Suicide as an indicator of quality of life: evidence from dialysis patients

Quality of life has been measured in many different ways for patients with chronic medical conditions. What is unique about the approach used here is that it uses suicide rates as a relatively objective measure of quality of life within the population of dialysis patients. Using a Heckman selection model, we estimate the relative suicide rates across patients undergoing both hemodialysis and peritoneal dialysis. Our empirical results show that patients on hemodialysis have relatively lower suicide rates after controlling for other factors. Specifically, our results indicate that 141 fewer suicides will occur for every 1,000 patients shifted from peritoneal to hemodialysis. Prior estimates of the higher costs of the latter modality yield an estimated expenditure of $42,043 per suicide avoided.