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急诊就诊后自杀未遂:患者安全目标的影响。

Suicide Attempts After Emergency Room Visits: The Effect of Patient Safety Goals.

机构信息

Department of Mental Health Law and Policy, Florida Mental Health Institute, University of South Florida, 13301 Bruce B Downs Blvd., Tampa, FL, 33612, USA.

出版信息

Psychiatr Q. 2015 Dec;86(4):497-504. doi: 10.1007/s11126-015-9345-7.

Abstract

In 2007 the Joint Commission National Patient Safety Goals included a requirement addressing risks associated with patient suicidality. The rational for this requirement was that suicide has been the most frequently reported sentinel event since the inception of the Sentinel Event Policy in 1996. The Patient Safety Goals on suicide required hospitals implement actions to assess suicide risk, meet client's immediate safety needs and provide information such as a crisis hotline to individuals and family members for crisis situations. This study performed a secondary data analysis to assess the effect of the 2007 Joint Commission Patient Safety Goals on suicide attempts among patients following treatment at hospital emergency rooms among individuals enrolled in the Florida Medicaid program. A difference-in-difference approach compared changes in rates of suicide attempts for individuals with a primary mental health diagnosis and individuals with a physical health diagnosis after emergency room treatment. In the 6 months following treatment, suicide rates declined after implementation of the goals among patients treated for a primary mental health diagnosis, and increased among patients with a poisoning diagnosis, compared to individuals with a physical health diagnosis. The goals were associated with a reduction in suicide attempts after emergency room treatment.

摘要

2007 年,联合委员会国家患者安全目标包括了一项与患者自杀风险相关的要求。这一要求的理由是,自 1996 年哨兵事件政策启动以来,自杀一直是最常报告的哨兵事件。关于自杀的患者安全目标要求医院采取行动评估自杀风险,满足患者的即时安全需求,并向个人和家属提供危机热线等信息,以应对危机情况。本研究进行了二次数据分析,以评估 2007 年联合委员会患者安全目标对佛罗里达州医疗补助计划中接受医院急诊治疗的患者在治疗后尝试自杀的影响。差异中的差异方法比较了急诊治疗后患有主要心理健康诊断和患有身体健康诊断的个体尝试自杀的比率变化。在治疗后的 6 个月内,与身体健康诊断的个体相比,接受主要心理健康诊断治疗的患者的自杀率在目标实施后下降,而中毒诊断的患者的自杀率上升。这些目标与急诊治疗后自杀尝试的减少有关。

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