Health Service Use of Sexually Abused Adolescents Aging Out of Care: A Matched-Cohort Study

Abstract

Objectives: While sexual abuse during childhood is a known risk factor of adult physical and mental health problems, little is known about the relationship between CPA services and healthcare use for these problems. This study aimed to assess whether sexually abused youth seek more medical services than their peers in the general population and whether those aging out of CPA’s care at the age of 18 use health services differently than those still receiving CPA service (those under the age of majority, e.g. 18). Method: A prospective matched-cohort study was used to assess the healthcare use of 481 sexually abused youth and 481 matched controls. Using administrative databases from a Canadian provincial public health insurance and from an urban child protection agency, healthcare use at 17 and 18 years of age was compared according to past childhood sexual abuse and to whether those receiving CPA services had aged out of care or not. Results: Results revealed that sexually abused youth were 5 times and 1.6 times more likely to use in- and outpatient services for a mental health and physical health problem, respectively, than youth from the general population. Furthermore, adolescents’ healthcare use for mental health problems remained the same at 17 and 18 years of age, regardless of age at CPA service termination, while healthcare use for physical health problems increased at 18 years of age when compared to 17 when aging out of care only. Conclusion and Implications: These results suggest that offering CPA services beyond 18 years of age could help sexually abused youth transitioning out of care, and who exhibit more physical health problems, make this transition more easily or with more resources.