Women referred for on-site domestic violence services in a managed care organization.
BACKGROUND
Limited data about victims of domestic violence in health care settings hinder development of appropriate services. A comprehensive program was established in a managed care organization to increase identification and referral of domestically abused female patients.


METHODS
Female victims of domestic abuse were referred to a trained social worker for further assessment. Information about the women was obtained from clinical consultation forms; initial interviews conducted by social workers; a survey administered to a convenience sample of women seen by the program; and medical chart review.


RESULTS
Of 265 women who agreed to a domestic violence referral, 177 (67%) were contacted for further evaluation. The study sample was ethnically diverse and included female victims seen for routine care, women who had been assaulted, women who had depression, and women with various somatic symptoms. Responses from 51 of the 177 women showed the most cited reasons for accepting referral were unhappiness with current situation, wanting to leave or change the situation, concern about children who witnessed abuse, and the suggestion by a health care practitioner that the patient's symptoms could be related to the abuse. Most reported having symptoms of depression in the previous year.


CONCLUSIONS
Comprehensive programs in the health care setting can increase identification of victims of domestic abuse. This descriptive report provides a greater understanding of victims of domestic abuse, their presentation in the medical setting, their motivation for accepting referral, and issues which affect their recovery. Links between health care and community resources are necessary for effective intervention.
Department of Internal Medicine, Kaiser Permanente Medical Center, Richmond, CA 94801-2565, USA. Brigid.mccaw@kp.org
Brigid
B
McCaw
Heidi M
HM
Bauer
William H
WH
Berman
Laura
L
Mooney
Margaret
M
Holmberg
Enid
E
Hunkeler
D000328:Adult; D018585:Battered Women / Q000523:psychology*; D002140:California; D003376:Counseling; D003419:Crisis Intervention; D003625:Data Collection; D003866:Depressive Disorder; D017579:Domestic Violence / Q000208:ethnology / Q000517:prevention & control*; D005260:Female; D006279:Health Maintenance Organizations / Q000458:organization & administration*; D006801:Humans; D008297:Male; D017533:Marital Status; D008485:Medical Audit; D008875:Middle Aged; D010865:Pilot Projects; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013001:Somatoform Disorders; D014481:United States