A rapidly growing literature points to the somatic, nonpsychiatric impacts of violence on women's health. In the present study, the long-term consequences of criminal victimization on medical use were examined among 390 adult women patients of a health maintenance organization (74 nonvictims and 316 victims of crime). Findings indicated that severely victimized women, compared with nonvictims, made physician visits twice as frequently in the index year and had outpatient medical expenses that were 2.5 times greater. Data on use across 5 years preceding and following crime were obtained from 15 rape victims, 26 physical assault victims, and 27 noncontact crime victims and were compared with five continuous years of use among 26 nonvictims. Victims' physician visits increased 15% to 24% during the year of the crime compared with less than 2% change among nonvictims. Significant differences continued and were most pronounced during the second year following victimization. These long term deleterious effects suggest that criminally victimized women's needs for medical treatment transcend the traditional focus on emergency care and forensic evaluation. Medical management of all types of victimized women can be improved by attention to the underlying etiology of their symptoms. Achievement of this goal requires that physicians identify victimization history and provide access to appropriate support services. Because all forms of violence against women are prevalent among primary care populations and victimization is clearly linked to health, health care providers cannot afford to miss this relevant history.
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