Patterns of healthcare services utilization associated with intimate partner violence (IPV): Effects of IPV screening and receiving information on support services in a cohort of perinatal women
Patterns of healthcare services utilization associated with intimate partner violence (IPV): Effects of IPV screening and receiving information on support services in a cohort of perinatal women
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DOI：
10.1371/journal.pone.0228088
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发表时间：
2020-01-31
期刊：
影响因子：
3.7
通讯作者：
Cohen, Arnon
中科院分区：
文献类型：
--
作者：
Daoud, Nihaya;Kraun, Lotan;Cohen, Arnon
背景经历亲密伴侣暴力（IPV）的女性面临着严重的健康后果，但她们的医疗服务利用模式尚不清楚，IPV筛查和接受信息对这些模式的影响也不清楚。比较五个HCS的利用模式（访问家庭医生，妇科医生，专家和急诊室，住院治疗）在围产期妇女谁报告经历与没有经历任何IPV和IPV类型（身体和/或性;情感和/或口头;社会和经济）的队列; 2.检查是否IPV筛选，接收信息的支持服务，或两者兼而有之，影响模式;和3。比较这些协会之间的种族群体（阿拉伯和犹太妇女）。MethodsWe进行了一项前瞻性研究，使用注册表数据HCS利用率从以色列最大的健康基金（Clalit）在一年后的2014-2015年调查的一个队列的868围产期妇女在以色列（327阿拉伯少数民族，542犹太人）对他们的报告经历IPV，IPV筛查，并接收信息。使用多变量分析，我们计算了与任何IPV和IPV类型报告相关的五种HCS使用的调整后比值比（AOR）和95%置信区间（CI）。我们调整IPV筛选，接收有关服务的信息，两者，在总样本中，并分别在ethnic groups.ResultsAny IPV和IPV类型有显着的关联与一些HCS利用变量，不同的方向和模式的民族。经历IPV与阿拉伯妇女中较高的HCS利用率相关，犹太妇女中较低的利用率。经历过IPV的阿拉伯女性去看妇科医生的可能性是没有经历过IPV的女性的两倍（任何IPV的AOR（95% CI）为2.00，1.14-3.51;情感和/或语言IPV为2.17，1.23-3.81，社会和经济IPV为1.83，1.04-3.22）。在犹太女性中，经历任何IPV与急诊室就诊的可能性较低相关（0.62，0.41-0.93）;经历身体和/或性IPV与家庭医生就诊的可能性较低相关（OR = 0.20，0.05-0.82）。IPV筛查和接收信息与较低的HCS利用率在阿拉伯womenals.ConclusionsDifferent HCS利用模式的妇女谁报告经历与不经历IPV在不同的种族群体建议复杂的关系，取决于HCS如何解决妇女的需求，开始与IPV筛查和提供信息。这可能会为在HCS解决IPV问题的定制方案提供信息，特别是针对少数群体妇女。
BackgroundWhile women experiencing intimate partner violence (IPV) face significant health consequences, their patterns of healthcare services (HCS) utilization are unclear, as are the effects of IPV screening and receiving information on these patterns.Objectives1. Compare utilization patterns of five HCS (visits to family physician, gynecologist, specialist and emergency room, and hospitalization) in a cohort of perinatal women who reported experiencing versus not experiencing any IPV and IPV types (physical and/or sexual; emotional and/or verbal; social and economic); 2. Examine whether IPV screening, receiving information on support services, or both, affect patterns; and 3. Compare these associations between ethnic groups (Arab and Jewish women).MethodsWe conducted a prospective study using registry data on HCS utilization obtained from Israel's largest Health Fund (Clalit) in the year following a 2014-2015 survey of a cohort of 868 perinatal women in Israel (327 Arab minority, 542 Jewish) on their reports of experiencing IPV, IPV screening, and receiving information. Using multivariate analysis, we calculated adjusted odds ratios (AOR) and 95% confidence intervals (CI) for the five HCS utilizations in association with reports of any IPV and IPV types. We adjusted for IPV screening, receiving information about services, and both, in the total sample, and separately among ethnic groups.ResultsAny IPV and IPV types had significant associations with some HCS utilization variables, with different directions and patterns for the ethnic groups. Experiencing IPV was associated with higher HCS utilization among Arab women, lower utilization in Jewish women. Arab women experiencing IPV were twice as likely to visit a gynecologist than women not experiencing IPV (AOR (95% CI) was 2.00, 1.14-3.51 for any IPV; 2.17, 1.23-3.81 for emotional and/or verbal IPV, and 1.83, 1.04-3.22, for social and economic IPV). Among Jewish women, experiencing any IPV was associated with lower likelihood of emergency-room visits (0.62, 0.41-0.93); and experiencing physical and/or sexual IPV was associated with lower likelihood of family physician visits (OR = 0.20, 0.05-0.82). Both IPV screening and receiving information were associated with lower HCS utilization among Arab women only.ConclusionsDifferent HCS utilization patterns among women who reported experiencing versus not experiencing IPV in different ethnic groups suggest complex relationships that hinge on how HCS address women's needs, starting with IPV screening and providing information. This might inform tailored programs to tackle IPV at the HCS, particularly for minority women.