Risk factors observed in health care system 6 months prior completed suicide

Abstract Background Suicide continues to be a growing public health issue, and suicidal behaviors have been identified as a critical problem in the military population, with the number of soldiers dying by suicide exceeding those killed in action. Objective This study aimed to characterize the population with attempted or completed suicides at the South Texas Veterans Health Care System and to analyze differences between those 2 populations. Other outcomes included adherence to psychiatric medications 6 months before suicide attempt or completion and psychiatric hospitalizations, psychiatric emergency department visits, and “no-show” appointments to mental health providers. Methods Data were collected from the Suicide Prevention and Application Network for patients from South Texas Veterans Health Care System who had attempted or completed suicide between September 1, 2011, and September 30, 2013. Those data were supplemented with data from the computerized patient-record system. A retrospective chart review was conducted to collect further information. Results Of 120 events included in the analysis, there were 97 attempts (81%) and 23 completions (19%). Men were significantly more likely to complete a suicide than women were (P = .025). Those that attempted suicide were more likely to have previous attempts compared with those who completed suicide (mean of 1.01 versus 0.17 respectively, P = .0035). The most frequent method for attempt was toxic ingestion (accounting for 61.9% of attempts), while the most frequent method of completing suicide was by using a firearm (87.0%); there was a statistically significant difference found between methods used for suicide attempt versus completion (P < .0001). Significantly more attempts than completions involved alcohol (21 versus 0 respectively; P = .013). Those on divalproex were less likely to complete suicide (16 attempts, 0 completions; P = .040). There were no differences between groups for the secondary outcomes studied. Conclusions Characteristics associated with completion of suicide in this analysis include male gender and using a firearm, while having previous attempts, being on divalproex, or using alcohol are associated with being more likely to attempt rather than complete suicide. More information is needed on how to appropriately identify high-risk veterans, and suicide safety plans should be developed for these patients to minimize their risk.

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Early mortality after neonatal surgery: analysis of risk factors in an optimized health care system for the surgical newborn

Revista Brasileira de Epidemiologia ◽

10.1590/s1415-790x2013000400014 ◽

2013 ◽

Vol 16 (4) ◽

pp. 943-952 ◽

Cited By ~ 4

Author(s):

Dora Catré ◽

Maria Francelina Lopes ◽

Angel Madrigal ◽

Bárbara Oliveiros ◽

Joaquim Silva Viana ◽

...

Keyword(s):

Risk Factors ◽

Health Care ◽

Health Care System ◽

Early Mortality ◽

Neonatal Surgery ◽

Care System

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Comorbidity in cardioneurology

East European Journal of Neurology ◽

10.33444/2411-5797.2016.2(8).14-19 ◽

2018 ◽

pp. 14-19

Author(s):

N. Kravchuk ◽

N. Svyrydova ◽

T. Parnikosa ◽

V. Sereda ◽

I. Dovgiy ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Cardiovascular Disease ◽

Health Care ◽

Cause Of Death ◽

Health Care System ◽

Severe Form ◽

Cerebrovascular Pathology ◽

Modern Health Care ◽

Care System

The problem of comorbidity in cardioneurology is one of the urgent problems of modern health care system. When comorbidity main cause of death in the vast majority of patients is cardiovascular and cerebrovascular pathology. The most severe form of disease is stroke. Heart failure - a new epidemic of cardiovascular disease, which manifests itself as one of the major risk factors for stroke.

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Sex and Labor Trafficking in Paraguay: Risk Factors, Needs Assessment, and the Role of the Health Care System

Journal of Interpersonal Violence ◽

10.1177/0886260518788364 ◽

2018 ◽

pp. 088626051878836 ◽

Cited By ~ 1

Author(s):

Kimberly Stanford ◽

Alyssa Cappetta ◽

Roy Ahn ◽

Wendy Macias-Konstantopoulos

Keyword(s):

Risk Factors ◽

Health Care ◽

Needs Assessment ◽

Health Care System ◽

Labor Trafficking ◽

Care System

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EVALUATION OF QUALITY OF LIFE OF PATIENTS WITH PRIMARY BRONCHIAL ASTHMA IN THE HEALTH CARE SYSTEM

UZBEK MEDICAL JOURNAL ◽

10.26739/2181-0664-2021-4-8 ◽

2021 ◽

Vol 2 (4) ◽

pp. 51-54

Author(s):

Dilrabo Alikulova ◽

◽

Rixsi Salikhodjaeva

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Health Care ◽

Primary Health Care ◽

Health Care System ◽

Bronchial Asthma ◽

Primary Health ◽

Close Relatives ◽

Care System

The study of risk factors leading to the development of asthma, conducted in the form of a survey and interviews. 52% of patients with a diagnosis of asthma noted the presence of the disease among close relatives. Among the risk factors leading to bronchial asthma, the most common are pollen and tobacco (49.1%). 59.2% of patients diagnosed with asthma do not follow the diet. Keywords:asthma, nurses, primary health care, prevention, risk factors

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Victimization of People With Severe Mental Illness Outside and Within the Mental Health Care System: Results on Prevalence and Risk Factors From a Multicenter Study

Frontiers in Psychiatry ◽

10.3389/fpsyt.2020.563860 ◽

2020 ◽

Vol 11 ◽

Cited By ~ 1

Author(s):

Verena Rossa-Roccor ◽

Peter Schmid ◽

Tilman Steinert

Keyword(s):

Mental Health ◽

Risk Factors ◽

Health Care ◽

Mental Illness ◽

Mental Health Care ◽

Severe Mental Illness ◽

Health Care System ◽

Multicenter Study ◽

Mental Health Care System ◽

Care System

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"Risk" Factors Affecting Readmission of the Elderly Into the Health Care System

Medical Care ◽

10.1097/00005650-198605000-00006 ◽

1986 ◽

Vol 24 (5) ◽

pp. 429-437 ◽

Cited By ~ 70

Author(s):

Carol C. Fethke ◽

Ian M. Smith ◽

Nancilee Johnson

Keyword(s):

Risk Factors ◽

Health Care ◽

Health Care System ◽

The Elderly ◽

Factors Affecting ◽

Care System

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Patient and health care system characteristics are associated with delayed treatment of tuberculosis cases in Taiwan

BMC Health Services Research ◽

10.1186/s12913-019-4702-0 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Chien-Chou Chen ◽

Po-Huang Chiang ◽

Yen-Hsu Chen ◽

I-Chun Fan ◽

Ta-Chien Chan

Keyword(s):

Risk Factors ◽

Health Care ◽

Health System ◽

Health Care System ◽

Initial Visit ◽

System Delay ◽

Tuberculosis Patients ◽

Health System Delay ◽

Treatment Services ◽

Care System

Abstract Background The decline of the incidence rate of tuberculosis in Taiwan has been partly attributed to the launch of the directly observed therapy short course (DOTS) program in 2006, followed by the DOTS-Plus in 2007. However, with the phasing out of the specialized tuberculosis care system and the declining incidence, clinical workers in Taiwan might become less familiar with the presentation of tuberculosis. Complementing the patient-pathway analysis with health system delay estimates, the objective of this study is twofold: to estimate the alignment between patient care initiation and the availability of prompt diagnostic and treatment services, and to identify the risk factors of delayed tuberculosis treatment. Methods The study population included all Taiwanese patients with incident tuberculosis in 2013. We (1) identified 11,507 incident tuberculosis patients from the 2013 National TB Registry, and (2) linked 10,932 Taiwanese from the registry to the 2012–2013 National Health Insurance Research Database. We assessed patient’s care-seeking pathways and associated the determinants of health system delay in a Cox model. Results The overall health system delay was 46 days. We found that 20.5 and 3.5% of 10,932 tuberculosis patients were diagnosed and treated respectively at the initial visit to seek care for TB-related symptoms. Risk factors related to the prolonged health system delay included female gender (adjusted HR = 0.921, 95% CI: 0.884, 0.960), age > =65 years (adjusted HR = 0.720, 95% CI: 0.692, 0.750), non-severe (chest X-ray without cavities) (adjusted HR =0.721, 95% CI 0.683–0.760), chronic respiratory diseases (adjusted HR = 0.544, 95% CI: 0.522, 0.566), living in long-term care facilities (adjusted HR = 0.580, 95% CI: 0.525,0.640), an initial visit at a primary care clinic (adjusted HR = 0.588, 95% CI: 0.565, 0.612), and living in southern Taiwan (adjusted HR = 0.887, 95% CI: 0.798, 0.987). Conclusions The low access to TB diagnostic and treatment services at the initial visit and the prolonged health system delay indicate inefficiency in the health care system. Strengthening training of physicians at public hospitals and health workers at nursing homes might improve the efficiency and timeliness of tuberculosis diagnosis and treatment in Taiwan.

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