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Suicide loss, changes in medical care utilization, and hospitalization for cardiovascular disease and diabetes mellitus

 Jaelim Cho  ;  Sang Hyuk Jung  ;  Changsoo Kim  ;  Mina Suh  ;  Yoon Jung Choi  ;  Jungwoo Sohn  ;  Seong-Kyung Cho  ;  Il Suh  ;  Dong Chun Shin  ;  Kathryn M. Rexrode 
 European Heart Journal, Vol.37(9) : 764-770, 2016 
Journal Title
 European Heart Journal 
Issue Date
Adult ; Aged ; Bereavement ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/psychology* ; Cardiovascular Diseases/therapy ; Diabetes Mellitus/epidemiology ; Diabetes Mellitus/psychology* ; Diabetes Mellitus/therapy ; Family/psychology ; Female ; Hospitalization/statistics & numerical data ; Humans ; Male ; Middle Aged ; Patient Acceptance of Health Care/psychology ; Patient Acceptance of Health Care/statistics & numerical data ; Proportional Hazards Models ; Republic of Korea/epidemiology ; Residence Characteristics ; Risk Factors ; Rural Health ; Socioeconomic Factors ; Suicide/psychology* ; Urban Health
Cardiovascular disease ; Diabetes mellitus ; Hospitalization ; Suicide loss
AIMS: The impact of suicide loss on family members' cardiometabolic health has little been evaluated in middle-aged and elderly people. We investigated the effect of suicide loss on risks for cardiovascular disease (CVD) and diabetes mellitus (DM) in suicide completers' family members using a national representative comparison group. METHODS AND RESULTS: The study subjects were 4253 family members of suicide completers and 9467 non-bereaved family members of individuals who were age and gender matched with the suicide completers in the Republic of Korea. National health insurance data were used to identify medical care utilization during the year before and after a suicide loss. A recurrent-events survival analysis was performed to estimate the hazard ratios (HRs) of hospitalizations for CVD, DM, or psychiatric disorders, after adjusting for age, residence, and socioeconomic status. Among subjects without a past history of CVD, DM, or psychiatric disorders, the increased risks of recurrent hospitalizations were observed for CVD [HR 1.343, 95% confidence interval (CI) 1.001-1.800 in men; HR 1.240, 95% CI 1.025-1.500 in women] and DM (HR 2.238, 95% CI 1.379-3.362 in men; HR 1.786, 95% CI 1.263-2.527 in women). In subjects with a past history of CVD, DM, or psychiatric disorders, the number of medical care visits decreased after a suicide loss, and suicide completers' family members showed lower rates of hospitalization for CVD and DM than the comparison group. CONCLUSION: Compared with non-bereaved family members, suicide completers' family members without a past history of CVD, DM, or psychiatric disorder showed a high risk of hospitalization for those conditions.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
Yonsei Authors
김창수(Kim, Chang Soo) ORCID logo https://orcid.org/0000-0002-5940-5649
서일(Suh, Il) ORCID logo https://orcid.org/0000-0002-9689-7849
손정우(Sohn, Jung Woo)
신동천(Shin, Dong Chun) ORCID logo https://orcid.org/0000-0003-4252-2280
조성경(Cho, Seong-Kyung)
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