ACCIDENTAL HYPOTHERMIA.

Abstract

<h3>Background</h3> Reducing the rate of suicide remains a key public health goal. This paper estimates the lifetime costs of suicide and non-fatal self harm events in four European countries (Germany, Hungary, Ireland and Portugal) participating in the Optimising Suicide Prevention in Europe (OSPI) project. It then looks at what level of suicide reduction would need to be achieved for an area based suicide prevention intervention to be considered cost-effective. <h3>Methods</h3> Different elements of cost: direct costs (eg, police, funeral services, healthcare use), lost productivity and intangible costs of pain, grief and premature loss of life are described. Data on suicide rates and non-fatal suicide attempts, life expectancy and economic activity in Germany, Hungary, Ireland and Portugal are then used to model the lifetime costs. Decision modelling techniques are used to determine the effectiveness threshold required for a multi-level community based prevention intervention, such as that used in the OSPI project, to be considered cost-effective. <h3>Results</h3> The costs of suicide are substantial and impact across sectors. The average lifetime costs of each completed suicide are around 2 million in EU countries. Increasingly policy makers want to know not only about effectiveness but also the cost effectiveness of interventions when determining how best to make use of budgets. Our analysis suggests that if an area-wide suicide prevention intervention were to achieve only a modest 1% reduction rate in the number of suicides, in most scenarios this remains highly cost-effective.