Researchers: Nihaya Daoud¹

Background: Intimate partner violence (IPV) has been defined by the World Health Organization as a public health problem that affects one-third of the women globally. Women victims of IPV tend to use more health care services (HCS). In response, health care systems around the world have established policies and guidelines for screening and detection of IPV. In Israel, there is a lack of research on the use of HCS among women victims of IPV.

Objectives: To examine the associations between experiencing IPV and the use of HCS, and examine how IPV screening, receiving information on support services can affect this association and examine whether these associations differ among Arab and Jewish women.

Method: We linked prospective data on the use of HCS obtained from Clalit Sick Fund to survey data on IPV and IPV screening and receiving information. The survey was conducted in 2014-2015 and included a stratified sample of 1,401 women interviewed face-to-face during their visit to a 63 Maternal and Child Health Clinics in five districts of the Ministry of Health in Israel. We received data on the use of HCS for 868 women insured in Clalit Sick Fund for one follow-up year after the interview. This includes the use of family physician, gynecologist, any specialist, hospitalization and visits to the emergency room. We conducted a multivariate analysis for each of the HCS variables using logistic regression and Generalized Estimating Equations (GEE). We fitted five models that adjust for socio-demographic and socioeconomic variables, screening for IPV and receiving information.

Findings: We found significant associations between some IPV variables and utilization of some HCS. These associations were different for Arab and Jewish women, whereas Arab women exposed to IPV use more HCS (gynecologist and emergency room, and hospitalized) while Jewish women with IPV used less HCS (gynecologist, specialist and emergency room). Exposure to IPV was not associated with use of a family physician services in the two groups of women. Screening of IPV, receiving information and both were not associated with use of HCS, or the associations between IPV and use of HCS.

Summary and conclusions: The results supported partially our hypothesis about the associations between IPV HCS utilization. Differences between Arab and Jewish women victims for these associations should bring the attention of policy makers as Arab women victims of IPV use more medical services to compensate for the lack of social and psychological support services. Screening of IPV and receiving information did not affect the association between IPV and HCS utilization is another important finding that calls for updating the guidelines for IPV screening and provision of information on support services for women victims of IPV.

Research end date: 11/2018