Patterns of healthcare utilization prior to suicide according to educational attainment: a nationwide register-based population study
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Norwegian Institute of Public Health Norway
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A1315
Background and objective:
Suicide prevention is complex and difficult. Timely help, improved quality of care and correct assessment by healthcare professionals can reduce suicide risk, but then the at-risk individuals must utilize healthcare services. Studies suggest that most of those who die by suicide have consultations with primary healthcare services (PHC) and about 25’ with mental health services (MHS), the last year prior to suicide. Total healthcare utilization prior to suicide, and differences from the general population, are still unknown. The same is the association between educational attainment and healthcare service use prior to suicide. Therefore, the object of this nationwide register-based study is to examine patterns of healthcare consultations one month and one year prior to suicide.

Data stems from the Norwegian population registry, The Primary Health Care Database, The Specialist Health Care Database, The National Education Database and The Cause of Death Registry, which includes all Norwegian residents in the ages 18-65 from 2008-2021. This is a descriptive article, and the results will be presented in cross-tables and figures.

Preliminary analyses indicate a clear association between educational attainment and any consultation within the healthcare services last year prior to suicide. This applies to both sexes, but stronger among men. We find an educational gradient among those with a consultation with MHS prior to suicide, in favor of those with higher education. Among men there is a significant association between educational attainment and contact with PHC the last month prior to suicide. Those who die by suicide utilize the healthcare system more than the general population.

Men without higher education utilize the healthcare system to a low extent. However, as they constitute over half of the suicides it is missed potential for suicide prevention measures. Actions for increasing healthcare use in this group should be investigated.

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