Long-term Healthcare Effects of Domestic Violence

描述：家庭暴力(DV)是一个主要的社会问题，高达25%的妇女在一生中受到影响。然而，随着时间的推移，关于DV对医疗保健利用和成本以及对健康状况的影响的知识只是最基本的。这一知识差距是研究卫生环境中DV方案结果和有效性的主要障碍。 目的：评估DV在11年期间对成年妇女及其子女的医疗费用和利用率的纵向影响。对于妇女，评估DV对健康状况和风险状况的影响(例如过度饮酒)。次要目标：估计男性和老年人中DV的流行情况。 网站：团体健康合作社(GHC)，华盛顿和爱达荷州的一家大型医疗保健组织。 方法：随机抽取18-年龄段的6667名妇幼保健员进行电话调查。 在过去的3年中，为了确定DV的存在或不存在，并衡量健康状况、社会功能和健康风险结果，对参与者进行了评估。将调查数据链接到自动成本和利用率数据。纵向比较患有和不患有DV的女性(及其子女)在医疗保健利用率和成本方面的差异。对健康状况、社会功能和健康风险结果进行类似的比较。 主要结果：医疗成本、使用率、使用模式(来自ICD代码)、身体健康状况、心理健康状况、社会功能和健康风险概况(例如过量饮酒)。 主要研究好处：这项研究将：1)使用基于人群的调查来确定女性DV受害者和未接触DV的对照妇女组；2)涵盖所有级别的护理 从医院到初级保健；3)对女性受害者(及其子女)和一组非DV受害者进行11年的纵向跟踪，以评估DV对医疗费用和利用的影响；4)确定DV对身心健康状况、社会功能和健康风险的影响；5)按类型、持续时间和频率估计DV在女性中以及在男性和老年人中的流行率。

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.