Table 2.

Studies involving linkage with state Violent Death Reporting System data

Source	Linked databases	Sample	What VDRS added	Findings
Denneson et al. 2010 (65)	Oregon VDRS to Veterans Integrated Service Network 20 Data Warehouse	All veterans aged ≥18 who suicided in Oregon between 2000–2005 who had health care-related contact with a Department of Veterans Affairs Medical Center in the 12 months before death n=112	Patient identifiers (name, DOB, DOD, last 4 of SSN), cause of death, veteran status, sex, race-ethnicity, education, marital status	• 63% had ≥1 primary care contact, 48% had ≥1 VA mental health-related contact in the year before death  • 68% were screened for depression, and 41% for SI in year before death  • Median number of days between last contact and death = 42 (range 0–358)  • The majority who were screened denied SI
Basham et al. 2011(53)	Oregon VDRS to Veterans Integrated Service Network 20 Data Warehouse	All veterans aged ≥18 who suicided in Oregon between 2000–2005 n=968	Patient identifiers (name, DOB, DOD, last 4 of SSN), cause of death, veteran status, sex, race-ethnicity, education, marital status	• 21.9% had any type of VA encounter  • Of the patients with a psychiatric inpatient stay, 38.7% had their suicide within 30 days of discharge  • 48% of decedents were prescribed antidepressants within 12 month of death
Weis et al. 2006 (66)	South Carolina VDRS to South Carolina Data Warehouse: inpatient and outpatient charges, Department of Mental Health records, and arrest data	All South Carolina suicide decedents in 2004 n=491	Patient identifiers, law enforcement and coroner narratives (used to validate criminal history)	• 57.4% had a hospital or emergency room discharge in 2003 or 2004, with an average of 3 visits per person  • 24.8% had a suicide attempt in 2003 or 2004  • 47.5% of the suicide attempt encounters were firearm-related  • 16.7% died within 30 days of the final hospital encounter  • Median number of days between last contact and death = 110 (many patients had more than 12 months of records linked)  • 91 decedents had a median of 8 (range 1–1800+) visits with the Department of Mental Health, where depression was the most common diagnosis
Cerel et al. 2016 (77)	Kentucky VDRS to Kentucky Outpatient Services Claims Files	All Kentucky homicide (n=569) and suicide (n=1,599) decedents from 2008–2010 + ED controls (4/case)	Patient identifiers	• 10.7% of suicide decedents visited an ED in the 6 weeks prior to death  • 22% of suicides occurred within 2 days of an ED visit  • 9.9% of suicides had a self-injury code within 6 weeks of death  • The odds of suicide among those with a mental disorder diagnosis was 1.93 (95% CI 1.52, 2.45) times the odds in those without a mental disorder diagnosis

VDRS=Violent Death Reporting System; DOB=date of birth; DOD=date of death; SSN=social security number; VA=Veterans Administration; SI=suicidal ideation; ED=emergency department; CI=confidence interval