Using diagnostic codes to screen for intimate partner violence in Oregon emergency departments and hospitals.
OBJECTIVE
Many of the 2.5 million Americans assaulted annually by intimate partners seek medical care. This project evaluated diagnostic codes indicative of intimate partner violence (IPV) in Oregon hospital and emergency department (ED) records to determine predictive value positive (PVP), sensitivity, and usefulness in routine surveillance. Statewide incidence of care for IPV was calculated and victims and episodes characterized.


METHODS
The study was a review of medical records assigned > or = 1 diagnostic codes thought predictive of IPV. Sensitivity was estimated by comparing the number of confirmed victims identified with the number predicted by statewide telephone survey. Patients were aged > or = 12 years, treated in any of 58 EDs or hospitals in Oregon during 2000, and discharged with one of three primary or 12 provisional codes suggestive of IPV. Outcome measures were number of victims detected, PPV and sensitivity of codes for detection of IPV, and description of victims.


RESULTS
Of 58 hospitals, 52 (90%) provided records. Case finding using primary codes identified 639 victims, 23% of all estimated female victims seen in EDs or hospitalized statewide. PVP was 94% (639/677). Provisional codes increased sensitivity (51%) but reduced PVP (50%). Highest incidence occurred in women aged 20-39 years, and those who were black. Hospitalizations were highest among women aged > or = 50 years, black people, or those with comorbid illness.


CONCLUSIONS
Three diagnostic codes used for case finding detect approximately one-quarter of ED- and hospital-treated victims, complement surveys, and facilitate description of injured victims.
Schafer
Sean D
SD
Office of Workforce and Career Development, Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA. sean.schafer@state.or.us
Drach
Linda L
LL
Hedberg
Katrina
K
Kohn
Melvin A
MA
D000293:Adolescent; D000328:Adult; D018585:Battered Women / Q000706:statistics & numerical data*; D003416:Criminal Law; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005568:Forms and Records Control; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D038801:International Classification of Diseases; D008403:Mass Screening; D008499:Medical Records / Q000145:classification*; D008875:Middle Aged; D009922:Oregon / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods*; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013179:Spouse Abuse / Q000175:diagnosis* / Q000706:statistics & numerical data