Figure 1The total number of medical care utilization for psychiatric disorder (F00-F99) during 1 year prior to death in suicides motivated by physical illnesses after stratification of age and gender, separately by gender (A: men, B: women). *p<0.05; Significant differences among quarters (within-group); using repeated-measures data analysis after adjusting for residence, socioeconomic status, and morbidity (cancer, hypertension, diabetes mellitus, ischemic heart disease, chronic obstructive pulmonary disease or asthma).
Table 1.General characteristics of suicides motivated by physical illnesses
|
Total (n = 1994) |
Medical care utilization (n = 1893) |
No medical care utilization (n=101) |
p-value |
Age (y) |
|
|
|
|
<40 |
117 (5.9) |
99 (5.2) |
18 (17.8) |
<0.001 |
40-64 |
661 (33.2) |
618 (32.6) |
43 (42.6) |
|
≥65 |
1216 (61.0) |
1176 (62.1) |
40 (39.6) |
|
Gender |
|
|
|
|
Men |
1253 (62.8) |
1176 (62.1) |
77 (76.2) |
0.006 |
Women |
741 (37.2) |
717 (37.9) |
24 (23.8) |
|
Residence |
|
|
|
|
Metropolitan |
648 (32.5) |
614 (32.4) |
34 (33.7) |
0.86 |
Urban |
1053 (52.8) |
999 (52.8) |
54 (53.5) |
|
Rural |
293 (14.7) |
280 (14.8) |
13 (12.9) |
|
Socioeconomic status1
|
|
|
|
|
Quintile 1 |
701 (35.2) |
663 (35.0) |
38 (37.6) |
0.013 |
Quintile 2 |
301 (15.1) |
281 (14.8) |
20 (19.8) |
|
Quintile 3 |
318 (16.0) |
295 (15.6) |
23 (22.8) |
|
Quintile 4 |
312 (15.7) |
299 (15.8) |
13 (12.9) |
|
Quintile 5 |
362 (18.2) |
355 (18.8) |
7 (6.9) |
|
Medical care utilization during 1 year prior to suicide |
|
|
|
|
No. of visits, median (IQR) |
16 (8, 25) |
|
|
|
Total medical expenditures (in thousands of Korean won), median (IQR) |
905 (231, 2664) |
|
|
|
Cancer (C00-C99) |
291 (14.6) |
|
|
|
Hypertension (I10-I15) |
595 (29.8) |
|
|
|
Diabetes mellitus (E10-E14) |
374 (18.8) |
|
|
|
Ischemic heart disease (I20-I25) |
124 (6.2) |
|
|
|
Chronic obstructive pulmonary disease or asthma (J40-J46) |
347 (17.4) |
|
|
|
Psychiatric disorder (F00-F99) |
445 (22.3) |
|
|
|
Table 2.The pattern of medical care utilization during 1 year prior to death in suicides motivated by physical illnesses
|
No. of medical care visits in individuals
|
|
12-10 mo prior to suicide |
9-7 mo prior to suicide |
6-4 mo prior to suicide |
Last 3 mo prior to suicide |
p-value |
Total subjects |
4.0 (1.0, 6.0) |
4.0 (1.0, 6.0) |
4.0 (2.0, 7.0) |
4.0 (2.0, 7.0) |
<0.0011
|
Age (y) |
|
|
|
|
|
<40 |
1.0 (0.0, 4.0) |
1.0 (0.0, 4.0) |
2.0 (0.0, 5.0) |
2.0 (0.0, 5.0) |
<0.001 |
40-64 |
3.0 (1.0, 6.0) |
3.0 (1.0, 6.0) |
3.0 (2.0, 6.0) |
4.0 (1.0, 7.0) |
|
≥65 |
4.0 (2.0, 7.0) |
4.0 (2.0, 7.0) |
4.0 (2.0, 7.0) |
4.0 (2.0, 7.0) |
|
Gender |
|
|
|
|
|
Men |
3.0 (1.0, 6.0) |
3.0 (1.0, 6.0) |
4.0 (1.0, 7.0) |
4.0 (2.0, 6.0) |
<0.001 |
Women |
4.0 (2.0, 7.0) |
4.0 (2.0, 7.0) |
4.0 (2.0, 7.0) |
5.0 (2.0, 8.0) |
|
Residence |
|
|
|
|
|
Metropolitan |
4.0 (1.0, 7.0) |
4.0 (1.0, 7.0) |
4.0 (2.0, 7.0) |
4.0 (2.0, 7.0) |
0.09 |
Urban |
3.0 (1.0, 6.0) |
4.0 (1.0, 6.0) |
4.0 (2.0, 7.0) |
4.0 (2.0, 7.0) |
|
Rural |
4.0 (1.0, 7.0) |
4.0 (2.0, 6.0) |
4.0 (2.0, 8.0) |
4.0 (2.0, 8.0) |
|
Socioeconomic status2
|
|
|
|
|
|
Quintile 1 |
4.0 (1.0, 6.0) |
4.0 (2.0, 6.0) |
4.0 (2.0, 7.0) |
4.0 (2.0, 7.0) |
0.09 |
Quintile 2 |
3.0 (1.0, 6.0) |
3.0 (1.0, 6.0) |
3.0 (2.0, 6.0) |
3.0 (1.0, 6.0) |
|
Quintile 3 |
3.0 (1.0, 6.0) |
4.0 (1.0, 6.0) |
3.0 (2.0, 6.0) |
4.0 (2.0, 7.0) |
|
Quintile 4 |
3.0 (1.0, 6.0) |
3.0 (1.0, 6.5) |
4.0 (2.0, 7.0) |
4.0 (2.0, 7.0) |
|
Quintile 5 |
4.0 (2.0, 6.0) |
4.0 (2.0, 7.0) |
4.0 (2.0, 8.0) |
5.0 (2.0, 7.0) |
|
Table 3.Total medical expenditures (in thousands of Korean won) during 1 year prior to death in suicides motivated by physical illnesses
|
12-10 mo prior to suicide |
9-7 mo prior to suicide |
6-4 mo prior to suicide |
Last 3 mo prior to suicide |
p-value |
Total subjects |
82 (18, 296) |
85 (20, 311) |
108 (23, 454) |
153 (28, 746) |
<0.0011
|
Age (y) |
|
|
|
|
|
<40 |
23 (0, 155) |
18 (0, 162) |
48 (0, 279) |
57 (0, 371) |
<0.001 |
40-64 |
78 (12, 353) |
75 (14, 315) |
114 (23, 618) |
162 (23, 914) |
|
≥65 |
89 (24, 295) |
98 (28, 319) |
112 (28, 406) |
156 (38, 698) |
|
Gender |
|
|
|
|
|
Men |
69 (11, 290) |
73 (15, 285) |
95 (20, 459) |
128 (22, 746) |
0.40 |
Women |
106 (28, 305) |
106 (28, 339) |
124 (30, 450) |
203 (42, 739) |
|
Residence |
|
|
|
|
|
Metropolitan |
85 (19, 348) |
88 (24, 349) |
112 (23, 421) |
156 (33, 795) |
0.91 |
Urban |
77 (17, 283) |
81 (17, 285) |
101 (22, 491) |
141 (27, 736) |
|
Rural |
92 (18, 266) |
106 (28, 327) |
122 (29, 440) |
182 (32, 727) |
|
Socioeconomic status2
|
|
|
|
|
|
Quintile 1 |
94 (18, 319) |
102 (24, 353) |
124 (22, 505) |
161 (34, 761) |
0.02 |
Quintile 2 |
60 (18, 232) |
59 (14, 208) |
78 (21, 349) |
106 (18, 415) |
|
Quintile 3 |
76 (14, 272) |
86 (17, 282) |
81 (18, 368) |
101 (18, 565) |
|
Quintile 4 |
80 (17, 308) |
75 (18, 281) |
119 (30, 559) |
156 (29, 782) |
|
Quintile 5 |
80 (20, 330) |
95 (26, 391) |
112 (30, 429) |
207 (50, 1016) |
|
Table 4.The pattern of medical care utilization during 1 year prior to death in suicides motivated by physical illnesses after stratification of disease group
|
12-10 mo prior to suicide |
9-7 mo prior to suicide |
6-4 mo prior to suicide |
Last 3 mo prior to suicide |
p-value1
|
No. of medical care visits |
Cancer |
4.0 (2.0, 7.0) |
5.0 (3.0, 8.0) |
6.0 (3.0, 9.0) |
6.0 (4.0, 8.0) |
<0.001 |
Hypertension |
5.0 (3.0, 8.0) |
5.0 (3.0, 8.0) |
6.0 (3.0, 8.0) |
6.0 (3.0, 8.0) |
0.003 |
Diabetes mellitus |
5.0 (3.0, 8.0) |
5.0 (3.0, 8.0) |
6.0 (3.0, 8.0) |
6.0 (3.0, 9.0) |
<0.001 |
Ischemic heart disease |
5.0 (3.0, 8.0) |
6.0 (3.0, 9.0) |
6.0 (3.0, 8.0) |
6.0 (3.0, 9.0) |
0.39 |
COPD or asthma |
5.0 (3.0, 8.0) |
5.0 (3.0, 8.0) |
6.0 (3.0, 9.0) |
6.0 (4.0, 9.0) |
<0.001 |
Medical expenditures (in thousands of Korean won) |
Cancer |
168 (36, 758) |
195 (59, 1005) |
560 (100, 1908) |
1116 (265, 2862) |
<0.001 |
Hypertension |
131 (46, 381) |
136 (47, 402) |
160 (48, 534) |
204 (61, 736) |
<0.001 |
Diabetes mellitus |
133 (52, 486) |
160 (59, 583) |
235 (76, 945) |
272 (68, 1333) |
<0.001 |
Ischemic heart disease |
182 (56, 580) |
184 (71, 703) |
240 (37, 821) |
426 (74, 1412) |
0.02 |
COPD or asthma |
137 (50, 363) |
162 (57, 486) |
219 (71, 742) |
248 (85, 1053) |
<0.001 |