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The influence of child abuse on the pattern of expenditures in women's adult health service utilization in Ontario, Canada

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  • Tang, Betty
  • Jamieson, Ellen
  • Boyle, Michael
  • Libby, Anne
  • Gafni, Amiram
  • MacMillan, Harriet

Abstract

Childhood maltreatment is a common and serious problem for women, particularly in relation to impairment in adulthood. To our knowledge, no system-wide study has addressed the influence of childhood maltreatment on the cost of these women's adult health service utilization. This paper examines this relationship. The 1990 Ontario Health Survey (OHS) gathered information regarding determinants of physical health status and the use of health services. The 1991 Ontario Mental Health Supplement (OHSUP) examined a variety of childhood experiences as well as the prevalence of psychiatric disorders from a sample of OHS respondents. These were province-wide population health surveys of a probability-based sample of persons aged 15 years and older living in household dwellings in Ontario. The OHSUP randomly selected one member from each participating OHS household to be interviewed regarding personal experiences and mental health. This analysis used data from women aged 15-64 who participated in both the OHS and OHSUP. Self-reported health service utilization was collected in four groups of women--those who reported no history of child abuse, those with a history of physical abuse only, those who reported sexual abuse only, and those who reported both physical and sexual (combined) abuse. We hypothesized that a history of child abuse would result in greater adult health care costs. The results indicated that having a history of combined abuse nearly doubles mean annual ambulatory self-reported health care costs to $775 (95% CI $504-$1045) compared to a mean cost of $400 with no abuse (95% CI $357-$443). Median annual ambulatory self-reported health care costs were also increased in the combined abuse group, to $314 (95% CI $220-$429), compared to $138 (95% CI $132-$169) in those with no abuse. We conclude that child abuse in women is significantly associated with increased adult self-reported health care costs.

Suggested Citation

  • Tang, Betty & Jamieson, Ellen & Boyle, Michael & Libby, Anne & Gafni, Amiram & MacMillan, Harriet, 2006. "The influence of child abuse on the pattern of expenditures in women's adult health service utilization in Ontario, Canada," Social Science & Medicine, Elsevier, vol. 63(7), pages 1711-1719, October.
    • Handle: RePEc:eee:socmed:v:63:y:2006:i:7:p:1711-1719
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    References listed on IDEAS

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    1. Browne, Gina & Byrne, Carolyn & Roberts, Jacqueline & Gafni, Amiram & Whittaker, Susan, 2001. "When the bough breaks: provider-initiated comprehensive care is more effective and less expensive for sole-support parents on social assistance," Social Science & Medicine, Elsevier, vol. 53(12), pages 1697-1710, December.
    2. Kessler, L.G. & Burns, B.J. & Shapiro, S. & Tischler, G.L. & George, L.K. & Hough, R.L. & Bodison, D. & Miller, R.H., 1987. "Psychiatric diagnoses of medical service users: Evidence from the Epidemiologic Catchment Area Program," American Journal of Public Health, American Public Health Association, vol. 77(1), pages 18-24.
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    Cited by:

    1. Rebecca Reeve & Kees Gool, 2013. "Modelling the Relationship between Child Abuse and Long-Term Health Care Costs and Wellbeing: Results from an Australian Community-Based Survey," The Economic Record, The Economic Society of Australia, vol. 89(286), pages 300-318, September.
    2. Tsur, Noga & Najjar, Afnan Attrash & Katz, Carmit, 2023. "“When I was a child, the doctor advised me to have sex more gently”: The perceptions and experiences with the healthcare system as conveyed by adult survivors of child sexual abuse," Social Science & Medicine, Elsevier, vol. 320(C).

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