Remember when people got really upset because the ACA was going to pay doctors to ask patients intrusive questions about domestic violence? This is why. “Prevalence of abuse and intimate partner violence surgical evaluation (PRAISE) in orthopaedic fracture clinics: a multinational prevalence study“:
Background
Intimate partner violence (IPV) is the leading cause of non-fatal injury to women worldwide. Musculoskeletal injuries, which are often seen by orthopaedic surgeons, are the second most common manifestation of IPV. We aimed to establish the 12-month and lifetime prevalence of IPV in women presenting to orthopaedic fracture clinics.
Methods
The PRAISE team of 80 investigators did a cross-sectional study of a consecutive sample of 2945 female participants at 12 orthopaedic fracture clinics in Canada, the USA, the Netherlands, Denmark, and India. Participants who met the eligibility criteria anonymously answered direct questions about physical, emotional, and sexual IPV, and completed two previously developed questionnaires (Women Abuse Screening Tool [WAST] and Partner Violence Screen [PVS]). We did a multivariable logistic regression analysis to investigate the risk factors associated with IPV.
Lots of researchers in five countries asked thousands of women who were evaluated for fractures if they had been abused. The results are horrifying. One in six women who went to an orthopedic clinic reported that they had been the victims of intimate partner violence in the last year. One in three reported being victims at some point in their lives.
Just sit and think about that for a second. One in three women who were concerned about a fracture had been abused in a relationship at some point.
Relatively few of the women were going to the clinic for concerns that linked directly to the IPV. That’s why we need to ask everyone, even if they don’t tell a story indicative of abuse. If you read the whole study, though, only 8% of the women in Canada and the US had ever been asked by another health care professional if they had been a victim of abuse. But 81% of women in those countries thought health care professionals in general should ask all women about intimate partner violence.
Get 81% of people in this country to agree about anything, and you’d have a tough time. This should be one of the least controversial provisions of the ACA.
