Background
Violent victimization
Health service utilization
Aims and hypotheses
Methods
Study design
Study sample
Control group
Measures
Victimization | Health service utilization |
---|---|
Since MONTH YEAR (the past twelve months), have you been subjected to… | Have you, during the past three months, because of own illness visited a doctor? |
…violence that led to injuries that forced you to seek medical care or dental care? | Have you, during the past twelve monthsa, ever considered yourself in need of medical care but did not seek medical care? |
…violence that led to visible marks or injuries that did not require medical care or dental care? | |
…violence that did not lead to visible marks or injuries? | |
… threats of violence or other threats that were so serious that you were frightened? |
Procedure
Statistical analyses
Results
Characteristics of the study sample
Participants (N = 200) | Non-participants (N = 86) | Statistic |
p
| |
---|---|---|---|---|
Median age (Q3-Q1) | 31 (41.5–25) | 35.5 (46–27) | U = 1.67 | .096 |
Sex | ||||
Female | 26 (13.0%) | 8 (9.3%) |
χ
2 = 0.79 | .376 |
Male | 174 (87.0%) | 78 (90.7%) | ||
Occupation | ||||
Employed | 32 (16.0%) | |||
Unemployed | 156 (78.0%) | |||
Students | 12 (6.0%) | |||
SMD at unlawful act | 92 (46.0%) | 53 (61.6%) | χ 2 = 5.88 | .015 |
SMD at investigation | 93 (46.5%) | 53 (61.6%) | χ 2 = 5.51 | .019 |
Principal DSM-IV diagnoses | ||||
Mental retardation | 12 (6.0%) | |||
Pervasive developmental disorders | 24 (12.0%) | |||
ADHD | 1 (0.5%) | |||
Substance-related disorders | 31 (15.5%) | |||
Psychotic disorders | 57 (28.5%) | |||
Mood disorders | 11 (5.5%) | |||
Paraphilias | 3 (1.5%) | |||
Adjustment disorder | 9 (4.5%) | |||
Personality disorders | 31 (15.5%) | |||
All others | 6 (3.0%) | |||
None | 15 (7.5%) | |||
Substance-related disordera
| 74 (37.0%) | |||
Offence | ||||
Violent crime | 181 (90.5%) | 76 (88.4%) | χ 2 = 0.30 | .585 |
Lethal crime | 15 (7.5%) | 8 (9.3%) | χ 2 = 0.26 | .607 |
Sanction | ||||
Forensic psychiatric care with separate discharge review | 73 (36.5%) | 48 (55.8%) | FET = 10.03 | .051 |
Forensic psychiatric care without separate discharge review | 15 (7.5%) | 4 (4.7%) | ||
Imprisonment | 81 (40.5%) | 28 (32.6%) | ||
Probation | 27 (13.5%) | 6 (7.0%) | ||
Imprisonment + probation | 1 (.5%) | 0 | ||
Prosecution dismissed | 3 (1.5%) | 0 |
Missing data
Detainees
N = 200
n (%) NA
| Controls
N = 600
n (%) NA
| Crude risk ratio (95% CI) | Wald |
p
| |
---|---|---|---|---|---|
Violent victimization | |||||
1. Medical attentiona
| 33 (16.6) 1 | 14 (2.4) 12 | 7.9 [4.0, 15.2] | 36.98 | <.001 |
2. Visible injuryb
| 63 (31.7) 1 | 19 (3.2) 12 | 16.9 [8.6, 32.9] | 68.16 | <.001 |
3. No visible injuryc
| 47 (23.6) 1 | 12 (2.0) 12 | 13.4 [6.8, 26.5] | 55.25 | <.001 |
4. Threat | 66 (33.3) 2 | 31 (5.3) 12 | 8.7 [5.3, 14.4] | 70.81 | <.001 |
5. Severe violence (1 + 2) | 73 (36.7) 1 | 32 (5.4) 12 | 10.1 [6.1, 16.8] | 79.31 | <.001 |
6. Violence (1 + 2 + 3) | 86 (43.2) 1 | 41 (7.0) 12 | 9.3 [5.9, 14.7] | 91.54 | <.001 |
7. Any (1 + 2 + 3 + 4) | 104 (52.3) 1 | 65 (11.1) 12 | 8.2 [5.4, 12.3] | 99.51 | <.001 |
Health service utilization | |||||
8. Appointment | 95 (47.7) 1 | 142 (23.7) 1 | 2.0 [1.4, 2.8] | 16.57 | <.001 |
9. Unmet need | 84 (42.2) 1 | 100 (16.7) 2 | 3.4 [2.4, 4.9] | 46.58 | <.001 |
Severe mental disorder
n = 92
n (%) NA
| Non-severe mental disorder
n = 108
n (%) NA
|
OR (95% CI) |
χ
2
|
p
| |
---|---|---|---|---|---|
Violent victimization | |||||
1. Medical attentiona
| 10 (11.0) 1 | 23 (21.3) 0 | 2.2 [1.0, 4.9] | 3.79 | .051 |
2. Visible injuryb
| 18 (19.8) 1 | 45 (41.7) 0 | 2.9 [1.5, 5.5] | 10.93 | .001 |
3. No visible injuryc
| 14 (15.4) 1 | 33 (30.6) 0 | 2.4 [1.2, 4.9] | 6.30 | .012 |
4. Threat | 24 (26.7) 2 | 42 (38.9) 0 | 1.8 [1.0, 3.2] | 3.30 | .069 |
5. Severe violence (1 + 2) | 22 (24.2) 1 | 51 (47.2) 0 | 2.8 [1.5, 5.2] | 11.29 | .001 |
6. Violence (1 + 2 + 3) | 29 (31.9) 1 | 57 (52.8) 0 | 2.4 [1.3, 4.3] | 8.80 | .003 |
7. Any (1 + 2 + 3 + 4) | 40 (44.0) 1 | 64 (59.3) 0 | 1.9 [1.1, 3.3] | 4.64 | .031 |
Health service utilization | |||||
8. Appointment | 42 (46.2) 1 | 53 (49.1) 0 | 1.1 [0.6–2.0] | 0.17 | .681 |
9. Unmet need | 35 (38.5) 1 | 49 (45.4) 0 | 1.3 [0.8–2.3] | 0.97 | .326 |
Rates and risk ratios of victimization
Rates and risk ratios of health service utilization
Association between violent victimization and health service utilization
Health service appointment | Unmet health care need | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Appointment
n = 95
n (%) | No appointment
n = 104
n (%) |
OR (95% CI) |
χ
2
|
p
| Unmet need
n = 84
n = (%) | No unmet need
n = 115
n = (%) |
OR (95% CI) |
χ
2
|
p
| |
Violent victimization | ||||||||||
1. Medical attentiona
| 17 (17.9) | 16 (15.4) | 1.2 [0.6, 2,5] | 0.23 | .634 | 16 (19.0) | 17 (14.8) | 1.4 [0.6, 2.9] | 0.64 | .424 |
2. Visible injuryb
| 33 (34.7) | 30 (28.8) | 1.3 [0.7, 2.3] | 0.80 | .732 | 33 (39.3) | 30 (26.1) | 1.8 [1.0, 3.4] | 3.90 | .048 |
3. No visible injuryc
| 25 (26.3) | 22 (21.2) | 1.3 [0.7, 2.6] | 0.73 | .392 | 26 (31.0) | 21 (18.3) | 2.0 [1.0, 3.9] | 4.33 | .037 |
4. Threat | 38 (40.4) | 28 (26.9) | 1.8 [1.0, 3.3] | 4.05 | .044 | 38 (45.8) | 28 (24.3) | 2.6 [1.4, 4.8] | 9.97 | .002 |
5. Severe violence (1 + 2) | 38 (40.0) | 35 (33.7) | 1.3 [0.7, 2.3] | 0.86 | .353 | 37 (44.0) | 36 (31.3) | 1.7 [1.0, 3.1] | 3.40 | .065 |
6. Violence (1 + 2 + 3) | 43 (45.3) | 43 (41.3) | 1.2 [0.7, 2.1] | 0.31 | .577 | 40 (47.6) | 46 (40.0) | 1.4 [0.8, 2.4] | 1.15 | .284 |
7. Any (1 + 2 + 3 + 4) | 54 (56.8) | 50 (48.1) | 1.4 [0.8, 2.5] | 1.53 | .216 | 52 (61.9) | 52 (45.2) | 2.0 [1.1, 3.5] | 5.42 | .020 |