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Abstract
Background Non-fatal self-inflicted (SI) injuries may be underidentified in administrative medical data sources.
Objective Compare patients with SI versus undetermined intent (UI) injuries according to patient characteristics, incidence of subsequent SI injury and risk factors for subsequent SI injury.
Methods Truven Health MarketScan was used to identify patients’ (aged 10–64) first SI or UI injury in 2015 (index injury). Patient characteristics and subsequent SI within 1 year were assessed. A logistic regression model examined factors associated with subsequent SI.
Results Among analysed patients (n=44 806; 36% SI, 64% UI), a higher proportion of patients with SI index injury were female, had preceding comorbidities (eg, depression), Medicaid (vs commercial insurance), treatment in an ambulance or hospital and cut/pierce or poisoning injuries compared with patients with UI index injury. Just 1% of patients with UI had subsequent SI≤1 year vs 16% of patients with SI. Among patients with UI index injury, incidence of and risk factors for subsequent SI injury were similar across assessed age groups (10–24 years, 25–44 years, 45–64 years). Severe injuries (eg, treated in emergency department), cut/pierce or poisoning injuries, mental health and substance use disorder comorbidities and Medicaid (among adult patients) were risk factors for subsequent SI among patients with UI index injuries.
Conclusions Regardless of circumstances that influence clinicians’ SI vs UI coding decisions, information on incidence of and risk factors for subsequent SI can help to inform clinical treatment decisions when SI injury is suspected as well as provide evidence to support the development and implementation of self-harm prevention activities.
- self-injurious behavior
- health services research
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Footnotes
Contributors CP conceived of the study, led the study design and interpretation of results, assisted with data analysis, drafted and edited the manuscript for important intellectual content and approved the final manuscript as submitted. LX assisted with the study design and interpretation of results, led data analysis, edited the manuscript for important intellectual content and approved the final manuscript as submitted. RWL assisted with the study design and interpretation of results, edited the manuscript for important intellectual content and approved the final manuscript as submitted. DMS assisted with the study design and interpretation of results, edited the manuscript for important intellectual content and approved the final manuscript as submitted. MFB assisted with the study design and interpretation of results, edited the manuscript for important intellectual content and approved the final manuscript as submitted.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Data available from authors on request.