Epidemiology and Long-Term Trends of Suicide-Related Hospitalizations in Taiwan: A Population-Based Study

Abstract

Background: Suicide is a significant public health issue worldwide, with profound impacts on individuals and society. In Taiwan, suicide has consistently ranked among the leading causes of death, with rates continuing to rise in recent years. Hospitalization due to suicide attempts or injuries is a key indicator of the severity of the issue and the effectiveness of preventive interventions. While suicide mortality has been widely studied, limited research has examined long-term trends in suicide-related hospitalizations, including variations by the methodology, gender, age, and region. Identifying these patterns is essential for developing effective suicide prevention programs and addressing high-risk populations.

Objectives: To examine the epidemiology of suicide-related hospitalized patients, including overall suicide mortality, hospitalization incidence, hospitalization prevalence, and fatality rates—and to analyze long-term trends in Taiwan.

Methods: This study utilized data from three national databases: the National Health Insurance Research Database (NHIRD), the Household Registration Database, and the Cause of Death Data in Taiwan. Information on 66,399 hospitalized patients with suicide-related injuries from January 1, 2000, to December 31, 2018, was collected from the NHIRD, and the Cause of Death Statistics from 1998 to 2020 was analyzed.

Results: The proportion of females hospitalized for attempted suicide (55.01%) was higher than that of males (44.99%). Hospitalizations were predominantly higher among individuals aged 20–39 years (46.63%). The three most common suicide methods were ingestion of solid or liquid substances (62.75%), jumping from buildings (19.13%), and burning charcoal (12.08%). Among these, females had higher rates of ingesting solid or liquid substances (11.32/100,000), cutting with tools (0.15/100,000), and jumping from buildings (3.2/100,000), whereas males had higher rates of burning charcoal (1.41/100,000), hanging (0.39/100,000), and firearm use. Regarding age, young adults aged 20–49 years were more likely to attempt suicide by jumping from buildings, burning charcoal, or using gas, while older adults aged 65 years and above predominantly used ingestion of solids, hanging, or cutting tools. Furthermore, suicide methods exhibited substantial regional variations.

Conclusions: From 1998 to 2020, suicide-related hospitalizations, mortality, and morbidity rates increased in Taiwan, underscoring a pressing public health concern that warrants immediate attention. The marked rise in hospitalization rates indicates that suicide attempts may be becoming more frequent or severe, emphasizing the urgent need to strengthen early intervention strategies.