Assessing Outcomes of Health System Suicide Risk Screening Programs

This contract action was not awarded competitively based on the following unique qualifiations. UTSW is the only entity with access to data resulting from a systematic program of comprehensive or universal suicide risk screening across multiple care settings with a general patient population (as opposed to, for example, a system that mainly serves veterans or other specific population subgroups) with the scope and scale necessary to conduct the analyses detailed in the Statement of Work. The data results from a systematic suicide screening program implemented in Parkland Health and Hospital System and exceeds what is required by applicable accreditation standards (particularly the Joint Commission’s National Patient Safety Goal 15.01.01), with the scope and scale necessary to conduct the analyses detailed in the Statement of Work. Specifically, UTSW is the only entity with the access and ability to analyze data on suicide risk screening scores from at least 500,000 unique general population patients, and/or from more than 2.5 million unique patient-encounters, since 2010. In addition, UTSW is the only entity able to take this scale of suicide screening data and link it to (1) data on mortality spanning a period of at least 12 months after each suicide risk screening and; (2) data on subsequent health care use during a period of at least 12 months after each suicide risk screening. Because non-fatal suicide behaviors – and especially suicide deaths – are rare in absolute terms, the Statement of Work of this contract requires data on suicide risk screening scores from at least 500,000 unique general population patients, and/or from more than 2.5 million unique patient-encounters in order to achieve adequate statistical power. In addition, screening scores alone are not sufficient to perform the analyses required to better understand the impact of a universal suicide screening program on suicide and other health-related outcomes. To perform these analyses (described below), it is also necessary to have access to mortality and health care use for the screened individuals, and to be able to link screening scores with this data. Without these data and linking capabilities, it is impossible to perform the analyses required to answer the following: • The fraction of patients in particular care settings who were identified with suicide risk, before and after implementation of a suicide risk screening program. • Patterns of suicide death and other relevant types of mortality over particular periods of follow-up after an index clinical encounter, for patient groups defined by care setting and identified suicide risk. • Patterns of non-fatal suicide events, and other relevant types of injury (e.g., unintentional overdoses, non-overdose unintentional injury) over particular periods of follow-up after an index clinical encounter, for patient groups defined by care setting and identified suicide risk. • Patterns of emergency department and hospital use and costs over particular periods of follow-up after an index clinical encounter, for patient groups defined by care setting and identified suicide risk. To the Government’s knowledge, only one entity – UTSW – can readily access the data required to perform the analysis services described in the Statement of Work.