicates that opportunities for suicide prevention exist in primary care and medical settings, where most individuals receive services prior to death. Efforts may target improved identification of mental illness and suicidal ideation, as a large proportion may remain undiagnosed at death.
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Metadaten
Titel
Health Care Contacts in the Year Before Suicide Death
verfasst von
Brian K. Ahmedani, PhD
Gregory E. Simon, MD
Christine Stewart, PhD
Arne Beck, PhD
Beth E. Waitzfelder, PhD
Rebecca Rossom, MD
Frances Lynch, PhD
Ashli Owen-Smith, PhD
Enid M. Hunkeler, MA
Ursula Whiteside, PhD
Belinda H. Operskalski, MPH
M. Justin Coffey, MD
Leif I. Solberg, MD
Publikationsdatum
01.06.2014
Verlag
Springer US
Erschienen in
Journal of General Internal Medicine / Ausgabe 6/2014
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-014-2767-3

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