KMID : 0371020130460030147
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Journal of Preventive Medicine and Public Health 2013 Volume.46 No. 3 p.147 ~ p.154
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Medical Care Utilization During 1 Year Prior to Death in Suicides Motivated by Physical Illnesses
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Cho Jae-Lim
Lee Won-Joon Sohn Jung-Woo Ha Kyoung-Hwa Kim Chang-Soo Shin Dong-Chun Moon Ki-Tae Suh Mi-Na Jung Sang-Hyuk
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Abstract
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Objectives: Many epidemiological studies have suggested that a variety of medical illnesses are associated with suicide. Investigating the time-varying pattern of medical care utilization prior to death in suicides motivated by physical illnesses would be helpful for developing suicide prevention programs for patients with physical illnesses.
Methods: Suicides motivated by physical illnesses were identified by the investigator¡¯s note from the National Police Agency, which was linked to the data from the Health Insurance Review and Assessment. We investigated the time-varying patterns of medical care utilization during 1 year prior to suicide using repeated-measures data analysis after adjustment for age, gender, area of residence, and socioeconomic status.
Results: Among 1994 suicides for physical illness, 1893 (94.9%) suicides contacted any medical care services and 445 (22.3%) suicides contacted mental health care during 1 year prior to suicide. The number of medical care visits and individual medical expenditures increased as the date of suicide approached (p<0.001). The number of medical care visits for psychiatric disorders prior to suicide significantly increased only in 40- to 64-year-old men (p=0.002), women <40 years old (p=0.011) and women 40 to 64 years old (p=0.021) after adjustment for residence, socioeconomic status, and morbidity.
Conclusions: Most of the suicides motivated by physical illnesses contacted medical care during 1 year prior to suicide, but many of them did not undergo psychiatric evaluation. This underscores the need for programs to provide psychosocial support to patients with physical illnesses
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KEYWORD
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Suicide, Medical care research, Mental disorders
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