Self-harm injury among older adults is a pressing problem that demands social attention in South Korea. This study sought to identify the association between physical and mental illness and hospitalization following self-harm injuries, compared to non-self-harm injuries, among older adults living in Korea. We analyzed individuals aged 65 and older who were admitted to hospitals either for self-harm or non-self-harm from a population-based survey of the Korea National Hospital Discharge In-depth Injury Survey (KNHDIS). A logistic regression analysis was performed. Compared with non-self-harm-related hospitalization, self-harm hospitalization was associated with higher odds of depression, other disorders of the nervous system, malignancies, alcohol misuse and dependence, and drug-related dependence. Dementia, anxiety disorder, diabetes, arthritis, cerebral palsy, and other paralytic syndromes had a lower likelihood of leading to self-harm than non-self-harm hospitalization. The findings of this study can inform medical professionals to identify older adults with a heightened risk of self-harming behavior leading to hospitalization.

This study aimed to identify the patient characteristics, comorbidities, risk factors, and means of the self-harm of patients who attempt self-harm in and outside of a hospital, and to determine the characteristics of death by suicide among survival and death patient groups in South Korea. This study used data from the Korean National Hospital Discharge In-depth Injury Survey conducted from 2007 to 2019. In total, 7192 outpatient participants and 43 inpatient participants performed self-harm. Frequency analysis, chi-square tests, Fisher’s exact test, and logistic regression analysis were performed using STATA, version 15.0 (StataCorp), and statistical significance was set at 5%. Thirty-one inpatients who performed self-harm survived, and 12 died. Among male inpatients, the older they were, the higher the rates of self-harm and mortality rates due to falls and poisoning if they had comorbidities and financial problems. In addition, the rate of self-harm attempts within a short period after hospitalization was high. Our evidence of the characteristics of patients who performed self-harm in the hospital and the influencing factors of self-harm can be used as primary data for predicting patients at a high risk of self-harm and for creating preventative policies to reduce the risk of self-harm among inpatients in South Korea.

Self-harm is an action that intentionally injures oneself and is divided into self-injury with suicidal intention (suicide attempt) and non-suicidal self-injury, which does not involve suicidal intention [1]. Patients who self-harm are 56.8 times more likely to die by suicide than the general population [2], and patients with non-suicidal self-injury are three times more likely to attempt suicide in the future [3]. This suggests that all self-harm behaviors should be considered a risk factors for suicide, regardless of suicidal intention [2].According to the '2021 White Paper on Suicide Prevention,' suicide is the leading cause of death among teenagers and 20s in Korea, and in 2019, the suicide rate of 10-24-year-old in Korea was 1.8 times higher than the average of OECD member countries [4]. Male adolescents are more successful in suicide than female adolescents, whereas female adolescents are more likely to have suicidal ideation or plans [5]. However, the male-female ratio of youth suicide rates in Korea decreased from 1.2 times in 2018 to 1.0 times in 2019 [2,4]. Meanwhile, worldwide, the suicide rate among those aged 15-19 years is higher than that of those aged 10-14 years, and the suicide rate rapidly increases with age in the late teens [6]. Such suicide-related characteristics according to sex and age should be considered when planning suicide prevention strategies for adolescents.In 2019, of the suicidal methods taken among adolescents aged 10-25 years who died by suicide in Korea, jumping accounts for 38.5%, hanging for 37.4%, and gas poisoning for 14% [4]. It has been reported that the suicide rate among Korean adolescents increases as they use lethal methods of suicide [7],

The Korean government has implemented a pilot project that introduces a new type of hospice care program called “Consultative Hospice Care” (COHC) since August 2017. The COHC is a new type of hospice program for terminally ill patients in acute care wards, which is different from the Independent Hospice Unit (IHU) care. This study aimed to compare the characteristics of two groups of hospice patients: COHC care only and both IHU care and COHC groups. Healthcare claim data from 1 April 2018 to 31 March 2020 were retrieved from the HIRA data warehouse system. The main outcome variable was patients receiving COHC only or both COHC and IHU care. The total number of hospice patients was 6482. A multivariate logistic regression analysis was used. Of 6482 hospice care recipients, 3789 (58.5%) received both COHC and IHU care. Those who received both COHC and IHU care were significantly associated with several factors: period from the first evaluation to death (adjusted odds ratio (aOR), 1.026; 95% confidence internal (CI), 1.024–1.029; p < 0.0001), disease severity measured by the Charlson Comorbidity Index (aOR, 1.032; CI, 1.017–1.047; p < 0.0001), consciousness (aOR, 3.654; CI, 3.269–4.085; p < 0.0001), and awareness of end-stage disease (aOR, 1.422; CI, 1.226–1.650; p < 0.0001). The COHC program had a critical role in hospice delivery to terminally ill patients. Policymakers on hospice care need to establish plans that promote efficient hospice care delivery systems.