Healthcare utilization by abused women: A case control study

Background: Previous studies observed an association between intimate partner violence (IPV) and increased health problems. Early detection of IPV by general practitioners (GPs) is required to prevent further harm and provide appropriate support. In general practice, a limited number of studies are available on healthcare utilization of abused women. Objectives: The aim of the study was to investigate the healthcare utilization of abused women compared to non-abused. Methods: The study was designed as a matched case-control study in 16 general practices in deprived areas in Rotterdam (The Netherlands). Electronic medical files of 50 victims of IPV were analysed for consultation frequency, referrals, medical prescription and reasons for encounter over a period of five years. Controls (n = 50) were non-abused women matched for general practice, age, number of children, and country of origin and education level. Results: Abused women visited their GP almost twice as often than non-abused, in particular for social problems (OR = 3.5; 95% CI: 1.2-10.5; P = 0.01), substance abuse (OR = 4.6; 95% CI: 0.9-22.7; P = 0.05) and reproductive health problems (OR = 3.0; 95% CI: 1.3-6.8; P = 0.009). Victims of IPV were significantly more often referred for additional diagnostics (OR = 3.6; 95% CI: 1.1-12.2; P = 0.03), to mental healthcare (OR = 2.9; 95% CI: 1.2-7.1; P = 0.02) than non-victims. Abused women received 4.1 times more often a prescription for anti-depressants (95% CI: 1.5-11.6; P = 0.005) than non-abused women. Conclusion: As compared to non-abused women, female victims of IPV visited their GP more frequently and exhibited a typical pattern of healthcare utilization. This could alert GPs to inquire about partner abuse in the past.