Table 1.
Characteristics of cohort used for prediction model development
| All visits | Visits per person | ||||||
|---|---|---|---|---|---|---|---|
| 1 | 2 | 3-5 | 6-10 | 11-20 | 21+ | ||
|
|
|||||||
| Sample and outcome characteristics | N (row %)† | N (row %) | N (row %) | N (row %) | N (row %) | N (row %) | N (row %) |
|
| |||||||
| Total number of visits | 1,518,968 (100) | 62,660 (4) | 67,306 (4) | 175,850 (12) | 221,286 (15) | 294,202 (19) | 697,664 (46) |
| Total number of unique people | 207,915 (100) | 62,660 (30) | 33,653 (16) | 46,588 (22) | 28,996 (14) | 20,355 (10) | 15,663 (8) |
| 90-day suicide attempts (visit-level) | 10,171 (100) | 104 (1) | 123 (1) | 529 (5) | 836 (8) | 1,488 (15) | 7,091 (70) |
| Event rate‡ (per 1,000 visits) | 6.7 | 1.7 | 1.8 | 3.0 | 3.8 | 5.1 | 10.2 |
| Unique 90-day suicide attempts (person-level) | 2,444 (100) | 104 (4) | 88 (4) | 299 (12) | 376 (15) | 484 (20) | 1,093 (45) |
| Rate of unique events per (1,000 people) | 11.8 | 1.7 | 2.6 | 6.4 | 13.0 | 23.8 | 69.8 |
| Visit characteristics | N (column %) | N (column %) | N (column %) | N (column %) | N (column %) | N (column %) | N (column %) |
|
| |||||||
| Female | 955,894 (63) | 37,988 (61) | 41,176 (61) | 109,163 (62) | 140,545 (64) | 189,708 (64) | 437,314 (63) |
| Age | |||||||
| 13 – 17 | 157,605 (10) | 5,923 (9) | 7,461 (11) | 21,808 (12) | 28,670 (13) | 35,937 (12) | 57,806 (8) |
| 18 – 29 | 262,965 (17) | 13,085 (21) | 14,811 (22) | 36,623 (21) | 41,613 (19) | 50,460 (17) | 106,373 (15) |
| 30 – 44 | 390,789 (26) | 15,818 (25) | 17,129 (25) | 46,287 (26) | 59,898 (27) | 78,127 (27) | 173,530 (25) |
| 45 – 64 | 538,274 (35) | 17,593 (28) | 18,959 (28) | 51,281 (29) | 67,175 (30) | 99,071 (34) | 284,195 (41) |
| 65 or older | 169,335 (11) | 10,241 (16) | 8,946 (13) | 19,851 (11) | 23,930 (11) | 30,607 (10) | 75,760 (11) |
| Race | |||||||
| White | 1,034,027 (68) | 38,391 (61) | 42,020 (62) | 113,819 (65) | 145,588 (66) | 195,701 (67) | 498,508 (71) |
| Asian | 69,952 (5) | 3,638 (6) | 3,596 (5) | 9,070 (5) | 10,923 (5) | 14,411 (5) | 28,314 (4) |
| Black | 142,153 (9) | 6,407 (10) | 6,664 (10) | 16,188 (9) | 21,170 (10) | 28,763 (10) | 62,961 (9) |
| Hawaiian / Pacific Islander | 17,034 (1) | 768 (1) | 824 (1) | 2,249 (1) | 2,648 (1) | 3,552 (1) | 6,993 (1) |
| Native American | 15,538 (1) | 524 (1) | 684 (1) | 1,660 (1) | 2,146 (1) | 3,079 (1) | 7,445 (1) |
| More than one or Other | 9,454 (1) | 501 (1) | 532 (1) | 1,444 (1) | 1,815 (1) | 2,119 (1) | 3,043 (0) |
| Not Recorded | 230,810 (15) | 12,431 (20) | 12,986 (19) | 31,420 (18) | 36,996 (17) | 46,577 (16) | 90,400 (13) |
| Ethnicity | |||||||
| Hispanic | 343,132 (23) | 16,719 (27) | 17,614 (26) | 44,096 (25) | 53,507 (24) | 69,381 (24) | 141,815 (20) |
| Insurance type§ | |||||||
| Commercial group | 1,113,389 (73) | 43,287 (69) | 48,397 (72) | 129,149 (73) | 163,331 (74) | 220,082 (75) | 509,143 (73) |
| Self-funded | 51,177 (3) | 1,848 (3) | 2,243 (3) | 6,911 (4) | 8,836 (4) | 10,653 (4) | 20,686 (3) |
| Medicare | 233,409 (15) | 10,545 (17) | 9,593 (14) | 23,031 (13) | 28,510 (13) | 39,393 (13) | 122,337 (18) |
| Medicaid | 75,581 (5) | 3,785 (6) | 4,016 (6) | 10,520 (6) | 12,634 (6) | 15,940 (5) | 28,686 (4) |
| Private pay | 198,591 (13) | 8,630 (14) | 8,529 (13) | 21,594 (12) | 25,169 (11) | 32,977 (11) | 101,692 (15) |
| State subsidized | 3,355 (0) | 178 (0) | 177 (0) | 581 (0) | 645 (0) | 658 (0) | 1,116 (0) |
| High deductible | 124,365 (8) | 6,277 (10) | 6,483 (10) | 15,272 (9) | 18,890 (9) | 22,464 (8) | 54,979 (8) |
| PHQ-9 Item 9 score§§ recorded | |||||||
| At index visit | 203,763 (13) | 10,553 (17) | 11,723 (17) | 32,684 (19) | 38,957 (18) | 44,559 (15) | 65,287 (9) |
| At any visit in past year (excluding index) | 330,784 (22) | 3,130 (5) | 8,378 (12) | 33,885 (19) | 52,788 (24) | 73,750 (25) | 158,853 (23) |
| At any visit in past 5 years (excluding index) | 414,467 (27) | 8,985 (14) | 14,195 (21) | 48,196 (27) | 68,153 (31) | 91,156 (31) | 183,782 (26) |
| Length of enrollment prior to visit | |||||||
| 1 year or more | 1,275,487 (84) | 47,203 (75) | 51,165 (76) | 138,025 (78) | 177,749 (80) | 244,739 (83) | 616,606 (88) |
| 5 years or more | 843,134 (56) | 30,230 (48) | 31,748 (47) | 86,692 (49) | 111,637 (50) | 158,585 (54) | 424,242 (61) |
| Diagnoses in prior 5 years (including index visit)* | |||||||
| Depression | 1,119,160 (74) | 31,496 (50) | 39,713 (59) | 115,121 (65) | 155,777 (70) | 222,537 (76) | 554,516 (79) |
| Anxiety | 981,688 (65) | 25,960 (41) | 32,775 (49) | 96,454 (55) | 132,595 (60) | 195,734 (67) | 498,170 (71) |
| Bipolar dx | 190,926 (13) | 2,340 (4) | 3,421 (5) | 11,591 (7) | 19,219 (9) | 29,453 (10) | 124,902 (18) |
| Schizophrenia | 54,770 (4) | 523 (1) | 818 (1) | 2,803 (2) | 4,287 (2) | 6,756 (2) | 39,583 (6) |
| Other MH condition | 76,862 (5) | 1,291 (2) | 1,626 (2) | 4,756 (3) | 7,795 (4) | 11,639 (4) | 49,755 (7) |
| Dementia | 64,914 (4) | 3,038 (5) | 3,018 (4) | 6,424 (4) | 7,770 (4) | 10,957 (4) | 33,707 (5) |
| Attention deficit disorder | 171,413 (11) | 5,258 (8) | 6,948 (10) | 21,341 (12) | 26,648 (12) | 33,118 (11) | 78,100 (11) |
| Autism spectrum disorder | 19,404 (1) | 428 (1) | 439 (1) | 1,597 (1) | 2,691 (1) | 4,362 (1) | 9,887 (1) |
| Personality disorder | 85,829 (6) | 700 (1) | 1,019 (2) | 3,728 (2) | 5,587 (3) | 11,177 (4) | 63,618 (9) |
| Alcohol use disorder | 196,139 (13) | 1,934 (3) | 2,289 (3) | 7,166 (4) | 11,878 (5) | 21,880 (7) | 150,992 (22) |
| Drug dependence disorder | 394,513 (26) | 6,048 (10) | 7,473 (11) | 22,512 (13) | 33,109 (15) | 55,724 (19) | 269,647 (39) |
| PTSD | 140,247 (9) | 1,655 (3) | 2,427 (4) | 8,552 (5) | 13,678 (6) | 24,258 (8) | 89,677 (13) |
| Eating disorder | 50,347 (3) | 495 (1) | 691 (1) | 2,542 (1) | 4,121 (2) | 7,089 (2) | 35,409 (5) |
| Traumatic brain injury | 43,063 (3) | 1,251 (2) | 1,552 (2) | 4,097 (2) | 5,584 (3) | 7,831 (3) | 22,748 (3) |
| Medication fills in prior 5 years | |||||||
| Antidepressants | 943,017 (62) | 21,792 (35) | 27,193 (40) | 83,871 (48) | 120,402 (54) | 183,700 (62) | 506,059 (73) |
| Benzodiazepines (anxiety/sedative) | 668,960 (44) | 15,839 (25) | 18,896 (28) | 55,752 (32) | 79,243 (36) | 122,967 (42) | 376,263 (54) |
| Hypnotics | 199,503 (13) | 4,271 (7) | 5,133 (8) | 15,916 (9) | 22,060 (10) | 35,221 (12) | 116,902 (17) |
| 2nd generation antipsychotics | 302,322 (20) | 2,675 (4) | 3,864 (6) | 14,481 (8) | 25,105 (11) | 43,914 (15) | 212,283 (30) |
| Encounters in prior 5 years with psychiatric diagnoses | |||||||
| Any inpatient encounter | 349,572 (23) | 6,604 (11) | 7,639 (11) | 22,331 (13) | 32,281 (15) | 52,631 (18) | 228,086 (33) |
| Any outpatient encounter | 1,388,497 (91) | 18,970 (30) | 44,370 (66) | 147,093 (84) | 204,523 (92) | 283,071 (96) | 690,470 (99) |
| Any emergency department encounter | 518,831 (34) | 11,626 (19) | 13,438 (20) | 38,366 (22) | 54,514 (25) | 85,945 (29) | 314,942 (45) |
| Any suicide attempt | 68,442 (5) | 692 (1) | 877 (1) | 3,061 (2) | 5,087 (2) | 9,015 (3) | 49,710 (7) |
†
Row percentages correspond to the percent of visits, people, and suicide attempts in clusters of a particular size. Row percentages across all cluster sizes sum to 100%.
‡
Visit-level event rate is calculated as the proportion of visits with 90-day suicide attempts x 1,000. A single event may occur in the 90 days following multiple visits that are close in time.
§
Insurance types at a visit are not mutually exclusive. A person may have insurance in more than one category at the time of visit.
§§
The 9th item of the Patient Health Questionnaire (PHQ-9) asks patients to report levels of suicidal ideation in the two weeks preceding their visit.
*
Summary diagnosis, medication, and encounters includes information available at the index visit and clinical history up to 5 years prior. Clinical history is left-censored at the time of health plan disenrollment.