자살예방정책 시행 후 자살률 추세 변화: 제5차 자살예방 기본계획에 대한 단절적 시계열 연구
Changes in Suicide Rate Trend After Implementation of Suicide Prevention Policy: An Interrupted Time Series Study on the Fifth Master Plan for Suicide Prevention
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives This study examined the shifts in the suicide trends in Korea during the initial phase of the Fifth Master Plan for Suicide Prevention, using interrupted time series analyses. Methods Interrupted time series analyses were performed using the monthly suicide data from January 2011 to April 2024. Quasi-Poisson regression models were applied to evaluate the changes in the level and slope of the suicide trend before and after policy implementation. The Autoregressive Integrated Moving Average (ARIMA) and Prophet models were used to compare the actual and predicted counterfactual numbers of suicides during the policy period. Results The quasi-Poisson regression model revealed a significant change in the trend of suicides among men, with an increasing slope during the policy period. For total suicides, the ARIMA and Prophet models suggested that the actual number of suicides was significantly higher than the counterfactual number during the policy period, with excess suicides averaging between 113 and 150 per month. The actual number of suicides among men was significantly higher than the counterfactual number during the policy period, with excess suicides averaging between 86 and 92 per month. No significant changes in the suicide trends among women were observed. Conclusion These findings suggest that the initial effects of the Fifth Master Plan for Suicide Prevention were inadequate to curb the rising suicide trends, particularly among men. This study underscores the need for timely policy responses to reverse the current increasing trend in suicides, with particular focus on the male population.
Abstract
Objectives This study examined the shifts in the suicide trends in Korea during the initial phase of the Fifth Master Plan for Suicide Prevention, using interrupted time series analyses. Methods Interrupted time series analyses were performed using the monthly suicide data from January 2011 to April 2024. Quasi-Poisson regression models were applied to evaluate the changes in the level and slope of the suicide trend before and after policy implementation. The Autoregressive Integrated Moving Average (ARIMA) and Prophet models were used to compare the actual and predicted counterfactual numbers of suicides during the policy period. Results The quasi-Poisson regression model revealed a significant change in the trend of suicides among men, with an increasing slope during the policy period. For total suicides, the ARIMA and Prophet models suggested that the actual number of suicides was significantly higher than the counterfactual number during the policy period, with excess suicides averaging between 113 and 150 per month. The actual number of suicides among men was significantly higher than the counterfactual number during the policy period, with excess suicides averaging between 86 and 92 per month. No significant changes in the suicide trends among women were observed. Conclusion These findings suggest that the initial effects of the Fifth Master Plan for Suicide Prevention were inadequate to curb the rising suicide trends, particularly among men. This study underscores the need for timely policy responses to reverse the current increasing trend in suicides, with particular focus on the male population.
참고문헌 (38)
- "Suicides by decade"[URL]
- "Suicide rates"[URL]
- Lee SY, "Policy options for the improvement of suicide prevention programs", Health Welf Policy Forum, 11, pp.34~49 (2015)
- Lee SU, "Changing trends in suicide rates in South Korea from 1993 to 2016 : a descriptive study", BMJ Open, 8, pp.e023144~ (2018)
- Ryu S, "Understanding the fluctuations in Korea’s suicide rates : a change-point analysis and interrupted time series analysis", J Korean Med Sci, 39, pp.e125~ (2024)
- "Master plans for suicide prevention"[URL]
- Jun J, "A brief review of the 5th national suicide prevention plan", Health Welf Policy Forum, 10, pp.58~69 (2023)
- Han C, "How to approach to suicide prevention", J Korean Med Assoc, 62, pp.79~84 (2019)
- Schlichthorst M, "Evaluating the effectiveness of components of national suicide prevention strategies", Crisis, 44, pp.318~328 (2023)
- Cha ES, "Impact of paraquat regulation on suicide in South Korea", Int J Epidemiol, 45, pp.470~479 (2016)
- "What to do about South Korea’s suicide problem" (2023)[URL]
- "The national action plan for suicide prevention" (2018)[URL]
- "Announcement of the fifth master plan for suicide prevention" (2023)[URL]
- Bernal JL, "Interrupted time series regression for the evaluation of public health interventions : a tutorial", Int J Epidemiol, 46, pp.348~355 (2017)
- ". Cause of death (104 items)"[URL]
- "Resident registration population"[URL]
- "Number of deaths by specific cause (intentional selfharm)"[URL]
- "Interrupted time series" (2020)[URL]
- Gianacas C, "Bayesian structural time series, an alternative to interrupted time series in the right circumstances", J Clin Epidemiol, 163, pp.102~110 (2023)
- Ogallo W, "Quantifying the impact of COVID-19 on essential health services : a comparison of interrupted time series analysis using Prophet and Poisson regression models", J Am Med Inform Assoc, 30, pp.634~642 (2023)
- Schaffer AL, "Interrupted time series analysis using autoregressive integrated moving average(ARIMA)models : a guide for evaluating large-scale health interventions", BMC Med Res Methodol, 21, pp.58~ (2021)
- Hyndman RJ, "Automatic time series forecasting : the forecast package for R", J Stat Softw, 27, pp.1~22 (2008)
- "prophet: automatic forecasting procedure"[URL]
- "Guide to the 2024 nationwide mental health care investment support project" (2024)[URL]
- Ilic M, "Worldwide suicide mortality trends(2000-2019) : a joinpoint regression analysis", World J Psychiatry, 12, pp.1044~1060 (2022)
- Lewitzka U, "Are national suicide prevention programs effective? A comparison of 4 verum and 4 control countries over 30 years", BMC Psychiatry, 19, pp.158~ (2019)
- Matsumoto R, "Impact of the Japanese Government’s ‘general principles of suicide prevention policy’on youth suicide from 2007 to 2022", BJPsych Open, 10, pp.e16~ (2023)
- Nakanishi M, "The impact of suicide prevention act(2006)on suicides in Japan", Crisis, 41, pp.24~31 (2020)
- Jang H, "Suicide rate and social environment characteristics in South Korea : the roles of socioeconomic, demographic, urbanicity, general health behaviors, and other environmental factors on suicide rate", BMC Public Health, 22, pp.410~ (2022)
- Raschke N, "Socioeconomic factors associated with suicidal behaviors in South Korea : systematic review on the current state of evidence", BMC Public Health, 22, pp.129~ (2022)
- "Increase in suicide deaths from January to March 2024, preparation of suicide prevention measures" (2024)[URL]
- Faust JS, "Suicide deaths during the COVID-19 stay-at-home advisory in Massachusetts, March to May 2020", JAMA Netw Open, 4, pp.e2034273~ (2021)
- Pirkis J, "Suicide trends in the early months of the COVID-19 pandemic : an interrupted time-series analysis of preliminary data from 21 countries", Lancet Psychiatry, 8, pp.579~588 (2021)
- Ryu S, "Trends in suicide deaths before and after the COVID-19 outbreak in Korea", PLoS One, 17, pp.e0273637~ (2022)
- Ha J, "The Werther effect of celebrity suicides : evidence from South Korea", PLoS One, 16, pp.e0249896~ (2021)
- Kim JH, "The Werther effect of two celebrity suicides : an entertainer and a politician", PLoS One, 8, pp.e84876~ (2013)
- Kim SW, "A social psychiatric approach to suicide prevention", J Korean Med Assoc, 62, pp.93~101 (2019)
- Heo JE, "Comparative study of suicide prevention policies in Korea and Japan", pp.2020