Using Diagnostic Codes to Screen for Intimate Partner Violence in Oregon Emergency Departments and Hospitals

• Published in: Public health reports (1974) Vol. 123; no. 5; pp. 628 - 635
• Main Authors: Schafer, Sean D., Drach, Linda L., Hedberg, Katrina, Kohn, Melvin A.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA Association of Schools of Public Health 01.09.2008; SAGE Publications; SAGE PUBLICATIONS, INC
• Subjects: Adolescent; Adult; Assaults; Battered Women - statistics & numerical data; Biological and medical sciences; Clinical outcomes; Criminal Law; Domestic violence; Emergency Service, Hospital - utilization; Epidemiology; Female; Forms and Records Control; Hospital records; Hospitalization; Hospitalization - statistics & numerical data; Humans; Incidence; International Classification of Diseases; Intimate partner violence; Intimate partners; Mass Screening; Medical records; Medical Records - classification; Medical sciences; Middle Aged; Miscellaneous; Oregon - epidemiology; Physical trauma; Population Surveillance - methods; Prevention and actions; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Assessment; Sensitivity; Sensitivity and Specificity; Spouse Abuse - diagnosis; Spouse Abuse - statistics & numerical data; Surveillance; Victim identification; Victimology; Violence against women; Oregon; United States; North America; America; Marital relation; Mistreatment; Emergency department; Intimate partner violence; Hospitalization; Diagnosis; Hospital; Victimology; Medical screening; Code; Public health
• ISSN: 0033-3549; 1468-2877
• DOI: 10.1177/003335490812300513

Objectives. 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 ≥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 ≥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 ≥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.