Department of Medical Sociology and Social Work, Kaohsiung Medical University, Kaohsiung, Taiwan.
Suicide Life Threat Behav. 2012 Aug;42(4):445-52. doi: 10.1111/j.1943-278X.2012.00103.x.
The characteristics of health care utilization during the last year of life by Taiwanese who died by suicide were analyzed. The degree of health services utilization was evaluated by extracting the data of National Health Insurance (NHI) outpatient cohort records in 2006. A total of 4,406 fatal suicide cases were matched with the 17,587,901 subjects in the NHI beneficiary registry file. Rate of visit of the suicide decedents for all NHI outpatient services during their last year before death was 85%, and that for mental disorders service only was 30.2%. Average number of visits per person-year of the suicide decedents was 24.5 visits per year, two times higher than that of the survivors. The average numbers of visits (ANV) of male suicide decedents who used the mental disorders services was increased 6.8 times compared to that for all survivors. The increase in female decedents, in contrast, was 2.7 times. The increase in ANV for 15-24 age group was 14.6 times, significantly higher than that for the other age groups (<4 times). Effective prediction or prevention of potential suicides through increased awareness and surveillance of medical care resource utilization is possible, especially for male and young adult patients under mental disorder health care.
分析了在台湾因自杀而死亡的人在生命的最后一年中医疗保健利用的特点。通过提取 2006 年国家健康保险(NHI)门诊队列记录的数据来评估卫生服务的利用程度。共有 4406 例致命自杀病例与 NHI 受益登记文件中的 17587901 名受试者相匹配。自杀死者在死亡前的最后一年中所有 NHI 门诊服务的就诊率为 85%,而仅精神障碍服务的就诊率为 30.2%。自杀死者的人均就诊次数为每年 24.5 次,是幸存者的两倍。与所有幸存者相比,使用精神障碍服务的男性自杀死者的平均就诊次数(ANV)增加了 6.8 倍。相比之下,女性死者的增加了 2.7 倍。15-24 岁年龄组的 ANV 增加了 14.6 倍,明显高于其他年龄组(<4 倍)。通过提高对医疗保健资源利用的认识和监测,有可能对潜在的自杀行为进行有效预测或预防,尤其是对精神障碍保健下的男性和年轻成年患者。