Direct and indirect cost of attempted suicide in a general hospital: cost-of-illness study

Abstract

CONTEXT AND OBJECTIVE: Knowledge of socioeconomic impact of attempted suicide may sensitize managers regarding prevention strategies. There are no published data on this in Brazil. The aim here was to describe the direct and indirect costs of care of hospitalized cases of attempted suicide and compare these with the costs of acute coronary syndrome cases. DESIGN AND SETTING: Cost-of-illness study at a public university hospital in Brazil. METHOD:The costs of care of 17 patients hospitalized due to attempted suicide were compared with those of 17 acute coronary syndrome cases at the same hospital, over the same period. The direct costs were the summation of the hospital and out-of-hospital costs resulting from the event, determined from the medical records. The indirect costs were estimated through the human capital lost. The Mann-Whitney test and analysis of covariance (ANCOVA) with transformation adjusted for age were used for comparisons. RESULTS:The average costs per episode of attempted suicide were: direct cost, US$ 6168.65; indirect cost, US$ 688.08; and total cost, US$ 7163.75. Comparative analysis showed a difference between the indirect costs to family members, with significantly higher costs in the attempted suicide group (P = 0.0022). CONCLUSION:The cost of care relating to attempted suicide is high and the indirect cost to family members reinforces the idea that suicidal behavior not only affects the individual but also his social environment. RESUMO

General hospital costs in England of medical and psychiatric care for patients who self-harm: a retrospective analysis

“… 18 Mean costs of just 17 self-harm cases (seven of which were self-injury and ten poisonings) were £4142 in one hospital in São Paulo, Brazil. 19 In the USA, large patient and injury databases have also been used to look at the costs of self-harm. National level costs for non-fatal self-harm events were reported in 2016 to be a mean of £6061, but this includes productivity losses in addition to medical costs.…”

The Monetary Value of Human Lives Lost to Suicide in the African Continent: Beating the African War Drums

“…Our study omits the health service costs (inpatient stay, intensive unit care and psychological assessment) related to suicide attempts [82]. However, suicide attempts often lead to serious physical injuries (broken bones, brain damage or organ failure) and mental health problems such as depression which undermine performance of activities of daily living [6,83]. Marcotte [84] postulated most suicide attempts are not fatal; thus, estimation of only the cost of completed (fatal) suicide might lead to significant underestimation of the total cost of suicide and suicide attempts in the continent.…”

Long-term impact of the expansion of a hospital liaison psychiatry service on patient care and costs following emergency department attendances for self-harm

“…Finally, Bayesian model averaging minimises issues of arbitrary and incorrect covariate selection and of overfitting. 20 Compared with previous studies based on select groups of patients (such as those who had taken an overdose) 32 or on small numbers of patients, 11 the data used in this analysis was taken from an unselected series of consecutive presentations of selfharm, including those that were admitted to hospital as well as those with emergency department attendance that did not result in admission.…”

“…5,6 The direct and indirect costs associated with self-harm are considerable. [7][8][9][10][11] Providing effective, evidence-based clinical care could reduce repeated self-harm attempts and suicide. 2,12 UK guidelines recommend that all patients presenting to healthcare because of self-harm should be offered a psychosocial assessment.…”