Healthcare utilization and costs for women with a history of intimate partner violence.
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.


METHODS
Longitudinal cohort study.


METHODS
Mixed-model health maintenance organization.


METHODS
Over 3000 (3333) women aged 18 to 64 years with > or = 3 year's cumulative enrollment prior to the survey, at least 1 year of which was after the 18th birthday.


METHODS
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.


METHODS
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.
Rivara
Frederick P
FP
Harborview Injury Prevention and Research Center and the Department of Pediatrics, University of Washington, Seattle, Washington 98104, USA. fpr@u.washington.edu
Anderson
Melissa L
ML
Fishman
Paul
P
Bonomi
Amy E
AE
Reid
Robert J
RJ
Carrell
David
D
Thompson
Robert S
RS
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D017579:Domestic Violence; D005260:Female; D005102:Health Expenditures; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008875:Middle Aged; D012747:Sexual Partners; D014861:Washington