Suicide mortality following nursing home discharge in the Department of Veterans Affairs health system

J.F. McCarthy, B.R. Szymanski, B.E. Karlin and I.R. Katz

American Journal of Public Health, 2013, vol. 103, issue 12, 2261-2266

Abstract: Objectives. We assessed suicide rates up to 6 months following discharge from US Department of Veterans Affairs (VA) nursing homes. Methods. In VA Minimum Data Set (MDS) records, we identified 281 066 live discharges from the 137 VA nursing homes during fiscal years 2002 to 2008. We used MDS and administrative data to assess resident age, gender, behaviors, pain, and indications of psychoses, bipolar disorder, dementia, and depression. We identified vital status and suicide mortality within 6 months of discharge through National Death Index searches. Results. Suicide rates within 6 months of discharge were 88.0 per 100 000 person-years for men and 89.4 overall. Standardized mortality ratios relative to age- And gender-matched individuals in the VA patient population were 2.3 for men (95% confidence interval [CI] = 1.9, 2.8) and 2.4 overall (95% CI = 2.0, 2.9). In multivariable proportional hazards regression analyses, resident characteristics, diagnoses, behaviors, and pain were not significantly associated with suicide risk. Conclusions. Suicide risk was elevated following nursing home discharge. This underscores the importance of ongoing VA efforts to enhance discharge planning and timely postdischarge follow-up.

Keywords: adult; aged; article; confidence interval; factual database; government; hospital discharge; human; male; middle aged; nursing home; psychological aspect; risk; suicide; United States; very elderly; veteran; young adult; epidemiology; psychology; suicide; trends; United States, Adult; Aged; Aged, 80 and over; Confidence Intervals; Databases, Factual; Humans; Male; Middle Aged; Nursing Homes; Odds Ratio; Patient Discharge; Suicide; United States; United States Department of Veterans Affairs; Veterans; Young Adult, Adult; Aged; Aged, 80 and over; Confidence Intervals; Databases, Factual; Humans; Male; Middle Aged; Nursing Homes; Odds Ratio; Patient Discharge; Suicide; United States; United States Department of Veterans Affairs; Veterans; Young Adult (search for similar items in EconPapers)
Date: 2013
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2013.301292_1

DOI: 10.2105/AJPH.2013.301292

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