141st APHA Annual Meeting and Exposition

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287056
High, but varied, healthcare utilization by both victims and perpetrators of partner violence


Wednesday, November 6, 2013

Catherine L. Kothari, MA, PhD Program in Interdisciplinary Health Sciences, Western Michigan University, Kalamazoo, MI
Rashmi Kothari, MD, Emergency Deparment, Western Michigan University School of Medicine, Kalamazoo, MI
Thomas Rohs, MD, Trauma Services, Borgess Medical Center, Kalamazoo, MI
Scott Davidson, MD, Trauma Surgery, Bronson Methodist Hospital, Kalamazoo, MI
Carrie Klein, JD, Prosecuting Attorney's Office, Kalamazoo County, Kalamazoo, MI
Amy Koestner, MSN, Trauma Services, Spectrum Health, Kalamazoo, MI
Mican DeBoer, RN, Trauma Services, Borgess Medical Center, Kalamazoo, MI
Rita Cox, RN, Trauma Services, Bronson Methodist Hospital, Kalamazoo, MI
Kim Kutzko, MPH, Emergency Medicine, Western Michigan University School of Medicine, Kalamazoo, MI
Purpose: To identify the utilization of emergency and trauma services by criminal-justice-involved partner-violence victims and defendants.

Methods: This was a cross-sectional study linking secondary data from two Level-1-Trauma-Center hospitals and the county-prosecutor's office: (1) Hospital data included one year (2010) of emergency department (ED) visits, and eleven years of in-patient (IP) injury-related admissions. (2) Prosecutor data contained all charging requests for crimes between intimate partners (N=21,179 crimes, from 2000-2010). Data linking was completed electronically (using LinkPlus, CDC software probabilistic algorithm for linking alpha-numeric values) with manual checks for quality and to verify uncertain matches.

Results/Outcomes: The 163,995 ED visits in 2010 were generated by 90,901 individuals. Five percent of these individuals (N=4,563) had been victims of partner violence and four percent (N=4,044) had been defendants at some point in the prior decade (2000-2010). The 30,301 hospitalizations, (with at least one ICD injury code) from 2000-2010, were generated by 26,266 individuals. Two-and-a-half percent of these individuals (N=637) had been victims of partner violence and three-and-a-half percent (N=920) had been defendants at some point in the prior decade (2000-2010). Incident-based utilization (within one day, six months and twelve months) varied by visit type and whether the individual was a victim or defendant. Individuals who had been both victims and defendants in charging requests had substantially higher utilization.

Conclusions: Emergency healthcare service utilization, outpatient and inpatient, by both victims and defendants is high. Understanding more about the type and timing of this utilization will aid prevention efforts and resource allocation.

Learning Areas:

Advocacy for health and health education
Clinical medicine applied in public health
Epidemiology
Public health or related research

Learning Objectives:
Identify the emergency department utilization by criminal-justice-involved victims and defendants of partner violence Identify the injury-related hospitalization by criminal-justice-involved victims and defendants of partner violence

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been co-investigator on a National Institute of Justice study linking emergency department visits and criminal justice domestic-violence victimization. I have been lead author on a published manuscript and co-author on seven published manuscripts and reports detailling study results.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5009.3: Topics in Traumatic Brain Injury, Violence and Emergency Care