Care provided in visits coded for intimate partner violence in a national survey of emergency departments.
OBJECTIVE
This article describes the health status of and care provided to patients in visits coded to intimate partner violence (IPV) victims in a national survey of emergency departments (EDs). Visits coded for IPV were defined by International Classification of Diseases, 8th edition-Clinical Modification (ICD-9-CM) codes.


METHODS
Data from the National Hospital Ambulatory Medical Care Survey for 1997-2001 were analyzed. The sample consisted of 111 ED visits with ICD codes for IPV (or 12 IPV visits per 10,000 ED visits, and 21 female IPV visits per 10,000 female ED visits).


RESULTS
The majority of visits coded to IPV were for patients who presented with mild to moderate pain (86%), physical or sexual violence (50%), and injuries to the body (38%). The majority of patients in visits coded to IPV received radiologic testing, wound care, and pain medications (odds ratios [ORs], 1.6, 3.3, and 2.3 respectively). Disposition was mostly referral to another physician or clinic (42%) or return to the ED when needed (20%), but much less to nonphysician services such as social services, support services, and shelters (14%). Uninsured IPV patients were more likely to receive radiologic testing and pain medications (ORs 5.1 and 3, respectively). Patients seen by nurses were 9 times more likely to receive wound care.


CONCLUSIONS
Caution should be exercised when interpreting the study results because they reflect only coded IPV visits in the ED and these might be the most obvious IPV cases. The results signal the need for further studies to evaluate access to and the quality of care for IPV patients and to improve screening, documentation, coding, and management practices.
Btoush
Rula
R
University of Medicine and Dentistry of New Jersey, School of Nursing, 65 Bergen St., # 1017, Newark, NJ 07101, USA. btoushrm@umdnj.edu
Campbell
Jacquelyn C
JC
Gebbie
Kristine M
KM
D000293:Adolescent; D000328:Adult; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D017579:Domestic Violence / Q000145:classification / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D038801:International Classification of Diseases; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D011247:Pregnancy; D012017:Referral and Consultation; D012742:Sex Offenses / Q000145:classification / Q000706:statistics & numerical data*; D012747:Sexual Partners; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000145:classification / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult