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Kim C, Dusing GJ, Jin H, Chum A. Examining the effects of social assistance on suicide-related behaviour among impoverished older adults in Korea using a nationwide cohort study from 2010-2019. Sci Rep 2024; 14:16632. [PMID: 39025874 PMCID: PMC11258222 DOI: 10.1038/s41598-024-61845-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/10/2024] [Indexed: 07/20/2024] Open
Abstract
Suicide rates among older adults in Korea are one of the highest in the world. Although prior research found that poverty is associated with suicide mortality among older adults in Korea, it is unknown whether being a recipient of social assistance may reduce suicide risk among older adults living in poverty. We examined the impact of the public assistance program on suicide-related behaviour (SRB). Data from a nationwide cohort in the Korean National Health Insurance Database, including demographic and medical treatment information, linked to the vital statistics for 2010-19 was used. The entire Korean population born before 1951 was included (n = 7,889,086). Flexible parametric survival model was performed to assess whether the risk of SRB hospitalisation and death differed across a) different levels of socioeconomic status, and b) social assistance status among the poor, using gender-stratified models. Older age, chronic disease, poverty, and being out of the labour market were associated with higher SRB hospitalisation and death for both genders. Among those living in poverty, social assistance recipients had lower rates for SRB death and hospitalisation, compared to the low-income non-recipients. Men who were non-recipients had 0.21 higher hazards ratio (95%CI 0.20 to 0.22) for SRB deaths compared to recipients, and the difference was 0.11 (95%CI 0.10 to 0.11) in women, with similar patterns for SRB hospitalizations. Poverty was associated with higher SRB death and hospitalisation among older adults in Korea. Social assistance targeting the older population may help reduce SRB.
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Affiliation(s)
- Chungah Kim
- School of Kinesiology and Health Science, York University, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Gabriel John Dusing
- School of Kinesiology and Health Science, York University, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Hyunju Jin
- Zhejiang Normal University, Zhejiang, China
- Seoul National University, Seoul, South Korea
| | - Antony Chum
- School of Kinesiology and Health Science, York University, 4700 Keele St, Toronto, ON, M3J 1P3, Canada.
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada.
- Unity Health Toronto, St. Michael's Hospital, 30 Bond St, Toronto, ON, M5B 1W8, Canada.
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Kim S, Sung HK, Lee J, Ko E, Kim SJ. Trends in emergency department visits for emergency care-sensitive conditions before and during the COVID-19 pandemic: a nationwide study in Korea, 2019-2021. Clin Exp Emerg Med 2024; 11:88-93. [PMID: 38204160 PMCID: PMC11009707 DOI: 10.15441/ceem.23.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/09/2023] [Accepted: 09/09/2023] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVE Emergency care systems worldwide have been significantly affected by the COVID-19 pandemic. This study investigated the trend of emergency department (ED) visits for emergency care-sensitive conditions (ECSCs) in Korea before and during the pandemic. METHODS We performed a longitudinal study using the national ED database in Korea from January 2019 to December 2021. We calculated the number and incidence rate of visits for ECSCs per 100,000 ED visits, and the incidence rate ratio of 2021 relative to the value in 2019. The selected ECSCs were intracranial injury, ischemic heart disease, stroke, and cardiac arrest. RESULTS The number of ED visits for all causes decreased by about 23% during the pandemic. The number of ED visits for intracranial injuries decreased from 166,695 in 2019 to 133,226 in 2020 and then increased to 145,165 in 2021. The number of ED visits for ischemic heart disease and stroke decreased in 2020 but increased to 2019 levels in 2021. In contrast, the number of ED visits for cardiac arrest increased from 23,903 in 2019 to 24,344 in 2020 and to 27,027 in 2021. The incidence rate and incidence rate ratio of these four ECSCs increased from 2019 to 2021, suggesting increasing relative proportions of ECSCs in total ED visits. CONCLUSION During the COVID-19 pandemic, the number of cardiac arrests seen in the EDs increased, but that of other ECSCs decreased. The decrease in ED visits for ECSCs was not as pronounced as the decrease in ED visits for all causes during the pandemic. Further studies are needed to determine clinical outcomes in patients with ECSC during the pandemic.
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Affiliation(s)
- Seonji Kim
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Ho Kyung Sung
- Public Health Research Institute, National Medical Center, Seoul, Korea
- National Emergency Medical Center, National Medical Center, Seoul, Korea
| | - Jeehye Lee
- National Emergency Medical Center, National Medical Center, Seoul, Korea
| | - Eunsil Ko
- National Emergency Medical Center, National Medical Center, Seoul, Korea
| | - Seong Jung Kim
- National Emergency Medical Center, National Medical Center, Seoul, Korea
- Department of Emergency Medicine, Chosun University College of Medicine, Gwangju, Korea
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Kim S, Sung HK, Kim T, Ko SK, Kim S, Lee JH. Trends in emergency department visits for suicide attempts before and during the COVID-19 pandemic in Korea: A nationwide study, 2016-2021. J Affect Disord 2023; 331:184-191. [PMID: 36948463 PMCID: PMC10028213 DOI: 10.1016/j.jad.2023.03.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/02/2023] [Accepted: 03/15/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND There is increasing concern that the effects of the COVID-19 pandemic will result in excess suicides by increasing known risk factors, such as suicide attempts. However, evidence on the long-term impacts of COVID-19 on suicide attempts is lacking. We aimed to assess the short- and long-term effects of the COVID-19 pandemic on patients with suicide attempts in emergency departments (EDs) and to evaluate age- and sex-specific differences. METHOD We conducted nationwide cross-sectional study among patients with suicide attempts in the ED from 2016 to 2021. The trend test were used to determine whether study subjects were affected by changes in ED visits for suicide attempts. We estimated the average annual percentage change (APC) stratified by sex and age groups. RESULTS The number of ED visits related to suicide attempts increased from 27,581 in 2016 to 37,719 in 2021. In particular, it decreased immediately after the COVID-19 pandemic but increased again in 2021. We identified that the average APC increased by 6.8 % overall, 1.6 % among males, and 10.8 % among females. Moreover, the APC of trend sharply increased in patients aged 10s and 20s. The in-hospital mortality was 3.6 % for females, compared to 9.5 % for males, which showed sex differences. LIMITATIONS Other information such as severity of injury, interpersonal relationships were not available. This study was limited to confirming causal relationship based on a descriptive study. CONCLUSIONS The incidence of suicide attempts in ED has increased in Korea. In particular, there was a sharp increase among women, adolescents and young adults. Patient-tailored treatment and preventive medical system for suicide attempts is important.
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Affiliation(s)
- Seonji Kim
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea
| | - Ho Kyung Sung
- National Emergency Medical Center, National Medical Center, Seoul, Republic of Korea
| | - Taehui Kim
- National Emergency Medical Center, National Medical Center, Seoul, Republic of Korea
| | - Sung-Keun Ko
- National Emergency Medical Center, National Medical Center, Seoul, Republic of Korea
| | - SeongJung Kim
- National Emergency Medical Center, National Medical Center, Seoul, Republic of Korea; Department of Emergency Medicine, Chosun University Hospital, Gwangju, Republic of Korea
| | - Jin-Hee Lee
- National Emergency Medical Center, National Medical Center, Seoul, Republic of Korea.
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Ilia S, Sakapeti E, Briassoulis P, Gerostergios G, Vgontzas A, Briassoulis G. Suicidality Prevalence in a Pediatric Psychiatric Clinic: Relation to Social and Environmental Risk Factors. CHILDREN 2023; 10:children10030558. [PMID: 36980115 PMCID: PMC10047874 DOI: 10.3390/children10030558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/11/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023]
Abstract
Suicidality is a growing public health problem in children and adolescents. The aim of this retrospective data analysis study was to estimate the prevalence of suicidality in pediatric patients admitted to an academic Pediatric Psychiatric Clinic (PPC) and to analyze social and environmental risk factors associated with suicide. Suicidal ideation was assessed by the Self-Injurious Thoughts and Behaviors Interview. Using established psychometric scales, social and stressful events were analyzed. During the four-year study, 249 episodes of care were experienced by 152 individuals (mean age 15.2 ± 2 years, girls/boys 107/45). Twenty-eight patients (11.2%) were admitted from the Pediatric Intensive Care Unit and the Department of Pediatrics, 162 (65.1%) from the Pediatric Emergency Department, and 59 (23.7%) from other Hospitals (p = 0.003). A significant longitudinal increase in admissions to PPC, with increasing trends of suicidal ideation, suicide attempts, and suicidality, was recorded. Suicidal behavior, bullying, internet addiction, friends quarreling, and family problems were risk factors for suicide attempts and suicidality. Our results have implications for prevention programs, highlighting an increasing need for care for suicide attempts and suicidal ideation, related to specific stressful events and contextual socio-environmental status.
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Affiliation(s)
- Stavroula Ilia
- Postgraduate Program “Emergency and Intensive Care in Children Adolescents and Young Adults”, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Pediatric Intensive Care Unit, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece
| | - Evangelia Sakapeti
- Postgraduate Program “Emergency and Intensive Care in Children Adolescents and Young Adults”, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Department of Psychiatry, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece
| | - Panagiotis Briassoulis
- Pediatric Intensive Care Unit, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece
- Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - George Gerostergios
- Department of Psychiatry, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece
| | - Alexandros Vgontzas
- Department of Psychiatry, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece
| | - George Briassoulis
- Postgraduate Program “Emergency and Intensive Care in Children Adolescents and Young Adults”, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Pediatric Intensive Care Unit, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece
- Correspondence: ; Tel.: +30-2810-394675
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Park JH, Seo YW, Chae S. Impact of the COVID-19 Pandemic on Adolescent Self-Harm: Based on a National Emergency Department Information System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4666. [PMID: 36901676 PMCID: PMC10001448 DOI: 10.3390/ijerph20054666] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/27/2023] [Accepted: 03/04/2023] [Indexed: 06/18/2023]
Abstract
Republic of Korea's suicide rate is the highest among Organization for Economic Co-operation and Development countries. In Republic of Korea, suicide is the leading cause of death among young people aged 10-19 years. This study aimed to identify changes in patients aged 10-19 years who visited the emergency department in Republic of Korea after inflicting self-harm over the past five years and to compare the situations before and after the outbreak of the COVID-19 pandemic. Analysis of government data revealed that the average daily visits per 100,000 were 6.25, 8.18, 13.26, 15.31, and 15.71 from 2016 to 2020, respectively. The study formed four groups for further analysis, with the population divided by sex and age (10-14 and 15-19 years old). The late-teenage female group showed the sharpest increase and was the only group that continued to increase. A comparison of the figures 10 months before and after the outbreak of the pandemic revealed a statistically significant increase in self-harm attempts by only the late-teenage female group. Meanwhile, visits (per day) in the male group did not increase, but the rates of death and ICU admission increased. Additional studies and preparations that account for age and sex are warranted.
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Affiliation(s)
- Ju-Hyeon Park
- Department of Emergency Medicine, School of Medicine, Daegu Catholic University, Daegu 42472, Republic of Korea
| | - Young-Woo Seo
- Department of Emergency Medicine, School of Medicine, Daegu Catholic University, Daegu 42472, Republic of Korea
| | - Seungbum Chae
- Department of Orthopedic Surgery, School of Medicine, Daegu Catholic University, Daegu 42472, Republic of Korea
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Lee KS, Sung HK, Yoo SY, Min HS. Temporal Trends and Characteristics of Adult Patients in Emergency Department Related to Suicide Attempt or Self-Harm in Korea, 2016-2020. J Korean Med Sci 2023; 38:e40. [PMID: 36786084 PMCID: PMC9925333 DOI: 10.3346/jkms.2023.38.e40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 11/02/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The implementation of an effective suicide prevention program requires the identification and monitoring of subpopulations with elevated risks for suicide in consideration of demographic characteristics, to facilitate the development of tailored countermeasures for tackling the risk factors of suicide. We examined the annual trends in emergency department (ED) visits for suicide attempts (SAs) or self-harm and investigated the sex- and age-specific characteristics of individuals who visited the ED for SA and self-harm. METHODS Data on ED visits for SAs or self-harm in Korea from 2016 to 2020 were extracted from the National Emergency Department Information System and assessed. We evaluated the age-standardized incidence rate of ED visits for SAs or self-harm, and hospital mortality among individuals who visited the ED for SAs or self-harm. In addition, the characteristics of the individuals were compared according to sex and age. RESULTS We identified 145,963 ED visits for SAs or self-harm (0.42% of the total ED visits) during the study period. The rate of ED visits increased in the youngest age group (19-29 years old), and was more prominent among women (increased by an annual average of 22.5%), despite the coronavirus disease pandemic. The middle-aged group (45-64 years old) had a higher rate of mortality than other age groups, and the highest proportion of individuals on Medical Aid. CONCLUSION It is necessary to plan age- and gender-specific suicide prevention programs that focus on improving the limited public mental health resources for the vulnerable populations.
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Affiliation(s)
- Kyung-Shin Lee
- Public Health Research Institute, National Medical Center, Seoul, Korea
| | - Ho Kyung Sung
- Public Health Research Institute, National Medical Center, Seoul, Korea
- National Emergency Medical Center, National Medical Center, Seoul, Korea
| | - So Young Yoo
- Department of Psychiatry, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Hye Sook Min
- Public Health Research Institute, National Medical Center, Seoul, Korea.
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