State Variation in Long-Term Care Availability, Regulation, and Cost and Suicide Mortality Among Older Adults in the United States: 2010–2015

Lohman, Matthew C.; Ko, Tomohiro M.; Rapp, Ashley; Bennion, Erica; Mezuk, Briana

doi:10.1016/j.jamda.2021.02.008

Cited by 6 publications

(3 citation statements)

References 32 publications

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“…The suicide mortality rate among both home care and PRAC recipients in the aged care population is lower than among the general population of older Australian adults (approximately 66/100,000) (Australian Institute of Health and Welfare, 2022b). This may suggest that community and PRAC aged care services confer protection against death by suicide, possibly because they provide regular safety monitoring (Lohman et al, 2021) and reduce access to means for suicide (Chauliac et al, 2020). Aged care services may also promote psychological well-being by reducing social isolation and improving functional independence (Royal Commission into Aged Care Quality and Safety, 2019).…”

Section: Discussionmentioning

confidence: 99%

Death by suicide among aged care recipients in Australia 2008–2017

Cations

Lang

Draper

et al. 2023

Int. Psychogeriatr.

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Objective: To characterize the features of aged care users who died by suicide and examine the use of mental health services and psychopharmacotherapy in the year before death. Design: Population-based, retrospective exploratory study Setting and participants: Individuals who died while accessing or waiting for permanent residential aged care (PRAC) or home care packages in Australia between 2008 and 2017. Measurements: Linked datasets describing aged care use, date and cause of death, health care use, medication use, and state-based hospital data collections. Results: Of 532,507 people who died, 354 (0.07%) died by suicide, including 81 receiving a home care package (0.17% of all home care package deaths), 129 in PRAC (0.03% of all deaths in PRAC), and 144 approved for but awaiting care (0.23% of all deaths while awaiting care). Factors associated with death by suicide compared to death by another cause were male sex, having a mental health condition, not having dementia, less frailty, and a hospitalization for self-injury in the year before death. Among those who were awaiting care, being born outside Australia, living alone, and not having a carer were associated with death by suicide. Those who died by suicide more often accessed Government-subsidized mental health services in the year before their death than those who died by another cause. Conclusions: Older men, those with diagnosed mental health conditions, those living alone and without an informal carer, and those hospitalized for self-injury are key targets for suicide prevention efforts.

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Section: Discussionmentioning

confidence: 99%

Death by suicide among aged care recipients in Australia 2008–2017

Cations

Lang

Draper

et al. 2023

Int. Psychogeriatr.

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“…While the CDC provides detailed Users’ Manuals for the NVDRS (Centers for Disease Control and Prevention 2020 , 2021 , 2022b ), there is a general lack of concrete guidance on how to reconcile incongruencies and integrate text narratives with the abstractor-coded variables. This review found that researchers who utilize the narratives as a means of case finding or case confirming often privilege the content within the qualitative data in classifying or categorizing cases and incident circumstances when coded variables were found to be insufficient (Davidson et al 2021a ; Lohman et al 2021 ; Yau and Paschall 2018 ; Wertz et al 2020 ). However, few studies reported information on missingness or incompleteness of these texts, much less how such data issues were addressed in the analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Our findings suggest several opportunities for researchers to leverage existing, advanced, and flexible data science methods to explore and analyze large amounts of unstructured textual data in a meaningful and efficient manner. Contrary to traditional textual analysis methods (e.g., manual review, keyword searches), which are often time-consuming and labor-intensive, natural language processing and topic modeling can be immensely useful in combing through large amounts of textual data, detecting patterns in circumstances, and building algorithms as an alternative for manual review, as illustrated by some of the studies included in this review (Mezuk et al 2003 ; Lohman et al 2021 ; Arseniev-Koehler et al 2020 ). However, these data science methods can be computationally intensive, require specialized and technical knowledge, and often rely on the amount of data included in narratives which, in turn, rely on the consistent and detailed abstraction of circumstances around violent deaths.…”

Section: Discussionmentioning

confidence: 99%

Research utility and limitations of textual data in the National Violent Death Reporting System: a scoping review and recommendations

Dang,

Kahsay,

James

et al. 2023

Inj. Epidemiol.

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Background Many studies of injury deaths rely on mortality data that contain limited contextual information about decedents. The National Violent Death Reporting System (NVDRS) is unique among such data systems in that each observation includes both quantitative variables and qualitative texts (called “narratives”) abstracted from original source documents. These narratives provide rich data regarding salient circumstances that can be used to inform prevention efforts. This review provides a comprehensive summary of peer-reviewed research using NVDRS narratives over the past 20 years, including the limitations of these texts and provides recommendations on utilizing and improving narrative quality for researchers and practitioners. Main body Studies that used narratives to examine deaths related to suicide, homicide, undetermined intent, accidental firearm, or legal intervention were identified by a title/abstract screening, followed by a full-text review. The search was conducted on English-language, peer-reviewed literature and government reports published from 2002 to 2022 in PubMed, PsycInfo, Scopus, and Google Scholar. Abstracted elements focused on the methodologies used to analyze the narratives, including approaches to explore potential biases in these texts. Articles were abstracted independently by two reviewers, with disagreements resolved through consensus discussion. During the 20-year period, 111 articles used narratives. Two-thirds studied suicide (n = 48, 43%) and homicides (n = 25, 23%). Most studies analyzed the narratives using manual review (n = 81, 73%) and keyword searches (n = 9, 8%), with only 6 (5%) using machine learning tools. Narratives were mainly used for case finding (n = 49, 44%) and characterization of circumstances around deaths (n = 38, 34%). Common challenges included variability in the narratives and lack of relevant circumstantial details for case characterization. Conclusion Although the use of narratives has increased over time, these efforts would be enhanced by detailed abstraction of circumstances with greater salience to injury research and prevention. Moreover, researchers and practitioners would benefit from guidance on integrating narratives with quantitative variables and standardized approaches to address variability in the completeness and length of narratives. Such efforts will increase the reliability of findings and set the stage for more widespread applications of data science methods to these texts.

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