Healthcare utilization and costs for women with a history of intimate partner violence
Healthcare utilization and costs for women with a history of intimate partner violence
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DOI：
10.1016/j.amepre.2006.10.001
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发表时间：
2007-02-01
影响因子：
5.5
通讯作者：
Thompson, Robert S.
中科院分区：
文献类型：
--
作者：
Rivara, Frederick P.;Anderson, Melissa L.;Thompson, Robert S.
目的：确定有亲密伴侣暴力（IPV）史的妇女与无IPV史的妇女相比的医疗保健利用和医疗保健费用。设计：纵向队列研究。设置：混合模式的健康维护组织。参与者：超过3 000名（3 333名）年龄在18至64岁之间的妇女，在调查前有≥ 3年的累积登记，其中至少有1年是在18岁生日之后。IPV从18岁起，通过对电话访谈的回答确定，使用行为风险因素监测系统的问题以及妇女遭受殴打的经历量表。（来自自动数据）在IPV发生期间和停止后，与自18岁起未报告IPV的女性的医疗保健利用率相比。共有1546名妇女报告IPV在其一生中，在采访时，IPV已经停止在87%的妇女，平均16.0年前采访。IPV期间所有类别的服务的医疗保健利用率高于没有IPV的妇女，并随着时间的推移IPV停止后下降。然而，与没有IPV的妇女相比，在妇女停止虐待5年后，医疗保健利用率仍然高出20%。与没有IPV的女性相比，有IPV病史的女性调整后的年度总医疗费用高出19%（每年439美元）。根据IPV的患病率为44%计算，每10万名18- 64岁的女性登记者每年因IPV而产生的额外费用约为1930万美元。结论：有IPV病史的女性在IPV结束后仍有较高的医疗利用率和医疗费用。鉴于其高患病率，IPV对医疗保健资源利用有重大影响，并明确指出了预防其发生和后果的努力。
Objective: To determine the healthcare utilization and medical care costs of women with a history of intimate partner violence (IPV) compared to women without a history of IPV.Design: Longitudinal cohort study.Setting: Mixed-model health maintenance organization.Participants: Over 3000 (3333) women aged 18 to 64 years with >= 3 year's cumulative enrollment prior to the survey, at least 1 year of which was after the 18th birthday.Main Exposure: IPV since age 18 as determined from responses to telephone interview using questions from the Behavioral Risk Factor Surveillance System and also the Women's Experience with Battering Scale.Outcome Measures: Healthcare utilization and costs (from automated data) during the time that IPV occurred and following its cessation, compared to healthcare utilization for women who did not report IPV since age 18.Results: A total of 1546 women reported IPV in their lifetime; at the time of interview, IPV had ceased in 87% of women, on average 16.0 years prior to interview. Healthcare utilization was higher for all categories of service during IPV compared to women without IPV, and decreased over time after cessation of IPV. However, healthcare utilization was still 20% higher 5 years after women's abuse ceased compared to women without IPV. Adjusted annual total healthcare costs were 19% higher in women with a history of IPV (amounting to $439 annually) compared to women without IPV. Based on prevalence for IPV of 44%, the excess costs due to IPV are approximately $19.3 million per year for every 100,000 women enrollees aged 18-64.Conclusions: Women with a history of IPV had significantly higher healthcare utilization and costs, continuing long after IPV ended. Given its high prevalence, IPV has a major impact on medical care resource utilization and efforts to prevent its occurrence and consequences are clearly indicated.