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Journal of General Internal Medicine

, Volume 33, Issue 6, pp 936–941 | Cite as

Women’s Healthcare Utilization Following Routine Screening for Past-Year Intimate Partner Violence in the Veterans Health Administration

  • Melissa E. Dichter
  • Anneliese E. Sorrentino
  • Terri N. Haywood
  • Scarlett L. Bellamy
  • Elina Medvedeva
  • Christopher B. Roberts
  • Katherine M. Iverson
Original Research

Abstract

Background

Experience of intimate partner violence (IPV) can have adverse health impacts and has been associated with elevated rates of healthcare service utilization. Healthcare encounters present opportunities to identify IPV-related concerns and connect patients with services. The Veterans Health Administration (VHA) conducts IPV screening within an integrated healthcare system.

Objective

The objectives of this study were to compare service utilization in the 6 months following IPV screening between those screening positive and negative for past-year IPV (IPV+, IPV−) and to examine the timing and types of healthcare services accessed among women screening IPV+.

Design

A retrospective chart review was conducted for 8888 female VHA patients across 13 VHA facilities who were screened for past-year IPV between April 2014 and April 2016.

Main Measures

Demographic characteristics (age, race, ethnicity, marital status, veteran status), IPV screening response, and healthcare encounters (based on visit identification codes).

Key Results

In the 6 months following routine screening for past-year IPV, patients screening IPV+ were more likely to utilize outpatient care (aOR = 1.85 [CI 1.26, 2.70]), including primary care or psychosocial care, and to have an inpatient stay (aOR = 2.09 [CI 1.23, 3.57]), compared with patients screening IPV−. Among those with any utilization, frequency of outpatient encounters within the 6-month period following screening was higher among those screening IPV+ compared with those screening IPV−. The majority of patients screening positive for past-year IPV returned for an outpatient visit within a brief time frame following the screening visit (> 70% within 14 days, >95% within 6 months). More than one in four patients screening IPV+ had an emergency department visit within the 6 months following screening.

Conclusions

Women who screen positive for past-year IPV have high rates of return to outpatient visits following screening, presenting opportunities for follow-up support. Higher rates of emergency department utilization and inpatient stays among women screening IPV+ may indicate adverse health outcomes related to IPV experience.

KEY WORDS

intimate partner violence service utilization Veterans Health Administration 

Notes

Funding Information

This study was funded by a grant from the U.S. Department of Veterans Affairs, Health Services Research and Development, IIR 15-142 (Dichter)

Compliance with Ethical Standards

The study was approved by the Corporal Michael J. Crescenz VA Medical Center institutional review board, including a waiver of informed consent.

Disclaimer

The views expressed in this article are those of the authors and do not necessarily represent the position or policy of the Department of Veterans Affairs or the US Government.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

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Copyright information

© Society of General Internal Medicine (outside the USA) 2018

Authors and Affiliations

  • Melissa E. Dichter
    • 1
    • 2
  • Anneliese E. Sorrentino
    • 1
  • Terri N. Haywood
    • 1
  • Scarlett L. Bellamy
    • 3
  • Elina Medvedeva
    • 1
  • Christopher B. Roberts
    • 1
  • Katherine M. Iverson
    • 4
    • 5
  1. 1.Center for Health Equity Research and Promotion U.S. Department of Veterans AffairsPhiladelphiaUSA
  2. 2.Department of Family Medicine and Community HealthUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaUSA
  3. 3.Department of Epidemiology and BiostatisticsDrexel University Dornsife School of Public HealthPhiladelphiaUSA
  4. 4.Women’s Health Sciences Division, National Center for PTSDVA Boston Healthcare SystemBostonUSA
  5. 5.Department of PsychiatryBoston University School of MedicineBostonUSA

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