Women's Health

Domestic violence victims have higher health care use and costs than other women, even long after the abuse has ended

Women who suffer from intimate partner violence (IPV) typically have more headaches, chronic pain, gastrointestinal and gynecologic problems, depression and anxiety, and injuries than other women. They also have significantly higher health care use and costs than other women, according to a new study supported by the Agency for Healthcare Research and Quality (HS10909).

Forty-six percent of 3,333 women aged 18 to 64 years enrolled in a large HMO in Washington State and northern Idaho reported IPV in their lifetime. For 87 percent of them, the abuse had ended an average of 16 years prior to the interview. Although health care use decreased over time after the IPV stopped, it was still 20 percent higher 5 years after the abuse ceased compared with women who had never been abused.

After adjusting for age, education, and other factors, use of health care by women with IPV was about 50 percent higher than women with no history of IPV for emergency department visits, twofold higher for mental health visits, and sixfold higher for use of alcohol or drug services. Abused women also had 14 to 21 percent more primary and specialty care visits and pharmacy use than women with no history of IPV.

Adjusted annual total health care costs were 19 percent higher in women with a history of IPV (amounting to $439 annually) compared with women without IPV. Based on the prevalence of IPV, the excess costs due to IPV were estimated at about $19.3 million per year for every 100,000 women aged 18 to 64 years who were enrolled in the HMO. Women reporting IPV were slightly older, had somewhat lower household incomes, and were slightly more likely to be working at the time of the interview than women without a history of IPV.

Routine screening can lead to increased identification of IPV, and interventions such as protection orders can reduce the risk of recurrent IPV by 50 percent, note the researchers.

See "Healthcare utilization and costs for women with a history of intimate partner violence," by Frederick P. Rivara, M.D., M.P.H., Melissa L. Anderson, M.S., Paul Fishman, Ph.D., and others, in the February 2007 American Journal of Preventive Medicine 32(2), pp. 89-96.

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