Department of Graduate Social Work, School of Behavioral and Applied Sciences, Azusa Pacific University, 901 East Alosta Avenue, Azusa, CA 91702-7000, USA.
Gerontologist. 2013 Apr;53(2):303-12. doi: 10.1093/geront/gns075. Epub 2012 May 15.
Despite growing awareness of elder abuse, cases are rarely prosecuted. The aim of this study was to examine the effectiveness of an elder abuse forensic center compared with usual care to increase prosecution of elder financial abuse.
Using one-to-one propensity score matching, cases referred to the Los Angeles County Elder Abuse Forensic Center (the Forensic Center) between April 2007 and December 2009 for financial exploitation of adults aged 65 and older (n = 237) were matched to a population of 33,650 cases that received usual care from Adult Protective Services (APS).
1 Significantly, more Forensic Center cases were submitted to the District Attorney's office (DA) for review (22%, n = 51 vs. 3%, n = 7 usual care, p < .001). Among the cases submitted, charges were filed by the DA at similar rates, as was the proportion of resultant pleas and convictions. Using logistic regression, the strongest predictor of case review and ultimate filing and conviction was whether the case was presented at the Forensic Center, with 10 times greater odds of submission to the DA (Odds ratio = 11.00, confidence interval = 4.66-25.98).
Previous studies have not demonstrated that elder abuse interventions impact outcomes; this study breaks new ground by showing that an elder abuse multidisciplinary team increases rates of prosecution for financial exploitation. The elder abuse forensic center model facilitates cooperation and group problem solving among key professionals, including APS, law enforcement, and the DA and provides additional resources such as neuropsychological testing, medical record review, and direct access to the Office of the Public Guardian.
尽管人们对虐待老年人的问题日益关注,但此类案件很少被起诉。本研究旨在检验老年虐待法医中心与常规护理相比在增加老年金融虐待案件起诉方面的效果。
使用一对一倾向评分匹配,将 2007 年 4 月至 2009 年 12 月期间向洛杉矶县老年虐待法医中心(法医中心)转介的 237 名年龄在 65 岁及以上的成年人遭受财务剥削的案件与接受成人保护服务(APS)常规护理的 33650 例病例进行匹配。
1 显著的是,更多的法医中心案件被提交给地方检察官办公室(DA)审查(22%,n=51 vs. 3%,n=7 常规护理,p<.001)。在提交的案件中,DA 提出指控的比例相似,提出的请求和定罪的比例也相似。使用逻辑回归,案件是否在法医中心提出是审查和最终提交、提出起诉和定罪的最强预测因素,提交给 DA 的可能性是 10 倍(优势比=11.00,置信区间=4.66-25.98)。
以前的研究没有表明老年虐待干预措施会影响结果;本研究开辟了新的领域,表明老年虐待多学科团队增加了对金融剥削的起诉率。老年虐待法医中心模式促进了 APS、执法部门和 DA 等关键专业人员之间的合作和集体问题解决,并提供了额外的资源,如神经心理学测试、病历审查和直接进入公共监护人办公室。