A. RATNASEKERA1, M. Harris1, R. Caplan2, J. Laughery2, D. Chen2, L. Mason1, K. Bradley1, C. Jurkovitz2 1Christiana Care, Surgery, Newark, DE, USA 2Institute for Research in Equity and Community Health, Newark, DE, USA
Introduction:
Higher incidences of interpersonal violence were reported throughout the country during the COVID time period. Effects of limited access to mental health (MH) care due to health care systems allocation towards pandemic surges may lead to post injury exacerbations of MH disorders. The objective of this study was to compare healthcare encounters and resource utilization related to interpersonal violence with MH disorders before and during the COVID pandemic.
Methods:
A retrospective analysis of the Delaware Healthcare Claims data of all patients age≥16 years who were insured and suffered interpersonal violence in Delaware was performed. Patients were followed up for one year from their index visit defined as the first interpersonal violence episode in an acute hospital setting during the pre-COVID (3/2018 to 12/2018) or the COVID (3/2020 to 12/2020) period. Census tract information was used to assess social determinants of health. The frequency of patients with at least one MH diagnosis and the median count and interquartile range (IQR) of claims days for MH diagnoses were assessed in the year after the index visit. Chi-squared and Wilcoxon rank sum tests were used to compare groups.
Results:
Of the 958 patients who had a healthcare encounter for interpersonal violence, 431 (45.0%) were in the COVID period. Black patients were more likely to experience interpersonal violence during COVID compared to patients from other racial groups (Table). Age, sex and insurance were similar between the 2 periods. Patients in the COVID period were more likely to live in census tracts with higher average percentage of public assistance households and higher average unemployment rate. Patients in the COVID era were more likely to have a penetrating injury at index visit than in the pre-COVID era (24.6% versus 15.2%, p<0.001). Among patients with a MH diagnosis, patients in the COVID era were less likely to have a psychotic disorder diagnosis (7.4% vs. 11.6%, p=0.031). Frequency of patients with MH claims and number of claims days were lower in the COVID period although not statistically significant (70.3% vs 74.4%, p=0.16; median [IQR] = 3 [0-10] vs 3 [0-13.5], p=0.051).
Conclusion:
Racial and socioeconomic disparities were amplified in those who suffered from interpersonal violence during the COVID period. MH disorders were prevalent in both time periods. Utilization of MH resources was similar. Further injury prevention efforts should be focused on MH in future pandemics or disasters.
