Moussa Laanani1, Claire Imbaud2, Philippe Tuppin3, Claire Poulalhon4, Fabrice Jollant5, Joël Coste6, Grégoire Rey2. 1. Centre for Epidemiology on Medical Causes of Death (CépiDc-Inserm), Le Kremlin-Bicêtre, France; Strategy and Research Department, French National Health Insurance, Paris, France. Electronic address: moussa.laanani@assurance-maladie.fr. 2. Centre for Epidemiology on Medical Causes of Death (CépiDc-Inserm), Le Kremlin-Bicêtre, France. 3. Strategy and Research Department, French National Health Insurance, Paris, France. 4. Centre of Research in Epidemiology and Statistics, Inserm, Villejuif, France. 5. Université de Paris, Paris, France; GHU Paris Psychiatrie et Neurosciences, Sainte-Anne hospital, Paris, France; McGill Group for suicide studies, McGill University, Montréal, Canada; Nîmes university hospital (CHU), Nîmes, France. 6. Université de Paris, Paris, France; Assistance Publique-Hôpitaux de Paris, Biostatistics and Epidemiology unit, Cochin Hospital, Paris, France; French National Public Health Agency, Saint-Maurice, France.
Abstract
BACKGROUND: This study was designed to describe contacts with health services during the year before suicide death in France, and prevalent mental and physical conditions. METHODS: Data were extracted from the French National Health Data System (SNDS), which comprises comprehensive claims data for inpatient and outpatient care linked to the national causes-of-death registry. Individuals aged ≥15 years who died from suicide in France in 2013-2015 were included. Medical consultations, emergency room visits, and hospitalisations during the year preceding death were collected. Conditions were identified, and standardised prevalence ratios (SPRs) were estimated to compare prevalence rates in suicide decedents with those of the general population. RESULTS: The study included 19,144 individuals. Overall, 8.5% of suicide decedents consulted a physician or attended an emergency room on the day of death, 34.1% during the week before death, 60.9% during the month before death. Most contacts involved a general practitioner or an emergency room. During the month preceding suicide, 24.4% of individuals were hospitalised at least once. Mental conditions (36.8% of cases) were 7.9-fold more prevalent in suicide decedents than in the general population. The highest SPRs among physical conditions were for liver/pancreatic diseases (SPR=3.3) and epilepsy (SPR=2.7). LIMITATIONS: The study population was restricted to national health insurance general scheme beneficiaries (76% of the population living in France). CONCLUSIONS: Suicide decedents have frequent contacts with general practitioners and emergency departments during the last weeks before death. Improving suicide risk identification and prevention in these somatic healthcare settings is needed.
BACKGROUND: This study was designed to describe contacts with health services during the year before suicide death in France, and prevalent mental and physical conditions. METHODS: Data were extracted from the French National Health Data System (SNDS), which comprises comprehensive claims data for inpatient and outpatient care linked to the national causes-of-death registry. Individuals aged ≥15 years who died from suicide in France in 2013-2015 were included. Medical consultations, emergency room visits, and hospitalisations during the year preceding death were collected. Conditions were identified, and standardised prevalence ratios (SPRs) were estimated to compare prevalence rates in suicide decedents with those of the general population. RESULTS: The study included 19,144 individuals. Overall, 8.5% of suicide decedents consulted a physician or attended an emergency room on the day of death, 34.1% during the week before death, 60.9% during the month before death. Most contacts involved a general practitioner or an emergency room. During the month preceding suicide, 24.4% of individuals were hospitalised at least once. Mental conditions (36.8% of cases) were 7.9-fold more prevalent in suicide decedents than in the general population. The highest SPRs among physical conditions were for liver/pancreatic diseases (SPR=3.3) and epilepsy (SPR=2.7). LIMITATIONS: The study population was restricted to national health insurance general scheme beneficiaries (76% of the population living in France). CONCLUSIONS: Suicide decedents have frequent contacts with general practitioners and emergency departments during the last weeks before death. Improving suicide risk identification and prevention in these somatic healthcare settings is needed.
Authors: Colin G Walsh; Kevin B Johnson; Michael Ripperger; Sarah Sperry; Joyce Harris; Nathaniel Clark; Elliot Fielstein; Laurie Novak; Katelyn Robinson; William W Stead Journal: JAMA Netw Open Date: 2021-03-01
Authors: Elisabeth Bondesson; Tori Alpar; Ingemar F Petersson; Maria E C Schelin; Anna Jöud Journal: BMC Public Health Date: 2022-08-25 Impact factor: 4.135