Suicide rates are higher in some Alaska Native and American Indian communities than the general U.S. population. Screening for suicide risk typically requires self-report, but many people may not engage with conventional screening because of distrust or are reluctant to disclose thoughts of suicide. Resource-sensitive methods of detecting suicide risk are needed. This study identifies routinely collected electronic health record data to identify demographic, clinical, and utilization factors associated with suicide-related visits in a tribal health care system. In this retrospective, case-control study, cases were defined as any person with a suicide-related visit from 2012 to 2015. Cases and controls were matched by age, sex, and urban/rural residence. We used conditional logistic regression to estimate odds ratios, which were interpreted as prevalence ratios (PR) based on the rare outcome assumption. The dataset included 314 cases and 1,169 controls. In the year before the index visit, cases had higher prevalence of poisoning or overdose (PR = 13.4, 95% confidence interval [CI] [3.5, 51.7]), emergency department and urgent care visits (PR = 15.8, 95% CI [6.6, 38.1]), and hospitalizations (PR = 4.5, 95% CI [3.0, 6.8]). Electronic health records can be used to identify factors that are significantly associated with suicide risk among those who may not be flagged by screening. Risk detection through electronic health record assessment might increase clinical workload in the short term, but this change would be offset by downstream prevention of suicide-related events. Such efforts could improve suicide risk detection and help to improve suicide-related health disparities in Alaska Native and American Indian populations. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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使用电子健康记录来识别阿拉斯加原住民卫生系统中的自杀风险因素。


一些阿拉斯加原住民和美洲印第安人社区的自杀率高于美国总人口。自杀风险筛查通常需要自我报告，但许多人可能因为不信任或不愿透露自杀想法而不会参与传统筛查。需要资源敏感的方法来检测自杀风险。本研究确定了常规收集的电子健康记录数据，以确定与部落卫生保健系统中自杀相关就诊相关的人口统计、临床和利用因素。在这项回顾性病例对照研究中，病例被定义为 2012 年至 2015 年间有过自杀相关就诊的任何人。病例和对照按年龄、性别和城市/农村居住地进行匹配。我们使用条件逻辑回归来估计优势比，根据罕见结果假设将其解释为患病率（PR）。该数据集包括 314 个病例和 1,169 个对照。在首次就诊前一年，病例中毒或用药过量（PR = 13.4，95% 置信区间 [CI] [3.5, 51.7]）、急诊科和紧急护理就诊（PR = 15.8，95% CI [ 6.6, 38.1]) 和住院治疗 (PR = 4.5, 95% CI [3.0, 6.8])。电子健康记录可用于识别那些可能未通过筛查标记的人中与自杀风险显着相关的因素。通过电子健康记录评估进行风险检测可能会在短期内增加临床工作量，但这种变化将被自杀相关事件的下游预防所抵消。这些努力可以改善自杀风险检测，并有助于改善阿拉斯加原住民和美洲印第安人与自杀相关的健康差异。 （PsycInfo 数据库记录 (c) 2020 APA，保留所有权利）。