Research paper
Contacts with Health Services During the Year Prior to Suicide Death and Prevalent Conditions A Nationwide Study
Moussa Laanani ab Claire Imbaud a Philippe Tuppin b Claire Poulalhon c Fabrice Jollant defg Joël Coste dhi Grégoire Rey a
a Centre for Epidemiology on Medical Causes of Death (CépiDc-Inserm), Le Kremlin-Bicêtre, France
b Strategy and Research Department, French National Health Insurance, Paris, France
c Centre of Research in Epidemiology and Statistics, Inserm, Villejuif, France
d Université de Paris, Paris, France
e GHU Paris Psychiatrie et Neurosciences, Sainte-Anne hospital, Paris, France
f McGill Group for suicide studies, McGill University, Montréal, Canada
g Nîmes university hospital (CHU), Nîmes, France
h Assistance Publique-Hôpitaux de Paris, Biostatistics and Epidemiology unit, Cochin Hospital, Paris, France
i French National Public Health Agency, Saint-Maurice, France
b Strategy and Research Department, French National Health Insurance, Paris, France
c Centre of Research in Epidemiology and Statistics, Inserm, Villejuif, France
d Université de Paris, Paris, France
e GHU Paris Psychiatrie et Neurosciences, Sainte-Anne hospital, Paris, France
f McGill Group for suicide studies, McGill University, Montréal, Canada
g Nîmes university hospital (CHU), Nîmes, France
h Assistance Publique-Hôpitaux de Paris, Biostatistics and Epidemiology unit, Cochin Hospital, Paris, France
i French National Public Health Agency, Saint-Maurice, France
Journal of Affective Disorders
Volume 274, 1 September 2020, Pages 174-182
Highlights
• Contacts with primary care services are frequent in the last weeks prior to suicide• Mental and physical conditions are more common among suicide decedents than in the general population• General practitioners and emergency rooms should be targeted for suicide preventive interventions• Contacts with Health Services During the Year Prior to Suicide Death and Prevalent Conditions: A Nationwide Study
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.