Health Care Utilization and Costs Associated with Physical and Non-Physical Only Intimate Partner Violence

To estimate health care utilization and costs associated with the type of intimate partner violence (IPV) women experience by the timing of their abuse, 3333 women were randomly sampled from the membership files of a large health plan and participated in a telephone survey to assess IPV history, including the type of IPV (physical IPV or non-physical abuse only) and timing of the abuse (ongoing; recent, not ongoing but in past 5 years; remote, ending at least 5 years prior). Automated annual health care utilization and costs were assembled over 7.4 years for women with physical IPV and non-physical abuse only by the time period during which their abuse occurred (ongoing, recent, remote), and compared to those of never-abused women (reference group). Mental health utilization was significantly higher for women with physical or non-physical abuse only compared to never-abused women—with the highest use among women with ongoing abuse (relative risk: physical: 2.58; non-physical: 2.13). Physically-abused women also used more emergency, hospital outpatient, primary care, pharmacy and specialty services; for emergency, pharmacy and specialty care, utilization was highest for women with ongoing abuse. Total annual health care costs were higher for physically abused women, with the highest costs for ongoing abuse (44% higher compared to non-abused women), followed by recent (24% higher) and remote abuse (19% higher). Women with ongoing or recent non-physical abuse only also had higher total annual costs (14% and 35%). Both physical and non-physical abuse contributed to higher health care utilization and costs.