Emergency Department Visits for Confirmed Cases of Intimate Partner Violence

Background and Purpose: More than 12 million individuals are victims of interpersonal violence (IPV) in the US per year. Nearly 15% of women and 4% of men are injured as a result of this abuse in their lifetime. For many victims of IPV-related injuries, the emergency department (ED) is the first point of care. The current study seeks to provide recent prevalence estimates of patients who seek care for confirmed sexual and physical abuse in EDs across the US and to describe the sociodemographic characteristics of this population.

Methods: This study employed data from the 2016 Nationwide Emergency Department Sample (NEDS) of the Healthcare Cost Utilization Project (HCUP) distributed by the United States Department of Health and Human Services Agency for Healthcare Research and Quality (AHRQ). The NEDS include data on approximately 31 million hospital-based ED visits from 953 hospitals approximating a 20-percent stratified sample of US hospital-owned EDs. The current sample contain patients discharged from the ED in 2016 with a diagnosis of either adult physical abuse, confirmed or adult sexual abuse, confirmed.

Results: Based on HCUP NEDS estimates, there were approximately 24,426 discharges from EDs with diagnostic codes for sexual abuse and 16,654 cases with physical abuse in 2016. Most victims of physical abuse were between the ages of 25-35 (31% [95% CI=29.78-32.69]) and female (85% [95% CI=80.25-88.81]). The majority of sexual abuse victims discharged from the ED were between the ages of 18 and 25 (43% [95% CI=41.03-45.26]) and female (93% [95% CI=91.72-93.69]). Most sexual and physical assault victims resided in a zip code with the lowest median household income (sexual abuse=37% [95% CI=33.55-40.71]; physical abuse=40% [95% CI=36.08-43.64]), had Medicaid as their primary payer (sexual abuse=30% [95% CI=25.28-35.05]; physical abuse=44% [95% CI=40.05-48.36]), and were discharged to home or self-care (sexual abuse=91% [95% CI=90.12-92.32]; physical abuse=88% [95% CI=86.29-89.51]). The average total charges for physical abuse victims were $4,687 (95% CI=4186.67-5187.20) and $3,350 (95% CI=3113.39-3587.86) for sexual abuse victims.

Conclusions and Implications: This study provides national estimates of IPV-related cases severe enough to admit to the ED. The costs of these visits total over 78 million for physical abuse and 81.8 million for sexual abuse. Given that 44% of individuals reporting physical abuse are insured through Medicaid, these admissions are costly to individuals, hospitals and society. Additionally as research suggests that victims of IPV visited the ED within two years preceding their DV-related homicide, it is important to target these individuals for screening and intervention strategies to discontinue the cycle of abuse.