title: Outcomes of domestic violence screening at an acute London trust: are there missed opportunities for intervention?
abstract: OBJECTIVE
  Domestic violence screening is advocated in some healthcare settings. Evidence that it increases referral to support agencies or improves health outcomes is limited. This study aimed to (1) investigate the proportion of hospital patients reporting domestic violence, (2) describe characteristics and previous hospital attendances of affected patients and (3) assess referrals to an in-house domestic violence advisor from Camden Safety Net.
  
  
  METHODS
  A series of observational studies.
  
  
  METHODS
  Three outpatient clinics at the Royal Free London NHS Foundation Trust.
  
  
  METHODS
  10,158 patients screened for domestic violence in community gynaecology, genitourinary medicine (GUM) and HIV medicine clinics between 1 October 2013 and 30 June 2014. Also 2253 Camden Safety Net referrals over the same period.
  
  
  METHODS
  (1) Percentage reporting domestic violence by age group gender, ethnicity and clinic. (2) Rates of hospital attendances in the past 3 years for those screening positive and negative. (3) Characteristics, uptake and risk assessment results for hospital in-house domestic violence referrals compared with Camden Safety Net referrals from other sources.
  
  
  RESULTS
  Of the 10,158 patients screened, 57.4% were female with a median age of 30 years. Overall, 7.1% reported ever-experiencing domestic violence, ranging from 5.7% in GUM to 29.4% in HIV services. People screening positive for domestic violence had higher rates of previous emergency department attendances (rate ratio (RR) 1.63, 95% CI 1.09 to 2.48), emergency inpatient admissions (RR 2.27, 95% CI 1.37 to 3.84) and day-case admissions (RR 2.03, 95% CI 1.23 to 3.43) than those screening negative. The 77 hospital referrals to the hospital-based domestic violence advisor during the study period were more likely to be taken up and to be classified as high risk than referrals from elsewhere.
  
  
  CONCLUSIONS
  Selective screening for domestic violence in high-risk hospital clinic populations has the potential to identify affected patients and promote good uptake of referrals for in-house domestic violence support.
authors.affiliation: Public Health Department, Royal Free London NHS Foundation Trust, London, UK Institute of Health Informatics, University College London, London, UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Warren-Gash
authors.affiliation: Public Health Department, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: Angela
authors.initials: A
authors.lastname: Bartley
authors.affiliation: Maternity Department, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: Jude
authors.initials: J
authors.lastname: Bayly
authors.affiliation: Public Health Department, Royal Free London NHS Foundation Trust, London, UK Geography & Environment-Department of Social Statistics & Demography, University of Southampton, Southampton, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Dutey-Magni
authors.affiliation: Marlborough Clinic, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Edwards
authors.affiliation: Ian Charleson Day Centre, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: Sara
authors.initials: S
authors.lastname: Madge
authors.affiliation: Community Gynaecology, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Miller
authors.affiliation: Community Safety, London Borough of Camden, London, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Nicholas
authors.affiliation: Community Gynaecology, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: Sheila
authors.initials: S
authors.lastname: Radhakrishnan
authors.affiliation: Marlborough Clinic, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: Leena
authors.initials: L
authors.lastname: Sathia
authors.affiliation: Child Safeguarding, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Swarbrick
authors.affiliation: Adult Safeguarding, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: Dee
authors.initials: D
authors.lastname: Blaikie
authors.affiliation: Public Health Department, Royal Free London NHS Foundation Trust, London, UK Research Department of Infection & Population Health, University College London, London, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Rodger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017579:Domestic Violence / Q000517:prevention & control / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: EPIDEMIOLOGY; PREVENTIVE MEDICINE; PUBLIC HEALTH