Journal article
Lifetime History of Sexual Assault and Emergency Department Service Use among Women Veterans
Women's health issues, Vol.30(5), pp.374-383
09/2020
DOI: 10.1016/j.whi.2020.05.003
PMID: 32571623
Abstract
Although sexual assault survivors are at increased risk for adverse physical and mental health outcomes and tend to use more health care services, little is known about women veterans’ lifetime history of experiencing sexual assault (lifetime sexual assault [LSA]) and emergency department (ED) use. We sought to examine associations between experiencing LSA, mental health diagnoses, and ED use among women veterans.
Computer-assisted telephone interviews were conducted with 980 women veterans enrolled at two Veterans Affairs (VA) Medical Centers to assess history of experiencing LSA, health care use, sociodemographic characteristics, and military history. Administrative data provided VA use, mental health, and medical diagnoses. Logistic regression analyses examined associations between experiencing LSA and mental health diagnoses and past 5-year ED use. Classification tree analysis characterized ED use in participant subgroups.
Sixty-four percent of participants visited a VA or non-VA ED during the previous 5 years. Women veterans with histories of mental health diagnoses and who experienced sexual assault had an odds of ED use almost two times greater than those with no history of experiencing sexual assault and no mental health diagnoses. The odds were similar for experiencing attempted (adjusted odds ratio, 1.85) and completed (adjusted odds ratio, 1.95) sexual assault. Classification tree analysis identified reliance on VA care and the composite variable representing experiencing LSA and mental health diagnoses as factors that best discriminated ED users from nonusers.
Experiencing LSA is associated with greater ED use in women veterans enrolled in the VA. Whether finding this reflects greater emergent health care needs, suboptimal access and treatment for conditions that could be managed in other settings, lack of health care coordination, or some combination of these factors is unclear.
Details
- Title: Subtitle
- Lifetime History of Sexual Assault and Emergency Department Service Use among Women Veterans
- Creators
- Mark W Vander Weg - Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IowaAnne G Sadler - Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IowaThad E Abrams - Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IowaKelly Richardson - Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IowaJames C Torner - Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IowaCraig H Syrop - Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IowaMichelle A Mengeling - Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- Women's health issues, Vol.30(5), pp.374-383
- DOI
- 10.1016/j.whi.2020.05.003
- PMID
- 32571623
- NLM abbreviation
- Womens Health Issues
- ISSN
- 1049-3867
- eISSN
- 1878-4321
- Publisher
- Elsevier Inc
- Grant note
- NRI 04-1941 / Department of Veterans Affairs (https://doi.org/10.13039/100000738) Health Services Research and Development (HSR&D) Service (https://doi.org/10.13039/100007217)
- Language
- English
- Date published
- 09/2020
- Academic Unit
- Psychiatry; Epidemiology; Psychological and Brain Sciences; Surgery; Obstetrics and Gynecology; Injury Prevention Research Center; General Internal Medicine; Neurosurgery; Community and Behavioral Health; Internal Medicine
- Record Identifier
- 9984214663802771
Metrics
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