Travel Distance to Hospital Is Associated With Self-Harm Hospital Presentation But Not Suicide

Area of Science:

• Public Health
• Epidemiology
• Mental Health Services Research

Background:

• Geographic access to healthcare, specifically emergency departments (EDs), is a critical determinant of timely medical intervention.
• The relationship between travel distance to EDs and health service utilization may differ between self-harm presentations and completed suicides.

Purpose of the Study:

• To examine the association between travel distance to the nearest ED and rates of hospital-presenting self-harm.
• To investigate the association between travel distance to the nearest ED and suicide rates.
• To analyze these associations within a large urban setting in Taiwan.

Main Methods:

• Utilized data from Taiwan's National Suicide Surveillance System spanning 2012-2016.
• Employed Bayesian hierarchical models for adjusted statistical analyses.
• Focused on area-level associations between travel distance and self-harm/suicide rates.

Main Results:

• A statistically significant inverse association was found between longer travel distance to the nearest ED and self-harm hospital presentation rates.
• No significant association was observed between travel distance to the nearest ED and suicide rates.
• Findings suggest geographical barriers may impede help-seeking behavior for self-harm.

Conclusions:

• Living in areas with greater travel distance to EDs may act as a barrier to accessing medical care following self-harm.
• This highlights the need for tailored suicide prevention and intervention strategies that consider geographical access.
• Implications for public health surveillance and service delivery in remote or underserved populations.