title: Assessing the extent of provision of comprehensive medical care management for female sexual assault patients in US hospital emergency departments.
abstract: OBJECTIVE
  To describe medical services provided to sexual assault patients in US emergency departments and to identify the percentage of hospitals always providing the 10 elements of comprehensive medical care management (CMCM).
  
  
  METHODS
  A cross-sectional study was conducted in a national sample of US hospitals. A 26-item telephone survey assessed provision of services to sexual assault survivors in accordance with CMCM. Management included acute medical care comprising history and physical examination; acute and long-term rape crisis counseling; STI testing and prophylaxis; emergency contraception counseling and provision; and HIV testing and prophylaxis. The primary outcome was extent of provision of these elements.
  
  
  RESULTS
  Overall, 582 emergency departments responded to the survey. The following components of CMCM were provided: acute medical care (582 [100.0%]); rape crisis counseling (234 [40.2%]); STI management (448 [77.0%]); emergency contraception (351 [60.3%]); and HIV management (380 [65.3%]). Only 101 (17.4%) hospitals provided all 10 elements of CMCM.
  
  
  CONCLUSIONS
  Less than one-fifth of US hospitals provide comprehensive services to sexual assault patients. A national program incorporating clinical guidelines, checklists, and funding for sexual assault forensic/nurse examiner programs could improve the standard of care provided in emergency departments-the primary point of contact for acute care of sexual assault survivors.
authors.affiliation: Division of Family Planning, Department of Obstetrics and Gynecology, John H. Stroger Jr Hospital of Cook County, Chicago, USA; Feinberg School of Medicine, Northwestern University, Chicago, USA; Planned Parenthood Federation of America, NY, USA. Electronic address: ashleshapatel16@yahoo.com.
authors.forename: Ashlesha
authors.initials: A
authors.lastname: Patel
authors.forename: Alicia
authors.initials: A
authors.lastname: Roston
authors.forename: Sandra
authors.initials: S
authors.lastname: Tilmon
authors.forename: Lisa
authors.initials: L
authors.lastname: Stern
authors.forename: Arden
authors.initials: A
authors.lastname: Roston
authors.forename: Daksha
authors.initials: D
authors.lastname: Patel
authors.forename: Louis
authors.initials: L
authors.lastname: Keith
mesh_terms: D003191:Comprehensive Health Care / Q000706:statistics & numerical data*; D003376:Counseling / Q000706:statistics & numerical data; D019548:Crime Victims / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D011902:Rape / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000517:prevention & control; D014481:United States
keywords: Emergency contraception; Emergency departments; HIV/STI testing and prophylaxis; Mental health counseling; Sexual assault; Sexual assault forensic/nurse examiner programs