Mezuk Briana, Lohman Matthew, Leslie Marc, Powell Virginia
At the time of the study, Briana Mezuk and Matthew Lohman were with the Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond. Briana Mezuk is also with the Institute for Social Research, University of Michigan, Ann Arbor. Marc Leslie and Virginia Powell are with the Office of the Chief Medical Examiner, Virginia Department of Health, Richmond.
Am J Public Health. 2015 Jul;105(7):1495-502. doi: 10.2105/AJPH.2015.302573. Epub 2015 May 14.
We investigated the epidemiology of suicide among adults aged 50 years and older in nursing homes and assisted living facilities and whether anticipating transitioning into long-term care (LTC) is a risk factor for suicide.
Data come from the Virginia Violent Death Reporting System (2003-2011). We matched locations of suicides (n = 3453) against publicly available resource registries of nursing homes (n = 285) and assisted living facilities (n = 548). We examined individual and organizational correlates of suicide by logistic regression. We identified decedents anticipating entry into LTC through qualitative text analysis.
Incidence of suicide was 14.16 per 100 000 in nursing homes and 15.66 in the community. Better performance on Nursing Home Compare quality metrics was associated with higher odds of suicide in nursing homes (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.21, 3.14). Larger facility size was associated with higher suicide risk in assisted living facilities (OR = 1.01; 95% CI = 1.00, 1.01). Text narratives identified 38 decedents anticipating transitioning into LTC and 16 whose loved one recently transitioned or resided in LTC.
LTC may be an important point of engagement in suicide prevention.
我们调查了养老院和辅助生活设施中50岁及以上成年人的自杀流行病学情况，以及预期转入长期护理（LTC）是否为自杀的危险因素。
数据来自弗吉尼亚暴力死亡报告系统（2003 - 2011年）。我们将自杀地点（n = 3453）与养老院（n = 285）和辅助生活设施（n = 548）的公开资源登记处进行匹配。我们通过逻辑回归分析了自杀的个体和组织相关因素。我们通过定性文本分析确定了预期进入LTC的死者。
养老院的自杀发生率为每10万人中有14.16例，社区为15.66例。养老院比较质量指标表现更好与养老院自杀几率更高相关（优势比[OR] = 1.95；95%置信区间[CI] = 1.21，3.14）。辅助生活设施规模越大与自杀风险越高相关（OR = 1.01；95% CI = 1.00，1.01）。文本叙述确定了38例预期转入LTC的死者以及16例其亲人最近转入LTC或居住在LTC的死者。
长期护理可能是自杀预防中的一个重要切入点。
