Physical abuse raises women's health costs by 42 percent

Mar 23 2009

Women experiencing physical abuse from intimate partners spent 42 percent more on health care per year than non-abused women, according to a long-term study of more than 3,000 women.

And the costs don't end when the abuse does. The study revealed that women who suffered physical abuse five or more years earlier still spent 19 percent more per year on health care than women who were never abused.

"Along with all the physical and emotional pain it causes, domestic violence also comes with a substantial financial price," said Amy Bonomi, co-author of the study and associate professor of human development and family science at Ohio State University.

The study is the largest to date to examine health care costs and utilization based on the timing and type of domestic violence that women suffer, Bonomi said.

The study, co-authored with researchers from the Group Health Cooperative and the University of Washington in Seattle, was published online this week in the journal Health Services Research . It will appear in an upcoming print edition.

The research examined data from 3,333 randomly selected women who belonged to Group Health, a health care system in the Pacific Northwest.

Women in the study were surveyed about whether they experienced any physical or emotional abuse from intimate partners and if so, when it occurred. Researchers then studied patterns of health care use and costs by the women over an 11-year period, from 1992 through 2002.

"We were able to track health care costs for quite a long time, giving us a good picture of how much domestic violence is actually costing our health care system," Bonomi said.

Women experiencing ongoing physical abuse had the highest health care costs -- 42 percent higher than non-abused women.

"It's likely that these women need more health care because they are seeking care for immediate injuries and associated health problems," Bonomi said.

Women who had been physically abused within the last five years, but not currently, had 24 percent higher yearly health costs. Abuse that occurred more than five years ago resulted in 19 percent higher costs.

The study separately examined women who experienced psychological abuse, which included verbal threats and chronic controlling behavior.

Those suffering psychological abuse within the past five years, but not currently, had yearly health care costs that were 33 percent higher than those of non-abused women.

"It's possible that it takes additional time for women with psychological abuse to seek care for their experiences," Bonomi said.

Another striking finding was that all abused women, whether they experienced physical or psychological abuse, used significantly more mental health services than non-abused women, Bonomi said.

Women suffering ongoing physical abuse were about 2.5 times more likely to visit a mental health provider in the past year than were non-abused women. The rate for psychologically abused women was two times higher.

"This lends support to the idea that mental health providers should always ask women about their abuse history when they first come in for treatment," Bonomi said.

But mental health was just one of several areas in which abused women used more services.

Physically abused women used significantly more primary care, pharmacy, specialty care, laboratory and radiology services.

For psychologically abused women, more services were needed in specialty care, pharmacy, and radiology.

Group Health, the health care system whose members were surveyed for the study, provides health and insurance services to more than 500,000 people in the Pacific Northwest.