TY  - JOUR
PY  - 2018//
TI  - Suicidal behavior and non-suicidal self-injury in emergency departments underestimated by administrative claims data
JO  - Crisis
A1  - Stanley, Barbara
A1  - Currier, Glenn W.
A1  - Chesin, Megan
A1  - Chaudhury, Sadia
A1  - Jager-Hyman, Shari
A1  - Gafalvy, Hanga
A1  - Brown, Gregory K.
SP  - 318
EP  - 325
VL  - 39
IS  - 5
N2  - BACKGROUND: External causes of injury codes (E-codes) are used in administrative and claims databases for billing and often employed to estimate the number of self-injury visits to emergency departments (EDs). AIMS: This study assessed the accuracy of E-codes using standardized, independently administered research assessments at the time of ED visits. <br><br>METHOD: We recruited 254 patients at three psychiatric emergency departments in the United States between 2007 and 2011, who completed research assessments after presenting for suicide-related concerns and were classified as suicide attempters (50.4%, n = 128), nonsuicidal self-injurers (11.8%, n = 30), psychiatric controls (29.9%, n = 76), or interrupted suicide attempters (7.8%, n = 20). These classifications were compared with their E-code classifications. <br><br>RESULTS: Of the participants, 21.7% (55/254) received an E-code. In all, 36.7% of research-classified suicide attempters and 26.7% of research-classified nonsuicidal self-injurers received self-inflicted injury E-codes. Those who did not receive an E-code but should have based on the research assessments had more severe psychopathology, more Axis I diagnoses, more suicide attempts, and greater suicidal ideation. LIMITATIONS: The sample came from three large academic medical centers and these findings may not be generalizable to all EDs. <br><br>CONCLUSION: The frequency of ED visits for self-inflicted injury is much greater than current figures indicate and should be increased threefold.<p />  <p>Language: en</p>
LA  - en
SN  - 0227-5910
UR  - http://dx.doi.org/10.1027/0227-5910/a000499
ID  - ref1
ER  -