Rady Faculty of Health Sciences, Max Rady College of Medicine, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada.
Prev Med. 2021 Aug;149:106616. doi: 10.1016/j.ypmed.2021.106616. Epub 2021 May 12.
The incidence of intimate partner violence (IPV) varies according to IPV definitions and data collection approaches. The criminal Justice system assesses IPV through a review of the evidence gathered by the police and the court hearings. We aimed to determine the association between IPV, as identified in criminal Justice disposition records, and subsequent healthcare-identified intentional injury inflicted by others, including violent death. We conducted a retrospective population-based matched-cohort study using linked multisectoral databases. Female adult Manitoba residents identified as victims of IPV in provincial prosecution and disposition records 2004 to 2016 (n = 20,469) were matched to three non-victims (n = 61,407) of similar age, relationship status and place of residence at the date of the IPV incident. Outcomes were first healthcare use for intentional injury and violent death, assessed in Emergency Department visits, hospitalizations and Vital Statistics deaths records. Conditional Cox Regression was used to obtain Hazard Ratios (HR) with 95% confidence intervals (CI). The risk of intentional injury was 8.5 per 1000 women among non-victims of IPV and 55.8 per 1000 women among IPV victims. The Hazard Ratios associated with IPV were 3.8 (95% CI: 3.4, 4.3) for intentional injury and 4.6 (95% CI: 2.3, 9.2) for violent death, after adjustment. IPV victims experienced half the risk of subsequent intentional injury if the accused received a probation sentence. Our findings suggest that Justice involvement represents an opportunity for intersectoral collaborative prevention of subsequent intentional injury among IPV victims.
亲密伴侣暴力（IPV）的发生率因 IPV 定义和数据收集方法而异。刑事司法系统通过审查警方收集的证据和法庭听证来评估 IPV。我们旨在确定刑事司法判决记录中确定的 IPV 与随后由他人造成的医疗保健确定的故意伤害之间的关联，包括暴力死亡。我们使用链接的多部门数据库进行了回顾性基于人群的匹配队列研究。2004 年至 2016 年在省级起诉和判决记录中被确定为 IPV 受害者的成年马尼托巴省女性居民（n=20469）与 61407 名年龄、关系状况和居住地点与 IPV 事件日期相似的非受害者相匹配（n=61407）。结果是首次在急诊就诊、住院和生命统计死亡记录中评估因故意伤害而使用的医疗保健。使用条件 Cox 回归获得危险比（HR）和 95%置信区间（CI）。非 IPV 受害者的故意伤害风险为每 1000 名妇女 8.5 例，而 IPV 受害者为每 1000 名妇女 55.8 例。调整后，与 IPV 相关的故意伤害的 HR 为 3.8（95%CI：3.4，4.3），暴力死亡的 HR 为 4.6（95%CI：2.3，9.2）。如果被告被判缓刑，IPV 受害者随后故意伤害的风险将降低一半。我们的研究结果表明，司法介入为 IPV 受害者随后故意伤害的跨部门合作预防提供了机会。
