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Suicide Prevention Denmark Plan 1999 Males (30-70 y)

Suicide Prevention Denmark Plan 1999 Males (30-70 y). Samir Mohamed Ahmed Zaki Youssef Health Economics 2011 University of Copenhagen. Suicide Prevention Plan 1999. Suicide Attempts Decrease?! Successful Suicide

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Suicide Prevention Denmark Plan 1999 Males (30-70 y)

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  1. Suicide PreventionDenmark Plan 1999 Males (30-70 y) Samir Mohamed Ahmed Zaki Youssef Health Economics 2011 University of Copenhagen

  2. Suicide Prevention Plan 1999 • Suicide Attempts Decrease?! • Successful Suicide • But other Causes of Death may decrease also! • So what happened?

  3. States • State 1: Population (without suicide attempts) • State 2: Suicide Attempt • State 3: Suicide • State 4: Other causes of death N.B : I will use term “Healthy Population” for State 1

  4. Probabilitiesstarted by probabilities of age group 20-30 Age 30-40 40-50 50-60 60-70

  5. Probabilities • Differ according to age • Calculated as average of (1992-1998) and (1999-2005) from STATBANK • Assumed that probability of causes of death other than suicide is the same for healthy population and suicide attempters • Probability of committing suicide attempt among suicide attempters is 15% during the first year then decreases over time so I use this probability as the model is one year interval (Limitation in this first run of Markov model!)

  6. Distribution of Cohort

  7. Distribution of Cohort Hypothetical Population 10,000Population of Markov Model * 10,000 • Before • After

  8. State 2: Costs & EffectsBased on assumptions! Cost: DRG 2107 (Poison Detoxification) + DRGs 2118 and 1911 (Hospitalized for observation by accident or poisoning and for Psychiatric illness), + DRG 1903 (based on assumption that suicide attempters have Depressive Neurosis) + Telephone consultation & Outpatient visit = 34417 Kr. (Calculated according to 2005 Prices) Effect: QALYs: 0.8 If we assume that suicide attempter will have mild depression along his life!

  9. Costs & Effects

  10. Total Costs Over time(34417 Kr. Per suicide Attempt) Before After 836.7452 1677.27 2295.051 2667.588 1057.851 2101.423 2737.524 3158.224 Cost of Suicide Prevention Plan Suicide Attempts increase and its costs! Though successful suicide decrease (case fatality)

  11. QALYs Before After 9.897577 19.4906 28.43836 35.92697 9.913869 19.57126 28.66352 36.54021 QALYs increase

  12. Conclusion?! • Suicide Prevention Plan is successful in methods restriction more than preventing suicide attempts • So costs increase (Costs of Prevention Plan + Costs of suicide attempts) • QALYs increase for the whole population (males 30-70) due to decrease of causes of death (including suicide) but suicide attempts have negative impact.

  13. Next Steps • Changing Probabilities of suicide attempt/suicide attempt over time in the next run of Markov model after comprehensive literature review • Looking for the cost of prevention plan and real costs of suicide attempts • I may include psychiatric illness and alcohol abuse as states in the model

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