Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
Int J Environ Res Public Health. 2023 Sep 27;20(19):6843. doi: 10.3390/ijerph20196843.
Suicide is the second leading cause of death among adolescents. As nearly 20% of adolescents visit emergency departments (EDs) each year, EDs have an opportunity to identify previously unrecognized suicide risk. A novel Computerized Adaptive Screen for Suicidal Youth (CASSY) was shown in a multisite study to be predictive for suicide attempts within 3 months. This study uses site-specific data to estimate the cost of CASSY implementation with adolescents in general EDs. When used universally with all adolescents who are present and able to participate in the screening, the average cost was USD 5.77 per adolescent. For adolescents presenting with non-behavioral complaints, the average cost was USD 2.60 per adolescent. Costs were driven primarily by time and personnel required for the further evaluation of suicide risk for those screening positive. Thus, universal screening using the CASSY, at very low costs relative to the cost of an ED visit, can facilitate services needed for at-risk adolescents.
自杀是青少年死亡的第二大主要原因。由于每年近 20%的青少年都会去急诊部（ED）就诊，因此 ED 有机会识别以前未被发现的自杀风险。一项新的名为自杀青少年计算机自适应筛查（CASSY）的研究在多地点研究中显示，其对 3 个月内自杀企图具有预测性。本研究使用特定于地点的数据来估算在一般 ED 中对青少年实施 CASSY 的成本。如果普遍用于所有在场并能够参与筛查的青少年，那么每个青少年的平均成本为 5.77 美元。对于出现非行为性投诉的青少年，每个青少年的平均成本为 2.60 美元。成本主要由对筛查阳性者进行自杀风险进一步评估所需的时间和人员驱动。因此，使用 CASSY 进行普遍筛查，相对于 ED 就诊的费用来说，成本非常低，可以为高危青少年提供所需的服务。
