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利用国家紧急医疗服务信息系统(NEMSIS)对家庭内的家庭暴力进行人群水平监测。

Population-Level Surveillance of Domestic Assaults in the Home Using the National Emergency Medical Services Information System (NEMSIS).

机构信息

The School of Social Policy and Practice, The University of Pennsylvania, Philadelphia, PA, USA.

Mailman School of Public Health, Columbia University, New York, NY, USA.

出版信息

Prev Sci. 2024 Aug;25(6):882-890. doi: 10.1007/s11121-024-01683-w. Epub 2024 May 30.

Abstract

Violence in the home, including partner violence, child abuse, and elder abuse, is pervasive in the United States. An informatics approach allowing automated analysis of administrative data to identify domestic assaults and release timely and localized data would assist preventionists to identify geographic and demographic populations of need and design tailored interventions. This study examines the use of an established national dataset, the NEMSIS 2019, as a potential annual automated data source for domestic assault surveillance. An algorithm was used to identify individuals who utilized emergency medical services (EMS) for a physical assault in a private residence (N = 176,931). Descriptive analyses were conducted to define the identified population and disposition of patients. A logistic regression was performed to predict which characteristics were associated with consistent domestic assault identification by the on-scene EMS clinician and dispatcher. The sample was majority female (52.2%), White (44.7%), urban (85.5%), and 21-29 years old (24.4%). A disproportionate number of those found dead on scene were men (74.5%), and female patients more often refused treatment (57.8%) or were treated and then released against medical advice (58.4%). Domestic assaults against children and seniors had higher odds of being consistently identified by both the dispatcher and EMS clinician than those 21-49, and women had lower odds of consistent identification than men. While a more specific field to identify the type of domestic assault (e.g., intimate partner) would help inform specialized intervention planning, these data indicate an opportunity to systematically track domestic assaults in communities and describe population-specific needs.

摘要

家庭暴力包括伴侣暴力、儿童虐待和老人虐待在美国普遍存在。一种能够通过自动化分析行政数据来识别家庭攻击并及时提供本地化数据的信息学方法,将有助于预防人员确定需要的地理和人口群体,并设计定制的干预措施。本研究考察了使用一个已建立的全国性数据集 NEMSIS 2019 作为潜在的年度家庭暴力监测自动化数据来源的情况。使用算法来识别因私人住所内的身体攻击而利用紧急医疗服务 (EMS) 的个人 (N = 176,931)。进行描述性分析以定义所识别的人群和患者的处置情况。进行逻辑回归以预测哪些特征与现场 EMS 临床医生和调度员一致识别家庭暴力有关。该样本以女性为主 (52.2%),白人 (44.7%),城市 (85.5%),年龄在 21-29 岁之间 (24.4%)。现场发现的死者中男性比例过高 (74.5%),而女性患者更经常拒绝治疗 (57.8%) 或在治疗后违反医嘱出院 (58.4%)。与 21-49 岁的人相比,针对儿童和老人的家庭暴力更有可能被调度员和 EMS 临床医生一致识别,而女性被一致识别的可能性低于男性。虽然更具体的字段来识别家庭攻击的类型(例如,亲密伴侣)将有助于为专门的干预计划提供信息,但这些数据表明有机会在社区中系统地跟踪家庭暴力,并描述特定人群的需求。

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