Age and gender differences in medical care utilization prior to suicide

Abstract

BACKGROUND: Analysis of temporal patterns of medical care utilization prior to suicide may aid in developing suicide prevention programs. The aim of this study was to investigate age and gender differences in temporal patterns of medical care utilization during 1 year prior to suicide. METHODS: Medical care utilization data of all suicide completers in the Republic of Korea whose death occurred in 2004 (7903 men and 3620 women) was used. Differences among the quarters in medical expenditures and number of medical care visits were analyzed using a repeated measures analysis. Total medical expenditures were compared to those of age- and gender-matched controls by multiple logistic regression analysis. RESULTS: Among suicides, 84% (81% in men, 91% in women) contacted medical care in the year prior to suicide. In 10-39 year-old women, the number of medical care visits for gastrointestinal disease increased significantly during the final 3 months prior to suicide. All suicide completers showed that the number of medical care visits for psychiatric disorders increased significantly during the final 3 months with the exception of 10-19 year age group. Total medical expenditures during the year prior to suicide were elevated significantly and associated significantly with suicide risk (OR, 1.20; 95% CI, 1.19-1.21). LIMITATIONS: Inaccuracies in the underlying disease and death statistics data may have led to misclassification bias. CONCLUSIONS: Medical care utilization increased as the date of suicide approached. There are age and gender differences in medical care utilization in the year prior to suicide.