J Prev Med Public Health.  2014 Nov;47(6):327-335. 10.3961/jpmph.14.038.

Medical Care Expenditure in Suicides From Non-illness-related Causes

Affiliations
  • 1Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea. preman@yuhs.ac
  • 2Samsung Life Insurance, Seoul, Korea.
  • 3National Cancer Center, Goyang, Korea.
  • 4Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

Abstract


OBJECTIVES
Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated.
METHODS
Suicides motivated by non-illness-related factors were identified using the investigator's note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status.
RESULTS
Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women.
CONCLUSIONS
Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.

Keyword

Suicide; Health expenditures; Social behavior disorders
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