Dataset Information

Repeat Self-Inflicted Injury Among U.S. Youth in a Large Medical Claims Database.

ABSTRACT: INTRODUCTION:This study describes characteristics of nonfatal self-inflicted injuries and incidence of repeat self-inflicted injuries among a large convenience sample of youth (aged 10-24 years) with Medicaid or commercial insurance. METHODS:In 2018, Truven Health MarketScan medical claims data were used to identify youth with a self-inflicted injury in 2013 (or index self-inflicted injury) diagnosed in any inpatient or outpatient setting. Patients with 2 years of healthcare claims data (1 year before/after index self-inflicted injury) were assessed. Patient and injury characteristics, repeat self-inflicted injuries ?1 year, time to repeat self-inflicted injury, and number of emergency department and urgent care facility visits per patient are reported. A regression model assessed factors associated with repeat self-inflicted injuries. RESULTS:Among 4,681 self-inflicted injury patients, 70% were female. More than 71% of patients were treated for comorbidities (50% for depression) ?1 year preceding the index self-inflicted injury. Poisoning was the most common index self-inflicted injury mechanism (60% of patients). Approximately 52% of patients had one or more emergency department visit and 1% had one or more urgent care facility visit, respectively, during the 2-year observation period. More than 11% of patients repeated self-inflicted injury ?1 year (and 3% ?7 days). Repeat self-inflicted injury was associated with younger patient age, being female, a self-inflicted injury event preceding the index self-inflicted injury, index self-inflicted injury treatment setting, and patient comorbidities. CONCLUSIONS:Approximately one in ten youth repeated self-inflicted injury within 1 year and nearly half of youth with clinically treated self-inflicted injuries never received care in hospitals or emergency departments. Physicians and families should be aware of risk factors for repeat self-inflicted injury, including mental health comorbidities. Multilevel strategies are needed to prevent youth self-inflicted injuries.

SUBMITTER: Peterson C

PROVIDER: S-EPMC6380925 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Repeat Self-Inflicted Injury Among U.S. Youth in a Large Medical Claims Database.

Peterson Cora C Xu Likang L Leemis Ruth W RW Stone Deborah M DM

American journal of preventive medicine 20190115 3

<h4>Introduction</h4>This study describes characteristics of nonfatal self-inflicted injuries and incidence of repeat self-inflicted injuries among a large convenience sample of youth (aged 10-24 years) with Medicaid or commercial insurance.<h4>Methods</h4>In 2018, Truven Health MarketScan medical claims data were used to identify youth with a self-inflicted injury in 2013 (or index self-inflicted injury) diagnosed in any inpatient or outpatient setting. Patients with 2 years of healthcare claim ...[more]

PMID: 30658863

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Project description:BackgroundSepsis is the leading cause of death worldwide. Although the mortality of sepsis patients has been decreasing over the past decade, the trend of medical costs and cost-effectiveness for sepsis treatment remains insufficiently determined.MethodsWe conducted a retrospective study using the nationwide medical claims database of sepsis patients in Japan between 2010 and 2017. After selecting sepsis patients with a combined diagnosis of presumed serious infection and organ failure, patients over the age of 20 were included in this study. We investigated the annual trend of medical costs during the study period. The primary outcome was the annual trend of the effective cost per survivor, calculated from the gross medical cost and number of survivors per year. Subsequently, we performed subgroup and multiple regression analyses to evaluate the association between the annual trend and medical costs.ResultsAmong 50,490,128 adult patients with claims, a total of 1,276,678 patients with sepsis were selected from the database. Yearly gross medical costs to treat sepsis gradually increased over the decade from $3.04 billion in 2010 to $4.38 billion in 2017, whereas the total medical cost per hospitalization declined (rate = - $1075/year, p < 0.0001). While the survival rate of sepsis patients improved during the study period, the effective cost per survivor significantly decreased (rate = - $1806/year [95% CI - $2432 to - $1179], p = 0.001). In the subgroup analysis, the trend of decreasing medical cost per hospitalization remained consistent among the subpopulation of age, sex, and site of infection. After adjusting for age, sex (male), number of chronic diseases, site of infection, intensive care unit (ICU) admission, surgery, and length of hospital stay, the admission year was significantly associated with reduced medical costs.ConclusionsWe demonstrated an improvement in annual cost-effectiveness in patients with sepsis between 2010 and 2017. The annual trend of reduced costs was consistent after adjustment with the confounders altering hospital expenses.

Dataset Information

Repeat Self-Inflicted Injury Among U.S. Youth in a Large Medical Claims Database.

Publications

Repeat Self-Inflicted Injury Among U.S. Youth in a Large Medical Claims Database.

Similar Datasets

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