利用傷害型態及醫療利用辨識親密伴侶暴力受虐者

Identifying Victims of Intimate Partner Violence by Patterns of Injury and Medical Utilization

鄭倩樺(Chien-Hua Cheng) ； 鍾其祥(Chi-Hsiang Chung) ； 簡戊鑑(Wu-Chien Chien)

《醫務管理期刊》 13卷1期 (2012/03) Pp. 32-47

https://doi.org/10.6174/JHM2012.13(1).32

摘要

目的：比較18-64歲親密伴侶受虐及非受虐住院患者傷害類型及醫療利用，並進一步找出受虐的預測因子。方法：使用1997-2009年全民健保資料庫，選取國際疾病分類第九版臨床修訂版（ICD-9-CM），995.8x與E967.3為親密伴侶受虐個案及E800-E949為非受虐個案進行分析。結果：受虐者為女性、低收入戶、下頷骨骨折、顱內損傷、頸部開放性傷口及憂鬱的比例高於非受虐者；受虐者有2處以上傷害的比例為（70.6%），高於非受虐者（48.3%），然而，在住院天數、醫療費用及住院死亡比例，均低於非受虐者。年齡25-54歲、低收入戶、顱內損傷、顏面骨骨折、頸部開放性傷口、傷害部位2處以上及憂鬱是親密伴侶受虐的預測因子。結論：有頭、頸、臉部傷害及憂鬱等診斷較可能是親密伴侶虐待所致，醫療專業人員可利用各種預測因子，辨識住院傷患，以提高對於受虐者的保護。

關鍵字

親密伴侶暴力 ； 傷害 ； 全民健保資料庫

並列摘要

Objective: To compare the types of injury and patterns of medical utilization in inpatients aged 18-64 in victims of intimate partner violence (IPV) and those with unintentional injuries.Method: Data were obtained from the National Health Insurance Research Database from 1997 through 2009. We defined IPV cases as those with ICD-9-CM N-code 995.8x and E-code E967.3 and controls (unintentional injuries) as E800-E949.Results: IPV was more common in females than in males. The proportion of cases in low-income households was higher than that of controls. Fractures of the face, intracranial injury, open wounds of the neck and depression were significantly higher for those coded IPV. The proportion of those with IPV who had more than 2 injury sites was 70.6%. In terms of average length of stay, average medical expenditure, and inpatient mortality, however, the proportion of those with IPV was lower than that of those with unintentional injuries. The predictors of coded IPV were female gender, low-income household, fracture of the face, intracranial injury, open wound of the neck, depression, and more than 2 injury sites.Conclusion: This study highlights several factors that might help in the detection of victims of IPV at a medical visit. Medical professionals could use them to detect victims of IPV and protect them from additional abuse.

並列關鍵字

Intimate partner violence ； Injury ； National Health Insurance Research Database

參考文獻

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