Healthcare Utilization, Physical and Psychiatric Comorbidities Before Self-Injurious Behavior in Patients with Asthma: A Nested Case-Control Study

Abstract

Background

Patients with asthma experience more physical, psychological, and financial burdens; a link between asthma and suicidality has been reported in research.

Purpose

This study analyzed the medical utilization and comorbidity before their self-injurious behavior in patients with asthma.

Methods

We enrolled 186,862 patients newly diagnosed with asthma between 1999 and 2013 from the National Health Insurance Research Database in Taiwan. A total of 500 case subjects had ever conducted self-injurious behaviors during the study period. Based on a nested case-control study, each case was matched with 10 controls derived from the asthma cohort to analyze differences between them and their medical use models.

Results

The results indicated that, compared to the control group, the cases presented higher frequencies of outpatient visits and hospitalizations. Regarding comorbidity, the cases had more cardiovascular diseases (adjusted odds ratio [aOR]=1.58; p<0.001), bipolar disorder (aOR=2.97; p<0.001), depression (aOR=4.44; p<0.001), and sleep disorder (aOR=1.83; p<0.001) than the controls.

Conclusion

The evidence-based information serves as a reference for medical staff to reduce the occurrence of self-injurious behavior in patients with asthma.

Keywords:

• self-injurious behavior
• asthma
• medical utilization
• psychiatric comorbidity
• physical comorbidity

Acknowledgments

This manuscript was edited by Wallace Academic Editing.

Author Contributions

Drs. Huang and Kuo conceived of and designed the study. Dr. Kuo acquired the data. Dr. Liao and Mr. Su performed statistical analysis. Drs. Chiou and Pan provided administrative and material support. Drs. Huang, Kuo and Ms. Wang drafted the manuscript. Dr. Kuo made critical revisions to the manuscript for crucial intellectual content, and Drs. Kuo and Chen supervised the study. All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no competing interests.

Additional information

Funding

This research was supported by grants from the National Science and Technology Council, Taiwan (grant numbers: MOST 108-2314-B-532-005 and 110-2314-B-532-003-MY3) and Taipei City Hospital (10201-62-008, and 10301-62-041). The funding organizations had no involvement in the study design, data collection, analysis, interpretation of data, writing of the report, or decision to submit the paper for publication.