Healthcare use before and after suicide attempt in refugees and Swedish-born individuals.

Tytuł:: Healthcare use before and after suicide attempt in refugees and Swedish-born individuals.
Autorzy:: Amin R; Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden. .
Rahman S; Department of Global Public Health, Karolinska Institutet, 17177, Stockholm, Sweden.
Tinghög P; Swedish Red Cross University College, 14157, Huddinge, Sweden.
Helgesson M; Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden.
Runeson B; Centre for Psychiatry Research, Department of Clinical Neuroscience, S.t Göran's Hospital, Karolinska Institutet, Stockholm County Council, 11281, Stockholm, Sweden.
Björkenstam E; Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden.
Qin P; National Centre for Suicide Research and Prevention, University of Oslo, 0374, Oslo, Norway.
Mehlum L; National Centre for Suicide Research and Prevention, University of Oslo, 0374, Oslo, Norway.
Holmes EA; Department of Clinical Neuroscience (CNS), K8, Psychology, Karolinska Institutet, 17177, Stockholm, Sweden.; Department of Psychology, Uppsala University, 75237, Uppsala, Sweden.
Mittendorfer-Rutz E; Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden.
Źródło:: Social psychiatry and psychiatric epidemiology [Soc Psychiatry Psychiatr Epidemiol] 2021 Feb; Vol. 56 (2), pp. 325-338. Date of Electronic Publication: 2020 Jun 16.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: [Berlin] : Springer International, [c1988-
MeSH Terms:: Refugees*
Suicide, Attempted*
Delivery of Health Care ; Humans ; Risk Factors ; Sweden/epidemiology
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Grant Information:: 2017-01032 Vetenskapsrådet
Contributed Indexing:: Keywords: Attempted suicide; Cohort; Disability pension; Healthcare; Migration; Refugees
Entry Date(s):: Date Created: 20200620 Date Completed: 20210210 Latest Revision: 20210217
Update Code:: 20240105
PubMed Central ID:: PMC7870606
DOI:: 10.1007/s00127-020-01902-z
PMID:: 32556379
: Czasopismo naukowe

Pełny tekst

Purpose: There is a lack of research on whether healthcare use before and after a suicide attempt differs between refugees and the host population. We aimed to investigate if the patterns of specialised (inpatient and specialised outpatient) psychiatric and somatic healthcare use, 3 years before and after a suicide attempt, differ between refugees and the Swedish-born individuals in Sweden. Additionally, we aimed to explore if specialised healthcare use differed among refugee suicide attempters according to their sex, age, education or receipt of disability pension.
Methods: All refugees and Swedish-born individuals, 20-64 years of age, treated for suicide attempt in specialised healthcare during 2004-2013 (n = 85,771 suicide attempters, of which 4.5% refugees) were followed 3 years before and after (Y - 3 to Y + 3) the index suicide attempt (t0) regarding their specialised healthcare use. Annual adjusted prevalence with 95% confidence intervals (CIs) of specialised healthcare use were assessed by generalized estimating equations (GEE). Additionally, in analyses among the refugees, GEE models were stratified by sex, age, educational level and disability pension.
Results: Compared to Swedish-born, refugees had lower prevalence rates of psychiatric and somatic healthcare use during the observation period. During Y + 1, 25% (95% CI 23-28%) refugees and 30% (95% CI 29-30%) Swedish-born used inpatient psychiatric healthcare. Among refugees, a higher specialised healthcare use was observed in disability pension recipients than non-recipients.
Conclusion: Refugees used less specialised healthcare, before and after a suicide attempt, relative to the Swedish-born. Strengthened cultural competence among healthcare professionals and better health literacy among the refugees may improve healthcare access in refugees.

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