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有自杀意念的自杀高风险群体中精神卫生保健利用的决定因素

Determinants of Mental Health Care Utilization in a Suicide High-risk Group With Suicidal Ideation.

作者信息

Kim Hyun-Soo, Lee Moo-Sik, Hong Jee-Young

机构信息

Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea.

出版信息

J Prev Med Public Health. 2016 Jan;49(1):69-78. doi: 10.3961/jpmph.15.016.

Abstract

OBJECTIVES

The suicide rate in Korea is increasing every year, and is the highest among the Organization for Economic Cooperation and Development countries. Psychiatric patients in particular have a higher risk of suicide than other patients. This study was performed to evaluate determinants of mental health care utilization among individuals at high risk for suicide.

METHODS

Korea Health Panel data from 2009 to 2011 were used. Subjects were individuals at high risk of suicide who had suicidal ideation, a past history of psychiatric illness, or had utilized outpatient services for a psychiatric disorder associated with suicidal ideation within the past year. The chi-square test and hierarchical logistic regression were used to identify significant determinants of mental health care utilization.

RESULTS

The total number of subjects with complete data on the variables in our model was 989. Individuals suffering from three or more chronic diseases used mental health care more frequently. Mental health care utilization was higher in subjects who had middle or high levels of educational attainment, were receiving Medical Aid, or had a large family size.

CONCLUSIONS

It is important to control risk factors in high-risk groups as part of suicide prevention strategies. The clinical approach, which includes community-based intervention, entails the management of reduction of suicidal risk. Our study identified demographic characteristics that have a significant impact on mental health care utilization and should be considered in the development of suicide prevention strategies. Further studies should examine the effect of mental health care utilization on reducing suicidal ideation.

摘要

目的

韩国的自杀率逐年上升,在经济合作与发展组织国家中位居榜首。尤其是精神科患者的自杀风险高于其他患者。本研究旨在评估自杀高危人群中精神卫生保健利用的决定因素。

方法

使用2009年至2011年的韩国健康面板数据。研究对象为有自杀意念、有精神疾病病史或在过去一年内因与自杀意念相关的精神障碍而使用过门诊服务的自杀高危个体。采用卡方检验和分层逻辑回归来确定精神卫生保健利用的显著决定因素。

结果

我们模型中变量数据完整的受试者总数为989人。患有三种或更多慢性疾病的个体更频繁地使用精神卫生保健服务。教育程度为中等或高等、正在接受医疗救助或家庭规模较大的受试者精神卫生保健利用率更高。

结论

作为自杀预防策略的一部分,控制高危人群的风险因素很重要。包括社区干预在内的临床方法需要对降低自杀风险进行管理。我们的研究确定了对精神卫生保健利用有重大影响的人口统计学特征,在制定自杀预防策略时应予以考虑。进一步的研究应考察精神卫生保健利用对减少自杀意念的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f289/4750515/1ab1d0e26758/jpmph-49-1-69f1.jpg

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