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Abstract
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Background Service utilization was found to be higher among patients with comorbidity, but few studies investigated this phenomenon in older adults and those comorbid with suicide risks. Identifying suicide risks in medical settings offers opportunities for suicide prevention. We aimed to examine the overall service use in medical patients with suicide risks.
Methods Consecutive patients admitted to a university-affiliated hospital in northern Taiwan were recruited in 2012. We recorded medical healthcare utilization and physical diagnoses in the electronic medical records and assessed major suicide risk factors including depressive symptoms by Patient Health Questionnaire-9 (PHQ-9) through face-to-face interviews. The composite score of service use was calculated to make individual comparison using standardized weights of three main sources of service (emergency, hospitalization, and inpatient care).
Results Among the 230 participants (46.5% females, mean-aged 62.6±16.0 years), about 30% reported significant depressive symptoms (PHQ-9≥10) or lifetime suicide ideation. The top three major physical illnesses were categorized as cardiovascular, gastrointestinal, and tumorous diseases. Comorbidity and higher service use were significantly associated across major risk factors of suicide. Specifically, patients with suicide ideation or attempt and depression had remarkably more service contacts in the previous year.
Conclusion Our findings suggest the importance of suicide risk identification among medical patients irrespective of reasons for contact. Healthcare providers may serve as gatekeepers to assess suicide risks and connect people to proper services for suicide risk management and medical cost-savings.
Keywords: Comorbidity; depression; suicide risk; service utilization; Taiwan
Language: en |