Racial/Ethnic differences in health care visits made before suicide attempt across the United States.
Racial/Ethnic differences in health care visits made before suicide attempt across the United States.
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DOI：
10.1097/mlr.0000000000000335
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发表时间：
2015-05
期刊：
影响因子：
3
通讯作者：
Williams K
中科院分区：
文献类型：
--
作者：
Ahmedani BK;Stewart C;Simon GE;Lynch F;Lu CY;Waitzfelder BE;Solberg LI;Owen-Smith AA;Beck A;Copeland LA;Hunkeler EM;Rossom RC;Williams K
自杀是一个公共卫生问题，但人们对自杀未遂前的医疗就诊模式以及这些模式是否因种族/民族而有所不同知之甚少。检查自杀未遂前进行的医疗保健就诊类型、这些就诊时间以及是否记录了心理健康或药物使用诊断的种族/民族差异。回顾性纵向研究，2009-2011 年。心理健康研究网络的 10 个卫生系统中有 22,387 名试图自杀的人加入了健康计划。根据自我报告的种族/族裔和诊断，自杀未遂前 52 周内不同类型医疗就诊的累计百分比。数据来自每个站点的虚拟数据仓库。超过 38% 的人在企图自杀前一周内进行过任何医疗保健就诊，约 95% 的人在前一年内进行过医疗保健；这些百分比因种族/族裔群体而异（p<0.001）。白人在自杀未遂 1 周内就诊的比例最高 (>41%)。亚裔美国人在 52 周内访问的可能性最小。夏威夷/太平洋岛民在尝试之前住院和急诊就诊的比例最高，但记录心理健康或药物滥用诊断的可能性最小。总体而言，就诊在初级保健和门诊普通医疗机构中最为常见。这项研究提供了自杀未遂前就医的种族/民族差异的时间证据。医疗保健系统可以使用这些信息来帮助集中设计和实施其自杀预防举措。
Suicide is a public health concern, but little is known about the patterns of healthcare visits made before a suicide attempt, and whether those patterns differ by race/ethnicity. To examine racial/ethnic variation in the types of healthcare visits made before a suicide attempt, when those visits occur, and whether mental health or substance use diagnoses were documented. Retrospective, longitudinal study, 2009–2011. 22,387 individuals who attempted suicide and were enrolled in the health plan across 10 health systems in the Mental Health Research Network. Cumulative percentage of different types of healthcare visits made in the 52-weeks before a suicide attempt, by self-reported racial/ethnicity and diagnosis. Data were from the Virtual Data Warehouse at each site. Over 38% of individuals made any healthcare visit within the week before their suicide attempt and ~95% within the preceding year; these percentages varied across racial/ethnic groups (p<0.001). White individuals had the highest percentage of visits (>41%) within 1-week of suicide attempt. Asian Americans were the least likely to make visits within 52 weeks. Hawaiian/Pacific Islanders had proportionally the most inpatient and emergency visits before an attempt, but were least likely to have a recorded mental health or substance use diagnosis. Overall, visits were most common in primary care and outpatient general medical settings. This study provides temporal evidence of racial/ethnic differences in healthcare visits made prior to suicide attempt. Healthcare systems can use this information to help focus the design and implementation of their suicide prevention initiatives.