Center for the Advancement of Health
Friday, January 10, 2003
January 8, 2003
Women who experience physical or sexual violence from an intimate partner or other family member lean heavily on the healthcare system, according to a new study.
"The main finding of this study is that being a domestic violence case-patient, as documented in the medical record, is associated with significantly higher healthcare utilization rates," says study author Robert S. Thompson, M.D., of the Department of Preventive Care at Group Health Cooperative, an HMO in Seattle, Wash.
Approximately 25 percent of U.S. women experience intimate partner violence in their lifetimes, according a 1998 National Violence Against Women survey, cited in the study.
For a five-year study period from 1997 to 2002, Thompson and colleagues examined the medical records of several groups of adult female GHC patients. In one group, 62 women were documented domestic violence victims who visited a doctor for a physical examination or to treat an injury, chronic pelvic pain or depression. A second group of more than 2,000 women saw a doctor for the same reasons but had no documentation of domestic violence in their medical records. A third group included more than 6,000 women drawn from the general population of GHC patients.
The partner violence fell along a continuum of severity. One woman had been injured by her physically abusive son and feared for her safety, for example, while another woman's record described a bruise on her calf from a fight with her husband.
The domestic violence victims made more doctor visits, an average of more than 17 per year, compared with an average of more than 10 for the second group and more than six for the third group. In fact, 27 percent of the domestic violence victims had more than 20 doctor visits per year. Also, annual healthcare costs were significantly higher for those who had experienced domestic violence: more than $5,000 per year, compared with approximately $3,400 and $2,400 for the second and third groups, respectively.
"The pattern is one of broadly increased utilization [by domestic violence victims] at multiple levels of care," Thompson says. The study results are published in the January issue of the American Journal of Preventive Medicine.
The researchers pointed out several study limitations, including that since most women in their domestic violence study group suffered from conditions like chronic pelvic pain and depression, it's possible these results don't reflect healthcare use by domestic violence victims without these conditions.
The researchers note that more research is needed on the long-term history of domestic violence, and such research should include women's' perspectives to measure factors such as social isolation.
"This study provides information that should prove useful to health plans, policy makers, advocacy groups and researchers," Thompson concludes.
This research was supported by grants from the Agency for Healthcare Research and Quality, and the Group Health Foundation.