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Health care utilisation two years prior to suicide in Sweden : a retrospective explorative study based on medical records

Bergqvist, Erik LU orcid ; Probert-Lindström, Sara LU orcid ; Fröding, Elin ; Palmqvist-Öberg, Nina LU ; Ehnvall, Anna LU ; Sunnqvist, Charlotta LU ; Sellin, Tabita ; Vaez, Marjan ; Waern, Margda and Westrin, Åsa LU (2022) In BMC Health Services Research 22. p.1-10
Abstract

OBJECTIVE: Previous literature has suggested that identifying putative differences in health care seeking patterns before death by suicide depending on age and gender may facilitate more targeted suicide preventive approaches. The aim of this study is to map health care utilisation among individuals in the two years prior to suicide in Sweden in 2015 and to examine possible age and gender differences.

METHODS: Design: A retrospective explorative study with a medical record review covering the two years preceding suicide.

SETTING: All health care units located in 20 of Sweden's 21 regions.

PARTICIPANTS: All individuals residing in participating regions who died by suicide during 2015 (n = 949).

RESULTS: Almost 74%... (More)

OBJECTIVE: Previous literature has suggested that identifying putative differences in health care seeking patterns before death by suicide depending on age and gender may facilitate more targeted suicide preventive approaches. The aim of this study is to map health care utilisation among individuals in the two years prior to suicide in Sweden in 2015 and to examine possible age and gender differences.

METHODS: Design: A retrospective explorative study with a medical record review covering the two years preceding suicide.

SETTING: All health care units located in 20 of Sweden's 21 regions.

PARTICIPANTS: All individuals residing in participating regions who died by suicide during 2015 (n = 949).

RESULTS: Almost 74% were in contact with a health care provider during the 3 months prior to suicide, and 60% within 4 weeks. Overall health care utilisation during the last month of life did not differ between age groups. However, a higher proportion of younger individuals (< 65 years) were in contact with psychiatric services, and a higher proportion of older individuals (≥ 65 years) were in contact with primary and specialised somatic health care. The proportion of women with any type of health care contact during the observation period was larger than the corresponding proportion of men, although no gender difference was found among primary and specialised somatic health care users within four weeks and three months respectively prior to suicide.

CONCLUSION: Care utilisation before suicide varied by gender and age. Female suicide decedents seem to utilise health care to a larger extent than male decedents in the two years preceding death, except for the non-psychiatric services in closer proximity to death. Older adults seem to predominantly use non-psychiatric services, while younger individuals seek psychiatric services to a larger extent.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Aged, Delivery of Health Care, Female, Humans, Male, Medical Records, Patient Acceptance of Health Care/psychology, Retrospective Studies, Suicide/prevention & control, Sweden/epidemiology
in
BMC Health Services Research
volume
22
article number
664
pages
1 - 10
publisher
BioMed Central (BMC)
external identifiers
  • pmid:35581647
  • scopus:85130142454
ISSN
1472-6963
DOI
10.1186/s12913-022-08044-9
project
Health Care Contacts of High-Risk Suicidal Patients, Aspects on Emotional Contact and Experiences of Treatment with the Attempted Suicide Short Intervention Program
language
English
LU publication?
yes
additional info
© 2022. The Author(s).
id
a5e35884-55a3-490e-ac5b-1773062bd101
date added to LUP
2022-05-23 17:11:23
date last changed
2024-06-13 17:29:17
@article{a5e35884-55a3-490e-ac5b-1773062bd101,
  abstract     = {{<p>OBJECTIVE: Previous literature has suggested that identifying putative differences in health care seeking patterns before death by suicide depending on age and gender may facilitate more targeted suicide preventive approaches. The aim of this study is to map health care utilisation among individuals in the two years prior to suicide in Sweden in 2015 and to examine possible age and gender differences.</p><p>METHODS: Design: A retrospective explorative study with a medical record review covering the two years preceding suicide.</p><p>SETTING: All health care units located in 20 of Sweden's 21 regions.</p><p>PARTICIPANTS: All individuals residing in participating regions who died by suicide during 2015 (n = 949).</p><p>RESULTS: Almost 74% were in contact with a health care provider during the 3 months prior to suicide, and 60% within 4 weeks. Overall health care utilisation during the last month of life did not differ between age groups. However, a higher proportion of younger individuals (&lt; 65 years) were in contact with psychiatric services, and a higher proportion of older individuals (≥ 65 years) were in contact with primary and specialised somatic health care. The proportion of women with any type of health care contact during the observation period was larger than the corresponding proportion of men, although no gender difference was found among primary and specialised somatic health care users within four weeks and three months respectively prior to suicide.</p><p>CONCLUSION: Care utilisation before suicide varied by gender and age. Female suicide decedents seem to utilise health care to a larger extent than male decedents in the two years preceding death, except for the non-psychiatric services in closer proximity to death. Older adults seem to predominantly use non-psychiatric services, while younger individuals seek psychiatric services to a larger extent.</p>}},
  author       = {{Bergqvist, Erik and Probert-Lindström, Sara and Fröding, Elin and Palmqvist-Öberg, Nina and Ehnvall, Anna and Sunnqvist, Charlotta and Sellin, Tabita and Vaez, Marjan and Waern, Margda and Westrin, Åsa}},
  issn         = {{1472-6963}},
  keywords     = {{Aged; Delivery of Health Care; Female; Humans; Male; Medical Records; Patient Acceptance of Health Care/psychology; Retrospective Studies; Suicide/prevention & control; Sweden/epidemiology}},
  language     = {{eng}},
  pages        = {{1--10}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Health Services Research}},
  title        = {{Health care utilisation two years prior to suicide in Sweden : a retrospective explorative study based on medical records}},
  url          = {{http://dx.doi.org/10.1186/s12913-022-08044-9}},
  doi          = {{10.1186/s12913-022-08044-9}},
  volume       = {{22}},
  year         = {{2022}},
}