| To Register SMDM Homepage | |
|
|
|
||||
Purpose: Cost per case prevented is an important component of analyses designed to assess the cost effectiveness of suicide prevention interventions. Yet, costs of suicide-related injuries have been exclusively limited to the average cost of an emergency department visit or inpatient admission. This study attempts to define episodic costs by exploring the marginal utilization and costs of healthcare services leading up to and immediately following a suicide attempt resulting in hospitalization.
Methods: A private-sector, medical claims database was used to identify persons hospitalized between 1998 and 2001 with a suicide-related diagnosis (ICD-9-CM E950-959), and to assess characteristics of the attempters and their utilization and cost of inpatient services. For each person identified, we then linked to a complementary outpatient claims database to assess average utilization and cost of outpatient services for each of the 12 months preceding and following the inpatient admission date.
Results: Preliminary results from 1998 indicate that for the 134 persons attempting suicide for which an inpatient admission was required, average length of stay was 4 days and average costs were $6,023. The utilization and cost of outpatient services significantly increased 8 months preceding the suicide-related inpatient admission and remained significant until 8 months following the admission (Normal distribution; Kolmogorov-Smirnov goodness-of-fit p > 0.10; 95% CI: $148 - $308, mean = $228). Total episodic costs of suicide-related injuries ($8,855), which includes the cost of the inpatient admission and the statistically significant marginal increase in costs of outpatient services, is nearly 50% greater than the costs of the hospitalization alone.
Conclusions: Suicide attempts requiring hospitalization represent just the tip of the healthcare utilization and cost iceberg. These results suggest that arbitrarily-defined episodes of suicide-related injury can be inaccurate and inadequate and that incorporating marginal costs of illness and injury over a statistically defined range will provide policymakers with the best assessment of cost per case prevented. Next steps for prevention include exploring the use of medical claims as a monitoring device for detecting aberrant increases in healthcare utilization as a possible predictor of suicidal behavior.
See more of Poster Session - CEA: Methods and Applications; Health Services Research
See more of The 26th Annual Meeting of the Society for Medical Decision Making (October 17-20, 2004)