{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T02:25:58Z","timestamp":1789784758215,"version":"4.0.1"},"reference-count":56,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T00:00:00Z","timestamp":1656028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Malaya Grant Challenge","award":["GC001-14HTM"],"award-info":[{"award-number":["GC001-14HTM"]}]},{"name":"Geran Penyelidikan Dana UiTM Cawangan Selangor","award":["600-UiTMSEL (PI 5\/4) (020\/2022)"],"award-info":[{"award-number":["600-UiTMSEL (PI 5\/4) (020\/2022)"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Our study aims to describe and determine factors associated with hospitalization among victims of elder abuse and neglect (EAN) in rural Malaysia. A cross sectional study based on the baseline data of the Malaysian Elder Mistreatment Project (MAESTRO) collected from November 2013 until July 2014 involving 1927 older adults in Kuala Pilah, Negeri Sembilan was conducted. EAN was determined using the modified Conflict Tactics Scale (CTS) and hospitalization rates were determined based on self-report. The prevalence of overall EAN was 8.1% (95%CI 6.9\u20139.3). Among male respondents, 9.5% revealed history of abuse and among female respondents, 7.2% reported experiencing EAN. The annual hospitalization rates per 100 persons within the past one year among EAN victims and non-victims were 18 per 100 persons (SD = 46.1) and 15 per 100 persons (SD = 64.1) respectively. Among respondents with history of EAN, 16.0% (n = 21) had been hospitalized in the past 12 months while among respondents with no EAN experience, 10.2% (n = 153) were hospitalized. Multivariable analyses using Poisson regression did not show any significant association between EAN and hospitalization. This could be due to the complex interactions between medical and social circumstances that play a role in hospital admissions, factors affecting the health care system, and access to health care among EAN victims.<\/jats:p>","DOI":"10.1371\/journal.pone.0270163","type":"journal-article","created":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T17:39:44Z","timestamp":1656092384000},"page":"e0270163","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Elder abuse and hospitalization in rural Malaysia"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0632-8253","authenticated-orcid":true,"given":"Muhammad Abbas M.","family":"Firdaus","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2129-6352","authenticated-orcid":true,"given":"Raudah","family":"Mohd Yunus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2692-9016","authenticated-orcid":true,"given":"Noran Naqiah","family":"Hairi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan Yuen","family":"Choo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farizah","family":"Hairi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leny Suzana","family":"Suddin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajini","family":"Sooryanarayana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norliana","family":"Ismail","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devi","family":"Peramalah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zainudin M.","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharifah N.","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inayah A.","family":"Razak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajaratulnisah","family":"Othman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awang","family":"Bulgiba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,6,24]]},"reference":[{"key":"pone.0270163.ref001","unstructured":"WHO. Elder abuse 2020 [Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/elder-abuse]."},{"issue":"1\u20132","key":"pone.0270163.ref002","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1080\/08946560903436379","article-title":"A physician\u2019s perspective: Elder abuse and neglect over 25 years","volume":"22","author":"JG O\u2019Brien","year":"2010","journal-title":"Journal of elder abuse & neglect"},{"issue":"6","key":"pone.0270163.ref003","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1111\/jgs.13454","article-title":"Elder abuse: Systematic review and implications for practice","volume":"63","author":"XQ Dong","year":"2015","journal-title":"Journal of the American Geriatrics Society"},{"key":"pone.0270163.ref004","unstructured":"Hall JE, Karch DL, Crosby A. Uniform definitions and recommended core data elements for use in elder abuse surveillance. Version 1.0. 2016."},{"key":"pone.0270163.ref005","unstructured":"CDC. Violence Prevention: Elder Abuse 2020 [Available from: https:\/\/www.cdc.gov\/violenceprevention\/elderabuse\/fastfact.html]."},{"issue":"2","key":"pone.0270163.ref006","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1093\/ageing\/afm194","article-title":"The prevalence of elder abuse and neglect: a systematic review","volume":"37","author":"C Cooper","year":"2008","journal-title":"Age Ageing"},{"issue":"4","key":"pone.0270163.ref007","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1177\/1524838013495963","article-title":"A review on the prevalence and measurement of elder abuse in the community","volume":"14","author":"R Sooryanarayana","year":"2013","journal-title":"Trauma, Violence, & Abuse"},{"issue":"2","key":"pone.0270163.ref008","doi-asserted-by":"crossref","first-page":"e147","DOI":"10.1016\/S2214-109X(17)30006-2","article-title":"Elder abuse prevalence in community settings: a systematic review and meta-analysis","volume":"5","author":"Y Yon","year":"2017","journal-title":"The Lancet Global Health"},{"key":"pone.0270163.ref009","unstructured":"IPH IfPH. National Health and Morbidity Survey (NHMS) 2018: Elderly Health. Vol. II: Elderly Health Findings, 2018. In: National Institutes of Health MoHM, editor. 2019. p. 182."},{"issue":"6","key":"pone.0270163.ref010","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1111\/jgs.15370","article-title":"Elder Abuse and Chronic Pain: Cross-Sectional and Longitudinal Results from the Preventing Elder Abuse and Neglect Initiative","volume":"66","author":"RM Yunus","year":"2018","journal-title":"J Am Geriatr Soc"},{"issue":"8","key":"pone.0270163.ref011","doi-asserted-by":"crossref","first-page":"e017025","DOI":"10.1136\/bmjopen-2017-017025","article-title":"The prevalence and correlates of elder abuse and neglect in a rural community of Negeri Sembilan state: baseline findings from The Malaysian Elder Mistreatment Project (MAESTRO), a population-based survey","volume":"7","author":"R Sooryanarayana","year":"2017","journal-title":"BMJ Open"},{"issue":"20","key":"pone.0270163.ref012","doi-asserted-by":"crossref","first-page":"1947","DOI":"10.1056\/NEJMra1404688","article-title":"Elder abuse","volume":"373","author":"MS Lachs","year":"2015","journal-title":"New England Journal of Medicine"},{"issue":"2","key":"pone.0270163.ref013","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1080\/08946566.2021.1919271","article-title":"The under-reporting of elder abuse and neglect: a Malaysian perspective","volume":"33","author":"RM Yunus","year":"2021","journal-title":"Journal of Elder Abuse & Neglect"},{"issue":"5","key":"pone.0270163.ref014","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1001\/jama.2009.1109","article-title":"Elder self-neglect and abuse and mortality risk in a community-dwelling population","volume":"302","author":"X Dong","year":"2009","journal-title":"JAMA"},{"issue":"3","key":"pone.0270163.ref015","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1370\/afm.1095","article-title":"Psychosocial effects of physical and verbal abuse in postmenopausal women","volume":"8","author":"CP Mouton","year":"2010","journal-title":"The Annals of Family Medicine"},{"issue":"4","key":"pone.0270163.ref016","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/j.puhe.2012.01.015","article-title":"Fear of crime and psychological and physical abuse associated with ill health in a Swedish population aged 65\u201384 years","volume":"126","author":"N Olofsson","year":"2012","journal-title":"Public Health"},{"issue":"10","key":"pone.0270163.ref017","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1016\/j.jagp.2013.01.036","article-title":"The relationship between elder mistreatment and suicidal ideation in rural older adults in China","volume":"21","author":"L Wu","year":"2013","journal-title":"Am J Geriatr Psychiatry"},{"issue":"17","key":"pone.0270163.ref018","doi-asserted-by":"crossref","first-page":"3089","DOI":"10.1177\/0886260514554427","article-title":"Intimate partner violence and its association with physical and mental health symptoms among older women in Germany","volume":"30","author":"H St\u00f6ckl","year":"2015","journal-title":"Journal of interpersonal violence"},{"issue":"2","key":"pone.0270163.ref019","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1093\/geront\/46.2.200","article-title":"The extent and frequency of abuse in the lives of older women and their relationship with health outcomes","volume":"46","author":"BS Fisher","year":"2006","journal-title":"The Gerontologist"},{"issue":"5","key":"pone.0270163.ref020","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1159\/000368577","article-title":"Association between elder abuse and metabolic syndromes: findings from the Chicago health and aging project","volume":"61","author":"X Dong","year":"2015","journal-title":"Gerontology"},{"issue":"5","key":"pone.0270163.ref021","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1111\/jgs.12212","article-title":"Mortality and disability outcomes of self-reported elder abuse: a 12-year prospective investigation","volume":"61","author":"MJ Schofield","year":"2013","journal-title":"J Am Geriatr Soc"},{"issue":"10","key":"pone.0270163.ref022","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1001\/jamainternmed.2013.238","article-title":"Elder abuse as a risk factor for hospitalization in older persons","volume":"173","author":"X Dong","year":"2013","journal-title":"JAMA Intern Med"},{"issue":"4","key":"pone.0270163.ref023","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.ajem.2012.12.028","article-title":"Association between elder abuse and use of ED: findings from the Chicago Health and Aging Project","volume":"31","author":"X Dong","year":"2013","journal-title":"Am J Emerg Med"},{"issue":"6","key":"pone.0270163.ref024","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1093\/geront\/42.6.734","article-title":"Adult protective service use and nursing home placement","volume":"42","author":"MS Lachs","year":"2002","journal-title":"The Gerontologist"},{"issue":"2","key":"pone.0270163.ref025","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1093\/geront\/46.2.193","article-title":"Behavioral health services utilization among older adults identified within a state abuse hotline database","volume":"46","author":"L Schonfeld","year":"2006","journal-title":"The Gerontologist"},{"issue":"4","key":"pone.0270163.ref026","doi-asserted-by":"crossref","first-page":"605","DOI":"10.2105\/AJPH.94.4.605","article-title":"Prevalence and 3-year incidence of abuse among postmenopausal women","volume":"94","author":"CP Mouton","year":"2004","journal-title":"American Journal of public health"},{"key":"pone.0270163.ref027","unstructured":"Jackson L. The cost of elder abuse in Queensland: who pays and how much Brisbane: Elder Abuse Prevention Unit (EAPU); 2009 [Available from: https:\/\/www.eapu.com.au\/uploads\/research_resources\/Who_Pays_Financial_Abuse_QLD_SEP_2009-EAPU.pdf]."},{"issue":"7","key":"pone.0270163.ref028","doi-asserted-by":"crossref","first-page":"e026667","DOI":"10.1136\/bmjopen-2018-026667","article-title":"Social support and depression among community dwelling older adults in Asia: a systematic review","volume":"9","author":"TAMT Mohd","year":"2019","journal-title":"BMJ open"},{"issue":"2","key":"pone.0270163.ref029","first-page":"1","article-title":"Attitude towards ageing and perceived health status among the elderly in Malaysia\/Noor\u2019ain Mohamad Yunus \u2026[et al.]","volume":"2","author":"M Yunus","year":"2016","journal-title":"Advances in Business Research International Journal"},{"issue":"5","key":"pone.0270163.ref030","doi-asserted-by":"crossref","first-page":"e011057","DOI":"10.1136\/bmjopen-2016-011057","article-title":"Elder mistreatment in a community dwelling population: the Malaysian Elder Mistreatment Project (MAESTRO) cohort study protocol","volume":"6","author":"WY Choo","year":"2016","journal-title":"BMJ Open"},{"key":"pone.0270163.ref031","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/B978-0-12-812112-2.00003-3","volume-title":"The End of Alzheimer\u2019s","author":"TJ Lewis","year":"2017","edition":"2"},{"issue":"1","key":"pone.0270163.ref032","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1093\/ageing\/afr107","article-title":"Elder abuse and neglect in Ireland: results from a national prevalence survey","volume":"41","author":"C Naughton","year":"2012","journal-title":"Age Ageing"},{"issue":"7","key":"pone.0270163.ref033","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1093\/gerona\/61.7.726","article-title":"Physical and cognitive domains of the instrumental activities of daily living: validation in a multiethnic population of Asian older adults","volume":"61","author":"T-P Ng","year":"2006","journal-title":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences"},{"issue":"8","key":"pone.0270163.ref034","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1093\/ndt\/gfv071","article-title":"Analyzing hospitalization data: potential limitations of Poisson regression","volume":"30","author":"CG Weaver","year":"2015","journal-title":"Nephrology Dialysis Transplantation"},{"key":"pone.0270163.ref035","article-title":"Health service inequalities during the COVID-19 pandemic among elderly people living in large urban and non-urban areas in Florida, USA","volume":"8","author":"X. Yu","year":"2020","journal-title":"SAGE open medicine"},{"issue":"3","key":"pone.0270163.ref036","doi-asserted-by":"crossref","first-page":"e17882","DOI":"10.1371\/journal.pone.0017882","article-title":"Validation of statistical models for estimating hospitalization associated with influenza and other respiratory viruses","volume":"6","author":"L Yang","year":"2011","journal-title":"PLoS One"},{"key":"pone.0270163.ref037","article-title":"Modeling Hospitalization Decision and Utilization for the Elderly in China","volume":"2021","author":"X Xu","year":"2021","journal-title":"Discrete Dynamics in Nature and Society"},{"key":"pone.0270163.ref038","unstructured":"Lund LRL. Poisson Regression Analysis using SPSS Statistics 2018 [Available from: https:\/\/statistics.laerd.com\/spss-tutorials\/poisson-regression-using-spss-statistics.php]."},{"issue":"1","key":"pone.0270163.ref039","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/096228029900800102","article-title":"Multiple imputation: a primer","volume":"8","author":"JL Schafer","year":"1999","journal-title":"Stat Methods Med Res"},{"issue":"10","key":"pone.0270163.ref040","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1001\/jamainternmed.2013.248","article-title":"Hospitalization in older persons: not just a medical outcome, a social outcome as well: comment on \u201cElder abuse as a risk factor for hospitalization in older persons\u201d","volume":"173","author":"KE Covinsky","year":"2013","journal-title":"JAMA internal medicine"},{"issue":"5","key":"pone.0270163.ref041","doi-asserted-by":"crossref","first-page":"S330","DOI":"10.1093\/geronb\/50B.5.S330","article-title":"Health, social support, and the utilization of health services among older adults","volume":"50","author":"MJ Penning","year":"1995","journal-title":"The Journals of Gerontology Series B: Psychological Sciences and Social Sciences"},{"issue":"2","key":"pone.0270163.ref042","doi-asserted-by":"crossref","first-page":"e044768","DOI":"10.1136\/bmjopen-2020-044768","article-title":"Identifying patterns of health care utilisation among physical elder abuse victims using Medicare data and legally adjudicated cases: protocol for case\u2013control study using data linkage and machine learning","volume":"11","author":"T Rosen","year":"2021","journal-title":"BMJ open"},{"issue":"4","key":"pone.0270163.ref043","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/S0196-0644(97)70003-9","article-title":"ED use by older victims of family violence","volume":"30","author":"MS Lachs","year":"1997","journal-title":"Annals of emergency medicine"},{"issue":"5","key":"pone.0270163.ref044","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1159\/000351338","article-title":"Association between reported elder abuse and rates of admission to skilled nursing facilities: findings from a longitudinal population-based cohort study","volume":"59","author":"X Dong","year":"2013","journal-title":"Gerontology"},{"issue":"10","key":"pone.0270163.ref045","doi-asserted-by":"crossref","first-page":"801","DOI":"10.3949\/ccjm.69.10.801","article-title":"Elder abuse and neglect: what physicians can and should do","volume":"69","author":"M Ahmad","year":"2002","journal-title":"Cleveland Clinic journal of medicine"},{"issue":"3","key":"pone.0270163.ref046","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.cger.2018.04.007","article-title":"Identifying and initiating intervention for elder abuse and neglect in the emergency department","volume":"34","author":"T Rosen","year":"2018","journal-title":"Clinics in geriatric medicine"},{"issue":"1","key":"pone.0270163.ref047","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1111\/jgs.14480","article-title":"Diagnosis of elder abuse in US emergency departments","volume":"65","author":"CS Evans","year":"2017","journal-title":"Journal of the American Geriatrics Society"},{"issue":"1","key":"pone.0270163.ref048","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.jemermed.2012.01.061","article-title":"Characteristics of family violence victims presenting to emergency departments in Hong Kong","volume":"44","author":"KL Chan","year":"2013","journal-title":"The Journal of emergency medicine"},{"issue":"2","key":"pone.0270163.ref049","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1177\/1524838017692798","article-title":"Consequences of Elder Abuse and Neglect: A Systematic Review of Observational Studies","volume":"20","author":"RM Yunus","year":"2019","journal-title":"Trauma Violence Abuse"},{"issue":"2","key":"pone.0270163.ref050","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1093\/heapol\/czh009","article-title":"Overcoming barriers to health service access: influencing the demand side","volume":"19","author":"T Ensor","year":"2004","journal-title":"Health policy and planning"},{"key":"pone.0270163.ref051","first-page":"1352","article-title":"Malaria in the United Republic of Tanzania: cultural considerations and health-seeking behaviour","volume":"78","author":"L Oberl\u00e4nder","year":"2000","journal-title":"Bulletin of the World Health Organization"},{"issue":"1","key":"pone.0270163.ref052","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1093\/pubmed\/fdh207","article-title":"Health seeking behaviour and health service utilization in Pakistan: challenging the policy makers","volume":"27","author":"BT Shaikh","year":"2005","journal-title":"Journal of public health"},{"issue":"4","key":"pone.0270163.ref053","doi-asserted-by":"crossref","first-page":"e0176394","DOI":"10.1371\/journal.pone.0176394","article-title":"Complementary and alternative medicine (CAM) use and delays in presentation and diagnosis of breast cancer patients in public hospitals in Malaysia","volume":"12","author":"NM Mohd Mujar","year":"2017","journal-title":"PloS one"},{"issue":"6","key":"pone.0270163.ref054","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1007\/s10943-018-0636-9","article-title":"Religion, culture and meaning-making coping: A study among cancer patients in Malaysia","volume":"58","author":"F Ahmadi","year":"2019","journal-title":"Journal of religion and health"},{"issue":"1","key":"pone.0270163.ref055","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1080\/08946566.2017.1382414","article-title":"Building the adult protective services system of tomorrow: The role of the APS national voluntary consensus guidelines","volume":"30","author":"J Bobitt","year":"2018","journal-title":"Journal of elder abuse & neglect"},{"key":"pone.0270163.ref056","unstructured":"Ministry of Health Malaysia. Guidelines for the Hospital Management of Child Abuse and Neglect: Ministry of Health Malaysia; 2009."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0270163","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T17:40:29Z","timestamp":1656092429000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0270163"}},"subtitle":[],"editor":[{"given":"Tariq Jamal","family":"Siddiqi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,6,24]]},"references-count":56,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0270163","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,24]]}}}