Forma Leena, Aaltonen Mari, Pulkki Jutta, Raitanen Jani, Rissanen Pekka, Jylhä Marja
School of Health Sciences and Gerontology Research Center (GEREC), University of Tampere, 33014 Tampere, Finland.
Institute for Advanced Social Research, University of Tampere, 33014 Tampere, Finland.
Eur J Ageing. 2016 Oct 4;14(2):143-153. doi: 10.1007/s10433-016-0397-9. eCollection 2017 Jun.
The aim of the study is (1) to describe and analyse health and social service use and medicine purchases in the last 2 years of life among older adults who died by suicide and (2) to compare use and purchases between three groups: those who died by suicide, died a natural death or who lived longer. Nation-wide Finnish register data were used. The data consist of 316,639 decedents who died at the age of 70 years or older in 1998-2008 and 222,967 people who lived longer. Use of hospital, long-term care and home care, and the purchase of prescribed psychotropic medications were studied for the 2-year period. Binary logistic regression analyses were applied. 1118 older adults died by suicide (0.4 % of all deaths). A majority of older adults who died by suicide had multiple somatic diseases and mental disorders, especially depression, and had contact with health and social services in the last 2 years of life. At the same level of morbidity, use of hospital and long-term care was less common among those who died by suicide than among those who died of natural causes, but more common than among those who lived longer. Those who died by suicide received less home care than those who lived longer. A high proportion of suicides occurred in the first month following hospital discharge. Health and social services should improve support for older adults with chronic diseases and depression.
（1）描述和分析自杀死亡老年人生命最后两年的健康和社会服务使用情况以及药品购买情况；（2）比较三组人群的使用和购买情况：自杀死亡者、自然死亡者和寿命更长者。使用了芬兰全国范围的登记数据。数据包括1998 - 2008年70岁及以上死亡的316,639名死者以及222,967名寿命更长者。研究了这两年期间医院、长期护理和家庭护理的使用情况以及处方精神药物的购买情况。应用了二元逻辑回归分析。1118名老年人自杀死亡（占所有死亡人数的0.4%）。大多数自杀死亡的老年人患有多种躯体疾病和精神障碍，尤其是抑郁症，并且在生命的最后两年与健康和社会服务机构有接触。在相同发病率水平下，自杀死亡者中使用医院和长期护理的情况比自然死亡者少见，但比寿命更长者常见。自杀死亡者接受的家庭护理比寿命更长者少。很大一部分自杀事件发生在出院后的第一个月。健康和社会服务机构应加强对患有慢性病和抑郁症的老年人的支持。
