Btoush Rula, Campbell Jacquelyn C, Gebbie Kristine M
University of Medicine and Dentistry of New Jersey, School of Nursing, 65 Bergen St., # 1017, Newark, NJ 07101, USA.
Womens Health Issues. 2009 Jul-Aug;19(4):253-62. doi: 10.1016/j.whi.2009.03.004.
This article describes the health status of and care provided to patients in visits coded to intimate partner violence (IPV) victims in a national survey of emergency departments (EDs). Visits coded for IPV were defined by International Classification of Diseases, 8th edition-Clinical Modification (ICD-9-CM) codes.
Data from the National Hospital Ambulatory Medical Care Survey for 1997-2001 were analyzed. The sample consisted of 111 ED visits with ICD codes for IPV (or 12 IPV visits per 10,000 ED visits, and 21 female IPV visits per 10,000 female ED visits).
The majority of visits coded to IPV were for patients who presented with mild to moderate pain (86%), physical or sexual violence (50%), and injuries to the body (38%). The majority of patients in visits coded to IPV received radiologic testing, wound care, and pain medications (odds ratios [ORs], 1.6, 3.3, and 2.3 respectively). Disposition was mostly referral to another physician or clinic (42%) or return to the ED when needed (20%), but much less to nonphysician services such as social services, support services, and shelters (14%). Uninsured IPV patients were more likely to receive radiologic testing and pain medications (ORs 5.1 and 3, respectively). Patients seen by nurses were 9 times more likely to receive wound care.
Caution should be exercised when interpreting the study results because they reflect only coded IPV visits in the ED and these might be the most obvious IPV cases. The results signal the need for further studies to evaluate access to and the quality of care for IPV patients and to improve screening, documentation, coding, and management practices.
本文描述了在一项针对急诊科的全国性调查中，被编码为亲密伴侣暴力（IPV）受害者的就诊患者的健康状况及所接受的护理。被编码为IPV的就诊是根据《国际疾病分类》第8版临床修订本（ICD - 9 - CM）编码来定义的。
对1997 - 2001年国家医院门诊医疗护理调查的数据进行了分析。样本包括111次被编码为IPV的急诊科就诊（即每10000次急诊科就诊中有12次IPV就诊，每10000次女性急诊科就诊中有21次女性IPV就诊）。
大多数被编码为IPV的就诊患者表现为轻至中度疼痛（86%）、身体或性暴力（50%）以及身体损伤（38%）。大多数被编码为IPV的就诊患者接受了放射学检查、伤口护理和止痛药物治疗（优势比分别为1.6、3.3和2.3）。处置方式大多是转诊给另一位医生或诊所（42%）或必要时返回急诊科（20%），但转至社会服务、支持服务和庇护所等非医生服务机构的比例要低得多（14%）。未参保的IPV患者更有可能接受放射学检查和止痛药物治疗（优势比分别为5.1和3）。由护士诊治的患者接受伤口护理的可能性高出9倍。
在解释研究结果时应谨慎，因为这些结果仅反映了急诊科中被编码的IPV就诊情况，而这些可能是最明显的IPV病例。结果表明需要进一步研究，以评估IPV患者获得护理的机会和护理质量，并改善筛查、记录、编码和管理做法。
