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Women who were abused as children use more health care services than those who weren't abused

Health care costs are significantly greater for women who were physically or sexually abused as children than for women who left childhood unscathed, finds a new study funded in part by the Agency for Healthcare Research and Quality (HS10909).

Researchers from Ohio and Washington interviewed 3,333 women by telephone who received care from a health plan in the Pacific Northwest from January 1, 1992, to December 21, 2002. After placing the women in one of four categories (no abuse, physical and sexual abuse, physical abuse only, and sexual abuse only) the team looked at health care use during the 10-year period. Thirty-four percent (1,128) of women said they were abused as children. These women were more likely to have smoked, used recreational drugs in the past year, have symptoms of depression, and have a higher body mass index than women who had not suffered abuse as children.

Health care costs for women with a history of physical and sexual abuse averaged $3,203 annually, while costs for women who were not abused averaged $2,413, a nearly $800 difference. Women who endured both types of abuse also used more mental health, hospital outpatient, emergency department, primary care, specialty care, and pharmacy services than the nonabused group.

The authors report that their findings suggest abuse suffered in childhood may be a factor that drives the use of health services in adulthood. They recommend parents be offered parenting classes to reduce the prevalence of abuse and that mental health professionals evaluate children who have been abused, so treatment can be offered. Finally, health professionals should consider screening women who frequently use health services for prior abuse to improve their mental health and reduce their symptoms.

See "Health care utilization and costs associated with childhood abuse," by Amy E. Bonomi, Ph.D., M.P.H., Melissa L. Anderson, M.S., Frederick P. Rivara, M.D., M.P.H., and others in the March 2008 Journal of General Internal Medicine 23(3), pp. 294-299.

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