Identifying violence against persons at a safety-net hospital: Evidence from the first 6 months of implementation

Abstract

Objective: To examine the prevalence and predictors of screening for violence against persons and victim service utilization within an integrated safety-net health system.

Study setting: Emergency Department (ED) at Parkland Hospital-Dallas County's largest safety-net provider of services for minority and underinsured and uninsured patients.

Study design: Prospective, longitudinal study during the first 6 months of a universal violence against persons screener.

Data collection: Health records were extracted for all patients with a visit to the ED between January and July, 2021. Modeling described the patient population across screening (screened vs. not screened) and, among those screened, the results (positive vs. negative), average time spent in the ED, and referral patterns for victim services.

Principal findings: During the study period, 65,563 unique patients with 95,555 encounters occurred. Seventy-one percent (n = 67,535) were screened for violence against persons and, of those, 2% screened positive (n = 1349). Of the patients who screened positive, 1178 (87%) were referred to and 806 (60%) received care at victim services. Implementing screening did not increase the length of stay at ED.

Conclusions: Systematic implementation of comprehensive violence screening at a safety-net system can result in robust identification and timely referrals to victim services.

Keywords: access/demand/utilization of services; determinants of health/population health/socioeconomic causes of health; epidemiology; health promotion/prevention/screening; program evaluation; uninsured/safety net provider.