Emergency Department Discharges: Survivors of Domestic Violence

1
Emergency Department DischargesSurvivors of
Domestic Violence
County of San Diego November 16, 2006
2
Intimate Partner Violence Fact Sheet

• Nearly 5.3 million incidents of IPV occur each
  year among women 18 years, and 3.2 million occur
  among men
• IPV results in 2 million injuries and 1,300
  deaths nationwide each year
• IPV accounted for 20 of nonfatal violence
  against women in 2001
• One study found that 44 of women murdered by
  their intimate partner had visited an ED within 2
  years of the homicide
• Of these women, 93 had at least one injury visit

Source CDC, NCIPC, Intimate Partner Violence
Fact Sheet, accessed 10/17/2006 at
www.cdc.gov/ncipc/factsheets/ipvfacts.htm
3
ED Data Background

• Includes all patients treated and discharged from
  the ED.
• Does not represent all patients presenting to the
  Emergency Department
• Admitted patients are transferred to the hospital
  discharge (inpatient) database
• Inpatient and ED databases are mutually exclusive
• 8 23 of patients presenting to the ED are
  admitted
• ED Data represents the less serious injuries and
  illnesses
• Unique identifiers not included in ED database
• Multiple visits by the same person cannot be
  identified

4
Data Elements

• Facility ID Number
• Patient ZIP code
• Date of Birth
• Sex
• Race
• Ethnicity
• Service Date
• Patient Disposition

• Expected Source of Payment
• Principal Diagnosis
• Other Diagnoses
• Principal E-Code
• Other E-Codes
• Principal Procedure (CPT-4)
• Other Procedures

5
Methods

• 18 Civilian EDs in San Diego County
• FY 2005/2006 ED Records were examined
• July 2005 June 2006
• 16 hospitals reporting
• 584,049 total ED discharges
• gt97 of total ED discharges for San Diego County.

6
Methods

• Patients with an E967 E-Code were selected,
  identifying them as victims of child and adult
  battering and other maltreatment
• Additional codes identify the perpetrator as
• Spouse or Partner (Includes ex-spouse or
  ex-partner)
• Father or Stepfather
• Mother or Stepmother
• Child
• Sibling
• Grandparent
• Other relative
• Non-related caregiver
• Other specified or unspecified person
• No additional perpetrator information is available

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ED Discharged Survivors of Battering and
Maltreatment, FY 2005/06
N 918
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY 2005/06.
8
Hospitalized Survivors of Battering and
Maltreatment, 2001 - 2004
N 156
Source California OSHPD, Patient Discharge Data.
Compiled by CDHS, EPIC, 11/2006.
9
ED Discharged Survivors of Spousal Abuse by Age
Group, FY 2005/06
N 263
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY 2005/06.
10
Total Number of ED Discharges by Age Group, FY
2005/06
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY 2005/06.
11
ED Discharged Survivors of Spousal Abuse by
Gender, FY 2005/06
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY 2005/06.
12
Female ED Discharged Survivors of Spousal Abuse
by Age Group, FY 2005/06
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY 2005/06.
13
ED Discharged Survivors of Spousal Abuse by
Race/Ethnicity, FY 2005/06
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY
2005/06. Excludes 4 patients with
unknown race/ethnicity.
14
Total Number of ED Discharges by Race/Ethnicity,
FY 2005/06
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY 2005/06.
15
ED Discharged Survivors of Spousal Abuse by
Race/Ethnicity and Age Group, FY 2005/06
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY
2005/06. Excludes 4 patients with
unknown race/ethnicity.
16
ED Discharged Survivors of Spousal Abuse by
Region of Residence, FY 2005/06
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY
2005/06. Data for the North Inland
Region may be incomplete.
17
ED Discharged Survivors of Spousal Abuse by
Region of Residence and Age Group, FY
2005/06
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY
2005/06. Data for the North Inland
Region may be incomplete.
18
ED Discharged Survivors of Spousal Abuse by
Community, FY 2005/06
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY
2005/06. Shown are the 10 most
common communities in San Diego County where ED
discharges for spousal abuse reside.
19
ED Discharged Survivors of Spousal Abuse by
Service Day of Week, FY 2005/06
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY
2005/06. Standardized to 52 days
per year
20
ED Discharged Survivors of Spousal Abuse by
Source of Payment, FY 2005/06
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY 2005/06.
21
ED Discharged Survivors of Spousal Abuse by
Disposition, FY 2005/06
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY 2005/06.
22
ED Discharged Survivors of Spousal Abuse by
Mechanism of Injury, FY 2005/06
N 131 (50) Reported Mechanisms
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY 2005/06.
23
ED Discharged Survivors of Spousal Abuse by
Primary Diagnosis and Injury Location, FY 2005/06
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY
2005/06. Percentages reflect only
those primary diagnoses related to injury
(contusion, open wound, fracture, sprain,
concussion other injury.
24
ED Discharged Survivors of Spousal Abuse by Type
of Injury, FY 2005/06
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY
2005/06. Totals add up to more than
263 due to multiple injuries per patient.
Includes primary and all secondary diagnoses.
25
ED Discharged Survivors of Spousal Abuse by
Location of Injury, FY 2005/06
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY
2005/06. Totals add up to more than
263 due to multiple injuries per patient.
Includes primary and all secondary diagnoses.
26
ED Discharged Survivors of Spousal Abuse with
Contusions by Location of Injury, FY 2005/06
N 211 Contusion Injuries
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY
2005/06. May include multiple
injuries per patient.
27
ED Discharged Survivors of Spousal Abuse with
Face/Scalp/Neck Injuries by Type of Injury, FY
2005/06
N 180 Face/Scalp/Neck Injuries
Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY
2005/06. May include multiple
injuries per patient.
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ED Discharged Survivors of Spousal Abuse FY
2005/06

• 39 patients were diagnosed with substance use or
  abuse
• 15 patients were diagnosed with a mental illness
• 10 patients were diagnosed with complications of
  pregnancy
• An additional 5 patients were identified as
  having a normal pregnancy

Source HASDIC, CHIP, CoSD EMS, Emergency
Department Database, San Diego County, FY
2005/06.
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For More Information, Contact

• Leslie Upledger Ray or Holly Shipp
• 6255 Mission Gorge Road
• San Diego, CA 92120
• [phone]
• holly.shipp_at_sdcounty.ca.gov
• leslie.ray_at_sdcounty.ca.gov