Lähisuhdeväkivallasta aiheutuva palveluiden käyttö ja kustannukset : Terveys-, sosiaali- ja oikeuspalveluissa

Tutkimushankkeessa selvitettiin lähisuhdeväkivallan vaikutuksia terveys-, sosiaali-, ja oikeuspalveluiden käyttöön sekä kustannuksiin. Tutkimuksessa kerättiin tietoa perus- ja erikoissairaanhoidon, turvakotien, poliisin ja Kelan rekistereistä sekä Gender Based Violence -väestökyselystä. Rekisteritutkimuksessa tunnistettiin vuosina 2015–2020 yhteensä 33 000 lähisuhdeväkivallan uhria ja heille muodostettiin viisi kertaa suurempi vertailuryhmä. Väestötutkimukseen vastasi 2021–2022 yli 7 700 henkilöä. Lähisuhdeväkivallan aiheuttama terveydenhuoltopalveluiden lisäkustannus oli 1 024 €/hlö vuosittain verrattuna muuhun väestöön. Lisäkustannuksia kertyi 6 vuoden seurannan ajan. Viiden vuoden aikana naisten kokeman fyysisen parisuhdeväkivallan aiheuttamat suorat terveydenhuollon lisäkustannukset ovat 150 miljoonaa euroa vuodessa (väestötutkimuksen perusteella 146 000 naista fyysisen parisuhdeväkivallan uhrina). Väestötutkimuksen mukaan 16–74-vuotiaista suomalaisista parisuhdeväkivaltaa oli kokenut 44 % ja lapsuusajan lähisuhdeväkivaltaa 65 %. Naisista 48 % ja miehistä 39 % oli kokenut parisuhdeväkivaltaa. Parisuhdeväkivaltaa kokeneilla kustannukset olivat sosiaalipalveluissa 60–90 % ja oikeuspalveluissa (ml. poliisi) 70 % korkeammat verrattuna ei parisuhdeväkivaltaa kokeneisiin. Lapsuudessa koettu väkivalta näkyi puolestaan 50 % korkeampina sosiaali- ja oikeuspalveluiden kustannuksina aikuisuudessa. Julkaisu on läpikäynyt ulkopuolisen tieteellisen arvioinnin.Tämä julkaisu on toteutettu osana valtioneuvoston selvitys- ja tutkimussuunnitelman toimeenpanoa. (tietokayttoon.fi) Julkaisun sisällöstä vastaavat tiedon tuottajat, eikä tekstisisältö välttämättä edusta valtioneuvoston näkemystä

Domestic violence-related use of services and the resulting costs in health, social and legal services

The research project examined the impacts of domestic violence on the use of health, social and legal services and the resulting costs. In the study, data was collected from the registers of primary health care and specialist medical care, shelters, the police and the Kela, and from the Gender-Based Violence population survey. For the period 2015–2020, a total of 33,000 victims of domestic violence were identified in the registers and a control group was formed, which was five times larger. More than 7,700 people responded to the population survey. The additional cost in healthcare services as a result of domestic violence was EUR 1,024 per person annually compared to the rest of the population. Over a period of five years, the direct additional healthcare costs caused by physical intimate partner violence (IPV) experienced by women totalled EUR 150 million per year (146,000 women). According to the population survey, 44% of Finns aged 16–74 had experienced IPV, and 65% had experienced domestic violence in their childhood. IPV had been experienced by 48% of women and 39% of men. Among those who had experienced IPV, the costs in social services were 60–90% higher and in legal services (incl. the police), 70% higher than among those who had not experienced IPV. Domestic violence experienced in childhood was visible in adulthood as social and legal services costs that were 50% higher. This publication has undergone an external scientific review.This publication is part of the implementation of the Government Plan for Analysis, Assessment and Research (tietokayttoon.fi) The content is the responsibility of the producers of the information and does not necessarily represent the view of the Government

Impacts on health-related quality of life after prostate cancer treatment among a Finnish prostate cancer screening population

Background The measurement of health-related quality of life (HRQoL) has become an important health outcome among prostate cancer patients. Prostate-specific antigen (PSA) screening can be effective at detecting prostate cancer at an early stage. However, the screening can be associated with overdetection and overtreatment, resulting in a decreased HRQoL among patients. Since health care resources are limited, assessing HRQoL is crucially important to evaluate the acceptability of PSA screening. The main purpose of this thesis was to investigate the association between the treatment-related adverse effects of prostate cancer and HRQoL by using the generic HRQoL instrument, the 15D, in a Finnish randomised population-based prostate cancer screening trail. Patients and methods Data was collected from men with prostate cancer in the Finnish section of the European Randomized Study of Screening for Prostate Cancer (ERSPC). In the Finnish screening trial, approximately 20,000 men aged 55, 59, 63 and 67 from Helsinki and Tampere regions were randomly allocated to the screening arm, the remaining was treated as controls. From the period between May 1996 and Dec 2002, a total of 1667 men with newly diagnosed prostate cancer from the screening population were identified. Of these, 1417 men with prostate cancer who completed questionnaires were included in this study. The validated generic HRQoL measure, the 15D was used to measure HRQoL and the study focused both on overall HRQoL and three dimensions of the 15D (sleeping, elimination and sexual activity). Treatment-related side effects (urinary, sexual, bowel and hormone dimensions) were measured based on patient self-reports.   Results Both HRQoL and the prevalence of side effects were not statistically significantly different between screening and control groups whereas treatment choices between the two groups were statistically significantly different. The mean scores of sleeping and sexual dimensions of the 15D and the mean 15D scores of the screening population were statistically significantly lower in comparison with reference population. Treatment choices were associated with the prevalence of prostate-specific side effects, the sexual dimension of the 15D and overall HRQoL. Sex-related symptoms were the most common side effects and higher occurrence was observed in surgery patients. The presence of erectile side effects was associated with the sexual dimension of the 15D and overall HRQoL. However, other side effects were not found to be related to the three dimensions (sleeping, elimination and sexual activity) of the 15D or overall HRQoL. After adjusting for a number of factors, patients who experienced the worst sexual health state of the 15D were highly likely to have more comorbidites, the presence of diabetes and to be married. The impact of active treatment was more related to the second worst sexual health state of the 15D.   Conclusions Sexual dysfunction caused by treatment negatively impacted both the sexual dimension of HRQoL and overall HRQoL. The use of the 15D facilitated to measure overall HRQoL which covered prostate specific dimensions among prostate cancer patients. Since prostate cancer is common in elderly populations, more efforts are needed to accurately measure treatment-related side effects as well as their general health conditions. The findings from this study can be useful when assessing the negative effects of screening in terms of HRQoL and costs. Asiasanat:quality of life; prostate cancer; screenin

Health-Related Costs of Intimate Partner Violence : Using Linked Police and Health Registers

First published online November 18, 202