Long-term Healthcare Effects of Domestic Violence

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DESCRIPTION: Domestic violence (DV) is a major societal problem, impacting up to 25% of women in their lifetime. However, knowledge of the impact of DV over time on healthcare utilization and costs and on health status is only rudimentary. This knowledge gap is a major barrier to research on outcome and effectiveness of DV programs in health settings. Objective: Assess the longitudinal impact of DV over an 11-year period on the healthcare cost and utilization of adult women and their children. For the women, assess the effects of DV on health status and risk profiles (e.g. excessive drinking). Secondary objective: estimate DV prevalence among men and seniors. Site: Group Health Cooperative (GHC), a large HMO in Washington and Idaho. Methods: Telephone survey a random sample of 6667 women 18-64 years who have been GHC enrollees over the last 3 years to establish the presence or absence of DV and to measure health status, social functioning, and health risk outcomes. Link the survey data to automated cost and utilization data. Compare longitudinally cohorts of women with and without DV (and their children) on healthcare utilization and costs. Make similar comparisons for health status, social functioning, and health risk outcomes. Main outcomes: Healthcare costs, utilization rates, utilization patterns (from ICD codes), physical health status, mental health status, social functioning, and health risk profiles (e.g. excessive alcohol consumption). Major study benefits: The study will: 1) Use a population-based survey to identify female DV victims and a comparison group of women not exposed to DV; 2) Encompass all levels of care from hospital to primary care; 3) Follow female victims (and their children) and a comparison group of non-DV victims longitudinally over an 11-year period to assess the impact of DV on healthcare costs and utilization; 4) Determine the effect of DV on physical and mental health status, social functioning, and health risk profiles; 5) Estimate the prevalence of DV by type, duration and frequency among women and also among men and seniors.