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Socioeconomic Disparities in Post-Discharge Suicide Risk Among Individuals With Schizophrenia: A Population-Based
1Department of Health Administration, College of Nursing and Health, Kongju National University, Gongju, Korea.
Background:
The relationship between socioeconomic status (SES) and suicide in individuals with schizophrenia is complex and not fully understood. This population-based cohort study examined the association between SES and post-discharge suicide risk among individuals with schizophrenia in South Korea.
Methods:
Using data from the National Health Insurance Claims Database, as well as national mortality records, this study included 17,565 adults newly hospitalized for schizophrenia between 2017 and 2018. SES was proxied by insurance type-health insurance (HI) versus medical aid (MA). The association between insurance type and suicide risk was examined using Cox's proportional hazards model.
Results:
During the follow-up period, patients receiving MA-indicating lower SES-had a significantly higher risk of suicide (hazard ratio, 1.135; 95% confidence interval, 1.096-1.175), compared with those with HI, even after adjusting for age, sex, comorbidities, and outpatient follow-up within seven days post-discharge. While early outpatient visits were associated with reduced suicide risk, this effect was notably lower among MA recipients.
Conclusion:
These findings highlight persistent disparities in suicide outcomes within a universal healthcare system and underscore the need for targeted post-discharge interventions addressing structural barriers faced by socioeconomically disadvantaged individuals with schizophrenia.
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