Suicide typologies among Medicaid beneficiaries, North Carolina 2014-2017.

Autor: Caves Sivaraman JJ; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA. josie.caves@duke.edu.; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, USA. josie.caves@duke.edu.; Present Address: Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA. josie.caves@duke.edu., Ranapurwala SI; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA.; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, USA., Proescholdbell S; North Carolina Department of Health and Human Services, Division of Public Health, Injury and Violence Prevention Branch, Raleigh, North Carolina, USA., Naumann RB; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA.; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, USA., Greene SB; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA., Marshall SW; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA.; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, USA.
Jazyk: angličtina
Zdroj: BMC psychiatry [BMC Psychiatry] 2022 Feb 10; Vol. 22 (1), pp. 104. Date of Electronic Publication: 2022 Feb 10.
DOI: 10.1186/s12888-022-03741-5
Abstrakt: Background: There is a well-established need for population-based screening strategies to identify people at risk of suicide. Because only about half of suicide decedents are ever diagnosed with a behavioral health condition, it may be necessary for providers to consider life circumstances that may also put individuals at risk. This study described the alignment of medical diagnoses with life circumstances by identifying suicide typologies among decedents. Demographics, stressful life events, suicidal behavior, perceived and diagnosed health problems, and suicide method contributed to the typologies.
Methods: This study linked North Carolina Medicaid and North Carolina Violent Death Reporting System (NC-VDRS) data for analysis in 2020. For suicide decedents from 2014 to 2017 aged 25-54 years, we analyzed 12 indicators of life circumstances from NC-VDRS and 6 indicators from Medicaid claims, using a latent class model. Separate models were developed for men and women.
Results: Most decedents were White (88.3%), with a median age of 41, and over 70% had a health care visit in the 90 days prior to suicide. Two typologies were identified in both males (n = 175) and females (n = 153). Both typologies had similar profiles of life circumstances, but one had high probabilities of diagnosed behavioral health conditions (45% of men, 71% of women), compared to low probabilities in the other (55% of men, 29% of women). Black beneficiaries and men who died by firearm were over-represented in the less-diagnosed class, though estimates were imprecise (odds ratio for Black men: 3.1, 95% confidence interval: 0.8, 12.4; odds ratio for Black women: 5.0, 95% confidence interval: 0.9, 31.2; odds ratio for male firearm decedents: 1.6, 95% confidence interval: 0.7, 3.4).
Conclusions: Nearly half of suicide decedents have a typology characterized by low probability of diagnosis of behavioral health conditions. Suicide screening could likely be enhanced using improved indicators of lived experience and behavioral health.
(© 2022. The Author(s).)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje