National study of emergency department disposition for high suicide risk geriatric patients.

ABSTRACT: OBJECTIVE:To examine predictors of hospitalization among older adults at high risk for suicide treated in emergency departments (EDs). METHODS:This retrospective cohort analysis used national 2015 Medicare claims for adults ?65?years with ED visits for suicide ideation or deliberate self-harm (N?=?50,472) merged with data from the Area Health Resource File. Rates and adjusted risk ratios (ARR) of hospital admission were assessed. RESULTS:A majority of ED episodes resulted in hospital admission (81.9%) with most being admitted to a psychiatric unit (62.8%). Visits for self-harm with suicide ideation were most likely to result in hospitalization (94.7%) compared to suicide ideation alone (84.0%) or self-harm alone (73.1%). Current diagnosis of depression, bipolar, anxiety, cognitive, and personality disorder were associated with hospitalization. Co-occurring mental and substance use disorders were the most predictive mental health condition of admission. Overall, severity of current medical comorbidity was the strongest predictor of hospital admission. CONCLUSIONS:Most older adults treated in EDs for suicide ideation or self-harm are hospitalized. Medical morbidity plays a more prominent role than other patient factors in admission status.

SUBMITTER: Schmutte T 

PROVIDER: S-EPMC6500465 | biostudies-literature | 2019 May - Jun

REPOSITORIES: biostudies-literature