The Effects of Long-Term Care Infrastructure on Local Elderly Suicide Rate in South Korea

Background and Purpose: The elderly suicide rate in South Korea is the highest among the members of the Organization for Economic Cooperation and Development (OECD). Despite elderly suicide is a serious public health issue, there have been very few studies in South Korea that have examined factors related to elderly suicide rate at the regional level. As the long-term care(LTC) infrastructure is one part of the nation’s public safety net for elderly, LTC infrastructure is expected to lower elderly suicide rate. Thus, this study aims to examine the effects of LTC infrastructure on elderly suicide rate involving 229 local governments and more specifically to test whether LTC homes and facilities infrastructure affect local elderly suicide rates differently.

Methods: We performed descriptive statistics and panel fixed effect regression using the data set generated from the causes of death statistics by Statistical Office and administrative data from 229 local governments over 2010 to 2018. The local elderly suicide rate was defined as the number of elderly suicide cases per 100,000 elderly in each region. The explanatory variables are total number of LTC infrastructure, number of LTC home infrastructure, and number of LTC facility infrastructure per 1,000 elderly in each region. The other variables included in analysis were selected to control for key local socioeconomic and population characteristics. These included: suicide rate under 65, recipient rates of national basic livelihood security benefit, crude divorce rate, social welfare budget, number of psychiatrists per 100,000 people, financial self-sufficiency level, elderly population ratio, population movement rate.

Results: Descriptive statistics showed that number of LTC infrastructure per 1,000 elderly and elderly suicide rates vary by local governments. The result of panel fixed effect regression showed that total number of LTC infrastructure per 1,000 elderly was negatively associated with elderly suicide rates (b=-.464, p<.001), indicating that local governments with higher levels of LTC infrastructure presented significantly lower elderly suicide rates. Furthermore, number of LTC home infrastructure per 1,000 elderly (b=-.822, p<.001) and number of LTC facility infrastructure per 1,000 elderly (b=-.371, p<.05) had a significant effect on elderly suicide rates, indicating that LTC home infrastructure had a stronger impact on lowering elderly suicide rate than LTC facility infrastructure did.

Conclusion and Implications: Based on the findings of this study, we suggest that strengthening LTC services through the expansion of LTC infrastructure should be considered to prevent suicide in the elderly. In particular, expanding the long-term home care infrastructure plays an important role in solving elderly suicide problems.