Do Racial And Ethnic Differences Exist In Hospital Utilization And Concurrent Psychiatric Diagnoses For Suicide Attempts?

This thesis examines the potential differential rates of admission and rates of serious mental illness diagnoses based on race/ethnicity and rurality for cases of self-harm in inpatient hospital settings. The Health Care Utilization Project’s National Inpatient Sample was utilized to conduct binomial regression analyses on the main effects of and interactions between race and rurality for both rate of admission and rate of SMI diagnoses. ICD-10 codes were used to define cases of self-harm and were compared with DSM-V diagnoses to define SMI diagnoses. Results demonstrate a significantly increased odds of urban residents being admitted to inpatient units (p<.001, OR= 1.104), and urban minorities being significantly less likely to be admitted (p<.001, OR= .753). There was no significant main effect of race here (p=.222, OR= .965). Regarding rates of SMI diagnoses, Whites (p<.001, OR=.748) and urban residents (p<.001, OR= 1.129) were significantly more likely to be diagnosed while rural minorities (p<.001, OR= 1.315) were the least likely. The results suggest disparities in access to care for minorities and rural residents along the lines of insurance and hospital location, which may explain the rates of admission and rate of SMI diagnoses in urban areas.