Domestic violence: variation in case-management by the general practitioner in Belgium.
OBJECTIVE
to describe the medical interventions and referrals carried out by the general practitioner (GP) when taking care of victims and to quantify the between-physician variability in management of domestic violence.


METHODS
A nationwide sentinel network of 150 general practitioners, covering 1.5 % of the Belgian population, registered in 2002-2004 all episodes of domestic violence for which they were consulted, via paper registration forms. A multilevel analysis was carried out by fitting a random effects logistic regression model for every intervention/referral.


RESULTS
The most frequent interventions of the GP were providing a certificate of injury (54 %), and making an appointment for a next visit (33 %). Half of the patients were referred or hospitalised upon the first consultation, most frequently they were advised to go to the police (17 %) or referred to a psychologist or psychiatrist (11 %). The intra cluster correlation coefficient (ICC) of the interventions varied between 11 % and 39 % and the median odds ratios between 1,82 and 3,96.


CONCLUSIONS
GP consultations for domestic violence are frequent and involve considerable between-physician variability in care.
Bossuyt
Nathalie
N
Scientific Institute of Public Health, Unit of Epidemiology, J. Wytsmanstraat 14, B-1050, Brussels, Belgium. nathalie.bossuyt@iph.fgov.be
van Casteren
Viviane
V
D000275:Adjustment Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001530:Belgium; D019090:Case Management / Q000706:statistics & numerical data*; D003068:Coercion; D003430:Cross-Sectional Studies; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D018571:Sentinel Surveillance; D012737:Sex Factors; D012742:Sex Offenses / Q000523:psychology / Q000706:statistics & numerical data; D013179:Spouse Abuse / Q000523:psychology / Q000534:rehabilitation* / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D055815:Young Adult