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. 2022 Oct 3;5(10):e2236273.
doi: 10.1001/jamanetworkopen.2022.36273.

Trends in US Emergency Department Use After Sexual Assault, 2006-2019

Emily L Vogt  1   2 , Charley Jiang  2 , Quinton Jenkins  2   3 , Maya J Millette  2   3 , Martina T Caldwell  4 , Kathleen S Mehari  5 , Erica E Marsh  2
Affiliations

Trends in US Emergency Department Use After Sexual Assault, 2006-2019

Emily L Vogt et al. JAMA Netw Open. .

Abstract

Importance: Adult sexual assault (SA) survivors experience numerous emergent health problems, yet few seek emergency medical care. Quantifying the number and types of survivors presenting to US emergency departments (EDs) after SA can inform health care delivery strategies to reduce survivor morbidity and mortality.

Objective: To quantify ED use and factors that influenced seeking ED care for adult SA from 2006 through 2019.

Design, setting, and participants: This cross-sectional study used SA data from the Nationwide Emergency Department Sample from 2006 through 2019, which includes more than 35.8 million observations of US ED visits from 989 hospitals, a 20% stratified sample of hospital-based EDs. The study also used the Federal Bureau of Investigation's Uniform Crime Reporting Program, which includes annual crime data from more than 18 000 law enforcement agencies representing more than 300 million US inhabitants. The study sample included any adult aged 18 to 65 years with an ED visit in the Nationwide Emergency Department Sample coded as SA. The data were analyzed between January 2020 and June 2022.

Main outcomes and measures: Annual SA-related ED visits, subsequent hospital admissions, and associated patient-related factors (age, sex, race and ethnicity, income quartile, and insurance) were analyzed using descriptive statistics.

Results: Data were from 120 to 143 million weighted ED visits reported annually from 2006 through 2019. Sexual assault-related ED visits increased more than 1533.0% from 3607 in 2006 to 55 296 in 2019. Concurrently, admission rates for these visits declined from 12.6% to 4.3%. Female, younger, and lower-income individuals were more likely to present to the ED after SA. Older and Medicaid-insured patients were more likely to be admitted. Overall, the rate of ED visits for SA outpaced law enforcement reporting.

Conclusions and relevance: This cross-sectional study found that US adult SA ED visits increased from 2006 through 2019 and highlighted the populations who access emergency care most frequently and who more likely need inpatient care. These data can inform policies and the programming needed to support this vulnerable population.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Caldwell reported receiving grants from the Blue Cross Blue Shield of Michigan Foundation and Robert Wood Johnson Foundation and personal fees from Partners in Contraceptive Choice and Knowledge outside the submitted work. Dr Marsh reported receiving personal fees from Myovant Sciences and Pfizer outside the submitted work. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Emergency Department (ED) Visits and Admissions for Adults Aged 18 to 65 Years With Any Diagnosis of Sexual Assault vs All Other Diagnoses, 2006-2019
Figure 2.
Figure 2.. Emergency Department (ED) Visits for Sexual Assault vs Federal Bureau of Investigation (FBI) Uniform Crime Reporting Program–Reported Sexual Assaults, 2006-2019
NEDS, National Emergency Department Sample.
See this image and copyright information in PMC

Comment in

  • doi: 10.1001/jamanetworkopen.2022.36285

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