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青少年自杀与医疗服务利用中的性别差异。

Gender Differences in Youth Suicide and Healthcare Service Use.

作者信息

Gontijo Guerra Samantha, Vasiliadis Helen-Maria

机构信息

1 Department of Community Health Sciences, Faculty of Medicine and Health Sciences of the University of Sherbrooke, Charles Le Moyne Hospital Research Center, Longueuil, QC, Canada.

出版信息

Crisis. 2016 Jul;37(4):290-298. doi: 10.1027/0227-5910/a000387. Epub 2016 Jun 1.

Abstract

BACKGROUND

Healthcare service use among suicide decedents must be well characterized and understood since a key strategy for preventing suicide is to improve healthcare providers' ability to effectively detect and treat those in need.

AIMS

To determine gender differences in healthcare service use 12 months prior to suicide.

METHOD

Data for 1,231 young Quebec residents (≤ 25 years) who died by suicide between 2000 and 2007 were collected from public health insurance agency databases and coroner registers. Healthcare visits were categorized according to the setting (emergency department [ED], outpatient, and hospital) and their nature (mental health vs. non-mental health).

RESULTS

Girls were more likely than boys (82.5% vs. 74.9%, p = .011) to have used healthcare services in the year prior to death. A higher proportion of girls had used outpatient services (79.0% vs. 69.5%, p = .003), had been hospitalized (25.7% vs. 15.6%, p < .001) and had received a mental health-related diagnosis (46.7% vs. 33.1%, p < .001). However, no gender differences were observed in ED visits (59.5% vs. 54.5%, p = .150).

CONCLUSION

There is an important proportion of suicide decedents who did not receive a mental health diagnosis and healthcare services in the year prior to death. Future studies should focus on examining gender-specific individual and health system barriers among suicide decedents as well as the quality of care offered regarding detection and treatment.

摘要

背景

由于预防自杀的一项关键策略是提高医疗服务提供者有效识别和治疗有需要者的能力,因此必须对自杀死亡者的医疗服务使用情况进行充分的描述和了解。

目的

确定自杀前12个月医疗服务使用情况的性别差异。

方法

从公共医疗保险机构数据库和验尸官登记处收集了2000年至2007年间自杀死亡的1231名魁北克年轻居民(≤25岁)的数据。医疗就诊情况根据就诊地点(急诊科、门诊和医院)及其性质(心理健康与非心理健康)进行分类。

结果

在死亡前一年,女孩比男孩更有可能使用医疗服务(82.5%对74.9%,p = 0.011)。更高比例的女孩使用过门诊服务(79.0%对69.5%,p = 0.003)、住过院(25.7%对15.6%,p < 0.001)并接受过与心理健康相关的诊断(46.7%对33.1%,p < 0.001)。然而,在急诊科就诊方面未观察到性别差异(59.5%对54.5%,p = 0.150)。

结论

有相当一部分自杀死亡者在死亡前一年未接受心理健康诊断和医疗服务。未来的研究应侧重于检查自杀死亡者中特定性别的个体和卫生系统障碍,以及在识别和治疗方面提供的护理质量。

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