A National Data Linkage Study of Medical Services Utilization and Diagnoses of Suicide Patients within a Year before Death in Taiwan, 2006-2015

Wei-Chen Huang ； Chun-Yuan Lin ； Chia-Yi Wu ； Ming-Been Lee ； Chia-Ta Chan ； Chun-Ying Chen

《Journal of Suicidology》 Vol.17 No.3 (2022/09) Pp. 248-260

https://doi.org/10.30126/JoS.202209_17(3).0009

摘要

Background: Suicide is an important public issue globally, but large-scale studies of the medical services used by suicide patients are lacking. This study aimed to reveal the medical services utilization and diagnoses before suicide death. Methods: This was a national data linkage study. Cause of Death Data and the National Health Insurance Research Database (NHIRD) were used to collect the medical services utilization of suicide patients within a year prior to death; a control group was paired by 10 times the amount. Logistic regression was used to calculate odds ratios (ORs), and the ORs and prevalence were used to calculate the population attributable fraction (PAF). Results: Among the visits to out-patient and emergency departments, the suicide group visited the psychiatry department the most (OR = 9.9, 95% CI = 9.6-10.2). Among the usage of in-patient services, the suicide group visited the emergency department the most (OR = 41, 95% CI = 36.5-130.9), and the psychiatry department was ranked third (OR = 6.3, 95% CI = 6.3-6.8). As for diagnoses of the suicide group, mental disorders were the most common diagnoses in out-patient and emergency departments (OR = 4.8, 95% CI = 4.7-4.9, PAF = 0.38) and in in-patient departments (OR = 4.5, 95% CI = 4.3-4.7, PAF = 0.25). Drug-induced mental disorders were the most used diagnoses among mental disorders in out-patient and emergency departments (OR = 51, 95% CI = 42.8-61.8, PAF = 0.01), and personality disorders were the most used diagnoses among mental disorders in inpatient departments (OR = 20.5, 95% CI = 13.5-31.2, PAF = 0.01). Malignant neoplasms were the second most common physical illness under the sequence of PAF among out-patient and emergency departments (PAF = 0.05, OR = 2.9, 95% CI = 2.8-3.1) and was also ranked the second among in-patient departments (PAF = 0.03, OR = 1.3, 95% CI = 1.2-1.4). Conclusion: Our study is the first national data linkage suicide death analysis on medical services usage and diagnosis. The patients visiting psychiatry and emergency departments, and those with diagnoses of mental disorders, should be treated with caution, especially those with personality disorders and drug-related disorders. Patients seen in the oncology department and diagnosed with malignant neoplasms need special attention due to their suicide risk.

關鍵字

Suicide ； mental disorder ； physical illness ； national database