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Association between emergency department resources and diagnosis of intimate partner violence

Choo, Esther K.a; Nicolaidis, Christinab; Newgard, Craig D.c; Hall, Michael K.d; Lowe, Robert A.c; McConnell, Michael Kennedyd; McConnell, K. Johnc

European Journal of Emergency Medicine: April 2012 - Volume 19 - Issue 2 - p 83–88
doi: 10.1097/MEJ.0b013e328348a9f2

Objective There is little information about which intimate partner violence (IPV) policies and services assist in the identification of IPV in the emergency department (ED). The objective of this study was to examine the association between a variety of resources and documented IPV diagnoses.

Methods Using billing data assembled from 21 Oregon EDs from 2001 to 2005, we identified patients who were assigned a discharge diagnosis of IPV. We then surveyed ED directors and nurse managers to gain information about IPV-related policies and services offered by participating hospitals. 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.

Results In 754 597 adult female ED visits, IPV was diagnosed 1929 times. Mandatory IPV screening and victim advocates were the most commonly available IPV resources. The diagnosis of IPV was independently associated with the use of a standardized intervention checklist (odds ratio: 1.71; 95% confidence interval: 1.04–2.82). Public displays regarding IPV were negatively associated with IPV diagnosis (odds ratio 0.56; 95% confidence interval: 0.35–0.88).

Conclusion IPV remains a rare documented diagnosis. Most common hospital-level resources did not demonstrate an association with IPV diagnoses; however, a standardized intervention checklist may play a role in clinician's likelihood of diagnosing IPV.

aDepartment of Emergency Medicine, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, Rhode Island

bDepartment of General Internal Medicine

cDepartment of Emergency Medicine, Center for Policy and Research in Emergency Medicine, Oregon Health and Science University, Portland, Oregon

dDepartment of Emergency Medicine, University of California, San Francisco, California, USA

Correspondence to Esther K. Choo, MD, MPH, Department of Emergency Medicine, Rhode Island Hospital, Alpert Medical School of Brown University, 55 Claverick Street, Second Floor, Providence, RI 02903, USA Tel: +1 401 444 08731; fax: +1 401 444 4407; e-mail:

Received February 3, 2011

Accepted May 10, 2011

© 2012 Lippincott Williams & Wilkins, Inc.