Changes in Incidents and Payment Methods for Intimate Partner Violence Related Injuries in Women Residing in the United States, 2002 to 2015.
Adolescent
Adult
Aged
Emergency Service, Hospital
/ statistics & numerical data
Female
Health Care Surveys
Health Expenditures
/ statistics & numerical data
Humans
Interpersonal Relations
Intimate Partner Violence
/ statistics & numerical data
Middle Aged
Odds Ratio
Patient Protection and Affordable Care Act
United States
Young Adult
Journal
Women's health issues : official publication of the Jacobs Institute of Women's Health
ISSN: 1878-4321
Titre abrégé: Womens Health Issues
Pays: United States
ID NLM: 9101000
Informations de publication
Date de publication:
Historique:
received:
02
05
2019
revised:
28
04
2020
accepted:
15
05
2020
pubmed:
3
7
2020
medline:
21
10
2020
entrez:
3
7
2020
Statut:
ppublish
Résumé
Violence in interpersonal relationships is a substantial health and social problem in the United States and is associated with a myriad of immediate and long-term physical, behavioral, and neurocognitive impairments. The present study sought to determine the incidence of U.S. emergency department (ED)-attended intimate partner violence (IPV) from 2002 to 2015 and examine the differences in payment sources before and after implementation of the Affordable Care Act. We analyzed ED visits among female patients aged 15 years or older between 2002 and 2015 from the National Hospital Ambulatory Medical Care Survey. Using International Classification of Disease, Ninth Revision, Clinical Modification, codes from patient visit records, we classified each ED visit to determine the frequency and estimate the relative proportion and national frequency of IPV visits. We explored bivariate and multivariate associations between IPV-related injuries with age, race, ethnicity, method of payment, and region, noting changes over time. Between 2002 and 2015, female patients visited EDs an estimated 2,576,417 times for IPV-related events, and the proportion of ED visits for IPV increased during that time period. The percentage of ED visits for IPV-related events did not differ significantly by region, race, or ethnicity. Compared with women 25-44 years of age, women aged 65 to 74 (odds ratio, 0.15; 95% confidence interval, 0.05-0.43; p < .001) and 75 years and older (odds ratio, 0.20; 95% confidence interval, 0.08-0.53; p = .001) were less likely to visit an ED for IPV. Women were more likely to pay for IPV-related services out-of-pocket (i.e., self-pay) (odds ratio, 1.85; 95% confidence interval, 1.24-277; p = .003) before the enactment of the Affordable Care Act. The increase in the percentage of IPV-related ED claims paid by private insurance suggests that the Affordable Care Act may have increased women's willingness and ability to seek medical attention for IPV-related injuries and disclose IPV as the source of injuries.
Sections du résumé
BACKGROUND
Violence in interpersonal relationships is a substantial health and social problem in the United States and is associated with a myriad of immediate and long-term physical, behavioral, and neurocognitive impairments. The present study sought to determine the incidence of U.S. emergency department (ED)-attended intimate partner violence (IPV) from 2002 to 2015 and examine the differences in payment sources before and after implementation of the Affordable Care Act.
METHODS
We analyzed ED visits among female patients aged 15 years or older between 2002 and 2015 from the National Hospital Ambulatory Medical Care Survey. Using International Classification of Disease, Ninth Revision, Clinical Modification, codes from patient visit records, we classified each ED visit to determine the frequency and estimate the relative proportion and national frequency of IPV visits. We explored bivariate and multivariate associations between IPV-related injuries with age, race, ethnicity, method of payment, and region, noting changes over time.
RESULTS
Between 2002 and 2015, female patients visited EDs an estimated 2,576,417 times for IPV-related events, and the proportion of ED visits for IPV increased during that time period. The percentage of ED visits for IPV-related events did not differ significantly by region, race, or ethnicity. Compared with women 25-44 years of age, women aged 65 to 74 (odds ratio, 0.15; 95% confidence interval, 0.05-0.43; p < .001) and 75 years and older (odds ratio, 0.20; 95% confidence interval, 0.08-0.53; p = .001) were less likely to visit an ED for IPV. Women were more likely to pay for IPV-related services out-of-pocket (i.e., self-pay) (odds ratio, 1.85; 95% confidence interval, 1.24-277; p = .003) before the enactment of the Affordable Care Act.
CONCLUSIONS
The increase in the percentage of IPV-related ED claims paid by private insurance suggests that the Affordable Care Act may have increased women's willingness and ability to seek medical attention for IPV-related injuries and disclose IPV as the source of injuries.
Identifiants
pubmed: 32611507
pii: S1049-3867(20)30042-6
doi: 10.1016/j.whi.2020.05.002
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
338-344Informations de copyright
Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.