Date

September 2009

Document Type

Thesis

Degree Name

M.P.H.

Department

Dept. of Public Health and Preventive Medicine

Institution

Oregon Health & Science University

Abstract

Importance: Intimate partner violence (IPV) affects 1.9 million U.S. women each year and is associated with high-risk health behaviors and increased medical and mental health needs. However, IPV remains a challenge for healthcare providers to identify. Study Objective: To assess the association between hospital IPV policies and services and the likelihood of IPV diagnosis in the emergency department (ED) in a statewide sample of Oregon hospitals. Methods: Using billing data assembled from 21 Oregon EDs from 2001 to 2005, we identified patients assigned a discharge diagnosis of IPV. We then surveyed ED administrators to gain information about IPV-related policies and services offered by the participating hospitals during the same time period. We combined billing data, survey results and hospital-level variables. Multivariate analysis assessed the likelihood of receiving a diagnosis of IPV depending on the policies and services available at each hospital. Results: In 754,597 adult female ED visits, IPV was diagnosed 1,929 times (0.26% of visits). Mandatory IPV screening and victim advocates (such as social workers) were the most commonly available IPV policies and services. The diagnosis of IPV was independently associated with the use of a standardized intervention checklist (OR 1.79, 95% CI 1.13-2.85). Public displays regarding IPV were negatively associated with IPV diagnosis (OR 0.55, 95% CI 0.37-0.83). Conclusion: Hospital-level policies and services such as standardized intervention checklists may improve the ability of clinicians to diagnose IPV.

Identifier

doi:10.6083/M4HQ3WW8

School

School of Medicine

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