J Prev Med Public Health.  2013 May;46(3):147-154.

Medical Care Utilization During 1 Year Prior to Death in Suicides Motivated by Physical Illnesses

• Cho J
• Lee WJ
• Moon KT
• Suh M
• Sohn J
• Ha KH
• Kim C
• Shin DC
• Jung SH

Abstract

OBJECTIVES
Many epidemiological studies have suggested that a variety of medical illnesses are associated with suicide. Investigating the time-varying pattern of medical care utilization prior to death in suicides motivated by physical illnesses would be helpful for developing suicide prevention programs for patients with physical illnesses.
METHODS
Suicides motivated by physical illnesses were identified by the investigator's note from the National Police Agency, which was linked to the data from the Health Insurance Review and Assessment. We investigated the time-varying patterns of medical care utilization during 1 year prior to suicide using repeated-measures data analysis after adjustment for age, gender, area of residence, and socioeconomic status.
RESULTS
Among 1994 suicides for physical illness, 1893 (94.9%) suicides contacted any medical care services and 445 (22.3%) suicides contacted mental health care during 1 year prior to suicide. The number of medical care visits and individual medical expenditures increased as the date of suicide approached (p<0.001). The number of medical care visits for psychiatric disorders prior to suicide significantly increased only in 40- to 64-year-old men (p=0.002), women <40 years old (p=0.011) and women 40 to 64 years old (p=0.021) after adjustment for residence, socioeconomic status, and morbidity.
CONCLUSIONS
Most of the suicides motivated by physical illnesses contacted medical care during 1 year prior to suicide, but many of them did not undergo psychiatric evaluation. This underscores the need for programs to provide psychosocial support to patients with physical illnesses.

Keyword

Suicide; Medical care research; Mental disorders

MeSH Terms

Adult
Age Factors
Aged
Demography
Fees, Medical
Female
Health Services Needs and Demand/*statistics & numerical data/utilization
Humans
Male
Mental Disorders/psychology
Mental Health/statistics & numerical data
Middle Aged
Motivation
Sex Factors
Socioeconomic Factors
Suicide/economics/prevention & control/*statistics & numerical data
Time Factors