Violence against women from different relationship contexts and health care utilization in Spain

Studies reported an excess of health services utilization among women with violence by an intimate partner (IPV). However, little is known about health utilization by women victims of other forms of interpersonal violence than IPV. This study aimed to determine the effect of violence from different relationship contexts on health care utilization.

A cross-sectional study following a multistage cluster sampling scheme was conducted. Women aged 18 to 70 years were randomly selected according to their scheduled health care visit. The number of women invited to participate was 16,419 and 73% accepted. After exclusion, the final sample consisted of 10,815 women. The outcome variables were health care utilization (primary care, specialty services, emergency rooms, and hospital admissions) and the predictor variable was interpersonal violence from different relationship contexts. Multivariable adjusted logistic regression models were conducted to assess the independent effect of each violence relationship context on health care utilization.

Compared with never abused women, use of health services was significantly higher for abused women, although the rates varied depending on the violence relationship context. The greatest probability of service use was among women whose abuse was perpetrated by both a partner and others. Comparing the magnitude of effect of each violence category by perpetrators other than a partner, this effect was stronger for violence in a social context in the case of emergency rooms only.

Regardless of the perpetrator, lifetime violence increased health services utilization. Violence affects women's behavior in terms of how they use health services.