Published online November 30, 2007
PEDIATRICS Vol. 120 No. 6 December 2007, pp. 1270-1277 (doi:10.1542/peds.2007-1148)
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ARTICLE

Intimate Partner Violence and Health Care Costs and Utilization for Children Living in the Home

Frederick P. Rivara, MD, MPHa, Melissa L. Anderson, MSb, Paul Fishman, PhDb, Amy E. Bonomi, PhD, MPHb,c,d, Robert J. Reid, MD, PhDb, David Carrell, PhDb and Robert S. Thompson, MDb

a Harborview Injury Prevention and Research Center and Departments of Pediatrics and Epidemiology, University of Washington, Seattle, Washington
b Center for Health Studies, Group Health, Seattle, Washington
c Department of Human Development and Family Science, Ohio State University, Columbus, Ohio
d Columbus Children's Research Institute at Columbus Children's Hospital, Columbus, Ohio

Objective. The goal was to determine whether differences in health care costs and utilization exist for children whose mothers experienced intimate partner violence versus those who did not.

Methods. A longitudinal cohort study was performed in an integrated health care delivery organization with 760 children of mothers with no history of intimate partner violence and 631 children of mothers with a history of intimate partner violence since age 18. Health care utilization and costs for children before, during, and after intimate partner violence exposure were compared with utilization and costs for children with nonabused mothers.

Results. Health care utilization and health care costs were higher in most categories of care for children of mothers with a history of intimate partner violence, with significantly higher values for mental health services, primary care visits, primary care costs, and laboratory costs. Children of mothers with a history of intimate partner violence that ended before the child was born had significantly greater utilization of mental health, primary care, specialty care, and pharmacy services than did children of mothers who reported no intimate partner violence. Children exposed directly to intimate partner violence (after birth) had greater emergency department and primary care use during the intimate partner violence and were 3 times as likely to use mental health services after the intimate partner violence ended.

Conclusions. Children whose mothers experienced intimate partner violence have higher health care utilization and costs, even if their mothers' abuse stopped before they were born. Screening of women for intimate partner violence should be a routine part of their health care, and interventions for both the women and their children are likely necessary to minimize the effects of intimate partner violence in the family.

Key Words: intimate partner violence • health care cost • health care utilization

Abbreviations: IPV—intimate partner violence

Accepted Jun 11, 2007.


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