title: Suicide mortality among patients receiving care in the veterans health administration health system.
abstract: Understanding and reducing mortality from suicide among veterans is a national priority, particularly for individuals receiving care from the US Veterans Health Administration (VHA). This report examines suicide rates among VHA patients and compares them with rates in the general population. Suicide mortality was assessed in fiscal year 2001 for patients alive at the start of that fiscal year and with VHA use in fiscal years 2000-2001 (n = 4,692,034). Deaths from suicide were identified by using National Death Index data. General population rates were identified by use of the Web-based Injury Statistics Query and Reporting System. VHA rates were 43.13/100,000 person-years for men and 10.41/100,000 person-years for women. For male patients, the age-adjusted standardized mortality ratio was 1.66; for females, it was 1.87. Male patients aged 30-79 years had increased risks relative to men in the general population; standardized mortality ratios ranged from 2.56 (ages 30-39 years) to 1.33 (ages 70-79 years). Female patients aged 40-59 years had greater risks than did women in the general population, with standardized mortality ratios of 2.15 (ages 40-49 years) and 2.36 (ages 50-59 years). Findings offer heretofore unavailable comparison points for health systems. Prior to the conflicts in Afghanistan and Iraq and before recent VHA initiatives, rates were higher among VHA patients than in the general population. Female patients had particularly high relative risks.
authors.affiliation: US Department of Veterans Affairs Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, Michigan 48113-0170, USA. john.mccarthy2@va.gov
authors.forename: John F
authors.initials: JF
authors.lastname: McCarthy
authors.forename: Marcia
authors.initials: M
authors.lastname: Valenstein
authors.forename: H Myra
authors.initials: HM
authors.lastname: Kim
authors.forename: Mark
authors.initials: M
authors.lastname: Ilgen
authors.forename: Kara
authors.initials: K
authors.lastname: Zivin
authors.forename: Frederic C
authors.initials: FC
authors.lastname: Blow
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006787:Hospitals, Veterans / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D012737:Sex Factors; D013405:Suicide / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data; D014728:Veterans / Q000706:statistics & numerical data*; D055815:Young Adult